Podcasts about Mayo Clinic

This week's episode of SelfWork focuses on suicide - but not as a pre-determined sign that someone needs hospitalization. That might be true, of course. But many, many people have suicidal thoughts or ideas, even fantasies, of what could happen that would allow them to escape pain that may feel intolerable. And in those cases, talking about suicide or those fantasies can be a positive sign - a sign of trust, of reaching out, of connection. And a sign of not wanting to die. We're going to explore these ideas today on SelfWork. Because talking about suicide - recognizing that feeling as if that's an answer to your pain -  is normal to feel. It's not a sin or a sign you're weak. I've literally talked with hundreds of people in my thirty years as a clinician about those thoughts. Because talking about it can lead to more understanding, greater trust, deeper self-compassion, and recognition of a desire to live. If you or someone you love has struggled to reveal any kind of emotional pain - if your family or culture created the need for you to remain rigidly stoic, with tight control (or even denial) of hurt or pain - this approach may save your life. If this triggers you in any way, here are the International Suicide Prevention Hot Lines. The listener voicemail is from a woman whose addictions seemed to have been a huge part of her not mothering well from the perspective of her oldest child – who now has estranged herself from her mom. We'll talk about what she can do in this circumstance to help herself cope with her loss, not allowing the estrangement to sabotage the rest of her life. Vital Links: Click Here for the fabulous offer from Athletic Greens - now AG1 - with bonus product with your subscription! The history of suicide Sociologist Jason Manning's research findings on factors leading to suicidal thinking Mayo Clinic article about the distinction between suicide as a wish for death and suicide as a source of relief NAMI's statistics on suicide CBS Sunday Morning's episode on Donna's Law. You can hear more about this and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you'd like to join my FaceBook closed group, then click here and answer the membership questions! Welcome! My book entitled Perfectly Hidden Depression has been published and you can order here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life. And it's available in paperback, eBook or as an audiobook! And there's another way to send me a message! You can record by clicking below and ask your question or make a comment. You'll have 90 seconds to do so and that time goes quickly. By recording, you're giving SelfWork (and me) permission to use your voice on the podcast. I'll look forward to hearing from you!      

Stories in this episode: Day in History: 1923: St. Olaf Choir to perform in Rochester 'I got played': Rochester native Sarah Wade voted off 'Survivor' SE Rochester apartment building condemned with order to evacuate tenants Hattie is laying eggs now at the Mayo Clinic, and a Super Bowl-sized crowd will watch The top moments from the 2022-23 high school wrestling season: A banner year for southeastern Minnesota

How can you find the right doctor? What should you ask during your appointment? How can you pleasurably and safely explore anal play? What is unique about sexual health within the gay and queer community? And what is a butt clock?Erectile dysfunction, STIs, vaccinations, and safe anal play are important conversations for men – particularly queer men – to have with their doctor's and partners. However sometimes the most important conversations are also the most difficult ones. In this episode, Effy and Jacqueline celebrate Pride and Men's Health Month by speaking with the “butt stuff” doctor, Mayo Clinic trained gastroenterologist, Doctor Carlton.With 3 million likes and over 200,000 followers on TikTok, Doctor Carlton shares his expertise on men's sexual health and pleasure, tips for tops and bottoms, and sex advice for every body and orientation.To learn more about Dr. CarltonDoctor Carlton is a Mayo Clinic trained gastroenterologist in San Diego, California who you have probably seen on Tik Tok or Instagram talking about Butt Stuff tips and LGBTQ health. He has been featured on Mashable and in Instinct Magazine and even recently headlined Austin Kink Weekend in Texas. Who better to learn butt stuff from than a doctor who knows all the science and a gay man who has had PLENTY of real life experience with it! Welcome Doctor Carlton!TikTok: @doctorcarltonInstagram: @doctorcarltonSupport the showConnect with us on IG and more:Curious Fox @wearecuriousfoxesEffy Blue @coacheffyblueJacqueline Misla @jacquelinemisla Email us: listening@wearecuriousfoxes.comLeave us a voicemail: 646-450-9079 Join the conversation: fb.com/WeAreCuriousFoxes

This is a KeyLIVE LIVE episode from Central Group on Educational Affair (CGEA) meeting in Rochester, Minnesota hosted by the Mayo Clinic of Medicine and Science. Authors:  Chan TM, Stukus D, Leppink J, Duque L, Bigham BL, Mehta N, Thoma B Publication details: Social Media and the 21st-Century Scholar: How You Can Harness Social Media to Amplify Your Career J Am Coll Radiol. 2018 Jan;15(1 Pt B):142-148 View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME? Click here!

Hitan Kamdar is the Executive Director of Patient Access at The GW Medical Faculty Associates. Hitan holds a Bachelor of Science in Electrical Engineering, a Master of Science in Operations Management, and a Master of Business Administration and Management from Kettering University. Hitan's story is inspiring to say the least. Having come from the automotive industry, Hitan has held positions at notorious organizations such as The Mayo Clinic and Michigan Medicine. 

Senolytics are a science field with the potential to revolutionize human aging. In 2016, two of the top medical research institutions in the country- The Mayo Clinic, and Scripps- published some pretty astounding research. They identified ingredients that help our bodies naturally eliminate senescent cells! And in the years since, many other studies have demonstrated the power of these little-known ingredients. Meanwhile at Neurohacker, the research we were doing for healthy aging products - Qualia Life and Qualia Skin - led us to the emerging research on cellular senescence. Our team of scientists and doctors for years evaluated senolytic ingredients - ranking each according to its efficacy and mechanism of action. In this episode we sat down with two members of the Neurohacker Science Team - Dr. Greg Kelly and Dr. Nick Bitz with the goal of sharing everything we have learned along the way. The message is clear: the research surrounding senolytics is absolutely worth paying attention to. And today, we're here to break down the science for you.

In this HCI Podcast episode, Dr. Jonathan H. Westover talks with Bill George about his book, True North: Emerging Leader Edition. Bill George (https://www.linkedin.com/in/williamwgeorge/) is the former chairman and chief executive officer of Medtronic. He joined Medtronic in 1989 as president and chief operating officer, was chief executive officer from 1991-2001, and board chair from 1996-2002. He is currently a senior fellow at Harvard Business School, where he has taught leadership since 2004. Bill is the author of: Discover Your True North and The Discover Your True North Field book, Authentic Leadership, 7 Lessons for Leading in Crisis True North, Finding Your True North, and True North Groups. He served on the boards of Goldman Sachs, ExxonMobil, Novartis, Target, and Mayo Clinic. He received his BSIE with high honors from Georgia Tech, his MBA with high distinction from Harvard University, where he was a Baker Scholar, and honorary PhDs from Georgia Tech, Mayo Medical School, University of St. Thomas, Augsburg College and Bryant University. Part of the LinkedIn Podcast Network #LinkedInPresents Please consider supporting the podcast on Patreon and leaving a review wherever you listen to your podcasts! Check out FindLaw at FindLaw.com. Check out Shopify at www.shopify.com/hci. Check out the HCI Academy: Courses, Micro-Credentials, and Certificates to Upskill and Reskill for the Future of Work! Check out the LinkedIn Alchemizing Human Capital Newsletter. Check out Dr. Westover's book, The Future Leader. Check out Dr. Westover's book, 'Bluer than Indigo' Leadership. Check out Dr. Westover's book, The Alchemy of Truly Remarkable Leadership. Check out the latest issue of the Human Capital Leadership magazine. Each HCI Podcast episode (Program, ID No. 592296) has been approved for 0.50 HR (General) recertification credit hours toward aPHR™, aPHRi™, PHR®, PHRca®, SPHR®, GPHR®, PHRi™ and SPHRi™ recertification through HR Certification Institute® (HRCI®). Each HCI Podcast episode (Program ID: 24-DP529) has been approved for 0.50 HR (General) SHRM Professional Development Credits (PDCs) for SHRM-CP and SHRM-SCPHR recertification through SHRM, as part of the knowledge and competency programs related to the SHRM Body of Applied Skills and Knowledge™ (the SHRM BASK™). Human Capital Innovations has been pre-approved by the ATD Certification Institute to offer educational programs that can be used towards initial eligibility and recertification of the Certified Professional in Talent Development (CPTD) and Associate Professional in Talent Development (APTD) credentials. Each HCI Podcast episode qualifies for a maximum of 0.50 points. Learn more about your ad choices. Visit megaphone.fm/adchoices

Host: Darryl S. Chutka, M.D. [@chutkaMD] Guest: Mitchell R. Humphreys, M.D. Benign prostatic hyperplasia or BPH is quite common in middle-age and older men. It's estimated that up to 70% of men over age 60 have symptoms from BPH. While BPH is not a life-threatening condition, it does produce symptoms which can negatively affect the lifestyle of our patients. Since most of the patients with BPH are managed by primary care providers, we should be comfortable with the variety of treatment options available. When should treatment be initiated? What's available pharmacologically? And when should a urologist be consulted to consider a surgical option? In this podcast, we'll discuss these questions and more with Mitchell R. Humphreys, M.D., from the Department of Urology at the Mayo Clinic.  This episode is brought to you by: Astellas Oncology | https://astellasoncology.com/ Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.   

Are you ready to dive into a world where science fiction is becoming a reality?Today's episode features Dr. Tim Nelson, Ph.D., founder of HeartWorks, in partnership with the Mayo Clinic.Mike is exploring the incredible work Dr. Nelson and his team are doing to help save the lives of children with congenital heart disease (CHD) using stem cells. This groundbreaking technology uses induced pluripotent stem cells to rebuild pediatric hearts, giving hope to thousands of families affected by CHD.Find out what life is like for children like baby Ryals and 10-year-old Ava who are battling CHD. Learn how Dr. Nelson's innovative technology can change their lives and the lives of countless others.In addition to discussing the emotional impact this work has on families and medical professionals, Mike and Dr. Nelson also discuss the potential market for heart-related therapies, the realities of the transplant industry, and Dr. Nelson's incredible vision for heart treatment in the future.This episode is packed with inspiring stories, and expert insights from Peter Diamandis, and Bill Weir of ABC News Nightline.Join them in exploring a future where we can mend broken hearts with our own cells, and don't forget to share this episode with friends and family who might be inspired by this life-changing work.Key Takeaways (01:22) An introduction to Dr. Tim Nelson and his work (12:50) What is Tim's vision for the future? (15:20) The future of stem cell research (27:57) The business model for this technology (34:00) The potential downside to this tech Additional Resources Find out more about Tim's work and get his free bonuses, including a walk-through of his model, videos, and scheduling a virtual lab tour at webuildhearts.org/free If you want to find out how to work with Tim and his team, visit webuildhearts.org/collaborate

Bias, Equity, and Reality: Issues When Using AI for ECG-based Diagnostics Guests: Gari Clifford, Ph.D. @GariClifford and Reza Sameni, Ph.D. @RezaSameni Hosts: Anthony H. Kashou, M.D. (@anthonykashoumd) Joining us today to discuss issues when using AI for ECG-based diagnostics is Gari Clifford, Ph.D., Chair of Biomedical Informatics at Emory University and professor of Biomedical Engineering at Georgia Institute of Technology, and Reza Sameni, Ph.D., associate professor of the department of Biomedical Informatics at Emory University. Drs. Clifford and Sameni share interests in machine learning, digital hardware design, statistical signal processing and application areas span across cardiovascular disease, neuropsychiatric health, among others. Tune in to learn about issues when using AI for ECG-based diagnostics. Specific topics discussed: What are the key barriers to building AI models from electrocardiogram data? What can be done to mitigate the bias in AI models beyond balancing data. Can you expand on what you mean by addressing bias is much deeper than just balancing data? What parting advice do you have for anyone wanting to use AI on large volumes of ECGs? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. Facebook: MayoCVservices LinkedIn: Mayo Clinic Cardiovascular Services NEW 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.

Artículo de Glen Allsopp 16 empresas dominan los resultados de Google: https://detailed.com/google-control/ Por primera vez en 2016 Glen analizó las grandes empresas están detrás de miles de marcas de los supermercados. Con la llegada de la IA y gracias a Semrush… Prueba Semrush gratis 14 días: https://borjagiron.com/semrush Herramienta SEO gratis Ahrefs: https://borjagiron.com/ahrefs XOVI: https://borjagiron.com/xovi 25 Mejores herramientas con Inteligencia Artificial https://borjagiron.com/mejores-herramientas-inteligencia-artificial/ Mejores buscadores con Inteligencia Artificial https://borjagiron.com/mejores-buscadores-inteligencia-artificial/ Las 16 compañías en este informe están detrás de al menos 562 marcas individuales que reciben tráfico de Google cada día. 3.700 millones de clics del motor de búsqueda cada mes. Un promedio de 6.5 millones de clics mensuales por sitio. Analizando webs como Esquire, Elle, Cnet o Mayoclinic podremos aprender cómo hacen SEO que funciona. Vemos que aparecen en los primeros resultados en el 84% de las búsquedas. Claves: Autoridad y relaciones. Nos quedan las migajas.Cada vez más difícil.Mercado inglés.Monetizar no por anuncios es mejor opción.Crea newsletter. Ideas: 1: Firstfinds: No es su sitio típico de revisión de productos, ya que los usuarios pueden votar sobre elementos ( similares a Reddit ) y las páginas individuales a menudo contienen poco más que un enlace y un titular. 2: Vogue generó 100.000 suscriptores en su newsletter dando cobertura a un solo evento 3: Certificados en los pie de página de sitios de salud. 4: Prueba social en las cabeceras. 5: Ziff Davis es la compañía detrás de la plataforma SEO, Moz ( técnicamente su marca iContact realizó la adquisición ). ¿Quieres que traduzca y enumere las estrategias que han analizado y que mejor funcionan del artículo en un próximo episodio? Comparte y recomienda el podcast. Deja un comentario en ivoox. Dale a me gusta en ivoox. Deja 5 estrellas si me escuchas desde Spotify o Apple Podcast. Si veo interés lo crearé. Únete a la comunidad de Emprendedores: https://borjagiron.com/comunidad Recuerda suscribirte al podcast para no perderte el resto de noticias, novedades, trucos y tendencias del mundo del SEO. Si te ha gustado comparte el episodio, dale a me gusta, deja 5 estrellas o comenta el episodio. Me ayudarás a seguir creando episodios completamente gratis. También puedes acceder al curso de SEO desde https://triunfacontublog.com Soy Borja Girón, has escuchado el podcast SEO para Google, nos escuchamos en el próximo episodio.

Host: Darryl S. Chutka, M.D. [@chutkaMD] Guest: Colin P. West, M.D., Ph.D. The practice of medicine is often stressful and at times, even frustrating. Sometimes the stress and frustration can get out of hand and lead us to feeling overwhelmed and hopeless. This has been described as burnout. There's good evidence to suggest that well over half of all physicians practicing in the U.S. have exhibited some symptoms of burnout at some time during their career. Healthcare professional burnout not only has negative consequences for the clinician, but also for patients, as patient care can often suffer. What are the symptoms of burnout, can we prevent them and how can we manage those who are experiencing professional burnout? We'll discuss these questions and more with Colin P. West, M.D., Ph.D., an internist in the Division of General Internal Medicine at the Mayo Clinic. Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

This week's CPhT Connect podcast featured Matthew Rewald, BS, CPhT, DPLA, Pharmacy Technician Education Coordinator at Mayo Clinic. Matthew shared his journey to his current role, which spanned over 20 years and multiple positions. Like many in the pharmacy field, Matthew started in a community pharmacy and then pursued new opportunities to advance his career. He emphasized continually developing your skills and education to make yourself more marketable for new roles. Matthew's story is an excellent reminder that advancing your career is often an "accidental journey with purpose." Even when the path isn't clear, preparing yourself for new opportunities can lead to exciting places.

Aortic Dissection Guest: Malakh L. Shrestha, M.B.B.S., Ph.D. Host: Kyle W. Klarich, M.D. Joining us today to discuss aortic dissection is Malakh L. Shrestha, M.B.B.S., Ph.D., cardiac surgeon at Mayo Clinic Rochester, Minnesota. Dr. Shrestha was recruited from Germany and starting a Center for Excellence for Aortic Disease at Mayo Clinic; he also contributed to the American Association of Thoracic Surgery (AATS) guidelines for aortic dissection. Tune in to learn more about the surgical approach to aortic dissection. Specific topics discussed: The AATS guidelines and what it means to surgeons interested in aortic disease. How to look for aortic dissection. What is the frozen elephant trunk technique? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV. NEW 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.

GET MY FREE INSTANT POT COOKBOOK: https://www.chefaj.com/instapot-download ------------------------------------------------------------------------------------ MY LATEST BESTSELLING BOOK: https://www.amazon.com/dp/1570674086?tag=onamzchefajsh-20&linkCode=ssc&creativeASIN=1570674086&asc_item-id=amzn1.ideas.1GNPDCAG4A86S ----------------------------------------------------------------------------------- Disclaimer: This podcast does not provide medical advice. The content of this podcast is provided for informational or educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health issue without consulting your doctor. Always seek medical advice before making any lifestyle changes. To ask a question to any of the doctors that appear on Chef AJ LIVE! please send them to us in advance. https://www.chefaj.com/ Welcome to the debut episode of Dr. Esser's Prescription for Health. Join Chef AJ and Dr. Esser for a high energy, informative conversation that will transform your health. Learn where health comes from and get educated, energized and inspired in 2023! Dr Stephan Esser is a 4th generation plant based eater! He comes from a line of passionate educators sharing the message of health. He is a Sports and Lifestyle Medicine Physician who completed medical school at the University of South Florida, Residency at Harvard Medical School, Fellowship at Mayo Clinic and is presently a full time clinician in private practice, adjunct faculty for three academic residency programs and the lead team physician for the University of North Florida. Dr. Esser is a lifetime advocate for plant-based nutrition. He completed residency in Physical Medicine and Rehabilitation at Harvard Medical School and a Sports Medicine Fellowship at Mayo Clinic. He is a nationally sought-after speaker and writer on topics related to lifestyle medicine and plant-based nutrition. He runs healthy living seminars and retreats in Jacksonville, Florida. He also provides non-operative sports and spine care to patients in the Jacksonville region at Southeast Orthopedic Specialists. For a telemedicine appointment please visit https://esserhealth.com/ You can follow him on Instagram at https://www.instagram.com/esserhealth/ On Facebook: https://www.facebook.com/EsserHealth Here are the FREE exercise videos he mentioned: https://yalegriffinprc.griffinhealth.org/programs-resources/prc-programs-resources/abe-for-fitness Dr. Esser's 4 week detox:http://esserhealth.com/detox/ To follow Dr. Esser on Instagram: https://www.instagram.com/esserhealth/

Dr Walter Rocca is a neurologist from the Mayo Clinic in Minnesota, USA, where he studies common neurological diseases as well as the aging processes between men and women. He has a particular focus on estrogen and the effects of menopause on health risks. In this episode, Dr Rocca explains how sex hormones have a much greater role in many of the body's functions than simply regulating the menstrual cycle and reproduction. He explains why it's so important to treat women with hormone replacement after bilateral oophorectomy with or without hysterectomy or early menopause, especially younger women. Dr Rocca's three take home messages: The ovaries are a tremendously important organ for healthy functioning of our heart, brain, bones, kidneys, lungs and more. For healthcare professionals: be very careful when thinking about removing the ovaries and/or the uterus, unless there is a very clear clinical indication. The longer-term harmful effects of these surgeries are greater than the apparent short-term benefit to symptoms. If a woman has a high genetic risk of ovarian cancer (>40% risk level), removal of the ovaries is appropriate, but she should be given estrogen therapy afterwards as the risk associated with this treatment is very low (including for BRCA carriers). If a natural menopause occurs early or prematurely, these women should also be offered estrogen therapy, unless there is a specific counterindication. More about Dr Walter Rocca

Dr. Elizabeth Klodas, a cardiologist who trained at Mayo Clinic and Johns Hopkins and practices in Minneapolis, Minnesota, joins Chris Meek for another installment of Next Steps Forward. She's the author of the book “Slay the Giant: The Power of Prevention in Defeating Heart Disease” and founder of One Step Foods, a company dedicated to helping patients minimize their dependence on medications through strategic dietary change. During an hour focused entirely on health, Dr. Klodas shares with the audience her evolution story of becoming a food-as-medicine innovator and entrepreneur, tips and tricks for heart disease prevention and the role that doctors and patients play in overall health.

Want to learn how to create habits that stick? Today's guest is Sarah Hays Coomer — a health and wellness coach, and journalist. Sarah shares the ways that she helps her clients build healthy sustainable habits into their daily routines, and her recent book, "The Habit Trip.”   In this episode, we talk about: Ways to ensure you're choosing or creating healthy plans that are sustainable A brief overview of Microdosing Wellness The story of Sarah becoming a health & wellness coach and joining the Mayo Clinic Sarah's experience as a health coach for Forbes and balancing coaching and writing The significance of the national board in health and wellness coaching Sarah's strategies for helping clients maintain habit changes The inspiration behind and approach to "The Habit Trip" book BIO:  Sarah Hays Coomer is a Mayo Clinic- and National Board-certified health & wellness coach, a National Strength and Conditioning Association Certified Personal Trainer, speaker, and author of three books: The Habit Trip: A Fill-in-the-Blank Journey to a Life on Purpose (2020, Running Press/Hachette), Physical Disobedience (2018, Seal Press/Hachette) and Lightness of Body and Mind (2016, Rowman & Littlefield). Her work has been featured in Forbes, The Wall Street Journal, HuffPost, Triathlete, NPR, Women's Health, Thrive Global, and The Tennessean, among others. She has spoken at organizations and universities nationwide including Google, Vanderbilt University, the Nashville Women's March, The University of the South, the Tennessee Immigrant and Refugee Rights Coalition, Confluence, and the Girls to the Moon Conference. Sarah lives in Nashville, TN with her family and two rescue pups, Ringo and Moon.   Mentioned In This Episode: Sarah's Website   Connect With Sarah on LinkedIn     The Habit Trip: A Fill-in-the-Blank Journey to A Life on Purpose   Physical Disobedience: An Unruly Guild to Health and Stamina for the Modern Feminist Links to resources: Health Coach Group Website https://www.thehealthcoachgroup.com/ Use the code HCC50 to save $50 on our website Leave a Review of the Podcast  

The following description was written by ChatGPT based off the full transcript of this episode: "In this AMA Update video and podcast, John Halamka, MD, MS, president of the Mayo Clinic Platform, joins AMA Chief Experience Officer Todd Unger to discuss the integration of artificial intelligence (AI) and specifically, ChatGPT, in medicine. They explore the Mayo Clinic Platform and its use of generative AI, as well as the potential benefits and downsides of this technology in health care. The discussion touches on the importance of credible sources and the potential for misinformation, as well as the need to balance the reduction of human burden with the risk of harm from incorrect diagnoses. Overall, the video and podcast offers insights into the future of AI in health care and its responsible integration."

Share this post with others: What happens when COVID meets BIND? What happens when someone in protracted benzodiazepine withdrawal gets long COVID? Does it set off a wave? Does it make their benzo symptoms worse? Tune in for answers and more. In today's episode, we explore COVID and benzodiazepine withdrawal (BIND). We also look at endogenous benzodiazepines, hear two benzo stories of success, and visit the launch of our new website and social media feeds. I hope you find it helpful. Podcast ID: BFP113 Chapters 0:00:00  INTRODUCTION0:03:10  Podcast Anniversary0:05:15  MAILBAG0:05:52  Endogenous Benzodiazepines0:07:21  Benzodiazepines in Potatoes0:09:44  BENZO SPOTLIGHT0:10:47  About the New Website0:12:48  Member Community on EA0:14:55  About Membership Tiers0:17:21  Our Handle / YouTube0:19:29  Social Media0:23:47  BENZO STORIES0:24:08  Ted's Story0:27:08  Judith's Story0:30:41  FEATURE: COVID and Benzos0:34:11  D's COVID Experience0:38:57  Jennifer: Could the vaccine be a trigger?0:40:33  Dan: COVID, Flu, and a Big Wave0:41:37  Jürg: COVID Setback?0:45:14  Annette: COVID Constriction0:46:36  Chuck: A Medical Perspective         0:49:11  Benzos and COVID Immunity0:50:13  Benzos and COVID Drugs0:51:12  Benzos and COVID Hospitalization0:52:11  Long COVID and BIND0:54:28  Long COVID Digestion Issues0:56:30  Neurological Effects of COVID0:58:53  COVID and Dysphagia (Swallowing)1:00:10  Long COVID Frequency1:00:53  My Theory / Summation1:01:58  Finding Hope1:04:46  CLOSING References The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Benzo Free of the resource or any recommendations or advice provided therein. RESOURCES BIND Symptoms. Easing Anxiety. https://easinganxiety.com/symptoms. COVID-19 (& Benzos). Benzodiazepine Information Coalition (BIC). https://www.benzoinfo.com/covid-19/. COVID-19: Long-term effects. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351. Long COVID or Post-COVID Conditions. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html. EA PODCAST EPISODES ON COVID Anxiety, Benzos, and a Virus. Episode 61. March 17, 2020. https://www.easinganxiety.com/post/anxiety-benzos-and-a-virus-bfp061. COVID and Benzos: Immunity, Vaccines, Symptoms. Episode 80. April 28, 2021. https://www.easinganxiety.com/post/covid-and-benzos-immunity-vaccines-symptoms-bfp080. EA VIDEOS ON COVID 10 Anxiety Tips for Dealing with Relationships during COVID. Video #20. September 24, 2020. https://www.easinganxiety.com/post/10-anxiety-tips-for-dealing-with-relationships-during-covid. 3 Basic Anxiety Tips amid COVID-19. Video #3. April 3, 2020. https://www.easinganxiety.com/post/3-basic-anxiety-tips-amid-covid-19. Anxiety and the Loss of Control During COVID-19. Video #5. April 11, 2020. https://www.easinganxiety.com/post/anxiety-and-the-loss-of-control-during-covid-19. Anxiety, Overwhelm, COVID & a Trip to Estes Park. Video #18. August 20, 2020. https://www.easinganxiety.com/post/anxiety-overwhelm-covid-a-trip-to-estes-park-vlog-7. Anxiety Rising: The Hidden Hardship of COVID-19. Video #10. May 20, 2020. https://www.easinganxiety.com/post/anxiety-rising-the-hidden-hardship-of-covid-19-vlog-1. REFERENCES Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual. Avallone R, Zeneroli ML, Venturini I, Corsi L, Schreier P, Kleinschnitz M, Ferrarese C, Farina F, Baraldi C, Pecora N, Frigo M, Baraldi M. Endogenous benzodiazepine-like compounds and diazepam binding inhibitor in serum of patients with liver cirrhosis with and without overt encephalopathy. Gut. 1998 Jun;42(6):861-7. doi: 10.1136/gut.42.6.861. PMID: 9691927; PMCID: PMC1727144. https://www.

Stories in this episode: Day in History: 1923: Special train to be run for a basketball game Oldest veteran in Olmsted County, if not the state, dies What you should know about rising rates of colorectal cancer in young adults: A Mayo Clinic doctor explains Climate change could help fuel Minnesota tourism 5 veterans who'll be key to the Rochester Grizzlies' postseason success

In this episode of Causes or Cures, Dr. Eeks chats with Dr. Jay Shah about why he believes that high blood pressure is a silent epidemic affecting millions of people. Dr. Shah will first describe what blood pressure is and how we measure it, what high blood pressure is, and why he believes we are experiencing a silent epidemic of high blood pressure. He will also make the case for why we should be continually monitoring blood pressure versus traditional methods of monitoring blood pressure, such as periodic visits to a healthcare provider or taking measurements at home with a blood pressure cuff. He'll explain the technology he is currently working with to do this. Finally, he'll also offer a few lifestyle tips for improving cardiac health.  Dr. Shah is a cardiologist who trained at Massachusetts General Hospital and Washington University School of Medicine. He founded and built the cardiovascular services at The Portland Clinic and served as the medical director of the Aortic Disease Program at The Mayo Clinic. He currently serves as the medical director for Aktiia. You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Or Facebook here.Or Twitter.Subcribe to her newsletter here.Support the show

It's the Friday news roundup! If you like crowds, crowdsourcing, or hanging in the sun, golly is this the weekend for you. We've got all you need to know about the nation's allegedly 3rd largest St. Patrick's Day parade, a great new way to inform city officials about our roadways, and the secret Steel City history — and potential future! — of Daylight Saving Time. As always, our Friday shows are powered by great local journalism. Check out the history of Pittsburgh's St. Patrick's parade. A Pittsburgh businessman is the father of daylight saving.  The Mayo Clinic did a study on the adverse medical events following daylight saving. There are a bunch of 311 events at 311.org You can contact 311 anytime on the city's website. Listen to our episode with Dashcam For Your Bike CEO Armin Samii and what inspired him to serve fellow cyclists. Want some more Pittsburgh news? Then make sure to sign up for our morning newsletter. We're also on Twitter @citycastpgh & Instagram @CityCastPgh! Not a fan of social? Then leave us a voicemail at 412-212-8893. Interested in advertising with City Cast? Find more info here.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Many laboratorians are not patient-facing. So, while laboratories are critical to patient care, they may lack visibility when it comes to policymaking. In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic, and William Morice II, M.D., Ph.D., president and CEO of Mayo Clinic Laboratories, discuss their leadership roles in national advocacy organizations and the importance of laboratorian engagement in the federal regulatory process.

Hailey A. Thompson, PharmD identifies the physiologic factors that increase venous thromboembolism risk in trauma patients, outlines current recommendations and their pitfalls for venous thromboembolism prophylaxis in trauma patients and discusses evidence for anti-Xa monitoring for venous thromboembolism prophylaxis with enoxaparin. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

These conversations are challenging and require us to lean into our curiosity and compassion as we navigate the nuances that are not easily unearthed in our typical short surface level conversations. In this episode of The Crunchy Allergist, Dr. Kara Wada interviews Dr. Siri Chand Khalsa, a board-certified physician and expert in integrative, lifestyle, and palliative medicine. Tune in as they discuss the link between daily habits and long-term vitality, and explore the role of decolonization in promoting greater understanding and inclusivity in healthcare. EPISODE AT A GLANCE- Who is Dr. Siri Chand Khalsa?- Dr. Khalsa's Physician Journey- The Impact of Dominant Narratives and Belief Systems in Healthcare- The Intersection of Healing, Anti-Racism, and Trauma- The Power of Curiosity in Personal Growth and Development ABOUT DR SIRI CHAND KHALSADr. Khalsa has had a life-long interest in mindful living as the basis for long-term vitality of mind, body, and spirit. She completed a residency in Internal Medicine at The Mayo Clinic in 2005 and is board-certified in Internal Medicine, Integrative Medicine, Lifestyle Medicine and Hospice/Palliative Medicine. Dr. Khalsa has deepened her studies on health and healing by becoming a Yoga Instructor, Reiki Master, and participating in a 2-year full-time program on Ayurveda at The Ayurvedic Institute in Albuquerque and India. Serving as an Integrative Medicine PCP, an instructor at the University of Arizona Integrative Medicine fellowship for physicians, and consultant to other medical practices, she has dedicated her career to promoting an increased understanding in clinical medicine of the link between long term vitality and the daily choices we make. She is currently focusing her energy to support physicians who want to expand their personal understanding of new ways of healing through an experiential process utilizing techniques in Ayurveda, yoga, mindfulness, and plant-based nutrition. CONNECT WITH DR SIRIFacebook → https://www.facebook.com/DoctorSiriChandFacebook → https://www.facebook.com/LuminousfoodsInstagram → https://www.instagram.com/DoctorSiriChandPinterest → https://www.pinterest.com/DoctorSiriChandTwitter → https://twitter.com/DoctorSiriChandTIKTOK → https://www.tiktok.com/@DoctorSiriChandLinkedIn → https://www.linkedin.com/in/DoctorSiriChandYouTube → https://www.youtube.com/DoctorSiriChandWebsite → https://drsirichand.com/ ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → http://www.drkarawada.com/LinkedIn → https://www.linkedin.com/in/crunchyallergist/Instagram → https://www.instagram.com/crunchyallergist/Facebook → https://www.facebook.com/CrunchyAllergistTwitter → https://twitter.com/CrunchyAllergyTikTok → https://www.tiktok.com/@crunchyallergist JOIN DR. KARA WADA'S BIRTHDAY GIVEAWAYWin a box full of Kara's Favorites → https://forms.gle/TW8mxEyNH5DGoWZC6 REGISTER FOR THE 2ND ANNUAL VIRTUAL SJOGREN'S SUMMITGet your tickets here → https://www.sjogrenssummit.com SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get my weekly dose of naturally-minded and scientifically-grounded approach to immune system health. THE BELONG COMMUNITY→ https://www.antiinflammatorycollective.com/If you are looking for more ways to work on reducing your pain and support in having that anti-inflammatory lifestyle, Belong is the right place for you.

In this episode of the PRS Global Open Keynotes Podcast, Dr. Rizzo and Nelson discuss the role of open reduction and internal fixation versus k-wire fixation in the management of metacarpal fractures. This episode discusses the following PRS Global Open article: A Comparison of Outcomes following Plate versus Pin Fixation of Metacarpal Shaft and Neck Fractures by Benjamin A. Nelson, Taylor P. Trentadue, Vivek Somasundaram, Priya Patel, John T. Capo and Marco Rizzo. Read the articles for free on PRSGlobalOpen.com: https://bit.ly/PlatevPin Dr. Marco Rizzo is a professor in the Department of Orthopaedic Surgery at the Mayo Clinic. Dr. Benjamin Nelson is an orthopedic surgery resident at Walter Reed National Military Medical Centre. Your host, Dr. Damian Marucci, is a board-certified plastic surgeon and Associate Professor of Surgery at the University of Sydney in Australia. #PRSGlobalOpen #KeynotesPodcast #PlasticSurgery

Surgical Removal of Papillary Fibroelastoma Guest: Juan A. Crestanello, M.D. Host: Malcolm R. Bell, M.D. Joining us today to discuss surgical removal of papillary fibroelastoma (PFE) is Juan A. Crestanello, M.D., professor of surgery and chair of cardiovascular surgery at Mayo Clinic in Rochester, Minnesota. Tune in to learn more about the surgical approach to papillary fibroelastoma. Specific topics discussed: What are PFEs? What are the risks of PFE? Where are they most commonly located? What are the indications for surgery? What is the surgical risk of resection of a PFE? What is the risk of stroke? What is the risk of stroke without resection? Can the valves be preserved? Can PFEs come back? PFE of the Heart - Surgical Management Process Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV. NEW 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.

Host: Darryl S. Chutka, M.D. [@chutkaMD] Guest: Tara Schmidt, MEd, RDN, LD Nutrition is so important to our health. What and how much we eat can help keep us healthy or increase our risk of developing a number of health problems including cardiovascular disease, diabetes, malignancy or a variety of degenerative health conditions. Unfortunately, many of our patients obtain their information regarding nutrition from the media which is often very inaccurate. It's our responsibility as primary care providers to assess our patients' nutritional status and give them accurate recommendations regarding dietary changes they should make in order to remain healthy. This starts with a nutritional history. Yet very few of us have had any formal education in nutrition. How do we take a nutritional history? What are the important questions to ask? We'll discuss this and other nutritional issues with our guest for this podcast, Tara Schmidt, MEd, RDN, LD, a registered dietician at the Mayo Clinic. Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Episode 294 - Dr. Edward Laskowski, M.D. - Professor, Department of Physical Medicine and Rehabilitation and Division of Sports Medicine, Department of Orthopedic Surgery and Former Co-Director: Mayo Clinic Sports Medicine “Don't forget the foundation. Movement is medicine.” “If we had a pill that could emulate the effects of exercise, it would be the best-selling pill in the world.” It's time for some action! You heard it right! The Two Fit Crazies are excited to bring you the amazing Dr. Ed Laskowski to speak about one of our favorite topics, “exercise is medicine!” Today's show will shed some light on the power of exercise as it relates to preventing and fighting disease. As the co-director of sports medicine at the Mayo Clinic in Minnesota for over 30-years, and a former member of the president's council under George W. Bush and Barak Obama, Dr. Laskowski shares groundbreaking statistics and evidence-based research that validates the powerful effects of exercise on the body and the mind. Listen as Dr. Laskowski unpacks the most current research that reveals “exercise is 800 times more powerful” than anything else you can do when it comes to fighting disease. From physiological to psychological benefits, Dr. Laskowski has made it his mission in life to research and educate the world about the power of including foundational movements in your daily routine. Whether you are a fitness professional, medical professional, caregiver, or someone looking to live a longer, more healthy life, this episode is a must! It's time to accept the fact that “exercise is medicine!” Stay Fit! Stay Crazie! Christine and Brian www.TwoFitCrazies.com tfcpro@twofitcrazies.com #twofitcrazies #podcast #wellness #fitness #MayoClinic #longevity #healthspan #lifespan #research #arthritis #sportsmedicine #sleep #nutrition #wellness #rejenerativemedicine #obesity #comorbidities #chronicdisease #fallprevention #cancer #osteoarthritis #GeorgeWBush #Obama #healthcare #presidentscouncil #foundationalmovements #medicine #ACL #PublicHealth #ProjectPlay #inclusivity #ACSM #ACE #AFAA #SCWFitness #keynote #fitpros #doctors #ALZ #dementia #Parkinsons #Depression #anxiety #exercise #activity #stability

In this episode of OccPod, Erin and Dr. Nabeel are joined by guest Dr. Laura Breeher for a discussion on the Minnesota Retaining Employment and Talent After Injury or Illness Network, or RETAIN. Dr. Breeher is the Section Chief of Occupational Medicine and Medical Director of Employee Occupational Health Services at Mayo Clinic in Rochester, MN. Since 2018, she has also served as co-medical director and principal investigator of RETAIN. Minnesota RETAIN is funded and sponsored by the U.S. Department of Labor and the Social Security Administration under a multi-year grant to the Minnesota Department of Employment and Economic Development. Implementation of the Minnesota RETAIN program is a collaboration among several core organizations including the Minnesota Department of Employment and Economic Development, Minnesota Department of Health, Minnesota Department of Labor and Industry, Mayo Clinic, Workforce Development Inc, and the Minnesota Governor's Workforce Development Board. To learn more about Minnesota RETAIN, visit www.mnretain.com. Thank you for listening!

Welcome back to 3 More Questions, an episode series where we continue the conversation that we started last week with our featured guest. On this episode, we're talking about our interview with Dr. John Noseworthy, CEO Emeritus of Mayo Clinic to learn even more about improving what's already working. ... BONUS RESOURCE: To gain confidence as a leader, you need a plan for tackling common leadership challenges. My new online course "Taking People With You" will give you practical ways you can resolve issues and keep your team moving forward toward your biggest goals. Get free access here — https://howleaderslead.com/courses/

Stories in this episode: Day in History: 1923: Only fire department vehicles can use sirens Zoning change for proposed Bakery Flats project heads to Rochester Council 'New people. New stories. New hope.' Rochester's Best Restaurant promoters Guatemalan family makes the most of Mayo Clinic trips for son's treatment 10 months after suffering broken neck, Chatfield's Kail Schott a state champion

This week, please join author Xuerong Wen, Associate Editor Sandeep Das, and Guest Host Mercedes Carnethon as they discuss the article "Comparative Effectiveness and Safety of Direct Oral Anticoagulants and Warfarin in Patients With Atrial Fibrillation and Chronic Liver Disease: A Nationwide Cohort Study." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass of the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor, Director of the Poly Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, I'm so excited about today's feature paper. It deals with the important condition where atrial fibrillation exists in patients with chronic liver disease and what do we do for anticoagulation in these patients. It's a comparative effectiveness and safety study of direct oral anticoagulants compared with warfarin in these patients. A huge, wonderful, important study that we're going to discuss. But before we get there, I'd like to tell you about some papers in this issue and I'd like you to tell me about some too. You got your coffee? Dr. Greg Hundley: Absolutely. Dr. Carolyn Lam: All right. I'll go first In this paper that describes a quantitative prognostic tool for the mitral valve prolapse spectrum and it's derived from the new mitral regurgitation international database quantitative or MIDA-Q registry, which enrolled more than 8,000 consecutive patients from North America, Europe, Middle East. And these were patients all diagnosed with isolated mitral valve prolapse or MVP in routine clinical practice of academic centers, all of which also did prospective degenerative mitral regurgitation quantification. The MIDA-Q score was calculated based on characteristics collected in routine practice combining the established MIDA score, which integrated guideline based markers of outcomes like age, New York Heart Association status, atrial fibrillation, LA size, pulmonary artery pressure left ventricular and systolic, I mentioned, and ejection fraction. Integrating that with scoring points based on the degenerative mitral regurgitation quantitation that is measuring effective regurgitant orifice and volume. Dr. Greg Hundley: Very interesting Carolyn. So a scoring system that combines clinical information with what we might assess with echocardiography like regurgitant volume or regurgitant orifice area. So how well did this mortality risk score perform? Dr. Carolyn Lam: So the new score was associated with an extreme range of predicted survival under medical management and that ranged from 97% to 5% at five years for the extreme score ranges. And it was strongly, independently and incrementally associated with long-term survival over all the markers of outcomes. So the authors concluded, and these by the way were authors led by Dr. Maurice Serrano from Mayo Clinic, Rochester, Minnesota. These authors concluded that the score should allow integrated risk assessment of patients with mitral valve prolapse to refine clinical decision making in routine practice and ultimately reduce degenerative mitral regurgitation under treatment. Dr. Greg Hundley: Wonderful description Carolyn. Well I'm going to switch to the world of electrophysiology, Carolyn. And so as you know, the Brugada syndrome is an inherited arrhythmia syndrome caused by loss of function variants in the cardiac sodium channel gene SCN5A and that occurs in about 20% of subjects. And these authors led by Dr. Dan Roden at Vanderbilt University School of Medicine identified a family with four individuals diagnosed with Brugada syndrome, harboring a rare missense variant in the cardiac transcription factor, TBX5, but no SCN5A variant. And upon identifying these individuals, their objective was to establish TBX5 as a causative gene in Brugada syndrome and to define the underlying mechanisms by which it would be operative. Dr. Carolyn Lam: Oh wow. So a new gene variant. So what was the relationship? Dr. Greg Hundley: Right Carolyn? So using induced pluripotent stem cell derived cardiomyocytes from members of the affected family, multiple electrophysiologic abnormalities were detected in these cardiomyocytes including decreased peak and enhanced late cardiac sodium current. In these cells these abnormalities were entirely corrected by CRISPR/Cas9 mediated editing of that TBX5 variant and transcriptional profiling and functional assays in unedited and edited pluripotent stem cell derived cardiomyocytes showed direct SCN5A down regulation caused decreased peak sodium current and that reduced PDGF receptor expression and blunted signal transduction to phosphoinositide-3-kinase. And interestingly, PDGF receptor blockade markedly prolonged normal induced pluripotent stem cell derived cardiomyocyte action potentials. And also Carolyn interestingly in this study they did a separate analysis. It reviewed plasma levels of PDGF in the Framingham Heart Study and they found that they were inversely correlated with the QT corrected interval. And so Carolyn, these results established decrease SCN5A transcription by the TBX5 variant as a cause of Brugada syndrome and also reveal a new general transcriptional mechanism of arrhythmogenesis of enhanced late sodium current caused by reduced PDGF receptor mediated phosphoinositide-3-kinase signaling. Dr. Carolyn Lam: Wow. Wow, that's significant. Thanks Greg. So this next paper is also really important and could change the practice in the field of cardiac resynchronization therapy or CRT. You see, it suggests that the practice of what we do now, which is combining right bundle branch block with intraventricular conduction delay patients into a single non-left bundle branch block category when we select patients for CRT, that this may not be the way to go. So let's go back a bit and remember that benefit from CRT varies with QRS characteristics and individual trials are actually underpowered to assess the benefit for relatively small subgroups. So the current authors led by Dr. Friedman from Duke University Hospital and colleagues, therefore performed a patient level meta-analysis of randomized trials of CRT to assess the relationship between QRS duration and morphology with outcomes. Dr. Greg Hundley: Very interesting Carolyn. So another wonderful paper from the world of electrophysiology in trying to understand optimal mechanisms to resynchronize the ventricle in patients with differing bundle branch blocks or intraventricular conduction delays. So what did they find? Dr. Carolyn Lam: They found that patients with intraventricular conduction delays and a QRS duration of 150 milliseconds or more, CRT was associated with lower rates of heart failure hospitalizations and all cause mortality. The magnitude of CRT benefit among these patients with the interventricular conduction delay of 150 milliseconds or more and those with the left bundle branch block of 150 milliseconds or more were similar. In contrast, there was no clear CRT benefit for patients with a right bundle branch block of any QRS duration, although the authors could not rule out the potential for benefit at a markedly prolonged QRS duration. So they concluded that the practice of combining right bundle branch block with intraventricular conduction delay patients into a single non-left bundle branch block category when we make patient selections for CRT is not supported by the current data. And in fact, patients with an intraventricular conduction delay of 150 milliseconds or more should be offered CRT as is done for patients with a left bundle branch block of 150 milliseconds or more. Dr. Greg Hundley: Wow, Carolyn, so really interesting point. No clear CRT benefit for patients with right bundle branch block regardless of the QRS duration. Well we've got some other articles in the issue. I'll describe a couple from the mail bag. There's a Research Letter from Professor Lassen entitled "Risk of Incident Thromboembolic and Ischemic Events Following COVID-19 Vaccination Compared with SARS-COV2 Infection." Also Bridget Kuhn has a wonderful Cardiology News piece entitled "Collaborative Care Model Helps Heart Failure Patients Meet End-of-Life Goals." Dr. Carolyn Lam: There's an exchange of letters between Doctors Donzelli and Hippisley-Cox regarding that risk of myocarditis after sequential doses of COVID-19 vaccine, there's an AHA Update by Dr. Churchwell on continuous Medicaid eligibility, the lessons from the pandemic. There's an On My Mind paper by Dr. Parkhomenko on Russia's war in Ukraine and cardiovascular healthcare. Wow, what an issue. Thanks so much, Greg. Shall we go on to the feature discussion? Dr. Greg Hundley: You bet. Dr. Mercedes Carnethon: Well welcome to this episode of Circulation on the Run podcast. I'm Mercedes Carnethon, associate editor of the journal Circulation and Professor and Vice Chair of Preventive Medicine at the Northwestern University Feinberg School of Medicine. I'm very excited to be here today with Xuerong Wen and Sandeep Das, my fellow associate editor here at Circulation to talk about a wonderful piece by Dr. Wen and colleagues from the University of Rhode Island. So welcome this morning Xuerong and thank you so much for sharing your important work with us. Dr. Xuerong Wen: Thank you Dr. Carnethon. It was great meeting you all and I'm the Associate Professor of Pharmacoepidemiology and Health Outcomes at the University of Rhode Island. I'm happy to introduce my study to everyone. Dr. Mercedes Carnethon: Well thank you so much and thank you as well Sandeep for identifying this fantastic article and bringing it forth. Dr. Sandeep Das: Thanks Mercedes. It's great to be with you. Dr. Mercedes Carnethon: Great. Well let's go ahead and get into it. There's so much here to talk about. So Dr. Wen and colleagues studied the comparative effectiveness and safety of direct oral anticoagulants or DOACs and warfarin in patients with atrial fibrillation and chronic liver disease. So this is such an important topic. Can you tell us a little bit about what your study found? Dr. Xuerong Wen: So our study is a comparative effectiveness and the safety analysis using a national health administrative data from private health plans. So we compared the risk of hospitalized ischemic stroke, systemic embolism and major bleeding between DOACs and warfarin in patients with atrial fibrillation and chronic liver disease. So we also had to had compare to these primary outcomes between apixaban and rivaroxaban in the study population. So our studies show that among patients with atrial fibrillation and chronic liver disease, DOACs as a class was associated with lower risk of hospitalization of ischemic stroke and systemic embolism and major bleeding, compared with warfarin. And when compared risk outcomes between individuals apixaban has lower risks as compared to rivaroxaban. So that's our study results. Dr. Mercedes Carnethon: Well thank you so much. This seems like such an important question. We hear a lot about DOACs and some of their risks as well as their considerable benefits. I think what leaves me the most curious is why did you choose to pursue this question and in particular in patients with both atrial fibrillation and liver disease. So why was the intersection of these two particular conditions of interest to your study team? Dr. Xuerong Wen: That's a great question. So the liver actually plays a central role in both the synthesis of coagulation factors and the metabolism of anticoagulant drugs. And the clearance of the anticoagulants in liver ranges from 20% to 100% for DOACs and warfarin. So in clinical practice anticoagulation abnormalities and elevated risk of spontaneous or unprovoked venous thrombotic complications have been reported in patients with liver disease. While these patients with cirrhosis were excluded from the clinical trials of DOACs and also population based, the real world experience is very limited. So that is why we initiated this retrospective cohort study and based on the real world data in this specific population. Dr. Mercedes Carnethon: Oh, thank you so much for explaining that. I definitely learned a lot and really enjoyed reading the piece. I think it was very well organized and well written and I know that our readership will appreciate it. It obviously stood out to you as well, Sandeep. Can you tell me a little bit about why you thought that this would be an excellent piece for circulation? Dr. Sandeep Das: Yeah, absolutely. Thanks for the question. So in the broad field of what we call observational comparative effectiveness research, so basically that's using large observational data sets to try to answer important clinical questions and it's a really challenging thing to do. I mean we're all very familiar with the idea of using randomized trials to assess important clinical questions because of the structure of that design allows you to mitigate some of the effects of confounding. Here, it has to be done analytically. So what's the important factor that really drives you towards a great observational comparative effectiveness piece? So first the clinical importance. I feel a little guilty because I'm old enough to remember when warfarin was the only option available, but really as a clinician, or every patient, I really prefer DOACs over warfarin just for ease of use and lifestyle. So there's a huge sort of importance to the question. Second, the patients with chronic liver disease were excluded from the larger RCTs and the DOAC trials. So really we don't have the answer to the question already. It's an important question. Obviously the bleeding risk is tied up with the liver, warfarin directly antagonizes vitamin K, so there's real questions about safety and so this is the perfect storm and then on top of it was a really well done and well executed study. So when this came across my desk, the very first thing I thought was not, "Is this something that we're interested?" But rather, "How do we make it better? How do we make it more useful to the reader?" This had me from hello. Dr. Mercedes Carnethon: Well thanks so much. We rarely have the opportunity when we read an article to be able to ask the authors questions. So Sandeep, I know that you had mentioned that you had some follow up questions as well. Dr. Sandeep Das: Yeah. So the real thought that I have then is would you argue based on this that we know enough that we should change our practice? And that do you feel comfortable advocating that people now prescribe DOACs to these patients? Dr. Xuerong Wen: I would say yes. Okay. Although this is not a clinical trial, but our study is actually systematically compare the effectiveness and safety between DOAC users and also the warfarin users. And if you look at our table one, we compare with so many variables between these two users and we use the propensity score adjustment and we after propensity score weighting and the two control group almost balanced. And I know right now FDA actually suggested that emulate the trial using the large real world data to do the emulated trial. So our study actually conducted is based on the large population using large data and we use the propensity score weighting to control all this potential compounding factors. Although there are still some limitations in this study. I think we mentioned that in the discussion section and we discussed all potential compounding factors that still may exist. And also there are some misclassifications and out of all this limitations and we still found the two drugs performed differently in this specific population. So we feel that comfortable to say that a DOAC drug performs better than warfarin. And also I think based on other studies that based on the clinical trial in the general population, DOAC drug is performs much better than warfarin and considering that the clearance in liver for DOAC is less than warfarin. So plus all this information together, I think DOAC may be safer than wafarin in the patients with AF and chronic liver disease. Dr. Sandeep Das: Yeah, I would say that I agree that these data, even if you're skeptical about observational CT generally, which I admit that I tend to be, these are really reassuring data that at least the DOACs are... There's absolutely nothing that suggests that they're any worse than warfarin and all of the sort of soft indications for ease of use and patient happiness really would seem to favor DOACs. So I think this is the sort of rare observational CT paper that may actually change my practice. Dr. Mercedes Carnethon: I have a follow-up question, Xuerong, related to the design and as well your strategy to address differences between the groups. So inverse probability weighting is certainly a standard in the field to be able to manage differences between groups when you have a situation where can't, where it's not a randomized trial. Do you as well, and educate me, I admit I'm an epidemiologist whose methodological skills are sometimes challenged. Do you have the opportunity using this design and with inverse probability weighting to evaluate subgroup effects? So my specific question is were you able to determine whether or not these associations were similar based on age and gender in particular? Dr. Xuerong Wen: That's a great question. We did conducted a lot of subgroup study but not by age or gender. We conducted I think this study in a lot of subgroups using the propensity score weighting, but the subgroup that I think we did a subgroup like a patient with a different chronic liver disease. So that's what we did. And we also tested different methods inverse probability score weighting. So we did trimming and we used a different percentage of trimming and to see how that affect the study results. So we have done a lot of subgroup studies. We did not check the age and the gender, but that's a very good point. Maybe later, well I'll ask my student to do that. Dr. Mercedes Carnethon: Well, you're a good mentor. So I think that is a really certainly an appropriate approach. Sandeep, did you have additional questions? Dr. Sandeep Das: No, I wish I had thought of yours before you did. I think exactly the older age, women, racial ethnic groups that are underrepresented historically in trials. I think that that's really, again, the sweet spot of this observational research. We definitely, and NH definitely working on trying to increase enrollment of all these groups in our CTs. However, while we wait for that, I think that's exactly what we should be doing. Dr. Mercedes Carnethon: Well that's great. And Xuerong, you really alluded to really, I think what is one of my final questions related to what do you think based on what you have observed in this study, what do you see as the next steps in the research field for your team, your students, or other people who are carrying out this type of work? Dr. Xuerong Wen: Well, that's a great question. We currently have a couple of more manuscripts ongoing in this field, and we will continue conducting the comparative effectiveness and analysis to compare drugs head to head as well as developing and implementing new methodologies to this field. And we hope our study provides real world evidence for clinical decision making, prescribing anticoagulants to patients with atrial fibrillation and chronic liver disease. We also expect the physicians and researchers more and more value the real world data studies, especially when clinical trials are not feasible or ethical. Dr. Mercedes Carnethon: Well, thank you so much. That was such an excellent vision that you provided us with and we're just very grateful that you submitted this fantastic work to the journal Circulation. I know that our readers will enjoy really digging in. The podcast is meant as a teaser to bring you to the journal so that you can read about this wonderful work by Dr. Wen and colleagues. So again, thank you. I'm Mercedes Carnethon, joined with my associate editor partner here, Dr. Sandeep Das. And thank you very much for spending your time with us today, Dr. Wen. Dr. Xuerong Wen: Thanks for this great opportunity to disseminate my study with us, thank you. Dr. Sandeep Das: Thanks Mercedes. Dr. Mercedes Carnethon: Thank you for joining us for this episode of Circulation on the Run. Dr. Greg Hundley: This program is copyright of the American Heart Association 2023. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

This episode is a re-broadcast from 2021, but just as relevant today. How do you future-proof or recession-proof your career? Coaching is growing remarkably -- we go through information from the Global Wellness Summit, the Mayo Clinic and more to determine whether coaching is a viable option for an uncertain future. John Kim (The Angry Therapist) and Noelle Cordeaux (CEO of Lumia) are teaming up to tackle the big world of positive psychology, meaning, and life coaching. Everything Life Coaching is brought to you by Lumia-- at Lumia, we train and certify impact-driven coaches, making sure they've got all they need to build a business they love and transform lives, on their terms. Become a life coach, and make a bigger impact on the world around you! Schedule a call with us today to discuss your future as a coach. Music in this episode is by Cody Martin, used under a creative commons license. The Everything Life Coaching Podcast is Produced and Audio Engineered by Amanda Meyncke with assistance from Rithu Jagannath.   Resource mentioned in this episode: Global Wellness Report

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., speaks with Beshoi Nashed, a visiting medical student from the Medical University of the Americas in Saint Kitts and Nevis, about his personal perspective on life that has helped him succeed where many others are challenged. Timestamps:0:00 Intro01:08 Where were you first introduced to this no excuses philosophy perspective, and what is it?03:09 What's the perspective they had that they really imparted on you, what did it look like? 06:44 What do you think is important for our listeners to understand about, what is it that allows you to be successful with this no excuses approach?10:22 How has your practice changed, if at all, over that time?12:35 Where do you recommend our listeners get their own start?14:22 Outro

Today's guest is Dr. John Noseworthy, CEO Emeritus of Mayo Clinic. People come from all over the world to get treatment at the Mayo Clinic. It's always ranked at or near the top of the best hospitals in the country.  And it takes a special leader to step into an established organization with a sterling reputation – and make it even better. And Dr. Noseworthy is a special leader! He knew it was critical not only to keep that level of excellence but also to build on it. In his ten years at the helm, he relentlessly drove out inefficiency and waste. That freed up resources they could reinvest in even more of the research and care they're known for.  Now, it wasn't easy. Change never is! And that's especially true in an organization like Mayo where people already feel like things are working well. But a great leader drives change even in high performing organizations. Listen to learn how John does it, and how you can do it, too. You'll also learn: How to spot and eliminate inefficiency, even in a high-performing culture Advice for young people who want to find a satisfying career  Practical tips for helping subject-matter experts understand business principles What he would do about the US healthcare system if he had a magic wand

Guest host Dr. Neeraj Agarwal and Dr. Christian Kollmannsberger discuss practice-changing abstracts that were presented at the 2023 ASCO Genitourinary Cancers Symposium, including results from the TALAPRO-2, PROpel, TRITON3, ARASENS, KEYNOTE-057, CheckMate 274, and CheckMate 9ER studies. TRANSCRIPT Dr. Neeraj Agarwal: Hello and welcome to the ASCO Daily News Podcast. I'm Dr. Neeraj Agarwal, the director of the Genitourinary Oncology Program, and professor of Medicine at the Huntsman Cancer Institute at the University of Utah, and editor-in-chief of the ASCO Daily News.  Today, we will be discussing practice-changing abstracts and other key advances in GU Oncology featured at the 2023 ASCO Genitourinary Cancers Symposium. Joining me for this discussion is Dr. Christian Kollmannsberger, the chair of this year's ASCO GU. Dr. Kollmannsberger is a GU medical oncologist at the BC Cancer Vancouver Cancer Center and a clinical professor at the University of British Columbia.  Our full disclosures are available in the transcript of this episode, and the disclosures of all guests on the podcast can be found on our transcripts at asco.org/DNpod.  Christian, thank you for joining us on the podcast today.  Dr. Christian Kollmannsberger: Thank you very much, Neeraj. It's a real pleasure to be here and have this discussion. Dr. Neeraj Agarwal: Thank you. So, Christian, the GU meeting featured remarkable progress in various GU malignancies. Could you please share some of the prominent topics that made the headlines this year and give us an overall feel of ASCO GU this year? Dr. Christian Kollmannsberger: Absolutely. I think it was a great meeting with over 5,800 attendees from more than 70 countries. And most of the attendees were in person, so it was a great event. ASCO GU is truly the premier global event to feature the very best of GU cancer research and treatment. The theme of this year's meeting was "Today's Science, Tomorrow's Treatment," and that was reflected in the novel scientific and clinical findings that were presented and will potentially lead to changes in our daily clinical practice. It also reminds us how quickly the development today is and how quickly novel scientific progress is immediately translated into clinical practice, particularly oncology.   I was very impressed by the meeting's emphasis on diversity, interactivity, networking, multidisciplinary collaboration, and evidence-based care. We introduced several new features such as a “Meet the Professor session, a women's networking event, etc. And the first day really kicked off with a very rich focus on prostate cancer and much attention given to PARP inhibitors in our first session. As an example, LBA 17 was the first late-breaking abstract presented. And congratulations to you, Neeraj, on delivering this exciting data on the TALAPRO-2 trial, which were eagerly awaited. Let's start with that. Can you tell us about this trial? Dr. Neeraj Agarwal: Yes, of course. So the TALAPRO-2 trial was a phase 3 randomized trial where patients in newly diagnosed metastatic CRPC settings were randomized to standard of care enzalutamide plus placebo versus enzalutamide plus talazoparib PARP inhibitor. And as we know, Christian, the rationale has been that dual inhibition of PARP and AR may enhance the efficacy of each. And there's a laboratory preclinical rationale and based on which other studies have been done in the past. So, without getting into too much detail into the rationale for the trial, I'll come right to the results of the trial. So, this was the first-line mCRPC setting where rPFS was the primary endpoint as assessed by the independent radiology assessment. And in this trial, patients were recruited regardless of the homologous recombination repair gene alterations. So, patients were recruited and they were prospectively tested for whether they had these HRR gene alterations or not, but all comer population was included in this trial. And after a median follow-up of approximately 23 months, the trial read out, and we found that trial made the primary endpoint was improved radiographic progression-free survival with the rPFS being about 22 months in the enzalutamide arm and not reached in the combination arm with a 37% reduction in risk of progression or death.  If you look at the subgroup analysis of patients who were HRR+, there was a 54% reduction risk of progression or death. If you look at patients who were stratified in HRR- or unknown group, there was a 30% reduction risk of progression or death. If you specifically look at an exploratory analysis we did to look for patients who were HRR- by prospective tumor tissue testing; there was a 34% reduction in risk of death with a hazard ratio of 0.66 favoring the combination arm. So overall, the rPFS primary endpoint was met in all groups. We also see significant delay in PSA progression in the combination arm by more than nine months. We also see delays in the time to cytotoxic chemotherapy. We saw delay in progression or death on subsequent neoplastic therapy after the protocol treatment. We saw delays in deterioration of quality of life and global health status. All these were significant and happened on the talazoparib plus enzalutamide arm.  So overall, if you look at the totality of the data, these all favored the combination of talazoparib plus enzalutamide compared to enzalutamide alone. I want to highlight that overall survival is immature at 31% maturity with a hazard issue of 0.89, currently favoring enzalutamide plus talazoparib. But we'll have to look at more mature data as time passes.  Dr. Christian Kollmannsberger: Wow. Thank you, Neeraj. So, it sounds like that was a very positive trial, and it's potentially practice-changing. One of the concerns is always safety and toxicity. So can you tell us whether there were any new safety signals, and can you tell us more about the common adverse events that were noticed in TALAPRO-2? Dr. Neeraj Agarwal: No discussion is complete without talking about safety results, so I'm glad you asked me, Christian. The most common dose-affecting toxicity, if you will - so toxicities which led to dose modification and dose discontinuation of talazoparib were cytopenias, as we expect from this class of agents. So anemia, neutropenia, thrombocytopenia, these were the common toxicities. In fact, rate with anemia was 46.5%. Neutropenia and cytopenia were much less common.  I would like to highlight one fact which also came up during the discussion section after our oral presentation. The qualifying criteria for entry in this trial was a hemoglobin of 9-gram percent. And 49% of patients had grade 1 to 2 anemia at baseline, that is before starting treatment with talazoparib. So, we knew that if you mandate dose reduction, a lot of patients will not get adequate dosing of talazoparib. So, we waited for grade 3 anemia and then instituted dose reduction. And that I thought personally was a good strategy because the grade 3 anemia happened after a median duration of three months, 3.3 months to be more precise. And then, these patients underwent protocol-mandated dose reduction, following which the dose discontinuations were quite low actually. Only 8.3% patients discontinued talazoparib because of anemia, and the median dose intensity or median relative dose intensity of talazoparib in the talazoparib arm remained quite high at more than 80%, which translates to a talazoparib dose of 0.4 milligram daily when the starting dose was 0.5 milligram. So those were the hallmark of toxicities.   I do like to mention that those grade 3, 4 toxicities which are more known to affect the quality of life of our patients, such as grade 3, 4 anorexia, fatigue, nausea and vomiting, they were quite rare, happening in 1 to 4% patients who were on talazoparib. So overall, regarding the side effects, they were manageable, there were no new safety signals, and we could maintain adequate talazoparib dosing with dose reduction, which happened quite early during the protocol treatment.  Dr. Christian Kollmannsberger: Thank you, Neeraj. Very impressive results indeed. The patient population included in TALAPRO-2 was very similar to those included in the PROpel phase 3 trial, which tested the combination of abiraterone and olaparib in the first-line mCRPC setting. So, I'd like to just mention that we also saw LBA16 on the PROpel study, which was the final overall survival in PROpel, which was presented by Noel Clarke. So PROpel, as you know, was a randomized phase 3 trial evaluating efficacy and safety of olaparib plus abiraterone versus placebo plus abiraterone as first-line therapy for mCRPC in the first-line metastatic castration resistance setting. The enrollment in that study was independent of known defects in the homologous recombination repair gene pathway in contrast to other studies, such as MAGNITUDE, which tested the biomarker upfront. A total of 796 patients were randomly assigned to either olaparib plus abiraterone or placebo plus abiraterone. And we saw similar results, significant radiographic progression-free survival with olaparib plus abiraterone in PROpel, which was the primary endpoint similar to TALAPRO-2, and that was published last year in the New England Journal of Medicine Evidence.  Now, this abstract presented here at ASCO GU reported on overall survival with an overall survival majority of 47.9% and showed that with the addition of the PARP inhibitor olaparib to abiraterone, a statistically non-significant but clinically meaningful improvement in overall survival of about seven months were achieved compared to standard of care in abiraterone alone. The numbers were 42.1 versus 34.7 months in the all-comers population of patients in the first-line mCRPC setting. Importantly, I think the median overall survival of more than 42 months really represents the longest reported median overall survival thus far in a phase III trial for first-line metastatic castration-resistant prostate cancer. Although the median overall survival for the non-HRR group remains not statistically significant, with a hazard ratio of 0.89. Dr. Neeraj Agarwal: Such a great synopsis of the PROpel result data. Thank you, Christian, for highlighting these results. As we know, the combination is already approved by the EMA, the European Medical Agency, for patients in the first-line mCRPC setting who are not candidates for docetaxel chemotherapy. If this combination is approved by the FDA, we may have one more therapeutic option for our patients in first-line mCRPC.  So, just continuing on the PARP inhibitors, there was one more oral presentation with PARP inhibitor rucaparib by Dr. Alan Bryce from the Mayo Clinic, Arizona. This was Abstract 18 on the primary result of the TRITON3 trial. So to complete our PARP inhibitor section, I would like to summarize the result of the TRITON3 trial, which was a randomized phase III trial evaluating rucaparib versus physician choice, which notably included docetaxel in addition to abiraterone or enzalutamide in patients with chemotherapy-naive mCRPC with BRCA1, BRCA2 or ATM alterations. These patients had disease progression after having one novel hormonal therapy, or we call them second-generation androgen pathway inhibitors in any setting. So these patients had to have disease progression on a novel hormonal therapy.   In the BRCA subgroup and the subsequent intention to treat the population, the primary endpoint tested first was radiographic progression-free survival, and overall survival was the key secondary endpoint. The subgroup of patients with BRCA-altered disease had a median rPFS of 11.2 months with rucaparib compared to 6.4 months with physician choice of treatment - looks like almost doubling of the rPFS with the rucaparib. In the overall ITT population, median rPFS was 10.2 months with rucaparib and 6.4 months with the physician's choice of treatment. Although the overall survival data are immature, we still see a trend for improved overall survival with rucaparib. Regardless, the study clearly demonstrates the value of rucaparib for treating BRCA1 and BRCA2-altered mCRPC after disease progression on an androgen receptor pathway inhibitor. So these were the impressive results from the TRITON3 trial.  But before we switch to non-prostate abstract, I would like to complete the prostate cancer discussion by talking about the Abstract 15, which was based on the results of the ARASENS trial presented by Dr. Maha Hussain. As we know, ARASENS is a randomized phase 3 trial evaluating the efficacy and safety of darolutamide plus androgen deprivation therapy plus docetaxel versus androgen deprivation therapy or ADT plus docetaxel. So the triplet of ADT plus darolutamide plus docetaxel being compared to ADT plus docetaxel chemotherapy in patients with newly diagnosed metastatic castration-sensitive prostate cancer. A total of 1,300 patients were randomly assigned to the doublet versus triplet. As presented in the last ASCO GU meeting exactly one year ago, the primary endpoint of the study was met with a significant improvement in overall survival and a 32% reduction in risk of death for patients on the triplet therapy with ADT plus docetaxel plus darolutamide versus ADT plus docetaxel chemotherapy. So triplet therapy was already approved based on these data.  The abstract presented by Dr. Hussain this year is a post-talk analysis where Dr. Hussain and colleagues investigated the impact of triplet therapy across patients with high volume versus low volume per chartered criteria and higher risk versus low risk using latitude trial criteria. And investigators knew that these results would be highly attractive to practicing oncologists who are now choosing treatment based on volume of disease or risk of disease, more commonly, volume of disease.  So, let's come to what was presented this ASCO GU. So, after 1,305 patients in ARASENS, the majority had high-volume disease and high-risk disease. Among patients with high-volume disease, the addition of darolutamide reduced the risk of death by 30% compared with ADT and docetaxel, with a hazard ratio of 0.69. In the risk groups, the addition of darolutamide seems to favor both high-risk and low-risk groups. Among patients with low-volume disease, there was a trend towards improvement in overall survival with the addition of darolutamide, but it did not reach statistical significance. The great news was that there was no new safety signal. So, to summarize these data, the triplet of darolutamide plus ADT plus docetaxel showed superior overall survival compared to doublet of ADT plus docetaxel, with an important caveat that triplet was not compared with any of the modern doublets of ADT plus a second generation androgen receptor pathways inhibitor such as abiraterone, apalutamide, or enzalutamide, or even darolutamide. So, I wish there was a third arm of ADT plus darolutamide.  Having said that, triplet can be considered a standard of care now based on these data for patients with metastatic hormone sensory prostate cancer, where we would be using ADT plus docetaxel chemotherapy. And from this meeting data, this efficacy of triplet can be applied to high-volume disease and all risk disease. And we just need more time to see how the data pans out in low-volume patients with metastatic hormone-sensitive prostate cancer.  Dr. Christian Kollmannsberger: Yes, I completely agree, Neeraj. I think all the data presented in these abstracts are really impressive and will impact our daily clinical practice and our patients more or less immediately. I think the use of PARP inhibitors, whether as a monotherapy or in combination with androgen receptor pathway inhibitors, as well as now the option of triplet therapy in the metastatic castration sensitive setting really offer patients with metastatic prostate cancer new treatment strategies and most importantly, improved survival outcomes. And it is impressive to see how we have pushed the prognosis and the outcomes for our patients with prostate cancer, I would say, in the last five to ten years. And similar to last year, I think the entire Prostate Cancer Day at ASCO GU 2023 was full with impressive data and featured dynamic content throughout the day. Dr. Neeraj Agarwal: Indeed. So, let's move on to bladder cancer. Christian, what are your key takeaways from the bladder cancer studies presented at the meeting? Dr. Christian Kollmannsberger: I think there were interesting abstracts in both the non-muscle-invasive and the muscle-invasive setting and the metastatic setting. So, for example, Abstract 442 was presented by Dr. Andrea Necchi on the cohort B of the phase 2 KEYNOTE-057 trial. As a background here, the standard treatment for high-risk non-muscle-invasive bladder cancer involves transurethral resection of the bladder tumor, a TURBT, followed by intravesical BCG therapy to eradicate any residual disease. And patients who fail to adequately respond to BCG are usually recommended to undergo radical cystectomy. So in the cohort B of the phase 2  KEYNOTE-057 trial that investigated the safety and efficacy of pembrolizumab as a single agent for patients with BCG-unresponsive, high-risk non-muscle-invasive bladder cancer who were ineligible or declined to undergo radical cystectomy, enrolled patients received standard-dose pembrolizumab of 200 milligrams every three weeks for up to 35 cycles. So very common as we do it with other disease sites. And at a median follow-up of 45.4 months, the primary endpoints of disease-free survival at twelve months was 43.5%. The median disease-free survival duration was 7.7 months. These are encouraging results, and we should keep in mind that a radical cystectomy has immense impact on our patients' quality of life. So I think it is important that we do these trials.  Now in order to address potential biases in this phase II trial, such as the underlying heterogeneity of transurethral resection of bladder tumor quality, and to obtain a more comprehensive understanding of pembrolizumab's efficacy relative to a particular control group, we need further evaluation of pembrolizumab in a randomized trial before we can really go for regulatory approval. But overall, I think for the first time in a long time that we seem to be able to move the needle in non-muscle-invasive bladder cancer. Dr. Neeraj Agarwal: Thank you, Christian, for this great overview. Could you please also share the findings presented by Dr. Matt Galsky on Abstract 443? Dr. Christian Kollmannsberger: Of course, Neeraj. Abstract 443, presented by Matt Galsky, reported the extended follow-up results from the CheckMate 274 trial, which looked at another very important field where we haven't made that much progress, which is the adjuvant setting. And CheckMate 274 examined adjuvant nivolumab compared to placebo for patients with high-risk resected muscle-invasive urothelial carcinoma. In this trial, nivolumab was given at 240 milligrams every two weeks or placebo every two weeks for up to one year of treatment. After following up with patients for a median of 36.1 months, the study found that those who received nivolumab had a median DFS of 22 months compared to only 10.9 months for those who received placebo among the ITT patients. So basically, a doubling of the DFS with the addition of adjuvant nivolumab.  The results were particularly notable for patients with high PD-L1 expressions or PD-L1 expression of 1% or more, as those who are treated with nivolumab had a median DFS of 52.6 months, which was six times higher than the DFS in the control group where patients received placebo, which was only 8.4 months. And I think that is truly impressive. One year of adjuvant therapy with nivolumab continues to show a sustained disease-free survival benefit over a period of three years in both the ITT and the PD-L1-high patient population. In my view, these results reinforce the utility of nivolumab in the adjuvant urothelial carcinoma setting after surgery. And it will be interesting to see how the overall survival pans out in this study.  So, Neeraj, moving on to kidney cancer, what were your key takeaways from these studies on kidney cancer presented in this meeting?  Dr. Neeraj Agarwal: So, there were exciting results presented from multiple studies in this area as well. For example, Abstract 603 presented by Dr. Mauricio Burotto, senior author was, Dr. Toni Choueiri on the three-year follow-up from the phase 2 CheckMate-9ER trial. So, in this trial, patients were randomized one-to-one to nivolumab 240 milligrams every two weeks, plus cabozantinib 40 milligrams daily versus sunitinib 50 milligrams daily for four weeks, and it was a six-week cycle for sunitinib until disease progression or unacceptable toxicity. So this was the design of the phase 3 CheckMate-9ER trial. And after a median follow-up of three years, the benefit of nivolumab plus cabozantinib remained consistent with previous follow-ups. So, as we know, these data have been presented in the past, also published in the New England Journal of Medicine. But this meeting was a clear follow-up of these data.  Notably, the median overall survival of patients treated with cabozantinib plus nivolumab in the ITT population, which included all favorable intermediate and poor IMDC score patients, was significantly improved at 49.5 months compared to 35.5 months in the sunitinib arm. It is so heartening to see that median overall survival breaching the four-year mark in our patients with metastatic RCC in a consistent fashion. We saw similar data with the combination of ipilimumab plus nivolumab recently. And as these trials are maturing, we are probably going to see more combinations breaching this four-year mark. So importantly, no new safety signals emerged with the additional follow-up in either arm. And I think these results provide further support for the use of cabozantinib plus nivolumab as a first-line treatment option for patients with metastatic or advanced renal cell carcinoma. Dr. Christian Kollmannsberger: Indeed, I think it is extremely impressive what we've seen over the last 15 years in metastatic kidney cancer, going from a median overall survival of about a year to now more than four years. I think that is a great achievement, and we can see it on a daily basis in our clinical practice.  Now, before we wrap up, I would like to highlight another potentially practice-changing trial, LBA602, which titled, “Results from Phase 3 Study of 89Zr-DFO-Girentuximab for PET/CT Imaging of Clear Cell Renal Cell Carcinoma: The ZIRCON Trial” presented by Dr. Brian Shuch. The background of this is that the detection of renal masses poses a challenge due to the limitations of diagnostic options such as imaging and biopsy. And we often, in clinical practice, are confronted with "What exactly is this?" And what's even more importantly, “What's the histology of this?” And a non-invasive, accurate method is needed for pre-treatment risk stratification. Girentuximab, a monoclonal antibody that targets carbonic anhydrase IX expressed on clear cell renal cell carcinoma, can obviously now aid in the differentiation between clear cell renal cell carcinomas and other renal lesions when radiolabeled with this new agent.  The ZIRCON trial was open-label and designed to include patients with renal masses up to 7 cm in size or clear tumor stage cT1 who were scheduled for partial nephrectomy within 90 days of planned TLX250-CDx administration. The enrolled patients received a single intravenous dose of girentuximab on day 0 and underwent FDG PET/CT imaging on day 5 before their scheduled surgery. And the co-primary endpoints were to assess the sensitivity and specificity of girentuximab PET/CT imaging for detecting clear cell renal cell carcinoma in patients with indeterminate renal masses, with histology as the reference standard, which I think is a great way to test these agents because you get 100% validation.  In the primary analysis of 284 patients, the average sensitivity and specificity across all three central readers were 86% and 87%, respectively, exceeding the prespecified thresholds. The positive and negative predictive values were 93.4% and 78%, respectively. And with very few related adverse events reported, the study affirms that girentuximab PET/CT is safe and effective in identifying clear cell renal cell carcinoma in patients with indeterminate renal masses. And the findings hold potential for developing optimal management strategies for patients with indeterminate renal masses. I think this is important that we add a non-invasive method to this because we are confronted on a regular basis with patients who either cannot tolerate a biopsy or where the biopsy is indeterminate. And this could potentially be a great tool to help us with our pre-treatment planning of our treatment strategy. Dr. Neeraj Agarwal: Wow. So, it looks like a new PET scan using a unique tracer and antibody to detect the clear cell renal cell carcinoma with high specificity and sensitivity. It reminds me of drawing a crude analogy from the PSMA PET scan in prostate cancer. And hopefully, we will be able to use these newer scans that we call TLX250-CDx PET/CT scan. I hope they have a simpler name for this very soon. Or maybe follow up for patients who had kidney cancer, localized kidney cancer taken out by radical surgery, and then we are following them. And sometimes, we don't know if a small lung nodule is metastatic or not. And these kinds of imaging studies may help us down the line in monitoring those patients as well. So indeed, very exciting progress not only in the therapeutic area now but also in diagnostic fields at this GU ASCO.   So with that, we have seen multiple abstracts on prostate, bladder, and kidney cancer with real impact on how we practice medicine. Thank you, Christian, for sharing your insight with us today. It is an exciting time in GU Oncology, and we appreciate you taking the time to contribute to the discussion. Thank you so much.   Dr. Christian Kollmannsberger: Thank you, Neeraj, thank you for having me. And I completely agree it remains an exciting time in GU oncology.   Dr. Neeraj Agarwal: And thank you to our listeners for joining us today. You will find links to the abstracts discussed today on the transcripts of this episode.  Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts.   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.   Find out more about today's speakers:   Dr. Neeraj Agarwal  @neerajaiims Dr. Christian Kollmannsberger Follow ASCO on social media:    @ASCO on Twitter    ASCO on Facebook    ASCO on LinkedIn    Disclosures:   Dr. Neeraj Agarwal:    Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences   Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, crispr therapeutics, Arvinas   Dr. Christian Kollmannsberger: None disclosed  

Pneumeric CEO and Chief Medical Officer Johnathon Aho grew up in the shadow of the Mayo Clinic in Rochester, Minnesota, but it wasn't until he began studying engineering at Michigan Tech that he decided he wanted more in his life than writing code. So he pivoted to medicine, returned to Mayo, and in 2017 developed Capnospot, a visual detection device for treating collapsed lungs. We talk about why the usual therapy (listening for a gush of air from the chest cavity) fails as much as half the time, his 20 or so patents, Midwestern frugality, and why so much of a physician's life involves dealing with human goop. --- Send in a voice message: https://anchor.fm/successfully-funded/message