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3 episodes with mbbch
2 episodes with mbbch
2 episodes with mbbch
2 episodes with mbbch
2 episodes with mbbch
Gavin Giovannoni, MBBCh, PhD - Navigating and Pioneering High-Efficacy DMT Strategies: Optimizing Patient Outcomes in Multiple Sclerosis
Gavin Giovannoni, MBBCh, PhD - Navigating and Pioneering High-Efficacy DMT Strategies: Optimizing Patient Outcomes in Multiple Sclerosis
Gavin Giovannoni, MBBCh, PhD - Navigating and Pioneering High-Efficacy DMT Strategies: Optimizing Patient Outcomes in Multiple Sclerosis
Gavin Giovannoni, MBBCh, PhD - Navigating and Pioneering High-Efficacy DMT Strategies: Optimizing Patient Outcomes in Multiple Sclerosis
In this episode, Dr. Hany Demian, a pioneering medical doctor and CEO, known for his groundbreaking work in spine care and pain management, shares his journey from Cairo to Canada and the U.S., his innovative use of regenerative medicine and microscopic spine surgery, and his vision for improving patient care. He discusses the challenges and responsibilities of being a CEO in the medical field, his company BioSpine Institute's advancements in anti-aging treatments, and the importance of flexibility and discipline in leadership. This conversation is both inspiring and informative, offering valuable insights for C-suite leaders and medical professionals alike. Episode Highlights: 02:27 Dr. Demian's Journey and Career Insights 05:13 Innovations in Chronic Pain and Spine Care 08:29 Personal Stories and Impact of Treatments 19:56 Challenges and Responsibilities of a CEO Dr. Hany Demian, MD, MBBCH, CCFP, is a globally recognized leader in spine care, anti-aging, and healthcare innovation. As the Founder and CEO of Praesentia Healthcare, he has built a pioneering network of spine surgery centers and pain management clinics across the U.S. and Canada. In 2024, he also became CEO of BioSpine Institute, advancing micro-invasive spine surgery. Fluent in English, Arabic, and French, Dr. Demian blends medical expertise with business acumen, holding degrees from Ain Shams University and Harvard. Residing in Naples, Florida, he is dedicated to transforming patient care and redefining the future of healthcare worldwide. Connect with Dr. Demian:
Vaccinations play an important role in both our individual and community health. They help to prevent serious and sometimes deadly diseases by strengthening our immune system. But in recent years this cost effective method of disease prevention has come under the spot light, drawing attention to some myths and misconceptions. In this episode, Dr Anne von Gottberg dives into the importance of vaccinations, how to handle missed vaccines, vaccine dos and don'ts and recent changes in the Extended Programme onIimmunzation(EPI) in South Africa.About our Guest: Dr Anne von Gottberg is currently the laboratory lead at the Centre for Respiratory Diseases and Meningitis at the National Institute for Communicable Diseases, Johannesburg, South Africa; and Associate Professor within the School of Pathology, Faculty of the Health Sciences, University of the Witwatersrand, Johannesburg; and Honorary Professor, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town. She leads a laboratory team responsible for reference diagnostics for respiratory and meningitis pathogens nationally and regionally. The laboratory is the regional reference laboratory for the World Health Organization (WHO) Vaccine-preventable Invasive Bacterial Diseases (VP-IBD) Coordinated Global Surveillance Network for the southern African region; a National Influenza Centre (NIC); and a global WHO RSV and regional SARS-CoV-2 reference laboratory. She is currently a member of several committees and technical advisory groups for AFRO, Africa CDC and WHO. Her main interests include surveillance for meningitis and respiratory pathogens, assessing vaccine effectiveness where relevant. She has authored or co-authored more than 200 articles in peer-reviewed journals. In addition, she supervises a number of Masters and PhD students. Dr von Gottberg obtained her MBBCh and PhD at the University of the Witwatersrand, and trained for her specialisation in clinical microbiology (FC Path[SA] MICRO) at the National Health Laboratory Service (former South African Institute for Medical Research) and at the University of the Witwatersrand.WE'D LOVE YOUR FEEDBACK ON THIS EPISODE – Visit the Microbe Mail website to sign up for updates Follow on:Instagram: Microbe_MailX/Twitter: @microbemailFacebook: MicrobeMailTiktok: @microbe.mailWatch this episode on our new YouTube channel: Microbe MailE-mail us: mail.microbe@gmail.com
JACC Associate Editor Theresa McDonagh, MBBCH speaks with author Akshay S. Desai, MD, FACC about this paper on pulse pressure published in JACC and presented at AHA. In a pooled analysis of 16,950 patients with chronic HFmrEF or HFpEF enrolled from 4 global randomized clinical trials, a J-shaped relationship was observed between SBP and the risk of adverse CV events, with the lowest risk occurring at SBP values between 120 and 130 mmHg. A similar pattern was seen with PP, with the lowest risk found between 50 and 60 mmHg. Both higher SBP and higher PP independently predicted adverse CV events. Notably, PP remained a strong predictor of CV risk, independent of baseline SBP.
James Kim, MBBCh, PgDip, MScCH - Optimizing Glycemic Control With GLP-1 Receptor Agonists in Patients With Diabetes and Cardiovascular Risk: Translating the Evidence to Practice
Event Objectives:Compare rates of syphilis over time and between demographic factors and understand features associated with higher ratesReview specific missed opportunities for the prevention of congenital syphilisDescribe future directions to improve screening and treatment of syphilisClaim CME Credit Here!
Akshay S. Desai, MD, FACC presents his accepted HFSA presentation concerning the FINEARTS trial published in JACC, with commentary by Theresa McDonagh, MBBCH, JACC Associate Editor.
On this episode we talk with experts Dr. Amy Shapiro, Dr. Maria Elisa Mancuso, Dr. Steve Pipe, Dr. Johnny Mahlangu, and Dr. Lynn Malec to delve into the ongoing evolution of hemophilia therapies. The discussion highlights recent advancements in treatments such as emicizumab, extended half-life factor VIII therapies, and investigates medications in clinical trials like Concizumab, Marstacimab, and Fitusiran. The episode also reflects on the role of treatment individualization and the need for more inclusive research data. Contributors: Johnny Mahlangu, MBBCh, MMed, FCPath Lynn Malec, MD, MSc Elisa Mancuso, MD Steven Pipe, MD Amy Shapiro, MD Senior Advisor: Donna DiMichele, MD Hosted & Written by: Patrick James Lynch Featured Advertiser: Sanofi Subscribe to the Global Hemophilia Report Show Notes: Connect with the Global Hemophilia Report Global Hemophilia Report on LinkedIn Global Hemophilia Report on Twitter Global Hemophilia Report on Facebook Connect with BloodStream Media: BloodStreamMedia.com BloodStream on Facebook BloodStream on Twitter
Want to achieve peak health and feel young forever? Founder of Regeneration Man, Professor Paul Lee, PhD, MSc, MBBch, MRCS, MFSEM (UK), can teach you just how through his regenerative diagnostics approach in his book, Regeneration by Design. Go to https://regenman.com/ Regeneration Man City: Grantham Address: 41 Sandon Road Website: https://regenman.com/ Phone: +44 330 001 0048 Email: support@regenman.com
Send us a Text Message.Prof. Dr. Alan Widgerow, MBBCh, FCS, MMed, FACS, is Division Chief, Research, Center for Tissue Engineering ( https://sites.uci.edu/ctelab/team/ ) and Adjunct Professor Plastic Surgery, Dept of Plastic Surgery, University of California, Irvine ( https://faculty.uci.edu/profile/?facultyId=6048 ) and Chief Scientific Officer and Head of Skin Science Center of Innovation at Galderma ( https://www.galderma.com/ ).Prof. Widgerow is a plastic surgeon who ran a solo private practice in South Africa for over 20 years. Prof. Widgerow completed his undergraduate and post-graduate studies at the University of the Witwatersrand, South Africa. He has held various positions in numerous academic and professional associations including that of President of the Association of Plastic and Reconstructive surgery of Southern Africa (APRSSA). He is author of over 190 plastic surgical related publications and 2 books. He was also the founder and medical director of 13 wound clinics in South Africa. Prof. Widgerow relocated to Irvine California in Dec 2009 to pursue his interests in medical device innovations, cosmeceuticals and wound care, but he still plays an active role in academic medicine world-wide. In 2012 he was appointed to the Faculty of the University of California Irvine Plastic Surgery Dept as Full Adjunct Professor and Director of the Center for Tissue Engineering and in 2021 was appointed as its Division Chief of Research. He is involved in multiple projects related to adipose derived stem cell and adipose decellularized matrix, wound healing and transplantation. In 2018 he was awarded the Distinguished Faculty Mentor of the year Award by the Institute for Clinical and Translational Science, UCI. Prof. Widgerow has developed and licensed multiple products in the US and South African markets. In 2015 he joined ALASTIN Skincare, Inc. an early start up professional skin care company as their Chief Medical Officer. Over the past 6 years he has spearheaded the scientific innovations team introducing multiple new products based on novel wound healing pathways. The resulting products have been validated with gene expression, in vitro and ex-vivo testing, biopsies, and multiple clinical trials resulting in a range of products that have surpassed previous scientific validations in this space. He continues to pursue patented novel concepts, peptide technologies and vigorous testing thus contributing to Alastin Skincare's position as the fastest growing professional skin care company in the US for the past 4 years. In 2021, Alastin Skincare was acquired by Galderma, the largest privately owned dermatology company in the world, and in June 2022, Prof. Widgerow was appointed Chief Scientific Officer of Galderma, Head of the Skin Science Center for Innovation and Head of Alastin innovations. He is involved in aesthetic, prescription and consumer product science research and development.#AlanWidgerow #CenterForTissueEngineering #PlasticSurgery #UniversityOfCalifornia #Irvine #ChiefScientificOfficer #SkinScience #Galderma #Dermatology #ExtracellularMatrix #StemCells #Exosomes #ECM #Aging #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #ViralPodcast #STEM #Innovation #Technology #Science #ResearchSupport the Show.
In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Eoin P. Flanagan, MBBCh, FAAN who served as the guest editor of the Continuum® August 2024 Autoimmune Neurology issue. They provide a preview of the issue, which publishes on August 1, 2024. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Flanagan is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Additional Resources Continuum website: ContinuumJournal.com Subscribe to Continuum: shop.lww.com/Continuum More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @EoinFlanagan14 Transcript Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal have access to exclusive audio content not featured on the podcast. If you're not already a subscriber, we encourage you to become one. For more information, please visit the link in the show notes. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Eoin Flanagan, who recently served as Continuum's guest editor for our latest issue on autoimmune neurology. Dr Flanagan is a neurologist at Mayo Clinic in Rochester, Minnesota, where he's a professor of neurology. Eoin, why don't you introduce yourself to our listeners? Dr Flanagan: Yeah, it's a great pleasure to be here today. I'm a neurologist. I'm originally from Ireland – I did my medical school training over there, and then came over to the Mayo Clinic to train in neurology and in neuroimmunology. And delighted to be able to edit this exciting issue of autoimmune neurology of Continuum. I think, um, it's a really fascinating area that's moving very quickly, and I'm hoping that we can educate listeners to be able to feel comfortable when they come to see these patients and to realize how much of a growing specialty it is and how we're getting treatments, and we can really help these patients. Dr Jones: Yeah, it's a pretty exciting area. And, so, not only are you the Guest Editor for our latest issue of Continuum, this is the first-ever Continuum issue dedicated to autoimmune neurology, so I want to thank you for taking it on. This is something that our readers have been asking for for many years. I hope the topic wasn't too daunting. Dr Flanagan: No, absolutely, it's a pleasure to be able to do it, and it's just great when you read all the articles to kind of feel where the field is going and how much of a benefit we can now make for our patients. So, that's been a real joy to do. Dr Jones: Well, congratulations, and it's a magnificent issue. You have a lot to be proud of putting this group of authors together. So, for a few of our issues now, we've had the opportunity on the Continuum Audio podcast to interview the Guest Editor, which is really fun for me. I have to confess it's really a joy to talk to someone who is up to the minute not only in their narrow area of expertise at the article level, but, really, across the entire breadth of the subspecialty. And so, you've had an opportunity to delve into all relevant topics in autoimmune neurology. When you look at the issue as a whole, or the field as a whole, what do you think the biggest debate or controversy in the world of autoimmune neurology is right now? Dr Flanagan: Yeah, I think there's some changes happening. You know, initially, people used to recognize a disease called Hashimoto's encephalitis, where patients would have a presentation of encephalitis in the setting of thyroid antibodies. And what we're now realizing is that many of these patients actually have antibodies to neural-specific targets, because we know that the antibodies that target the thyroid don't really impact the brain. And what we're now realizing is that there's many antibodies out there that bind to different receptors in the brain (the NMDA receptor, for example, AMPA receptor), so we're really trying to refine the field towards these different antibody-associated disorders - and each different disorder may behave very differently. A patient with NMDA receptor encephalitis, for example, may be in the ICU, in hospital, may take them six, nine months to recover. On the other hand, a patient with LGI1-antibody encephalitis may get five days of steroids and be almost back to normal within a few weeks. So, it's a really broad spectrum. And, I think, what we're now learning is that each antibody has a role in helping define the disease, guide your treatment, guide your search for cancer - but, also, they behave differently - so these neural-specific antibodies are really important, while the older antibodies (like the thyroid antibodies) may just be a bystander and something that's happening in the background in a patient who's more prone to autoimmune disease. Dr Jones: Very helpful, and I think that resonates with our listeners who have taken care of patients with autoimmune neurologic disorders, and it really is, I think, a great prototype in our specialty, maybe (for lack of a better word) of how observations start at the bedside, and then discoveries are made at the bench, and those benefits are brought back to patients. You know, there's been a recognition of autoimmunity in neurology for a long time, right - responsiveness to immunosuppression, even before the biomarkers were discovered - tell us a little story about how that works for our listeners. Dr Flanagan: Yeah, so, I think one of the first steps is defining a clinical syndrome. So what you'll find is that some of these syndromes (for example, neuromyelitis optica spectrum disorder, where they have longitudinally extensive lesions within a spinal cord) provoked people to be interested that these looked different to MS, and then that went to the lab, and the aquaporin-4 antibodies were discovered - or, more recently, MOG antibodies were discovered. The aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder is a good prototype, because that went to the laboratory. Initially, they saw complement deposition on the pathology of these patients, they saw antibody deposition - the antibody was then discovered to aquaporin-4. And then, many labs around the world went to their own labs and they tried to delve in to determine what the pathogenesis was, and they found that complement was important in cell killing, that interleukin-6 elevation was important, and that complement appeared to be important. So, then, what they did was they tried to find treatments that would target those pathways. So, and now, we have treatments that are successful for this disease that can target complement, target interleukin-6, and target B cells (be it CD19 or CD20). So, we now have many different treatments, and this disease used to be very severe (so, had a 33% mortality at five years), and now these patients can live a long life with these treatments. So, I think that gives you an example of how you can follow the immunology of the disease and use targeted treatments to help our patients, and I think we can use that as a good prototype for many of the other antibodies, because every year we discover two to three new antibodies, and each disease is a bit different in its mechanism. So, there are now clinical trials in NMDA receptor encephalitis starting up. There's clinical trials in MOG antibody-associated disease. And I think we're going to see that as we move forward, that these treatment trials will come and we'll be able to help our patients better with proven treatments that we know work, rather than a history of we would just use five days of steroids and then we didn't know exactly what to do in the long term - and we could manage some of the relapse as well, but we couldn't really take care of the disease in the background - so, I think the NMO is a good model for moving forward, and the pharmaceutical companies are supporting moving forward with different trials for the disease. Dr Jones: So, a key message there is understanding the biology so we can be a little more targeted and less indiscriminate in the immunomodulation we're going to use. And we have parallels to that in the neuromuscular world, right, like using B-cell depletion for MuSK-associated neuromuscular junction disorders, as opposed to the trial-and-error approach, right? That's got to be a little more patient-centric and you get to a therapeutic response faster, right? Dr Flanagan: I think so. Yeah, and I think, in the future, that might be something where, you know, a different patient, if they had elevated cytokines that pointed more to an IL-6 elevation, then maybe, in that patient, you would target IL-6, while the next patient with the same disease has more prominent complement activation, maybe you would target complement, or another patient has more prominent B-cell markers elevated, that you would target B cells. So, I think, we're really moving towards a more individualized treatment in some of these disorders. So, it's a very exciting time, but we've only really made that breakthrough in one of the antibodies, and we have probably sixty, seventy antibody-mediated disorders now. So, it's going to get complicated, but it's also going to be, really, an exciting time for our patients, and I think an exciting time for neurology trainees and people who see patients in practice that we can now make diagnoses and guide their treatment that, previously, you know, these patients were told they might have presumed infectious encephalitis or we didn't know the exact cause. Dr Jones: So targeted not only to the diagnosis, but to the individual. Dr Flanagan: Yeah. Dr Jones: So, that's a level of complexity that I think is going to blow a lot of our minds, right? And it's exciting, but I think it also is a little daunting, right? Dr Flanagan: Absolutely. Yeah. Yeah, it's going to be complicated, and these are rare diseases, so they're difficult to do clinical trials in. But I think we can be guided, and our experience tells us that if you follow the mechanisms, that you can find targeted treatments. Now, you can also find targeted treatments in MS - you know, it took us a longer time to find successful high-efficacy treatments, but now we're doing much better with many high-efficacy treatments available. But, I think in these autoantibody-mediated diseases, really looking at the mechanisms and trying to figure out that and then targeting the treatment in that direction makes the most sense and is the most likely to be successful. Dr Jones: So, one of the purposes of Continuum is to educate our readers and our listeners, and because neurology is so broad, because it is evolving so quickly, it's really hard to stay current. And so, again, that's part of the purpose of the journal. I think one of the challenging areas is autoimmune neurology, because it changes fast, and it's complicated, and the treatments are high stakes and complicated to administer - so, I think this is an important topic. I know from my own experience in clinical practice, one of the challenging scenarios is you see a patient who may have an autoimmune neurological disorder, you obtain some serum or CSF markers of neurologic autoimmunity, right? And of the ten antibodies you check, one of them comes back, and it's a low titer-positive antibody. I know that's something that you get a lot of questions about. How do you approach that? Dr Flanagan: Yeah, I think, you know, we're all neurologists, and, you know, it's immediately back to the history, the examination, and the investigations, and what do they support - so, are you really dealing with an antibody-mediated disorder? And I think, from a neuroimmunology laboratory standpoint, we're always trying to get better tests, remove those less-specific tests (so, move away from the thyroid peroxidase antibodies) and really hone in on the exact targets and their mechanisms. So, I suppose, when you find a low-positive result, it's really important to go back to that clinical. And, I think, you know, that is job security for neurologists, right? Because you really have to interpret these in context. And, I think when you're seeing autoimmune cases, you need to have a good, broad understanding of differential diagnosis, because there are many different disorders that can present in a similar way, and you don't want to get distracted by that low-positive antibody and then put a patient on long-term immunosuppression that has many different risks. So, there is a potential for misdiagnosis, and I think that's an emerging area that we're recognizing that we always have to put the antibodies into clinical context. And, you know, there are more and more studies coming out that will help guide you, and I think the issue in Continuum will help guide you in terms of your understanding of, you know, what does a positive antibody mean? And it'll give a little bit on the methodology of how the antibodies are tested and how that can help you – or, sometimes, be it the titer may be very high that can help you. So, different aspects of the antibody test results can also help guide you in the likelihood of that being kind of a true positive versus a false positive. But I think always back to the history, exam, and the investigations, too. Dr Jones: You're being very gracious there, and I'm glad you bring it up that it's really not just about the laboratory performance of the test, right? It's about the pretest probability of the clinical syndrome if it doesn't clinically resemble an autoimmune neurological disorder. So, I'm not going to pretend to be an expert in Bayesian statistics, but I think we should recognize that if we obtain any test when there's a low likelihood of the syndrome or the diagnosis being present, we're more likely to have false positives than in other scenarios or other settings. So, I think that is a charge to the clinician, where if we are obtaining these tests, we do really need to think about the likelihood of there being a clinical autoimmune neurology syndrome, right? Dr Flanagan: That's exactly right. You know, one of the teachings that I sometimes give to the trainees is that, you know, if you have a ninety-year-old patient with mild cognitive impairment who comes into the emergency department with some worsened altered mental status, you know, you want to check for a urinary tract infection, you want to check a chest x-ray - you don't want to test neural antibodies upfront. So, you always have to consider the setting and avoid overtesting, because like any test, they're not perfect, and you can run into trouble if you order it too frequently - so, that's another thing that we try to educate people. And then if you do order the test, we like to educate people on, you know, what the positive test results mean, and is there any potential for false positives like we talked about? Dr Jones: And I think, keeping in mind - obviously, there are exceptions - but the subacute onset of multifocal neurological disorder is really suggestive of autoimmunity. It doesn't mean that it can't happen in other contexts. And it has been exciting not only on the diagnostic side, but on the therapeutic side. There are so many exciting new treatments. What do you think is on the horizon beyond what we've seen in the last few years with small- and large-molecule therapies for these disorders? Dr Flanagan: Yeah, I think there's new things. You know, people are always looking at different approaches. So, for example, there's a lot of interest in tolerance, and is there a way you could tolerize yourself out of some of these autoimmune conditions? There's a lot of work on CAR-T treatments, looking particularly in the field of lupus and other systemic autoimmune diseases, and I suspect that they will also be applied to autoimmune neurologic conditions. And then the other thing to mention is that we're seeing the more frequent use of immune checkpoint inhibitors in patients with lots of different types of cancers, including neuroendocrine tumor. So I think, in the future, everybody's going to have to learn about autoimmune neurology, because we're going to be seeing these patients more often, because there's going to be more neurologic immune-related adverse effects related to those immune checkpoint inhibitor treatments – so, I think we're going to continue to see autoimmune neurologic disorders pop up. And, you know, the immune checkpoint inhibitors are almost real-world laboratory experiments, because you're ramping up the immune system, and you can trigger many different types of autoimmune conditions. We're actually learning a lot from these patients that can help us in the way we diagnose and the way we treat these patients in the future, but I will say that, sometimes, they can cause a challenge, because some of these patients have difficult-to-control cancer - you need to up their immune system, but then they get autoimmune complications. We try and dampen down the immune system, and then we need to kind of ramp it back up to treat the cancer. And we've had some challenges where managing such cases can be difficult with that balance of cancer-directed immunotherapy versus immune-related adverse events, and, sometimes, that can pose a challenge for autoimmune neurologists when we see these patients. Dr Jones: So, those are challenges, and I imagine it's a challenging and often rewarding field. What is the most rewarding thing about caring for patients with autoimmune neurological disorders? Dr Flanagan: I think it's a few things. You know, one is that it's a multidisciplinary area, so many of these patients will have different subspecialties of neurology involved. So, we'll get to work with our colleagues, and we may work with our oncology colleagues, we work with our ophthalmologist, and we work with our physical medicine and rehab team – so, it's a real team approach to help the patient. So, that's one aspect that's very enjoyable, because everybody needs to work together. And then, you know, these are treatable conditions. So we can have patients who are in the intensive care unit - you know, quadriplegic, in a coma - and then we treat them, we see them back, and they can be back close to normal. So, particularly, with some of these antibodies that target the cell-surface receptors (like NMDA receptor encephalitis, MOG antibodies), these patients can really go from being really, really sick in the ICU to coming back to normal – so, that's very satisfying, and much of that is related to the improvements we have in treatments, and then we can manage them in the long term with some of these newer treatments that are coming along for these diseases. So, I think it's a very exciting area and exciting time for our patients with these disorders, and we're getting more and more clinical trials, so we're hoping that we'll have more and more treatments available into the future. Dr Jones: I think that has to be part of why the interest in autoimmune neurology has grown so much. I know as an educator - I hear this a lot from trainees - you know, the level of interest in MS and autoimmune neurology has really only grown over time. It must be because of better understanding of the pathobiology of disease, better treatment options, and something that our listeners may not know. Not only is Dr Flanagan an expert in autoimmune neurology - he's very well trained, he did fellowship in MS and autoimmune neurology, and behavioral neurology, right? Dr Flanagan: That's correct. Yeah. Yeah. Dr Jones: And, you know, it's going to sound like I'm trying to flatter Eoin here, but I'm really not (this is going to lead to a question). Eoin is, you know, very well recognized for his work in autoimmune neurology and discovery in this area. Uh, he happens to be one of the best doctors I know. And Eoin, you've won the Teacher of the Year Award several times. So, for our listeners who are looking into their careers and trying to manage multiple areas of interest, how do you do it? You do so many different things so well. Dr Flanagan: Well, you know, I'm lucky to have had the opportunity to work here at the Mayo Clinic and in the neuroimmunology lab. So, we have a lot of resources, and it's an exciting area, you know? We need to bring up the next generation of leaders, so we need to be enthusiastic about these conditions, and we really can do a lot for these patients. So I think when I cover on the hospital service - you work with the residents or work with the fellows and clinic - you know, these cases (when they come around) are really enjoyable to see you can get an answer, we can figure out what type of treatment to do, and we can really help these patients. So, I think that makes it a very exciting area and an easy area to teach residents and to convey some of the excitement that's happening in the field. So, it's just a great honor to be able to work with trainees to kind of let them know the field. And, you know, there's more and more fellowship opportunities in different centers in neuroimmunology, and I think more residents are becoming interested in the field of autoimmune neurology because of so much happening. But, in saying that, with these challenges, it's very hard to keep up with all these antibodies - I find it hard. There's 70 different antibodies - it's hard to know every single thing about every single one. So, we need to continue to educate, to try and simplify, to try and help our younger people be able to manage these patients, because no matter who it is in neurology, you're going to encounter these patients - if you cover the hospital, if you see regular patients in clinic, if you do consult service, you'll come across these patients - and we're going to see them more and more with immune checkpoint inhibitors and other treatments coming along. So, I think it's an exciting area, and it's an important area for everyone to be aware of. So, it's just a great pleasure to be able to be involved in the field and see such enthusiasm in junior people. Dr Jones: So, in addition to doing all those things well, you're also very humble. So, that's a great answer, and I think it is important - even though these are collectively rare - the opportunity to treat these patients and have wonderful outcomes is great, and I think the ability to recognize and feel comfortable. And, hopefully, Continuum has a place in that. I think your issue, Dr Flanagan, is a stellar issue and, uh, will be a benchmark for a generation of neurologists and how to approach these disorders. So, I want to thank you for being our Guest Editor for that topic and joining us today for such a thorough and fascinating discussion on autoimmune neurology. Dr Flanagan: Thanks so much. And thank you to the Continuum team for highlighting autoimmune neurology. It's an exciting field, and I think, really, there is a great group of authors that cover neuroimmunology comprehensively, and I think, hopefully, people will enjoy the edition. Dr Jones: Again, we've been speaking with Dr Eoin Flanagan, Guest Editor for Continuum's most recent issue on autoimmune neurology. Please check it out. And thank you to our listeners for joining today. Dr Monteith: This is doctor Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio.
In this episode of the AJR Podcast Series on Training and Education, Shaunagh McDermott, MBBCH, BAO, a radiology residency program director, joins host Monica Cheng, MD, to share insights into radiology residency education, recruitment, and ways to cultivate a culture of learning and growth.
Dr Heinrich Nolte graduated with an MBBCh from the University of the Witwatersrand. He received his. doctorate in Exercise Physiology from the University of Pretoria. In addition, Dr Nolte received an MA (HMS) specialising in Biokinetics (Cum Laude) and his BA (HMS) Honours, specialising in Biokinetics from the University of Pretoria. Afterwards, he completed postgraduate courses in Musculoskeletal Ultrasound, Advanced Cardiac Life Support and Advanced Clinical Care in HIV management, to name a few.Dr. Nolte is registered with the Health Professions Council of South Africa (HPCSA) as a Medical Practitioner and Biokineticist. He is a Honorary Researcher at the Movement Physiology Research Laboratory of the School of Physiology, Faculty of Health Sciences, University of the Witwatersrand and is a laboratory member of the Human Potential Translational Research Programme of the Yong Loo Lin School of Medicine at the National University of Singapore. Furthermore, Dr Nolte is a member of the American Physiological Society.Dr. Nolte is an international member of the American Academy of Physical Medicine and Rehabilitation (AAPM&R), a medical speciality organisation representing physicians who specialise in Physical Medicine and Rehabilitation. Dr Nolte has published numerous scientific research papers in international academic journals and presented papers at various international academic conferences.
Mamas Mamas, DPhil, MA, MBBCh and Joerg Herrmann, MD discuss the care of patients with ischemic heart disease and cancer.
Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice. In this episode, we spoke with a variety of specialists in neurology who presented research and gave talks at the 2024 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 29-June 2, in Nashville, Tennessee. Those included in this week's episode, in order of appearance, are: Anthony Feinstein, PhD, FRCPC, MBBCh, a professor of psychiatry at the University of Toronto. Brian G. Weinshenker, MD, a professor of neurology at the University of Virginia. Douglas A. Wajda, PhD, an assistant professor of neurology and member of the Health and Human Performance Department in the College of Education at Cleveland State University. Le Hua, MD, director of Clinical Operations and director of the Multiple Sclerosis Program at Cleveland Clinic's Lou Ruvo Center for Brain Health in Las Vegas, Nevada. Eion P. Flanagan, MB, BCh, a professor of neurology and chief of the Division of Multiple Sclerosis and Autoimmune Neurology at Mayo Clinic; and director of the Autoimmune Neurology Fellowship. Want more from the 2024 CMSC Annual Meeting? Click here for all of NeurologyLive®'s coverage of CMSC 2024. Episode Breakdown: 1:40 – Feinstein on the difficulties with improving fatigue in multiple sclerosis and the lack of improvement seen from approved disease-modifying therapies. 5:20 – Weinshenker on the key diagnostic aspects of neuromyelitis optica spectrum disorder and how it differs from other similarly presenting autoimmune disorders. 9:40 – Wajda on the use of the Cionic Neural Sleeve, the advantages it holds, and how it may be used to treat gait dysfunction in multiple sclerosis. 12:00 – Hua on the differential diagnosis of pediatric-onset MS vs late-onset MS, and the notable biologic changes observed. 19:30 – Flanagan on the diagnostic pearls for MOG-antibody associated disease and the importance of early recognition of this group. Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.
In this episode our guest, Rachel Umoren, MBBCh, MS, joins Kate Mulligan, PhD to discuss Virtual Simulation in Medical Education. General Resources:Virtual Simulation in Medical Education TranscriptSimulation and Game-Based Learning for the Health Professions by Rachel UmorenHealthcare Simulation DictionarySociety for Simulation in HealthcareVirtual prenatal counseling simulatorJMIR Medical Education - Increasing Realism and Variety of Virtual Patient Dialogues for Prenatal Counseling Education Through a Novel Application of ChatGPT: Exploratory Observational StudyJMIR Serious Games - Virtual Antenatal Encounter and Standardized Simulation Assessment (VANESSA): Pilot StudyVirtual simulations on newborn resuscitation and careVirtual Essential Newborn Care (2023, updated version) https://sites.uw.edu/virtualenc/Virtual simulations for neonatal education - PubMed (nih.gov)Electronic Helping Babies Breathe (2019)Doctor Creates Virtual Reality Simulation to Save Babies' Lives - On the Pulse (seattlechildrens.org)eHBB: a randomised controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource-scarce settings | BMJ OpenUsing Mobile Virtual Reality Simulation to Prepare for In-Person Helping Babies Breathe Training: Secondary Analysis of a Randomized Controlled Trial (the eHBB/mHBS Trial) - PMC (nih.gov)Virtual disaster evacuation simulatorEvacuation of Vulnerable and Critical Patients: Multimodal Simulation for Nurse-Led Patient Evacuation. - Abstract - Europe PMCEVAC: Evacuation of Vulnerable and Critical Pediatric Patients for Nurses - PubMed (nih.gov)EVAC Washington.eduVirtual team training simulations
Welcome to the first episode of season three of Conversations in Fetal Medicine, where we talk to Professor Asma Khalil. See below for her bio.We have not included any patient identifiable information, and this podcast is intended for professional education rather than patient information (although welcome anyone interested in the field to listen). Please get in touch with feedback or suggestions for future guests or topics: conversationsinfetalmed@gmail.com, or via Twitter (X) or Instagram via @fetalmedcast. Music by Crowander ('Acoustic romance') used under creative commons licence. Podcast created, hosted and edited by Dr Jane Currie. Biography of Prof. Khalil:Prof. Asma Khalil, MD,MBBCh, MRCOG, MSc(Epi), DFSRH, Dip(GUM)Professor of Fetal Medicine, St George's Hospital, University of LondonDirector of Fetal Medicine Unit, Liverpool Women's HospitalVice-President of Royal College of Obstetricians and GynaecologistsAsma Khalil is a Professor of Fetal Medicine. She is the Obstetric Lead at the National Maternity and Perinatal Audit (NMPA). She gained her MD at the University of London in 2008. She was elected as the Vice-President of the Royal College of Obstetricians and Gynaecologists.She set up the Laser service for fetal interventions at Liverpool Women's Hospital in 2011.Prof. Asma Khalil has published more than 400 peer-reviewed papers, and many published review articles and chapters. She was awarded many research prizes, both at national and international meetings. She was awarded the 2021 FIGO Women's Awards: Recognising Female Obstetricians and Gynaecologists. Her research interests include twin pregnancy, congenital infections, fetal growth restriction and hypertensive disorders in pregnancy.She had a fellowship with the National Institute of Health and Care Excellence (NICE). committed to the implementation of clinical guidelines in practice. She is the Lead author of the ISUOG guideline on the role of ultrasound in twins and congenital infections. She also led the guideline team developing the FIGO guideline on twin pregnancies. She was a member of the NICE Guideline Committee updating the Twin and Multiple Pregnancy guidance.
Host Dr. Nick van Terheyden aka Dr. Nick, discusses The Good, The Hype, and The Doctor's Perspective with Rob Brisk, MBBCh, PhD, Chief Scientific Officer at Eolas. Their discussion includes the intersection of AI and healthcare, exploring the potential of large language models like GPT-4 in revolutionizing healthcare, emphasizing the importance of clinicians' involvement in AI developments and responsible integration, the challenge of managing AI hype while building trust and educating both healthcare professionals and the public, & new and exciting possibilities and cautious considerations in the evolving world of AI in healthcare. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
host Denise BIllen-Mejia www.healandberadiant.com Guest Heba Ismail MBBCh/PhD www.medicine.iu.edu/faculty/43095/ismail-heba Dr. Heba Ismail is here again to chat about her slightly convoluted journey to the USA. She earned her MBBCh with honors from the Faculty of Medicine at Cairo University, in 1999 and completed her residency and pediatric endocrine training at Cairo University Children's Hospital. With a strong interest in research, she took a postdoctoral position In Washington State, which led to her resolve to practice in the US after she fulfilled her obligation in Eygpt After completing her US residency training at T.C. Thompson Children's Hospital in Chattanooga, TN, and her pediatric endocrine fellowship training at Seattle Children's Hospital, Heba became the Clinical Director of the Weight Management Program at Children's Hospital of Pittsburgh in 2014 and Clinical Director of the Diabetes Program there in 2016. In 2018, she joined the faculty at IU School of Medicine where she enjoys interacting with her patients, medical students and residents and continues her research into Type I diabetes She lives with her young son and daughter in Indianapolis Contact her through her blog EatYourGreenBananas.com or through LinkedIn If you are a healthcare professional yourself and find an episode relevant to your own work you will be able to apply for free CME credit (reciprocal CPD for non- US clinicians)here Not a medical professional? Of course, you are also welcome to subscribe and listen but please remember, while we are physicians, we are not YOUR physicians. Please consult with your own medical professional before acting on anything you hear on this, or any other, podcast. Please contact me at: office@aahypnosis.com with any comments or suggestions #endocrine #Indiana #Washington #Tennessee #USMLE # Post-doctoral #Giza #Cairo #pediatrics
The cure for multiple myeloma only happens with patient participation in research. In this episode, Faith Davies, MBBCh, MRCP, MD, FRCPath of the NYU Langone will share how research works in multiple myeloma, the various stages in clinical trials, the most critical steps that move curative therapies forward, how barriers to a cure can be removed and how patient participation is essential to the entire process. Thanks to our episode sponsor, GSK
The Doors are Open! Our FREE on-demand Vax Regret Solutions event is yours for the clicking. Do you know somebody dealing with COVID vax regret or side-effects? Could somebody you know be looking for answers but find themselves lost? Receive hope and healing from some of the most trusted names in healthcare in the world. Featuring: Dr. Peter McCullough, MD, MPH; Dr. Peter Breggin, MD; Dr. Pierre Kory, MD, MPA; Dr. Tess Lawrie, MBBCh, PhD; Dr. Heather Gessling, MD; Dr. Salome Masghati, MD, FACOG; Dr. Ryan Cole, MD; Dr. Leland Stillman, MD; Dr. Jeff Barke, MD; and Jessica Sutta (The Pussycat Dolls) and Brianne Dressen (REACT19) ************************************** Learn more at https://www.hopeisfuel.com/ If you enjoy this show please consider supporting it here: www.patrickcoffin.media/donate. We are 100% listener supported. Join the waiting list for our upcoming program Coffin nation here: www.coffinnation.com Follow Patrick on Facebook: www.facebook.com/patrickcoffin.media ************************************** Tucker Carlson is very good at what he does, which is engage guests and topics on his prime time-slotted Fox News show Tucker Carlson Tonight. With aplomb and wit—which is hard when your guest is an angry eedjit,as the Irish say—he gets down to brass tacks on whatever the topic is. His brand new book is titled Ship of Fools: How a Selfish Ruling Class Is Bringing America to the Brink of Revolution. And he means it. His thesis: you can have egalitarianism AND oligarchy. One of the has got to go. Yet the book, like its creator, is often hilarious in its own way. In this episode you will learn: Who the major players are—the “fools” of the title—and why they're included Why elites and oligarchs come in all religions, or none, and all skin colors A brief history of how American culture shifted toward Krazy in the last few years How the 2016 election of Donald Trump was a sign of electoral unhappiness that got worse over decades How liberals sell fake science, climate change (denying contrary evidence) and why abortion is the untouchable sacrament of the Left Some reasons to keep a sense of humor! Resources recommended in this episode: Ship of Fools: How a Selfish Ruling Class Is Bringing America to the Brink of Revolution by Tucker Carlson
Johnny Mahlangu, MBBCH, MMed, FCPath - Redefining Balance in Hemophilia: Can We Restore Hemostasis by Inhibiting Anticoagulation?
Johnny Mahlangu, MBBCH, MMed, FCPath - Redefining Balance in Hemophilia: Can We Restore Hemostasis by Inhibiting Anticoagulation?
Johnny Mahlangu, MBBCH, MMed, FCPath - Redefining Balance in Hemophilia: Can We Restore Hemostasis by Inhibiting Anticoagulation?
Johnny Mahlangu, MBBCH, MMed, FCPath - Redefining Balance in Hemophilia: Can We Restore Hemostasis by Inhibiting Anticoagulation?
Personalizing care goals to account for a patient's values, preferences, or circumstances can make a significant difference in share decision-making and treatment planning. In this episode, CANCER BUZZ speaks with Melissa Kah Poh Loh, MBBCh, BAO, assistant professor of Geriatric Hematology and Oncology at the University of Rochester Medical Center's Wilmot Cancer Institute about strategies to optimize critical conversations with patients with acute myeloid leukemia. “For older adults with acute myeloid leukemia, the treatment landscape has changed in the last few years…and their [patients'] preferences and goals really make a difference in what we ultimately choose together with patients and family members…incorporating this as part of the conversation is very important.” – Melissa Kah Poh Loh, MBBCh, BAO Melissa Kah Poh Loh, MBBCh, BAO Assistant Professor of Geriatric Hematology and Oncology University of Rochester Medical Center, Wilmot Cancer Institute Rochester, NY This is the second episode of a four-part series developed in connection with the ACCC education program Achieving and Maintaining Better Outcomes for Patients with Acute Myeloid Leukemia. This episode was made possible with support by Bristol Myers-Squibb. Additional Reading/Sources Strategies to Addressing Disparities in Patients with AML · Shared Decision-making in Acute Myeloid Leukemia · Talking about Acute Myeloid Leukemia (Cancer Support Community) · Shared Decision-making: Practical Implementation for the Oncology Team (ACCC)
Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice. In this episode, we spoke with a variety of specialists in neurology who presented research and gave talks at 4 recent major medical meetings—the Consortium of MS Centers Annual Meeting, the Annual Joint SLEEP Meeting, the Advanced Therapeutics in Movement and Related Disorders Congress, and the American Headache Society's Annual Scientific Meeting. Those included in this week's episode, in order of appearance, are: Amit Bar-Or, MD, FRCPC, FAAN, FANA, the Melissa and Paul Anderson President's Distinguished Professor at the Perelman School of Medicine of the University of Pennsylvania. Gavin Giovannoni, MBBCh, PhD, FCP, FRCP, FRCPath, a professor of neurology at Barts and The London School of Medicine and Dentistry. Dayna Johnson, PhD, MPH, MSW, MS, a sleep epidemiologist and assistant professor at the Rollins School of Public Health at Emory University. John Winkelman, MD, PhD, the chief of the Sleep Disorders Clinical Research Program at Massachusetts General Hospital. Laxman Bahroo, DO, a professor of neurology and the residency program director at MedStar Georgetown University Hospital. Ling Wan-Albert, OTD, OTR/L, an assistant professor of occupational therapy at the New York Institute of Technology. Sara Pavitt, MD, the chief of headache at UT Austin Dell Children's Hospital. Ali Ezzati, MD, the director of the Neuroinformatics Program at the University of California, Irvine. Want more from all of NeurologyLive's coverage of these medical meetings—including dozens more interviews with expert clinicians—click the links below: Consortium of Multiple Sclerosis Centers Annual Meeting SLEEP, the Joint American Academy of Sleep Medicine and the Sleep Research Society Meeting Advanced Therapeutics in Movement and Related Disorders Congress American Headache Society Annual Scientific Meeting Episode Breakdown: 1:15 – Bar-Or on the potential of BTK inhibition in multiple sclerosis at CMSC 2023 4:40 – Giovannoni on the understanding of MS as a smoldering disease at CMSC 2023 10:30 – Johnson on multilevel efforts to address modifiable factors of sleep health at SLEEP 2023 13:05 – Winkelman on moving away from dopamine agonists as first-line treatments for restless legs syndrome at SLEEP 2023 15:30 – Bahroo on the role of botulinumtoxins in Parkinson disease care at ATMRD 2023 19:00 – Wan-Albert on the impact of social isolation on cognition at ATMRD 2023 22:10 – Pavitt on the universal knowledge about pediatric headache for neurologists and nonspecialists at AHS 2023 24:05 – Ezzati on the use of machine learning models to improve treatment optimization in heterogenous migraine at AHS 2023 This episode is brought to you by Medical World News, a streaming channel from MJH Life Sciences®. Check out new content and shows every day, only at medicalworldnews.com. Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.
Jenni is joined by Medical Doctor, Nutritionist and Women's Health Advocate - Dr Hazel Wallace, aka The Food Medic.Hazel is also a Personal Trainer, Author, Blogger and Podcaster who has an incredible following on Social Media @thefoodmedic - giving her followers the important advice they need about being their healthiest and happiest selves whilst cutting through the confusing information we find online.Today's episode is an incredible one - packed with nutrition and health advice to make you a better and more informed runner!www.thefoodmedic.comLooking to buy a RunPod tshirt? Go here: Linktr.ee/runpod
Have you ever played the game "Would you Rather?" - listen to this episode to hear a microbial take on this fun game. And more importantly - is there even a correct answer at all? About our Guests: Dr Lauren Richards: I am a specialist physician with a sub-specialty in infectious diseases. I currently work at Helen Joseph Hospital in Johannesburg in the internal medicine and infectious diseases departments. I obtained my MBBCh and MMED at Wits University. I love my job and am still finding my ID niche. I think ID is the most exciting, interesting and surprising specialty out there!Follow Lauren on Twitter: @lolrichardsDr Nokukhanya Khaniyle- Lenaka : a registrar in paediatrics at the University of the Witwatersrand, Khanya is also a social media influencer with > 150 000 followers on instagram. She is a keynote speaker, promoting physical and mental well-being . Khanya was nominated as one of the "100 most influential Young South Africans" in the Science and Technology category in 2019. You can find her at: Social media: @dr_khanyileTik Tok: @dr_khanyile_ Visit the Microbe Mail website to sign up for updates E-mail: mail.microbe@gmail.comTwitter: @microbemailInstagram: Microbe_Mail
El International Liaison Committee on Resuscitation (ILCOR) es el organismo internacional que evalúa la ciencia disponible y emite recomendaciones sobre la resucitación de pacientes en paro cardiaco. Los integrantes de ILCOR representan los diferentes concilios de resucitación en el mundo. Los concilios emiten sus propias guías, basadas en las recomendaciones de ILCOR. La revisión anual de la ciencia no es una revisión de todos los temas, sino solamente de aquellas preguntas clínicas que necesitan revisión y/o hay alguna evidencia nueva que justifique un cambio en la recomendación, o simplemente un cambio en el nivel de la recomendación. A veces un tema se vuelve a verificar cuando es prudente incluir los resultados de algún estudio importante reciente. Los estudios no tienen que sugerir un cambio para ser importantes. Usted puede (y debe) leer el documento completo aquí. El documento completo explica el análisis detrás de las recomendaciones y los estudios que fueron considerados en la discusión. Dependiendo de los hallazgos, los diferentes concilios (ej. la American Heart Association) pueden entonces emitir actualizaciones a sus respectivas guías de acuerdo con las recomendaciones de ILCOR. Tratamiento en escena versus RCP durante transporte Sugerimos que los proveedores realicen la resucitación en la escena en vez de realizar el transporte mientras se resucita, a menos que haya una indicación apropiada para justificar el transporte (ej. oxigenación a través de membrana extracorpórea). (Recomendación débil, evidencia de muy baja certeza). Aumento en riesgo de lesiones para los rescatadores. Ahogamiento Las ventilaciones son importantes. Público general: comiencen con compresiones. Profesionales de la salud: comiencen con ventilaciones. Comenzar con las compresiones primero NO supone un retraso significativo. Temperatura pos-paro cardiaco Sugerimos activamente prevenir la fiebre mediante establecer una meta de temperatura igual o menor a 37.5 grados centígrados para pacientes comatosos luego del retorno de circulación espontánea. (Recomendación débil, baja certeza de evidencia) Se sugiere estandarizar la nomenclatura para evitar usar un término que esté vinculado directamente con un protocolo en específico (TTM/MET): Control de temperatura con hipotermia: control activo de temperatura con una meta de temperatura por debajo del parámetro normal. Control de temperatura con normotermia: control activo de temperatura con una meta de temperatura en el rango normal. Control de temperatura con prevención de fiebre: monitoreo de la temperatura y activamente prevenir y tratar la temperatura que esté por encima del rango normal. Ningún control de temperatura: ninguna estrategia de control activo de la temperatura. Sonografía durante el paro cardiaco Sugerimos en contra del uso rutinario de sonografía (POCUS) durante la RCP para diagnosticar causas reversibles del paro cardiaco (recomendación débil, nivel de evidencia muy bajo). Sugerimos que, si la sonografía puede ser realizada por personal experimentado sin interrumpir la RCP, pueda ser considerada como una herramienta diagnóstica adicional cuando hay sospecha clínica presente para una causa reversible (recomendación débil, nivel de evidencia muy bajo). Cualquier uso de sonografía diagnóstica durante RCP debe ser cuidadosamente considerada y sopesada ante el riesgo de interrumpir las compresiones torácicas y malinterpretar los hallazgos sonográficos (declaración de mejores prácticas). En un estudio del 2017, el uso de sonografía durante el paro cardiaco estaba asociado a interrupciones de 21 segundos en promedio. DEA en los niños e infantes. No significa que no se usen. Hay pocos estudios que documentan que un DEA se haya colocado y/o descargado en niños. Los diferentes concilios pueden tomar decisiones sobre sus respectivas guías. Posición de recuperación Colocar al paciente en posición de recuperación. La posición de recuperación no debe afectar la habilidad de verificar la vía aérea, respiración y circulación. Si se dificulta evaluar al paciente, es mejor colocarlo en posición supina. Referencias 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces Myra H. Wyckoff, MD, Robert Greif, MD, MME, Peter T. Morley, MBBS, Kee-Chong Ng, MBBS, Mmed(Peds), Theresa M. Olasveengen, MD, PhD, Eunice M. Singletary, MD, Jasmeet Soar, MA, MB, BChir, Adam Cheng, MD, Ian R. Drennan, ACP, PhD, Helen G. Liley, MBChB, Barnaby R. Scholefield, MBBS, MRCPCH, PhD, Michael A. Smyth, BSc(Hons), MSc, PhD, Michelle Welsford, MD, BSc, David A. Zideman, LVO, QHP(C), MBBS, Jason Acworth, MBBS, FRACP(PEM), Richard Aickin, MBChB, Lars W. Andersen, MD, MPH, PhD, DMSc, Diane Atkins, MD, David C. Berry, PhD, MHA, Farhan Bhanji, MD, MSc(Ed), Joost Bierens, MD, PhD, MCDM, MCPM, Vere Borra, PhD, Bernd W. Böttiger, MD, ML, DEAA, Richard N. Bradley, MD, Janet E. Bray, RN, PhD, Jan Breckwoldt, MD, MME, Clifton W. Callaway, MD, PhD, Jestin N. Carlson, MD, MS, Pascal Cassan, MD, Maaret Castrén, MD, PhD, Wei-Tien Chang, MD, PhD, Nathan P. Charlton, MD, Sung Phil Chung, MD, PhD, Julie Considine, RN, PhD, Daniela T. Costa-Nobre, MD, MHS, PhD, Keith Couper, RN, PhD, Thomaz Bittencourt Couto, MD, PhD, Katie N. Dainty, MSc, PhD, Peter G. Davis, MBBS, MD, Maria Fernanda de Almeida, MD, PhD, Allan R. de Caen, MD, Charles D. Deakin, MA, MD, Therese Djärv, MD, PhD, Michael W. Donnino, MD, Matthew J. Douma, PhD(c), MN, RN, Jonathan P. Duff, MD, Cody L. Dunne, MD, Kathryn Eastwood, PhD, BParamedicStud, BNurse, Walid El-Naggar, MD, Jorge G. Fabres, MD, MSPH, Joe Fawke, MBChB, Judith Finn, PhD, RN, Elizabeth E. Foglia, MD, MA, MSCE, Fredrik Folke, MD, PhD, Elaine Gilfoyle, MD, MMEd, Craig A. Goolsby, MD, MEd, Asger Granfeldt, MD, PhD, DMSc, Anne-Marie Guerguerian, MD, PhD, Ruth Guinsburg, MD, PhD, Karen G. Hirsch, MD, Mathias J. Holmberg, MD, MPH, PhD, Shigeharu Hosono, MD, PhD, Ming-Ju Hsieh, MD, MSc, PhD, Cindy H. Hsu, MD, PhD, Takanari Ikeyama, MD, Tetsuya Isayama, MD, MSc, PhD, Nicholas J. Johnson, MD, Vishal S. Kapadia, MD, MSCS, Mandira Daripa Kawakami, MD, PhD, Han-Suk Kim, MD, PhD, Monica Kleinman, MD, David A. Kloeck, MBBCh, FCPaed, Crit Care (SA), Peter J. Kudenchuk, MD, Anthony T. Lagina, MD, Kasper G. Lauridsen, MD, PhD, Eric J. Lavonas, MD, MS, Henry C. Lee, MD, MS, Yiqun (Jeffrey) Lin, MD, MHSc, PhD, Andrew S. Lockey, MBChB, PhD, Ian K. Maconochie, MBBS, LMSSA, PhD, R. John Madar, MBBS, Carolina Malta Hansen, MD, PhD, Siobhan Masterson, PhD, Tasuku Matsuyama, MD, PhD, Christopher J.D. McKinlay, MBChB, PhD, DipProfEthics, Daniel Meyran, MD, Patrick Morgan, MBChB, DipIMC, RCSEd, Laurie J. Morrison, MD, MSc, Vinay Nadkarni, MD, Firdose L. Nakwa, MBBCh, MMed (Paeds), Kevin J. Nation, NZRN, Ziad Nehme, , PhD, Michael Nemeth, MA, Robert W. Neumar, MD, PhD, Tonia Nicholson, MBBS, BScPsych, Nikolaos Nikolaou, MD, Chika Nishiyama, RN, DrPH, Tatsuya Norii, MD, Gabrielle A. Nuthall, MBChB, Brian J. O'Neill, MD, Yong-Kwang Gene Ong, MBBS, MRCPCH, Aaron M. Orkin, MD, MSc, PHH, PhD, Edison F. Paiva, MD, PhD, Michael J. Parr, MBBS, Catherine Patocka, MDCM, MHPE, Jeffrey L. Pellegrino, PhD, MPH, Gavin D. Perkins, MBChB, MMEd, MD, Jeffrey M. Perlman, MBChB, Yacov Rabi, MD, Amelia G. Reis, MD, PhD, Joshua C. Reynolds, MD, MS, Giuseppe Ristagno, MD, PhD, Antonio Rodriguez-Nunez, MD, PhD, Charles C. Roehr, MD, PhD, Mario Rüdiger, MD, PhD, Tetsuya Sakamoto, MD, PhD, Claudio Sandroni, MD, Taylor L. Sawyer, DO, Med, Steve M. Schexnayder, MD, Georg M. Schmölzer, MD, PhD, Sebastian Schnaubelt, MD, Federico Semeraro, MD, Markus B. Skrifvars, MD, PhD, Christopher M. Smith, MD, MSc, Takahiro Sugiura, MD, PhD, Janice A. Tijssen, MD, MSc, Daniele Trevisanuto, MD, Patrick Van de Voorde, MD, PhD, Tzong-Luen Wang, MD, PhD, JM, Gary M. Weiner, MD, Jonathan P. Wyllie, MBChB, Chih-Wei Yang, MD, PhD, Joyce Yeung, PhD, MBChB, Jerry P. Nolan, MBChB, Katherine M. Berg, MD In't Veld, M. A. H., Allison, M. G., Bostick, D. S., Fisher, K. R., Goloubeva, O. G., Witting, M. D., & Winters, M. E. (2017). Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions. Resuscitation, 119, 95-98.
To shed light on the differences in oncologic care between the US and the EU, Chadi invites a returning guest as well as a newcomer: Jarushka Naidoo, MBBCH, MD, Chair of the Thoracic Oncology Division, Beaumont RCSI Cancer Centre (Dublin, Ireland), and Marina Chiara Garassino, MD, Professor of Medicine, University of Chicago Medicine. The trio discuss discrepancies in diagnostics and pathology, how tissue samples are handled at molecular laboratories, treatment (oral and intravenous) and biopsy availability due to regulatory approvals, palliative care and hospice, academic and industry clinical trials and funding, and physician lifestyle and expectations. Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA
AO Trauma North America Internet Live Series: Orthopaedic Trauma Journal Club
Session ModeratorsModeratorJason Strelzow, MD, FRCSCModeratorBrianna Fram, MD, BAModeratorAdrian Huang, MBBCh, FRCS(C)ModeratorDavid Stockton, MD, MASc, FRCSC FEATURED AUTHORS AND ARTICLES Rami Alrabaa, MD - Trends in Surgical Treatment of Proximal Humeral Fractures and Analysis of Postoperative Complications Over a Decade in 384,158 PatientsHerman Johal, MD, MPH, FRCSC - Reverse Total Shoulder Arthroplasty Is the Most Cost-effective Treatment Strategy for Proximal Humerus Fractures in Older AdultsPatrick Curtin, MD, BS - Morbidity and Mortality of Fragility Proximal Humerus Fractures: A Retrospective Cohort Study of Patients Presenting to a Level One Trauma Center UPCOMING AO TRAUMA NORTH AMERICA EVENTS December 20, 2022AO Trauma NA Online Series— Journal Club
Listen to ASCO's Journal of Clinical Oncology essay, “Guilt and Gratitude,” by Dr. Ilana Hellmann, attending physician at Meir Medical Center in Israel. The essay is followed by an interview with Hellmann and host Dr. Lidia Schapira. Hellmann explores the guilt surrounding the toxic consequences of chemotherapy and her gratitude for the patients who continue to connect with their physicians, even after treatment. The interview starts at 06:15 TRANSCRIPT Narrator: Guilt and Gratitude, by Ilana Hellmann, MBBCh (10.1200/JCO.22.02000) It was the end of a long day in clinic. There was a knock on the door to my office and my assistant's head appeared: “Avi called and asked for an appointment.” The look on her face mirrored the thought that immediately went through my mind: That cannot be good. I asked her to fit him in to one of my clinics in the next few days. I had first met Avi about 5 years previously. He was then a 29-year-old computer programmer and recently married to Talia, an artist. He was tall, skinny and stressed. She was short, stout and happy, an eternal optimist. They had no children. He had had an irritating cough, then developed night sweats and by the time he was diagnosed, he had advanced stage Hodgkin lymphoma: stage IVB with all the poor prognostic factors on the list. He needed treatment quickly. We planned to give him the escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone protocol-nasty stuff, with lots of side effects, but with good results. I explained it all to Avi and Talia. Aside from all the usual suspects: hair loss, nausea, pulmonary and cardiac toxicity, bone marrow suppression, and secondary malignancies, there are high rates of infertility, especially in males. We sent Avi to collect sperm samples before starting treatment, and despite numerous valiant efforts, his samples were all of poor quality. There was nothing there that could be used in the future. His treatment course was not easy. The side effects were, from my point of view, mild. He had no life-threatening infections and no admissions because of side effects. But for Avi, it was awful. He described feeling like being run over by a truck. He stopped working, and things were strained between Avi and Talia. She found it very difficult to deal with his constantly long face, and he could not stand her persistent optimism. At one point, I remember a conversation close to the end of his treatment. I said something about how we were nearly there, to which he replied, “I started this treatment when I was young and now I am old.” He finished his chemotherapy and thankfully went into complete remission. I breathed a sigh of relief and smiled at Talia, both she and I thinking that now Avi would recover. Months went by and physically, Avi recovered. He went back to work and started exercising again. Then as the months turned into a year and then another year, testing revealed what was initially feared. Avi was infertile. The conversations in my office between Avi and Talia were tense and painful. Talia wanted to use a sperm donor. She wanted a child of her own and the experience of pregnancy and birth. Avi felt that he could not be father to a child that was biologically hers but not his. He wanted to adopt. Neither one of them was prepared to compromise and despite the interventions of a wonderful psychologist and then also a marriage counselor, it was a downward spiral. Then, Avi missed a follow-up appointment and stopped coming all together. It had been a good 2 years since I had last seen Avi when the assistant knocked on my door. The next morning I saw Avi in the waiting room. The woman next to him was not Talia but his mother. I concluded the obvious: divorce. The thought that now he was in relapse (why else would he need an appointment with me?) and would have to go through salvage therapy without her was paralyzing. I called him in to my office. He looked great! He greeted me with a big smile and a hug. We went through his medical history. I examined him and looked at his laboratory results. Everything looked perfect. Avi was relaxed and chatty, asking me about my work and my kids. I was going quietly crazy waiting for the punchline. I took a deep breath and asked him: “How's Talia?” He smiled and pulled out his cellphone. He showed me picture after picture of a beautiful 3 month old baby girl. “This is Lia,” he said. “I thought you deserved to know.” The tears sprang to my eyes. “How?” I asked. He explained that he had eventually acquiesced to Talia's pleas. She became pregnant with sperm from a donor. He said that the pregnancy for him was nothing short of terrifying, but that as soon as Lia was born, it was obvious to him that she was his. I was overwhelmed with emotion. I realized that I had been suppressing a tremendous feeling of guilt around what had happened to Avi (and Talia). The feeling of guilt was not foreign to me. I had experienced guilt around the death of a patient or around mistakes, real or perceived, that I had made. Avi, however, was cured of his disease, and I had done nothing wrong. This was an altogether different kind of guilt: one less spoken of and less obvious. The knowledge that we as physicians are able to cure patients from cancer is humbling. The fact that we cure them but leave them with life-long and life-changing side effects is devastating. I do not know how much Avi understood what he had done for me by coming in that day. During that visit, he was treating me and not the other way round, and the healing effect was enormous. I possibly overdid it in my reaction to Avi in my office that day. But as he got up to leave and I thanked him for taking the time to share his news, I think he knew. In the years since, I have learned to ask patients to call me when they are unwell, but to please remember to also call or text me when they are feeling better. There are many who have taken this very seriously, and those messages are often a tremendous source of inspiration and reassurance, especially on difficult days. To Avi and to all my other patients who take the time to call to say they are feeling better or to share some piece of good news, who are able to see the person in their physician, and understand my need, I thank you. Dr. Lidia Schapira: Hello, and welcome to JCO's Cancer Stories: The Art of Oncology, brought to you by ASCO Podcasts, which covers a range of educational and scientific content and offers enriching insight into the world of cancer care. You'll find all ASCO shows, including this one, at: podcasts.asco.org. I'm your host, Lidia Schapira, Associate Editor for Art of Oncology, and Professor of Medicine at Stanford University. Today, we're joined by Dr. Ilana Hellmann, Attending Physician in the Hematology Department at Meir Medical Center, affiliated to the Tel Aviv University Medical School, in Israel. In this episode, we will be discussing her Art of Oncology article, 'Guilt and Gratitude'. At the time of this recording, our guest has no disclosures. Ilana, welcome to our podcast and thank you for joining us. Dr. Ilana Hellmann: Thank you for inviting me, I'm delighted to be here. Dr. Lidia Schapira: It is our pleasure. Ilana, I'd love to start the show by asking you if you can recommend to our listeners any recent story or book that has moved or inspired you. Dr. Ilana Hellmann: So, I read to escape, I don't read medical books, I don't watch medical programs. And I heard someone recently recommend, on one of your podcasts, a book by Anthony Doerr, called, All the Light We Cannot See, which I absolutely love - it's one of the most beautiful books I've read in the last two or three years. And I've just finished his next book which took him years to finish, it's a 600-page beautiful book called, Cloud Cuckoo Land, it has an interesting name. Have you read it? Dr. Lidia Schapira: I have not read that one. Dr. Ilana Hellmann: It's a wonderful book, and if you read the last one, it's no less inspiring with lots of different characters over different time periods, and they're all connected to each other by a story, by a fairytale, and it's a beautiful book. I enjoyed it tremendously. Dr. Lidia Schapira: Oh, thank you for that. I have a book for my next trip now. Dr. Ilana Hellmann: Wonderful. Dr. Lidia Schapira: Let's talk a little bit about writing in Medicine, and writing, as a way of sharing our stories with our colleagues and our trainees. What was the motivation for you to write this piece? It seemed to me, when I first read it, that it took years to put it together. But what was the driver for sending it out to the world? Dr. Ilana Hellmann: It's quite a strange story. In fact, what happened, happened a large number of years ago - the baby is 10 today. I wrote it just after she was born. It was a long, long time ago, when I saw the patient and I was overwhelmed by what happened, and I sat down and wrote something and put it in a folder on my computer, and forgot about it. What then happened, as you say, that it took years and years to finish, is that I got a call from the computer tech people in the hospital who said, "We're coming to give you a new computer, and if you don't clean up all these things on your desktop, they're going to get lost." And I found this folder that I'd forgotten about completely, and I read it and wasn't finished. You know, I hadn't thought about it in all those years. The end part about what it had done to me over the years, and the things that have changed in my practice because of what happened came later. I think we, as doctors, not just oncologists, doctors in general - we see bunches of people during the day, and one goes out, the next one comes in, and another goes out. You know, you don't have time during the day to process what you're feeling, and you just have to get past it and go to the next patient. I find that occasionally, at the end of the day, I think, "Wow, I have to write this down." And the truth is that I've just about never shared anything of the things I've written. I work a lot with students, and we encourage students to write narratives, reflective diaries; you know, I thought, "Wow, it's kind of hypocritical of me to tell them what a wonderful thing it is to do and not share something like this with somebody else." And that's how it happened that I shared this particular piece. Dr. Lidia Schapira: So, before we go into what I think is the essence of the piece, tell us a little bit about what it's been like for you to share your writing with your students now. Have they had a chance to comment and react to this piece? Dr. Ilana Hellmann: My students haven't seen it yet. My colleagues, our residents, have all seen it, and it's been quite amazing. It's a side of us that we speak of less. There are things that are left behind closed doors, and it's been wonderful. I think people who've read it have then come to me privately and said, "Wow, that's an amazing story, and I'm so glad you shared it with me. And that's an amazing outlook, what you thought about it." So, it's been quite something. My students have been on holiday the last two months, we're just starting again with all of them, and I'll share it with them once it's published. Dr. Lidia Schapira: I think they'll appreciate it. But let's talk a little bit about this, and you just said there's so much that happens when we close the door. I don't want to trivialize the message in your essay and say that it's just about self-care, because I think it's about much more than that. So, let's talk a little bit about what it felt like to you to be on the receiving end of this gratitude. Patients often express that they are so grateful for what we've given them through our treatment, and, you know, an extension in life, or an improvement in symptoms, but it's rarer for us to really have and feel that compassion emanating from a patient, and it feels so good. Take us there. Tell us a little bit about what it felt like. Dr. Ilana Hellmann: Absolutely. I completely agree with your sentiment. As I wrote, I had no idea what was going to happen when he walks through the door. I expected something completely different. When he pulled out his cell phone and there were these pictures, it was just overwhelming. I couldn't stop the emotion; it was just amazing. And I knew that he'd come for me, literally. He'd come to say to me, "It's okay, I'm fine. I've gotten on with life, everything is good." I hadn't seen him in two years. He then disappeared, and I didn't see him again until he needed a letter for something, or other. And I've actually seen him again, I saw him two weeks ago because of this essay. And after that happened, I thought, "Wow." As you say, it's not just self-care, it's way deeper than that. And in a way, we are trained to look after our patients. The patient is the one with the disease. We need to think about what the patient is feeling, we need to make sure they don't have too many side effects and long-term stick to what we give them. And we are not trained to look after ourselves, or certainly, to ask our patients to consider what we feel, or whether what they're going through has any effect on us. But as I wrote, in the years since, I had a patient recently with lymphoma, and she was very, very unwell in the beginning, a young lady, she dreamed about going for a walk on the beach. And over the first few months that she was treated, she was very unwell and she could barely walk, and I said to her, you know, she kept saying to me, "I'm going to get to that beach. I'm going to get to that beach." And I said to her, "You know, when you get to that beach, it would be so wonderful if you could let me know." And when she got to the beach, she sent me a WhatsApp-- all she sent me was a picture of the waves rolling onto the beach. As you say, I was so grateful for her sharing that with me. And I think, and maybe this is the bottom line, that exposing that side of us to our patients makes us more human. You know, we're not just the people who hold their hand and give them their chemotherapy, and hopefully, help them get past whatever it is that they're ill with, but we are people. People like it. When I give patients my email or my phone number, I say to them, "You know, when you are not well, or whatever you need, let me know. But if you're feeling better, I'd love to hear that too." And I've never, ever had anybody dislike that. Most of them say, "That's wonderful. Absolutely, I'll let you know." And then, as I wrote, they take it very, very seriously, and it's such a wonderful thing. You know, in amongst the 20 emails of, "I've got terrible nausea, and I'm constipated, and another lump has appeared in my neck, I need a letter for some insurance," and so on, and so on, then to, "I just wanted to let you know that I'm really doing okay." Or, "Whatever you gave me, it feels better." And again, really, I think it just gives the patients a bit of a look into the human side of their physician. Dr. Lidia Schapira: And it definitely feels so healing I think for us. I was struck by your account when you talked about the fact that people walk in and out of your office, and you're constantly prepared for emergencies. Basically, our clinical time is often responding to all of the challenges and the problems that patients bring to us, because we deal with people who are so ill and it's very stressful, so, it almost seemed to me that you were surprised when what happened in that encounter was just meant to be a gift to you - an expression of gratitude, and that seems to have had a huge emotional impact. And as you were talking, I wondered, do you and your colleagues share these stories? The stories, the photos of your patient getting to the beach, and the messages of gratitude that often come months or years later? Dr. Ilana Hellmann: We do, we do. You know, as the years have gone by, technology has changed. There used to be that board in the doctor's room, where a patient would have written a letter, and would get pinned on the board - those days have gone. Today, patients, some of them write letters, and then people take a photograph, and we have a WhatsApp group, or an email-- I'm sure there was one like that, yesterday, from one of my other colleagues, who got a beautiful letter from a patient. Absolutely, absolutely. In the same way that when there's bad news about a patient that everybody knows, it's shared, when there are good things about when patients thank us, or if they're just better, you remember there was so and so who was really doing unwell. Well, you know, things are looking better. Definitely, definitely, we share, for sure. Dr. Lidia Schapira: So, how do you think this experience affected or changed your practice and how you treat in future patients? Dr. Ilana Hellmann: When I called Avi, the patient in the essay, and I hadn't spoken to him for many years-- he disappeared from follow-up, and it happens - young patient, he had better things to do than come and see his hematologist. When I called him, immediately, he recognized my voice when I said, "Hello", and he was very happy to hear from me. And when he heard why, and I sent him the piece, he was overwhelmed with the effect that it had on me. Immediately, we made a date, and he came in for an appointment, and we chatted about it. He had a lot to say about the essay. He was very, very stunned, in fact, by the accuracy, from his point of view, of how I had described him and his wife, and what they'd gone through, and what had happened, and he wanted to know if things have improved. You know, back when he was ill, it wasn't so easy to find a psychologist for him. It wasn't something that was-- now, we have two psychologists who work with us, and things are a lot better. But his biggest question to me was, he said, "You know, I never thought about your side. It never occurred to me that what was happening to me was affecting you." He said, "You know, are you counseled? Does somebody look after you?" That's a difficult question. It's not such a comfortable question. I don't what you would answer to that one. But certainly, not officially. There's definitely no special time to work through-- you know, things come up when we have meetings, but it's not as if I have sessions to say, "Oh, I had a bad day, and this is what happened, and so and so, and whatever," but I share more with my patients. They're sad, I say, "Yes. It makes me sad too." I used to think maybe it made me weaker, or it was unfair to the patient to show them my emotion, and I've learned that I think it's absolutely fine, to a certain limit, to show them that I'm human, and I'm with them, and that's okay. And as I say, I'd ask them specifically to share good things with me, and not just bad things. And it's something that I tell my residents and students, I say, "Even people who are unwell have good moments, and we need to encourage them, and also enjoy them ourselves." Dr. Lidia Schapira: I think we could talk for hours, and I sincerely hope that the listeners will talk with their colleagues - so, with somebody else about these same issues. I think it's a fabulous conversation. I'm not trying to evade answering your question of what I would've said, or what I would say; I had an almost transformative moment many years ago when I was a young oncologist, and a patient who was incredibly kind and tuned into me, who had metastatic cancer, saw my expression when I walked in the exam room, and she said, "You're having a bad day." And just that moment of empathic connection, when she recognized that I was under stress, I clearly showed it, was enormous for me. And I felt such deep compassion from her and was able to then turn this into a self-compassion moment, and then I sort of reset myself, and we had a good visit. But since then, I've been much more aware of the fact that our patients do also pick up some of these feelings. And when there's a good connection, their presence can be, and feel, very healing for us as well. And the answer to the question of, "Do we have psychologists? Do we need therapists?" I think is one that we as a collective group, or as a tribe, should often ask ourselves. What do we need? How do we vent? How do we unload? How do we share, and how do we get that social support that we need to do this difficult, stressful work, in the same way that we think about the mental health and well-being of our patients, as you so beautifully pointed out? So, I thank you very much. I think that as the Editor, and the readers who first looked at your essay, we were very moved by this sentiment that you have about the deep connection we feel, and how much we wish our patients well, and how grateful we are when they tell us that they are well. So, I wanted to give you an opportunity to finish the podcast with a thought or reflection. Dr. Ilana Hellmann: I think we don't reflect enough. Today, we teach students to think reflectively - "I saw something, it meant something to me. What does it do with me?" But it's not something I was taught, or it's certainly not the regular kind of discussion that happens, and that I think writing things down is so therapeutic - you think about something, you write it down, you read it again, you come back to it, as this happened to me, years later. It's a beautiful process. I would recommend to people to just try - when something happens, to just sit down with a piece of paper-- well, nobody sits with a piece of paper, in front of a computer and write it down. Dr. Lidia Schapira: Even if we don't have an IT person coming to give us an ultimatum, they're going to clear everything on our desktop by tomorrow. Dr. Ilana Hellmann: Right. Absolutely. Dr. Lidia Schapira: Until next time, thank you for listening to JCO's Cancer Stories. And thank you, Ilana, for a wonderful show today. Dr. Ilana Hellmann: Thank you. Dr. Lidia Schapira: Don't forget to give us a rating or review wherever you listen. Be sure to subscribe, so you never miss an episode. JCO's Cancer Stories: The Art of Oncology, is just one of ASCO's many podcasts. You can find all of the shows at: podcasts.asco.org. 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. Show Notes Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio Dr. Ilana Hellmann is an Attending Physician in the Hematology Department at Meir Medical Center, affiliated to the Tel Aviv University Medical School, in Israel.
Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice. In this episode, we spoke with Olwen C. Murphy, MBBCh, assistant professor of neurology, Johns Hopkins University; and Matthew R. Vogt, MD, PhD, assistant professor of pediatric infectious diseases, University of North Carolina at Chapel Hill. The pair spoke about the current clinical understanding of acute flaccid myelitis (AFM) and the existing treatment approach, as well as the current guidelines and the need to improve awareness ahead of the peak infection months in autumn. Click here for AFM resources: CDC – Acute Flaccid Myelitis SRNA – Acute Flaccid Myelitis Episode Breakdown: 1:15 – Background on AFM from the neurology perspective 3:50 – Background on AFM from the infectious disease perspective 6:10 – Ongoing work and research into AFM cases 9:15 – The evolution of the clinical care of patients with AFM 13:00 – The diagnostic approach and guidelines for AFM 16:05 – Neurology News Minute 19:00 – State of care and treatment approaches 21:45 – The importance of recognition of AFM 26:50 – Testing and differential diagnosis of AFM 32:30 – Message for the clinical community around awareness This episode is brought to you by the Medical World News streaming service. Check out new content and shows every day, only at medicalworldnews.com The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: Significant Correlations Identified Between Mental Health and Migraine FDA Issues Second CRL for Pimavanserin, Now for the Treatment of Alzheimer Disease Psychosis ICER Releases Report Comparing Cost-Effectiveness of ALS Agents Oral Edaravone and AMX0035 FDA Extends Review of Omaveloxolone in Friedreich Ataxia Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.
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One of the more innovative pain care models to debut recently involves a multidisciplinary team of acute and chronic pain specialists working together to reduce opioid utilization after surgery and improve patient satisfaction. How does the model work and what are lessons learned from scaling a perioperative pain clinic? In this episode of the Pain Matters Podcast, host Dr. Shravani Durbhakula, MD, MPH, MBA, sits down with Associate Professor and Director of the Perioperative Pain Program at Johns Hopkins School of Medicine, Dr. Marie N. Hanna, MD, MEHP, MBBCh to discuss how she innovated, launched and scaled a personalized perioperative pain clinic. Results of this model, one of the first in the U.S., have been overwhelmingly positive with reduced hospital stays and readmissions, reduced opioid usage, and improved patient satisfaction. Tune in to discover: How the personalized perioperative pain clinic at Johns Hopkins was started Why well-coordinated care and tapering protocols can reduce opioid usage in the short- and long-term for patients Ways to assemble a multidisciplinary team featuring acute and chronic pain specialistsHow the transition from acute post-surgical pain to chronic post-surgical pain is handled The importance of educating patients on pain treatment (and what it can do for your results)Success rates and resource utilization expectations using this treatment model
Talking points include: What is the immune system and why is it important? Infection and mitochondrial disease Immune function in mitochondrial disease About The Speaker: Dr. Peter McGuire Dr. Peter McGuire received his MBBCh (with Honours) from the Royal College of Surgeons in Ireland in 2003. Following a combined residency in Pediatrics and Medical Genetics at Mount Sinai Medical Center in New York City, he remained as an Assistant Professor in the Program for Inherited Metabolic Diseases at Mount Sinai. Dr. McGuire is board certified in Pediatrics, Clinical Genetics and Biochemical Genetics. In 2010, Dr. McGuire moved to the National Human Genome Research Institute (NHGRI) at the National Institutes of Health to join the Physician Scientist Development Program. He was appointed to the position of tenure track Investigator in 2016. Throughout his career, Dr. McGuire has been focused on improving the care of patients with disorders of mitochondrial metabolism. By combining his training in Immunology and Biochemical Genetics, he has fashioned a translational research program to understand the interplay between mitochondrial metabolism and the immune system. As Head of the Metabolism, Infection and Immunity Section (MINIS) at NHGRI, Dr. McGuire and his team study the interplay between metabolism and the immune system in patients with inborn errors of mitochondrial metabolism. The group focuses on two aspects of immunometabolism: 1) Immune system activation and end-organ mitochondrial metabolism The focus of the group's research on immune system activation and end-organ metabolism is based on the clinical observation that infection is a major cause of morbidity and mortality in patients with mitochondrial disease. The MINIS uses animal models, combined with infectious organisms, to yield insights into the metabolic perturbations seen in disorders of mitochondrial metabolism during infection and to identify potential targets for intervention. 2) Role of mitochondria in immune cell function The group also studies mitochondrial metabolism and immune cell function. Immune cells drastically alter their metabolic programming during activation and differentiation. The deficiencies present in patients with mitochondrial disease may affect these processes. The group developed a clinical protocol in the National Institutes of Health (NIH) Clinical Center, called the NIH MINI Study: Metabolism, Infection and Immunity in Inborn Errors of Metabolism (NIH Clinica
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SHR # 2863:: Sodium Restriction In Heart Failure? - Justin A. Ezekowitz, MBBCh, MSc - For years physicians have ordered their patients to restrict sodium for a variety of reasons. High blood pressure, cardiac function and heart failure are a few. The theory is that sodium attracts water and that fluid retention increases the blood volume thus increasing pressure in the heart and blood vessels. A recent study may show why this isn't working.
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Fellows' and Residents' Audio Corner Learn from an expert! This is for residents, fellows, students and anyone wanting a quick review of how to manage a neuroanesthesia case. February 2017 Intubation of the Patient With Unstable Cervical Spine. Mazen Maktabi, MBBCh in conversation with Brad Hindman, MD
In this episode, Dr. Peter Kotanko, MD FASN, Research Director from Renal Research Institute is joined by Drs. Valerie Luyckx, MBBCh, MSc, PhD from Children's Hospital in Zurich, Switzerland & Marcello Tonelli, MD, SM, FRCPC from the University of Calgary, as they discuss the intersection between kidney medicine and the United Nations Sustainable Development Goals.
In this episode, I interview Tess Lawrie about Iver Mixin', public health corruption, and C-word juices. Tess is a medical doctor with expertise in research analysis and has served as an external consultant for groups at Cochrane and the World Health Organization. She holds an MBBCh and PhD. She is the Director of the Evidence-based Medicine Consultancy Ltd, and CEO of EbMCsquared CiC, an independent, a not for profit, health-focused think tank, based in Bath, in the United Kingdom. She is also the founder of the British Ivermectin Recommendation Development initiative (now called BiRD International) and a co-founder of the new World Council for Health. If you haven't yet heard of it, The World Council for Health is a coalition of more than 80 international health advocacy organisations in more than 30 countries. Important Links The World Council for Health at https://worldcouncilforhealth.org/ Her research on pubmed: https://pubmed.ncbi.nlm.nih.gov/?term=lawrie-ta In the interview, we talk about updates to her meta-analysis: https://pubmed.ncbi.nlm.nih.gov/34469921/ And Andrew Hill's: https://pubmed.ncbi.nlm.nih.gov/34410284/ Timestamps 01:15 Tess's Bio 04:33 The interview begins 05:27 How she went from Ob/Gyn to research analysis, serving as a consultant for Cochrane and the WHO 08:54 How she got involved in the "horse drug" 14:43 Political and financial obstruction of ivermectin research 23:37 Why her meta-analysis and Andrew Hill's came to radically different conclusions 31:11 Why focusing exclusively on randomized controlled trials is nonsense 35:32 Public health manipulating preferences instead of acknowledging and serving them 37:05 Mortality in "horse drug" studies versus juice studies 40:34 How regulatory agencies are failing to represent us 45:32 The course of the viral illness 47:03 What she did when she had the C-word 52:06 What she does for prevention 55:42 "Horse drug" as a prophylactic? 1:01:25 Her take on the C-word juices 01:07:21 Interpreting the adverse efffect data: Underreported or overreported? Causal? 01:17:05 Rapid fire questions: HCQ, juice mandates, liability shields, masks, lockdowns 01:20:51 Introducing the World Council for Health During this critical time where our freedom of health and freedom of speech is in imminent danger, and where tens of thousands of people are facing imminent job losses as the result of medical mandates, I am devoting my analytical skills full time toward the battle for health freedom. This includes working directly with lawyers in lawsuits over mandates, lockdowns, and the current standard of care, scientifically analyzing the safety, efficacy, and risks of mandated medical treatments and their alternatives as well as ways to mitigate their harms, publishing my findings in scientific journals and sharing them with you. It is my firm conviction that this is the most important gift I can offer the world right now, and I view this as a needed public service. I would be extremely grateful if you could support me during this time. At https://chrismasterjohnphd.com/support, you can purchase one of my information products in amounts ranging from $3 to $30, or take advantage of my consulting services for more. You can also make a purchase using one of my affiliate links to buy something you would have bought anyway at no extra cost to you. Finally, at https://chrismasterjohnphd.com/donate, you can make a donation in any amount. In a world increasingly dominated by censorship, we may have censored certain words in this video in order to protect the show and keep our community connected. For the uncensored version, please see the link in the description. For uncensored material in general, head to chrismasterjohnphd.com/uncensored. To make sure we stay together as a community, please join my newsletter at chrismasterjohnphd.com/newsletter, where I can guarantee that I'll never deplatform myself. This interview was recorded during a Live Zoom recording, where members of the CMJ Masterpass sat in and submitted comments and questions in the live chat. If you would like to sit in on future interviews I conduct with the chance to contribute questions, sign up for the Masterpass at https://chrismasterjohnphd.com/masterpass and use the code INTERVIEW for 10% off the membership fee for as long as you remain a member. Don't forget to like, share, and subscribe as well. Thank you for your support!
AO Trauma North America Internet Live Series: Orthopaedic Trauma Journal Club
This Month's Selected Articles and Authors • Results of linked convertible total elbow arthroplasty for the management of distal humeral fractures in the elderly Jason Strelzow, BSc, MD, FRCSC • Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus Jesse Jupiter, MD, MA • Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique Shawn O'Driscoll, MD • Operative management of intra-articular fractures of the distal humerus M. Bradford Henley, MD Session Moderators • Adrian Huang, MBBCh, FRCS(C) Ortho • William Pannell, MD • Luke Harmer, MD, MPH, FRCSC • John Morellato, MBBS(Hons), FRCSC
Dr. Riaz Motara is doing things a little differently. Not only is Dr. Motara a cardiologist with 20 plus years experience, he founded the first woman's heart clinic in Africa and is the only functional medicine trained cardiologist in South Africa who focuses on cardiac-endocrinology. But six years ago Dr. Motara was faced with a problem – his waiting list for patients was too long and his time too limited. So he founded KardioFit, which is already Africa's largest digital health company, with the purpose of connecting the patient and medical professionals using technology that will create improved outcomes. The focus of KardioFit is on prevention and screening to catch any potential issues before they manifest into dis-ease by harnessing the powers of prediction and precision. Dr. Riaz Motara has a MBBCH and FCP (SA) from Wits Medical School. Join us as we explore:How nearly wanting to quit medicine changed Dr. Motara's life.The pitfalls of modern medicine vs the vision of functional medicine.How Dr. Motara approaches new patients as a functional cardiologist.The three pillars of diseaseThe number one cause of disease – it's not COVID, but COVID is making it worseWhy you should eat like your grandparentsWhy feeling guilty about what you eat is detrimentalThe interconnectedness of hormones, muscle mass and ageingWhy what you think about cholesterol is wrongThe history of heart rate variability and why it mattersAlcohol and CBD The power of working with a health coach – spoiler it's HUGEContactWebsite: https://www.brandmedgroup.com
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
The ATLANTIS trial will change the way antithrombotic treatments are chosen after successful transcatheter aortic valve implantation. In this interview, Roxana Mehran, MD, FACC; Jean-Philippe Collet, MD; and Zaid I. Almarzooq, MBBCh, discuss anti-xa oral anticoagulation after valve implantation for aortic stenosis. For 20+ insider interviews like these every month with CME/MOC credit, subscribe to ACCEL at www.ACC.org/ACCEL.
Dr. Dalia Moawad, MD, Executive Director & Disease Area Lead for Neurological Rare Diseases at Genentech discusses the three things her team learned during the pandemic from the launching of Evrysdi (risdiplam) the first at-home oral medicine for adults and children two months of age and older with spinal muscular atrophy (SMA). Dalia Moawad, M.D. Executive Director, Head of Neurological Rare Diseases, Medical Affairs. Dalia oversees the neurological rare disease portfolio for Genentech. At Genentech she has lead a portfolio of 10 established products, including most recently for the Evrysdi and the launch of the first influenza antiviral to come to market in 18 years. Between 2011 and 2014, she held several positions in early development and global clinical research with Bristol Myers Squibb and FivePrime Therapeutics. She spent 3 years at UCSF Gastroenterology Division focused on hepatology research before joining Genentech in 2006 with the anti-CD20 programs in immunology, first in late stage clinical development then medical affairs. Dalia holds an MBBCh from School of Medicine, Ain Shams University in Cairo. #Neuroscience #Evrysdi
In this episode, some of the world's leading intensivists from low-and middle-income countries discuss the special challenges that they have faced on the COVID-19 front lines, talk about what their countries are doing to combat the disease, and explore the impact of COVID-19 on their flu season as they are emerging from winter into spring. (Originally recorded November 5, 2020) Moderators: Steven Q. Simpson, MD, FCCP, and Alice Gallo De Moraes, MD. Panelists: Sai Praveen Haranath, MBBS, MPH, FCCP; Flavia Machado, MD; and Mervyn Mer, MBBCh, PhD, FCCP. For more tools to help in the fight against COVID-19, visit CHEST's COVID-19 Resource Center at chestnet.org/COVID19. **This program was made possible by an independent grant from Boehringer Ingelheim Pharmaceuticals, Inc., who provided financial support for the program.**
In this special first episode we will be talking with Dr. Liron Pantanowitz, from the University of Michigan about where digital pathology has been over the course of the past 20 years, seminal developments and advances in whole slide image and image analysis. We will discuss why it is taking so long for the full scale adoption of digital pathology in the clinical setting. In addition, we will examine the parallels and differences between the specialties of pathology and radiology, the benefits of switching to a fully digitized system, and what are the practical considerations of going digital. We will also touch on regulatory concerns, the current state of AI applications, recent acceleration during the COVID-19 pandemic and how Dr. Pantanowitz sees the field evolving over the next 10 years and beyond.
"Giving Feedback to Trainees," by Celeste Quan, MBBCh, DA, FCA, Senior Specialist, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa; and Ki Jinn Chin, MBBS, MMed, FRCPC, Associate Professor, Department of Anesthesia, Toronto Western Hospital, University of Toronto, Ontario, Canada. From ASRA News, November 2019, pp. 37-39. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.
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