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Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives
Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives! In this special episode, shot live at the American Diabetes Association (ADA) Scientific Sessions 2026 in Ner Orleans, Louisiana, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, are joined by Amit Gupta, MBBS, DNB, diabetologist, executive director of the Global Metabolic Health Alliance, and chair of the International Diabetes Federation (IDF) Education Committee, to discuss the state of diabetes care and treatment in India compared to the US.To begin the episode, Gupta introduces the mission of the IDF, highlighting its role as a worldwide federation of scientific societies and patient organizations focused on improving diabetes education, policy, advocacy, and access to care. The conversation explores how diabetes management differs across regions, emphasizing that while the underlying disease mechanisms and available therapies may be similar, access to medications, technologies, healthcare infrastructure, and education varies significantly between countries.Gupta discusses the impact of semaglutide becoming available as a generic therapy in India following patent expiration, describing how reduced costs have improved access to a medication previously limited by affordability barriers. The group considers how increased availability of GLP-1 receptor agonists may transform diabetes and obesity management, while also emphasizing that pharmacologic therapies alone cannot address the global metabolic health crisis. Gupta notes the importance of maintaining focus on long-term lifestyle changes, including nutrition, physical activity, and sustainable weight management, as essential components of comprehensive care.The discussion then shifts to diabetes education and the need for more individualized, patient-centered approaches. Gupta highlights that education must be adapted to regional and cultural contexts, explaining that the challenges faced by a person with diabetes in the United States, Africa, India, or other parts of the world may differ substantially, even though diabetes distress and the burden of daily decision-making are shared experiences. He emphasizes that access to technology, such as continuous glucose monitoring, does not eliminate the need for education and support.Isaacs, Bellini, and Gupta also address the growing challenge of misinformation online and the role of healthcare professionals in helping patients navigate unreliable sources of health information. Gupta explains that clinicians must approach misinformation constructively by providing evidence-based guidance rather than simply dismissing patients' beliefs, reinforcing the importance of translating scientific evidence into practical recommendations that patients can incorporate into their daily lives.The group further examines disparities in the availability of diabetes educators worldwide. Gupta notes that while some regions have established professional pathways for diabetes care and education specialists, many areas lack standardized training, recognition, or policy support to sustain these roles. He stresses that building effective diabetes education systems requires collaboration with policymakers to demonstrate the long-term benefits of structured education programs.The episode concludes with Gupta discussing his work developing a global consensus framework on lifestyle as the foundation of metabolic health. The conversation reinforces that advances in medications and technology must be paired with equitable access, effective education, and sustainable lifestyle interventions to reduce the global burden of diabetes and improve outcomes for people living with metabolic conditions.Editors' Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others. Gupta reports disclosures with Lilly, Abbott Diabetes, and the International Diabetes Federation.
Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives
Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!In this special episode recorded live at the American Diabetes Association (ADA) Scientific Sessions 2026 in New Orleans, Louisiana, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, welcome Trang Ly, PhD, MBBS, senior vice president and Chief Medical Officer at Insulet, to discuss the continued evolution of automated insulin delivery (AID) technology and emerging developments across the Omnipod platform. To begin the episode, Ly first reviews updates to Omnipod 5, focusing on enhancements aimed at increasing time in automated mode and improving glucose management. She explains that user feedback identified opportunities to support lower glucose targets and reduce interruptions related to system alerts. Data from real-world evidence and computer simulations suggest that lowering the glucose target from 110 to 100 mg/dL may lead to meaningful improvements in time in range and time in tight range without increasing hypoglycemia risk.The group discusses early clinical experience with these enhancements, including findings from users who transitioned to the updated system. Ly highlights that even a highly engaged population already using lower targets experienced additional improvements, including a 2% increase in time in range and a 5% increase in time in tight range over a short period of use. The conversation emphasizes the importance of making these improvements broadly available rather than waiting for routine follow-up visits, particularly given the potential benefits without additional safety concerns.The discussion then turns to Omnipod 6, with Ly sharing newly presented clinical trial data evaluating the next-generation system. She describes the study design, which enrolled users already achieving strong glycemic control on Omnipod 5 and assessed whether further intensification through algorithm improvements could safely provide additional benefits. The results demonstrated a 4% improvement in time in range and up to a 7% increase in time in tight range, with particularly notable improvements among individuals with type 1 diabetes aged 14 years and older.Ly explains that Omnipod 6 builds on previous technology through changes to the core algorithm, allowing the system to deliver more insulin when users do not bolus consistently. The panel explores how this approach may reduce the burden of diabetes management by allowing the algorithm to take on more responsibility while maintaining glycemic control. They discuss the potential psychological benefits of reducing the daily demands placed on people with diabetes, especially as sensor accuracy and automation continue to improve.The conversation also highlights future opportunities for AID in type 2 diabetes. Ly shares early feasibility data from a fully closed-loop system designed specifically for individuals with type 2 diabetes, emphasizing its simplified approach without requiring traditional pump programming or meal bolusing. In this study, participants experienced improvements in time in range, demonstrating the potential for automated insulin delivery to reach broader populations.Isaacs and Bellini discuss the need to reconsider barriers to insulin pump adoption in type 2 diabetes and recognize AID as an accessible option for patients who may benefit. Ly emphasizes that technology should support people across different levels of engagement, offering both highly customizable systems for those seeking intensive management and simpler automated approaches for those looking to reduce daily treatment demands.The episode concludes with a discussion of the future of diabetes technology, including improved connectivity, expanded device flexibility, and continued integration with complementary therapies such as GLP-1 receptor agonists. Ly underscores that innovation should not only improve clinical outcomes but also reduce the burden of care, allowing people with diabetes to spend less time managing their condition and more time living their lives.Editors' Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others. Ly reports a disclosure with Insulet.References1: Insulet. Insulet Reveals New Data Supporting Breakthrough Omnipod 6 and Fully Closed-Loop AID Systems Designed to Improve Outcomes, Reduce Effort, and Unlock Barriers to Care. June 6, 2026. Accessed June 7, 2026. https://investors.insulet.com/news/news-details/2026/Insulet-Reveals-New-Data-Supporting-Breakthrough-Omnipod-6-and-Fully-Closed-Loop-AID-Systems-Designed-to-Improve-Outcomes-Reduce-Effort-and-Unlock-Barriers-to-Care/default.aspx
Interview with Mythili Pathiyil, MBBS
Sepsis is a global health emergency, with nearly half of all septic patients being children. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, speaks with Niranjan Kissoon, MD, MBBS, FRCP(C), FACPE, MCCM, about his Thought Leader presentation at the 2026 Critical Care Congress, Making Sepsis the Next Success Story in Global Health. The panel also discusses how access and equity play a part in how sepsis is treated. From a global perspective, Dr. Kissoon emphasizes that the most important thing is advocacy and prevention from a governmental level by creating national action plans, making sure the healthcare system is resilient, and utilizing technology and innovation to create better ways of providing care; and from a societal level by educating patients and families about nutrition, hygiene, vaccinations, and seeking care early. Niranjan Kissoon, MD, MBBS, FRCP(C), FACPE, MCCM, is a professor in the Department of Pediatrics (Pediatrics and Surgery, Emergency Medicine) at the University of British Columbia in Vancouver, British Columbia, Canada. He is the past president of the World Federation of Pediatric Critical and Intensive Care Societies and currently serves as president of the Global Sepsis Alliance. He is cochair of the pediatric Surviving Sepsis Campaign, vice president of the Canadian Sepsis Foundation, and chair of World Sepsis Day and the International Pediatric Sepsis Initiative. He also serves on the Sepsis Alliance USA and the African Sepsis Alliance advisory boards and is also a founding member of the Caribbean Sepsis Alliance.
In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, preview their unofficial countdown of the sessions, themes, and abstracts they are most excited about heading into the 2026 European Alliance of Associations for Rheumatology (EULAR) Annual Meeting in London, June 3–6, including: Obesity, Weight Management, and Psoriatic Arthritis Sessions Personalized Medicine and Biomarkers in RMDs Sessions Fatigue and Quality of Life in Connective Tissue Disease Session Mitochondrial DNA and Interferon: Upstream Drivers of Autoimmunity Session Artificial Intelligence and Pattern Recognition in Rheumatology Sessions Axial Imaging in Axial Spondyloarthritis Session Head-to-Head Superiority Trials in RA and PsA Sessions CAR-T and CAR-NK Therapies: Efficacy, Limits, and What Comes Next Sessions
In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MBBS, a consultant rheumatologist at Freeman Hospital, dive into 2 emerging therapeutic strategies with the potential to reshape care for systemic lupus erythematosus (SLE) and psoriatic arthritis (PsA): Fc receptor blockade with nipocalimab and tyrosine kinase 2 (TYK2) inhibition with deucravacitinib, distinct pathways united by a shared goal of greater precision in immune modulation.
In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, examine the growing evidence for GLP-1 receptor agonists in rheumatological disease — drugs originally developed for glycemic control that are now drawing serious attention as potential immunomodulators with implications across the specialty.The conversation opens by tracing the arc of GLP-1 agonist development, from exenatide's approval in 2005 through to semaglutide's landmark cardiovascular and renal data in the SELECT1 and FLOW2 trials, before turning to the question now quietly circulating in rheumatology clinics: are these drugs doing something beyond shifting weight?
In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, turn from osteoarthritis to the inflammatory arthritides — examining what early data in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and lupus can and cannot yet tell us about the role of GLP-1 receptor agonists in disease modification.“Everyone is talking about [GLP-1 RAs] and what it can do for our patients. Much more evidence is needed to be much more better understanding about increasing effects beyond weight loss is needed. And I think that evidence will be just coming out very rapidly, year by year… but I think this is not the case where we're going to wait for strong evidence, good quality RCT data before we start to start to use them,” Buss said.
In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, are joined by guest Lucy Carter, MBBS, PhD, a consultant rheumatologist at Newcastle upon Tyne NHS Foundation Trust and honorary clinical senior lecturer at Newcastle University, to examine nearly 2 decades of B cell–targeted therapy in rheumatic disease — a story that has proven considerably more complicated than its early promise suggested.Carter, Arnold, and Buss trace the mixed legacy of rituximab in lupus and Sjögren disease and examining how incomplete B cell depletion, BAFF-driven rebound, and trial design limitations may have contributed to disappointing early results. The discussion then turns to newer approaches such as obinutuzumab, whose positive REGENCY and ALLEGORY trial data in lupus nephritis and systemic lupus erythematosus suggest that deeper, more durable B cell depletion may improve outcomes, while emerging CAR-T data raise broader questions about the future role of intensive immune reprogramming in autoimmune disease.
In the second part of this Joint Ventures episode on B cell therapies in rheumatic disease, hosts Jack Arnold, MBBS, PhD, and Rihards Buss, MD, return with guest Lucy Carter, MBBS, PhD, to move beyond the question of how to deplete B cells and toward the more conceptually challenging problem of what happens after depletion — and whether ianalumab's dual mechanism of action represents the most rational answer yet developed.The episode examines the biologic rationale behind combining rituximab with belimumab, reviews the landmark NEPTUNUS Sjögren disease trials in which ianalumab became the first targeted therapy to meet a phase 3 primary endpoint in the disease, and discusses how emerging therapies may ultimately reshape treatment selection, steroid reduction strategies, and long-term management of autoimmune conditions including Sjögren disease and systemic lupus erythematosus.
Introducing Joint Ventures — a new podcast exploring advances in rheumatologic disease and what they mean for real-world practice. Hosted by RheumatologyLive, the series is led by Jack Arnold, MBBS, PhD, and Rihards Buss, MBBS, 2 United Kingdom-based rheumatologists united by a shared interest in translating rapidly evolving science into thoughtful, patient-centered care.Joint Ventures is designed for rheumatologists and clinicians managing immune-mediated disease who are navigating an increasingly complex therapeutic landscape. Each episode will examine emerging evidence, new mechanisms of action, and shifting paradigms in rheumatology, with a focus on how these developments intersect with clinical reasoning, uncertainty, and long-term patient management.Arnold is an academic clinical lecturer in rheumatology at the Leeds Institute of Rheumatic and Musculoskeletal Medicine in University of Leeds, with research interests spanning systemic lupus erythematosus, clinical trials, and the application of deep learning in medicine. Buss is a consultant rheumatologist specializing in psoriatic arthritis at Newcastle's Freeman Hospital, with a particular focus on integrating new data into day-to-day clinical decision-making.
This April 2026 Heart Rhythm Journal publication reports a sub-analysis of the CHAMPION-AF trial evaluating left atrial appendage closure (LAAC) versus oral anticoagulation in patients with atrial fibrillation who previously underwent catheter ablation. The analysis demonstrated that LAAC with the WATCHMAN FLX device provided comparable protection against stroke, systemic embolism, and cardiovascular death when compared with NOAC therapy, while also reducing long-term non-procedural bleeding events. These findings support consideration of LAAC as an alternative stroke prevention strategy in selected post-ablation AF patients through individualized, shared decision-making. Digital Education Committee Member Danesh Kella, MBBS, FHRS discusses this article from the Heart Rhythm Journal that preceded the Heart Rhythm 2026 Late-Breaking Clinical Trial. He is joined in the conversation by Jason T. Jacobson, MD, FHRS, Ammar M. Killu, MBBS, and Gregory M. Marcus, MD, FHRS. Learning Objectives Describe the rationale for left atrial appendage closure as an alternative to chronic oral anticoagulation in patients with atrial fibrillation after catheter ablation. Review the efficacy and safety outcomes from the CHAMPION-AF sub-analysis comparing LAAC and NOAC therapy in post-ablation AF patients. Discuss patient selection considerations and the role of shared decision-making when choosing stroke prevention strategies following AF ablation. Podcast Contributors Danesh Kella, MBBS, FHRS Jason T. Jacobson, MD, FHRS Ammar M. Killu, MBBS Gregory M. Marcus, MD, FHRS Host and Contributor Disclosure(s): J.T. Jacobson •Board/Advisory Committee Membership: Abbott Medical •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical, Inc. •Research: CardioFocus, Inc., Johnson and Johnson •Stocks, Privately Held: Atlas 5D D. Kella •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, MBW Spectrum A. Killu •Board/Advisory Committee Membership: Boston Scientific •Honoraria/Speaking/Teaching/Consulting: AtriCure, Inc., Abbott, Biosense Webster, Inc., Siemans Healthineers •Research: Boston Scientific, Access Point Technologies G.M. Marcus •Honoraria/Speaking/Teaching/Consulting: InCarda Therapeutics •Research: NIH, PCORI, TRDRP •Stocks, Publicly Traded: InCarda Therapeutics
Augmenting anatomy with disease activity! Summit Shah, MD MPH, explains to host, Raisa Amiruddin, MBBS, how visualizing disease activity through molecular imaging helps in solving diagnostic uncertainties. Explore how PET/MRI, brain mapping, targeted radiotracers, and theranostics are driving the shift towards personalized, precision medicine in pediatric patients.
Description: "When joint pain is present, the diagnosis of psoriatic arthritis needs to be made as soon as possible, ideally within six months to limit joint inflammation" Dr. Vinod Chandran mentions as he discusses efforts to identify a diagnostic test for those at risk of developing psoriatic arthritis. Join host Jeff Brown as he speaks with leading rheumatologist and clinician scientist Dr. Vinod Chandran, Director of the Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network and the Departments of Medicine, Laboratory Medicine and Pathobiology, and the Institute of Medical Science at the University of Toronto to learn more about the progress and promising results towards developing a psoriatic arthritis diagnostic test through multi-omic assays and identifying the distinct differences between psoriasis and psoriatic arthritis. This episode provides an update on the progress to date of the NPF PsA Diagnostic Test grant initiative which has shown promising results with a potential test entering prospective study in multiple sites soon. Thank you to Johnson and Johnson for their support of this program activity. Timestamps: (0:00) Intro to Psoriasis Uncovered & guest welcome rheumatologist Dr. Vinod Chandran. (0:52) It is challenging to diagnose psoriatic arthritis with many factors leading to a delay in diagnosis. (4:56) The start of Dr. Chandran's involvement with the PsA Diagnostic Test Grant project. (7:55) The different types of omics and the definition of multi-omic. (9:57) How the multi-omic approach is used to find biomarkers relative to a specific disease pattern. (11:08) Development of a predictive or prevention-based test using gene expression. (13:46) First year results identify 200 markers across different omic approaches that distinguish psoriatic arthritis from psoriasis. (14:58) The significance of MRNA vs mIcroRNA's use in development of a diagnostic test and how critical that is to dissemination of a potential test. (17:08) Identifying the skin-joint axis in relation to different types of arthritis. (20:20) Next steps to moving the diagnostic test research forward as a prospective study in multiple sites and the cost effectiveness of delivering the test. (23:13) If you have psoriasis, musculoskeletal, back, and joint pain think of psoriatic arthritis and be diagnosed early to maintain a good quality of life. Key Takeaways: · Given challenges associated with diagnosing psoriatic arthritis and the impact on quality of life, in 2019 NPF launched the PsA Diagnostic Test Grant project with the goal of developing an early stage test that would identify and diagnose those with psoriatic arthritis before debilitating joint damage begins. · Progress towards a PsA Diagnostic Test includes the study of multi-omic data sets where 200 distinct biomarkers have been identified leading to a greater understanding of the different pathways between psoriatic arthritis, psoriasis, and the skin joint axis. · A potential diagnostic test is now moving towards the prospective study phase. Until the test is available and if joint pain is present and you have psoriasis, ask your health care provider if it could be psoriatic arthritis and treat appropriately. Guest Bio: Vinod Chandran, MBBS, MD, DM, PhD is a rheumatologist, clinician scientist, and Director of the Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network and the Departments of Medicine, Laboratory Medicine and Pathobiology, and the Institute of Medical Science at the University of Toronto where he is also a Professor of Medicine. His specialties include internal medicine, immunology, rheumatology, and genetic epidemiology. His research focus is on the development of biomarker-based strategies to improve early diagnosis and prognosis of psoriasis and psoriatic arthritis, identification of new treatment targets especially for those who do not respond to current therapies, and strategies to reduce the impact of disease. Dr. Chandran is a Co-Vice President of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis or GRAPPA. He is an active collaborator in a multi-center research consortia such as the International Psoriasis and Arthritis Research Team and the Spondyloarthritis Research Consortium of Canada. Dr. Chandran is the recipient of research funding from the National Psoriasis Foundation for his work in identifying a "Multi-omic Diagnostic Test for PsA in Psoriasis Patients". Resources: "Understanding the NPF Psoriatic Arthritis Diagnostic Test Grant Outcomes" Advance Online. February 18, 2026. "Managing Chronic Pain with Psoriatic Arthritis" Psoriasis Uncovered podcast episode with physiatrist Dr. Erin Maslowski, LB Herbert who lives with psoriatic disease, and moderator Susan McClelland-Tobert, a retired pediatric cardiologist who also lives with psoriatic disease. Glossary of terms: mRNA: Messenger RNA carries protein information or instructions from the DNA in a cell's nucleus to the cell's interior where the sequence is read and translated into corresponding amino acids for growing protein chains. Micro-RNA (miRNA): Micro-RNA act as the regulator. They are short and bind to specific target mRNA's to degrade or inhibit production of protein.
Results from the first-in-human, phase 1 MYTHIC trial (NCT04855656) demonstrated that combining the WEE1 inhibitor zedoresertib with the PYKMT1 inhibitor lunresertib achieved an overall response rate (ORR) of 18.5% via RECIST criteria in patients with CCNE1, FBXW7, and PPP2R1A-altered cancers.1 In patients with resistant/refractory ovarian cancer, the ORR was 33.3% across all dose levels and 50% at the potential recommended phase 2 dose. These data were presented by Timothy A. Yap, MBBS, PhD, FRCP, at the 2026 American Association for Cancer Research (AACR) Annual Meeting. Following his presentation, Yap joined CancerNetwork® for a discussion where he highlighted some of the most interesting takeaways from the trial. According to Yap, the disease states evaluated in this trial represent areas of unmet need where no specific standard-of-care options can target these alterations.Notably, based on results from this trial, the FDA granted fast track designation to lunresertib in combination with zedoresertib in patients with genomic-defined platinum-resistant ovarian cancer.2Yap is a medical oncologist and physician-scientist, as well as the Random Horne, Jr. Endowed Professor for Cancer Research and vice president and head of Clinical Development in the Therapeutics Discovery Division at UT MD Anderson Cancer Center.References1. Yap TA, Aggarwal R, Fontana E, et al. First data disclosure of the Phase I trial of the first in class combination of WEE1 inhibitor zedoresertib with PKMYT1 inhibitor lunresertib in patients with advanced solid tumors harboring CCNE1, FBXW7, or PPP2R1A genomic alterations. Presented at the 2026 AACR Annual Meeting; April 17-22, 2026; San Diego, CA. Abstract CT022.2. Following oral presentation of phase I Data at AACR 2026, Debiopharm announces FDA fast track designation for lunresertib in combination with zedoresertib for genomic-defined platinum-resistant ovarian cancer. News release. Debiopharm. April 20, 2026. Accessed May 4, 2026. https://shorturl.at/n1bWn
On this episode Gil and Gregg welcome Dr. Sai Praveen Haranath, Senior Vice President for Medical and Strategy at Apollo HealthAxis and Senior Consultant in Pulmonary and Critical Care at Apollo Hospitals, Hyderabad. Their conversation picks up where a chance green-room meeting at BioAsia 2026 left off. What follows is a candid, wide-ranging dialogue on the future of medicine: tele-critical care delivered from a command center in India to hospitals in rural America and the island of Fiji; AI tools that could restore empathy to time-starved clinicians; a 4.5-billion-person global access gap that demands urgent innovation; and Apollo's four-decade bet that prevention, technology, and human connection belong together. 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
Recorded and published daily during #ASGCT2026, Soundbites of the Annual Meeting captures the energy and breadth of the conference through quick-hit conversations, scientific snapshots, attendee perspectives, and highlights from across the field — offering a daily pulse on what’s happening throughout the meeting. Take a listen from Wednesday, May 13, 2026 as we talk with Claire Booth, MBBS, PhD, who discusses her keynote presentation and what she hopes audiences take away from it. This soundbite is hosted by Wan Du, PhD of the ASGCT Communications Committee.Show your support for ASGCT!: https://asgct.org/membership/donateSee omnystudio.com/listener for privacy information.
Welcome to the latest episode of late-breaker coverage from Heart Rhythm 2026 in Chicago, with host Deep Chandh Raja, MBBS, MD, PhD, FHRS and his guests Paul Chun Yih Lim, MBBS, FHRS and Abhishek Deshmukh, MD. This discussion reviews the late-breaking HRS 2026 trial Safety and Performance of a Novel ICD Lead for Left Bundle Branch Area Pacing: Results from the ASCEND CSP Trial Arrhythmia, which evaluated a novel implantable cardioverter-defibrillator (ICD) lead designed specifically for left bundle branch area pacing (LBBAP). Faculty discuss the safety profile, implant success, pacing performance, and clinical implications of conduction system pacing using dedicated ICD technology, as well as how these findings may influence future device implantation strategies and physiologic pacing approaches in patients requiring defibrillator therapy. Learning Objectives Assess the safety and procedural performance outcomes associated with left bundle branch area pacing in patients requiring ICD therapy. Evaluate the potential role of conduction system pacing technologies in advancing physiologic pacing and device-based arrhythmia management. Describe the design and intended clinical application of the novel ICD lead evaluated in the ASCEND CSP trial. Podcast Contributors Deep Chandh Raja, MBBS, MD, PhD, FHRS Paul Chun Yih Lim, MBBS, FHRS Abhishek Deshmukh, MD Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. A. Deshmukh Honoraria/Speaking/Teaching/Consulting: GE Healthcare, Biotronik, Medtronic, Biosense Webster Research: AltaThera Pharmaceuticals P. Lim Nothing to disclose.
Advances in immunotherapies for multiple sclerosis and related disorders have increased the risk of infections and raised important questions about vaccination efficacy. This episode reviews infection risks across treatment classes, emphasizes the importance of monitoring and patient education, and discusses optimal vaccine timing to preserve protective immune responses. In this episode, Aaron L. Berkowitz, MD, PhD, FAAN, speaks with Avindra Nath, MBBS, FAAN, coauthor of the article "Infection Risk and Vaccine Considerations in Multiple Sclerosis and Related Disorders" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology in the Department of Neurology at the University of California, San Francisco, in San Francisco, California. Dr. Nath is the chief of the Section of Infections of the Nervous System at the National Institute of Neurological Disorders and Stroke, National Institutes of Health, in Bethesda, Maryland Additional Resources Read the article: Infection Risk and Vaccine Considerations in Multiple Sclerosis and Related Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Full episode transcript available here Dr Berkowitz: Over the last decades, there has been a revolution in the treatment of multiple sclerosis, neuromyelitis optica spectrum disorder, and other immune-mediated neurologic conditions with countless new, highly effective medications. However, with every new treatment comes new risks; and in the case of immunomodulatory therapy, many of those risks relate to infection. Today, I have the privilege of talking with an expert on this topic, Dr Avindra Nath, about the infectious risks of treatments for multiple sclerosis and other immune-mediated neurologic disorders. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Berkowitz: This is Dr Aaron Berkowitz, and today I'm interviewing Dr Avi Nath about his article on vaccine considerations and infection risk in multiple sclerosis and related disorders, which he coauthored with Dr Amit Bar-Or. This article appears in the April 2026 Continuum issue on multiple sclerosis. Welcome to the podcast, Dr Nath, and could you please introduce yourself to our audience? Dr Nath: Thanks very much for inviting me to this podcast. I'm absolutely delighted to have the opportunity to discuss our areas of interest and expertise related to infections and vaccinations for MS patients. My area has been studying the infections of the nervous system since the beginning of the AIDS pandemic, and over the years and decades, we've developed expertise related to various types of CNS infections. That includes ones that are developing in individuals who have immune compromise due to a variety of different reasons. Dr Berkowitz: Fantastic. Well, glad to have the opportunity to speak with you today. When I was in medical school---and you were my attending, actually, we were just reminiscing, which we probably think was not that long ago, but is now over twenty years ago---there were just two medications for MS, right? Beta interferon and glatiramer acetate. And now we have over a dozen, and it's amazing to think of all the progress in these last two decades, as well as for related diseases like NMO. I don't think we even had the aquaporin-four biomarker, right, when I was working with you as a med student in the early 2000s. Dr Nath: And that certainly dates me a lot. Dr Berkowitz: Both of us. Dr Nath: Yeah. Dr Berkowitz: Of course, with all these new treatments, these have been amazing advances for our patients, right? But these come with new treatment-related risks to monitor for with the immunomodulatory medications for MS and related disorders. And one of those most important risks is that of infection. So, your article reviews the potential infectious complications of medications used to treat MS, NMO, etc, and also covers considerations related to thinking about vaccines in this patient population. So, as the MS treatment landscape grows, I can say as a general neurologist, keeping up with all these medications and what to screen for and what to worry about and when to vaccinate just becomes more challenging every year. And your article has so many helpful tables, some organized by medicine, some organized by- sorry, medication, some organized by infection, some by vaccines. So, this is gonna be a great resource for our providers to print out and tape up in their clinic rooms. We won't be able to get into all the depth and detail that you have in this article today, but I do want to focus on some of the key points here related to the common medications we use for MS and which infections to think about and which vaccine considerations we might need to keep in mind for these medications. But before we delve into the drugs, I just wanna ask you more broadly, you talk in the article about the challenge of patients with immune-mediated diseases who are on immunomodulatory therapy being at risk for both flares of their disease and for infections; and these infections can present somewhat atypically, right, in immunomodulated hosts, to maybe coin a term you can correct me on, because they can't mount the full inflammatory response. So how do you approach new symptoms in patients on these immunomodulatory medicines as far as distinguishing disease flare from a treatment-related infection? Dr Nath: So, I have to say that although a lot of new treatments have come along for MS, and they've really, you know, improved the outcome tremendously and there are so many different options, it has also kept people like me relevant because they cause a lot of various types of infections, and so keeps me in business all the same. But just as you mentioned, there's so many of them, even I have difficulty keeping track of what does what. So, you do need to be able to refer back to published literature, and the tables, I hope, will be quite useful in that regard. You're absolutely right, and you can get new infections, you can get reactivation of existing infections, and you can get atypical presentations of various types of infections that you may not normally think of. So that presents multiple challenges to the treating physician. The other interesting thing about MS is, just as you mentioned, that you already have CNS lesions to begin with. Now, on top of it, you have an infection, so now how to sort out what is the existing disease and what is the infection, it can again become challenging. But one thing is for sure: all these infections are caused by an organism. So, what you really need to do is, the underlying diagnostic is to demonstrate the presence of the organism. Whether you demonstrate it depending on the infection in the spinal fluid or in the brain or, you know, some peripheral organ system, that is going to be key to making the diagnosis. So, all your clinical acumen is good, but that alone may not be sufficient. Dr Berkowitz: Very good. So, when you see a, a patient now who has a new neurologic symptom in the context of an immune-mediated disease who's on immunomodulatory therapy, what goes through your mind? Are you thinking this disease and this drug, and sort of what are the infections, and does the syndrome match? Or are you thinking, you know, you can't always rely on the imaging to distinguish between, say, a flare of an MS and PML because white matter lesions could look similar? How do you sort of approach this scenario when it comes up? Dr Nath: So, you're right. You have to keep an open mind so that even though you know some infections are more likely to occur with certain types of medications, that doesn't mean that others cannot occur. So, I think when you first see the patient, you should not jump to conclusions, but rather have an open mind. But yes, for example, your patient is on natalizumab, the chances of PML are going to be high. It's a very interesting drug. It does not cause immune compromise in the periphery, but what it's doing is preventing these cells from getting into the brain. So, because then it's acting at the blood-brain barrier. So that means that organisms that are already present in the brain have an opportunity to get reactivated. Turns out you don't have a lot of organisms in the brain, except JC virus seems to be one of them that does somehow, in some individuals, manage to reside out there. And so that can get reactivated. It can get reactivated in the periphery and then enter the brain, too. So, where the very specific mutations have to occur in that virus in order to take residence in the brain. That would be a suspicion that you might have, and MRI can be useful in, again, helping you think about that possibility. If you have typical lesions involving the U fibers, they're demyelinating, usually you do not have much edema around them because patient is immune compromised, but certainly within the brain in these individuals. And so, then you need to demonstrate the organism. The demonstration of the organism should be in the spinal fluid and not in the blood because in the virus, it can-- is reservoir in the kidneys and in the lymph nodes, and periodically it'll shed into the blood. Detection of the organism in the blood can be a false positive, but in the spinal fluid, it shouldn't be there unless you have an infection. Or if you cause a traumatic tap, I guess, if a patient is viremic, that's a possibility, but those are extremely rare. So at least for PML, that's the way that you would diagnose it. Now, you can develop, for example, if an individual is on fingolimod, you can get a wide variety of infections. Here it's a totally different type of mechanism of action. Here the cells are trapped within the lymph nodes, so that means now your entire periphery is immune compromised, right? So here you can get viral infections, bacterial infections, fungal infections. So here, if a patient presents with new neurological symptoms, you have to have a really open mind for all these possibilities. Now, let's say a patient was on dimethyl fumarate, and dimethyl fumarate causes neutropenia early on. So here you have to worry about an individual developing bacterial infections, so latent tuberculosis or bacterial meningitis can occur in these individuals. That's something to keep in mind. It's not that other infections cannot occur with dimethyl fumarate, you can see PML and other things too, but the chances of bacterial infections are greater. So, you got to make sure that you draw all the cultures for that purpose. Similarly, if you're on a complement inhibitor, like a C5 inhibitor or the thing that I could use in NMO, there are the chances of meningococcal meningitis. So, these patients, you need to prevaccinate them before you start these kinds of treatments and look for that possibility. When you suspect bacterial infections, particularly acute bacterial meningitis, there time is of essence. Also, in some of the acute viral infections, for example---herpes encephalitis is another one---you have to be so careful, and if you suspect any of them, even if they're with possibly atypical manifestations, you treat first and then diagnose later, and draw all your cultures, whatever you need to, and just treat them. And these infections can also cause cerebral edema, so one has to be careful about doing spinal taps in these individuals. You want some kind of neuroimaging before you do them. In the days when we didn't have neuroimaging, we used to say, "Okay, if your patient has focal neurological signs or is comatose, you don't do it." But these days, you can get imaging very quickly and very easily. All the-- Because of our stroke management, we've learned how to do them so quickly. So, I think there's little excuse not to do imaging and prevent herniation from occurring. Dr Berkowitz: That's very helpful. So, using the information we know about the drug, and we're going to rapid-fire review some of that in a bit to know what infections the patient is susceptible to, but acknowledging that any patient can get any infection, right? Whether they're on particular medications or not. And then if you're not sure, based on the neuroimaging, which as you said, is helpful, but not always helpful in distinguishing between infections and flares or, as you said, in the case of meningitis, encephalitis, early on at least, especially in immunocompromised or immunomodulated, quote unquote, patient might not see the typical imaging. So really, when safe, getting CSF or cultures, PCRs, and other infectious studies too is really gonna be the definitive diagnostic maneuver here. Is that fair summary across the board? Dr Nath: I think you said that absolutely right. And you summarized that correctly. And, you know, thing about infection, a lot of neurological diseases are, you know, diagnosed by clinical acumen, like your Parkinson's and Alzheimer's and others. Think about infections is caused by an organism, demonstrate the organism, right? That should be your goal. It doesn't mean that clinical acumen is not important, but here you have an opportunity to demonstrate the organism, so you should depend upon that. Dr Berkowitz: Okay. Well, you gave us a nice segue by talking about some of the infections to worry about with some of the medications. So what I'd like to do now for the sort of second half of our interview here is to go through some of the more common medications used for MS, and if we have time, for NMO, and just sort of go kind of rapid fire here, and for each medication, if you can tell us the kind of top infectious concerns and whether when to consider them or what screening needs to take place before or during administration of the medication, and then any vaccine considerations we should be aware of. Some of these will obviously be quite short depending on the medicine. So, going back to the two medications I alluded to earlier that were the only ones in play when you and I last saw each other on the wards when I was a medical student, beta interferon, glatiramer acetate, any infections or vaccine considerations with these medications? Dr Nath: No, I think they're probably your safest medications now as far as immunomodulatory therapies are concerned. These two, and IVIG, if you ever use them, are probably the safest, do not require any vaccine considerations, per se. Dr Berkowitz: Perfect. Okay. So, moving on to fingolimod and others in the sphingosine-one phosphate receptor modulator family, what are the infectious considerations? Any prescreening or vaccination considerations? Dr Nath: I think all your patients should be prescreened for antibodies to JC virus, because there is a risk for PML, and those who are positive should be closely monitored. So, it's not an absolute contraindication for using these medications, but they just require closer monitoring. With this class of drugs, PML is of consideration. Also, these varicella-zoster virus infection, yeah, with that you can develop zoster encephalitis or myelitis. It can present with motor symptoms as well, which can be atypical. You don't usually see them otherwise in immune-competent individuals. So, varicella-zoster, sometimes you can develop encephalitis, also vasculitis with varicella-zoster, so one has to be careful. So, getting the shingles vaccine can be actually very helpful to prevent these things. And then some patients can even develop herpes simplex encephalitis also, and that can be extremely atypical. So, they don't- they can involve the basal ganglia, can involve the brain stem and cerebellum. So again, your index of suspicion should be very high. Interestingly, although HSV encephalitis has been associated with NMDA receptor encephalitis, those reports of NMDA receptor encephalitis have not been published yet with NMS patients. Not sure why, maybe they just have been missed. But that doesn't seem to be a major concern. And then there are a whole host of other infections that can occur with this class of drugs, and that can include toxo; fungal infections, particularly crypto. There's a case report of histoplasmosis; hepatitis virus, particularly hepatitis C; and then the poxvirus is a good example. You can get molluscum contagiosum; warts with papillomavirus; you can get atypical mycobacteria; and even Kaposi sarcoma, which is HHV8. So, there's a huge variety of infections with the sphingosine one phosphate receptor modulators. Dr Berkowitz: And any- aside from screening for JC virus before initiating these, any- and then continuing to monitor for JC antibody index, any other considerations as far as labs to send, monitoring before or on the drug or vaccine considerations for patients on fingolimod and the others in this category, siponimod, etcetera? Dr Nath: Yeah, there are a lot of things to consider. All the details are really available in the chapter if you look at them. But briefly, all the things that one could potentially vaccinate patients for, all these infections I mentioned, one should do so. The timing is critical so that if you can do it before treatment, I think, before starting treatment, that is absolutely important. And you got to give them at least, you know, two to three weeks for these vaccines to take effect before starting your medication. If your patient already arrives on a medication, then you got to play this game of you know, before the next dose, give them again two to three weeks before the next dose and start vaccinating them and get all the vaccines in. Broadly, about the things to worry about the vaccines are you have live vaccines, and you've got the inactivated vaccines or the subunit vaccines. You have to be careful with live vaccines, because if your patient is immunocompromised, that virus can sometimes itself cause harm. For example, you know, yellow fever is one, and there you can develop encephalitis from it. Measles, mumps, rubella, these are all live vaccines. Now, the good thing is that a lot of us have been immunized very early in childhood, but that may not be the case any longer. And so, these things, one has to be very careful with when you're giving live vaccines, that we want to avoid them as much as possible, and individuals are gonna be immune-compromised. But all the others, meningococcus, for example, you should- the HPV vaccines, the varicella zoster vaccines, all these things, you've got to pre-vaccinate and make sure that they have an antibody response to them before starting immunocompromising therapy. Dr Berkowitz: Perfect. Okay, moving on to some of the other orals. What infectious and/or vaccine considerations do we have with teriflunomide? Dr Nath: Okay, yeah. Teriflunomide is a very interesting drug. It's relatively safe. There is concern about the possibility of varicella zoster infection, people have reported that, and also tuberculosis. But PML is extremely rare, if not at all, and we haven't seen herpes encephalitis quite yet. Dr Berkowitz: Got it. How about dimethyl fumarate? Dr Nath: Yeah. So dimethyl fumarate is... as I mentioned earlier, it's interesting because it causes this neutropenia. It's transient, but it occurs early on, and these patients can be at risk of PML, although small. They can develop varicella zoster virus infection, herpes encephalitis, and also fungal infections. For example, cryptococcal infection has been reported with dimethyl fumarate. Dr Berkowitz: Okay. We've spoken a bit about natalizumab and PML, and you have extensive information on this in your article, and I'll defer the reader to that. But for natalizumab, what are the key points every neurologist should know about natalizumab and PML as far as from the practical perspective, screening, frequency of screening, when to worry, when to not use natalizumab at all in the first place based on what you find in your screening for JC virus? What are the key points every neurologist should know? Dr Nath: Uh, yes. You bring up an important point, and that is all patients should be monitored for JC virus. If they're JC virus-negative, so that's your most ideal patient to go on natalizumab, but that doesn't mean they cannot get infected with the virus. In fact, there's an interesting study claiming that, you know, patients, when they get these infusions, they're all sitting in the same room getting infused. Some have JC virus, some don't have JC virus, and so there's the potential that we may be aiding the transmission here in some way or another. The virus is an interesting one. It comes out in urine, and then it's spread through oral contamination, gets into the tonsils, and then spreads from there to your marrow and resides in the kidney and the marrow, as well as the lymph nodes, forever. So, you, you have to monitor these patients to see that during the course, even if they're negative, they could turn out positive. So, every six months or a year, an antibody test should be done on all patients irrespective. If a patient already has antibodies, that's not an absolute contraindication. It just means you've got to monitor them closely for development of new symptoms, and if, whenever there are new symptoms, don't just assume this is due to MS, but just make sure the MRI is done with and without contrast. The- and if there's still a suspicion, that you do a CSF evaluation for JC virus. Just detecting, looking for JC virus in the blood, a rising titer is another thing that can help you. And so, the titer is also important. And the reason you have rising titers is it means that there's an infection that's already occurred in the brain, and the immune system is reacting to that infection by increasing titers. But that alone is not sufficient to make the diagnosis. You still- that gives you an index of suspicion. You've got to then do the MRI and the spinal tap to, you know, be absolutely certain. So, each patient is a little bit different, so the way you monitor them is going to depend on where they are. You know, if they've had prior immunomodulatory therapy before starting natalizumab, or if they're on natalizumab for more than two years, then the chances of PML are much greater, so you may want to monitor them more closely. Uh, they never had any prior immunomodulatory therapy, you're just starting natalizumab, maybe once a year is sufficient. So, I think you've got to tailor it depending on what your risks are for each patient. Dr Berkowitz: Perfect. That's very helpful. And again, you write extensively about PML and natalizumab and PML considerations in your article. So, for a more detailed and in-depth discussion of what we just discussed, definitely hope readers will take a look at your article. Okay. Last but not least---certainly not least, 'cause we're using these probably, it seems, the most commonly in many places I've worked---rituximab, ocrelizumab are B-cell therapies for MS. What are some of the infectious and vaccine considerations related to these infusion medications? Dr Nath: So, there's concern for PML with anti-B-cell therapies also, maybe not to the same degree as natalizumab, but the same principles should be applied. A lot of people think that these are relatively safe. I don't think so. I think we see enough number of patients on B-cell therapies with PML. So, I would use the same caution because these infections are... you know, can be fatal. So, one should be very careful, even with anti-B-cell therapies. And just with natalizumab, you also have the risk of VZV infection causing shingles. HSV1 has been reported, but there's another interesting complication that has been reported with anti-B-cell therapies, and that is severe West Nile encephalitis. And as mosquitoes-borne diseases are getting more and more prevalent, and we're seeing West Nile cases erupting every summer, I think one's got to be, you know, very cognizant of the fact that this can occur. These patients should take precautions to prevent mosquito bites from occurring and not expose themselves to areas where they could be at risk for it. Unfortunately, there is no vaccine for it and no specific treatment for West Nile. So, all one can do is use prevention strategies for mosquito bites. Dr Berkowitz: Yeah, I'm glad you mentioned that. I think the only really truly severe neuroinvasive cases I've seen of West Nile virus have indeed been in patients who were being treated with B-cell therapy. Not, if I'm remembering correctly, for immune-mediated disease, but for a lymphoma, so probably other confounding factors there. But yeah, it's a disease we learn about and think about, but I've only seen the most severe cases in patients who had abnormal immune systems, so I'm glad you flagged that. This has been a very helpful discussion, and I've learned a lot from you. I learned a lot from your article, just as I did when you were my attending some 20-something years ago on the wards when I was a medical student. So, it's good to continue learning from you through your writing and research, and today from getting to talk to you again. I encourage our readers to read your article and to bookmark those tables for when these considerations come up for your patients on these immunomodulatory therapies and you're wondering which infections to worry about and how to manage vaccines in this patient population. So again, today I've been interviewing Dr. Avi Nath about his article on vaccine considerations and infection risk in multiple sclerosis and related disorders, which he wrote with Dr. Amit Bar-Or. This article appears in the April 2026 Continuum issue on multiple sclerosis. Be sure to check out Continuum Audio episodes from this and other issues, and thank you again to our listeners for joining today. Dr Nath: Thank you so much, Aaron, for that wonderful interview, and I'm extremely proud of all your accomplishments over the last 20 years. You've done an amazing job, and it was such a pleasure to see you and to be able to do this interview with you. Thank you again. Dr Berkowitz: Thanks. That means a lot. I never would have imagined- we won't say 20, how many, but 20-something years ago as the medical student looking up to you and all your expertise on these infections and all of your research that led to so much of our understanding on these, that I would find myself interviewing you two decades later. So, for all the students listening, you never know where you'll end up, but I appreciate your very kind words. Dr Nath: That's what we hope for all our students. Thank you so much. Dr Berkowitz: Thanks again. Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
Interview with Shalender Bhasin, MBBS, author of Testosterone Treatment in Prostate Cancer Survivors With Hypogonadism: A Randomized Clinical Trial, and Peter C. Albertsen, MD, author of Collaborating to Improve Quality of Life Among Prostate Cancer Survivors. Hosted by Eve Rittenberg, MD. Related Content: Testosterone Treatment in Prostate Cancer Survivors With Hypogonadism Collaborating to Improve Quality of Life Among Prostate Cancer Survivors
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Updates in US Food and Drug Administration approvals for poly-ADP-ribose polymerase inhibitors in Ovarian Cancer: A society of gynecologic oncology clinical practice reviewModerator:Ursula A. Matulonis, MD; Dana-Farber Cancer InstituteSpeakers:Bhavana Pothuri, MD; Perlmutter Cancer Center, NYU Langone HealthRóisín E. O'Cearbhaill, MD; Gynecologic Medical Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center; Department of Medicine, Weill Cornell Medical CollegeYvette Drew, MBBS, PhD; BC Cancer Centre Vancouver and University of British ColumbiaChristina Washington, MD; Stephenson Cancer Center, University of OklahomaUrsula A. Matulonis, MD, is joined by Bhavana Pothuri, MD, Róisín O'Cearbhaill, MD, Yvette Drew, MBBS, PhD, and Christina Washington, MD, to discuss recent updates in US Food and Drug Administration approvals for poly-ADP-ribose polymerase inhibitors (PARPi) in ovarian cancer. Based on the recent Society of Gynecologic Oncology clinical practice review published in Gynecologic Oncology, the speakers review the evolving role of PARP inhibitors and the clinical implications of updated regulatory approvals.The panel explores current evidence supporting PARP inhibitor use in ovarian cancer, including considerations for patient selection, biomarker testing, maintenance therapy, and safety considerations. The speakers also discuss how recent changes in FDA indications may affect clinical decision-making and treatment sequencing in practice.This podcast highlights practical clinical pearls to help guide practitioners in the appropriate integration of PARP inhibitors into the management of ovarian cancer patients.This podcast was developed by the Society of Gynecologic Oncology for Gynecologic Oncology.Check out more content on the journal's homepage at https://www.gynecologiconcology-online.net
Colin M. Dayan, MA, MBBS, FRCP, PhD - Innovation Through Immunomodulation: The Practicalities of Delaying the Progression of Type 1 Diabetes
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In this episode of Voices of Otolaryngology, Peter Santa Maria, MBBS, PhD, discusses his approach to innovation in patient care and how physicians can source ideas and inspiration to chart their own ideation course. Dr. Santa Maria shares his global journey with host Rahul K Shah, MD, MBA, AAO-HNS/F Executive Vice President and CEO. Starting with his childhood in Australia, then to Stanford University, and now in Pittsburgh, Pennsylvania, where he balances a busy otology/neurotology practice while managing an innovation lab to continue creating medical devices to improve the lives of his patients. Dr. Santa Maria outlines how his approach to innovation is needs-driven and structured and focuses on projects that deliver near-term relief for patients.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BVV865. CME credit will be available until 9 April 2027.The Power of Personalised: Unlocking the Secrets of Individualised Management of Resectable EGFRm NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BVV865. CME credit will be available until 9 April 2027.The Power of Personalised: Unlocking the Secrets of Individualised Management of Resectable EGFRm NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BVV865. CME credit will be available until 9 April 2027.The Power of Personalised: Unlocking the Secrets of Individualised Management of Resectable EGFRm NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BVV865. CME credit will be available until 9 April 2027.The Power of Personalised: Unlocking the Secrets of Individualised Management of Resectable EGFRm NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BVV865. CME credit will be available until 9 April 2027.The Power of Personalised: Unlocking the Secrets of Individualised Management of Resectable EGFRm NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BVV865. CME credit will be available until 9 April 2027.The Power of Personalised: Unlocking the Secrets of Individualised Management of Resectable EGFRm NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
Full article: Late Gadolinium Enhancement on Cardiac MRI in Patients With Takotsubo Syndrome: Insights From the Multicenter EVOLUTION Registry What is the significance of late gadolinium enhancement in patients with Takotsubo syndrome? Raisa Amiruddin, MBBS, is joined by Scott Bugenhagen MD, PhD, to discuss the recent AJR article by Cau et al. addressing this issue using data from the multicenter EVOLUTION registry.
Roadmaps for pediatric artificial intelligence (AI)! Nabile Safdar, MD, and Alex Towbin, MD, speak with host, Raisa Amiruddin, MBBS, about the sore spots, unsung wins, and potential targets of AI in children's healthcare while highlighting how the specialist's intuition remains the ultimate anchor for automated tools in radiology.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/WYB865. CME/NCPD/AAPA credit will be available until April 12, 2027.Transformative Care for Hemoglobinopathies: Guidance on the Gene Therapy Experience in SCD & Thalassemia In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Beam Therapeutics and Vertex Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.
In this discussion, Dr. Deep Chandh Raja, MBBS, MD, PhD, is joined by Dr. Chi Keong Ching, MBBS, FHRS, and Dr. Haris M. Haqqani, MD, PhD, FHRS, to review the growing empirical evidence supporting anatomically guided ablation strategies for idiopathic left ventricular (LV) summit ventricular arrhythmias. The panel highlights how integrating multimodality mapping with a nuanced understanding of the region's complex anatomy can improve procedural success and safety. They also emphasize the role of evolving techniques and shared clinical experience in refining outcomes for these challenging cases. Learning Objectives Describe the anatomical challenges of the left ventricular (LV) summit and their implications for catheter ablation of idiopathic ventricular arrhythmias. Evaluate the role of multimodality mapping and anatomically guided strategies in improving procedural success and safety. Identify emerging techniques and clinical insights that inform optimal ablation approaches for LV summit arrhythmias. Article AuthorsTakumi Yamada and G. Neal Kay Podcast ContributorsDr. Deep Chandh Raja, MBBS, MD, PhD Dr. Chi Keong Ching, MBBS, FHRS Dr. Haris M. Haqqani, MD, PhD, FHRS Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. C.K. Ching •Honoraria/Speaking/Teaching/Consulting: Abbott, Biotronik, Boston Scientific, Biosense Webster, Inc, Medtronic H. Haqqani •Honoraria/Speaking/Teaching/Consulting: Abbott Medical •Membership on Advisory Committees: Boston Scientific
India's top neurologist Dr. Neha Pandita sits down with Gaurav Arora on xMonks Drive, and she has something to say about Deepinder Goyal's Temple device.When the founder of Zomato started wearing a brain-monitoring device on his temple to track blood flow and slow ageing, the internet had opinions. But what does an actual movement disorder specialist think? Dr. Pandita's reaction was simple: she laughed. Not because the idea is stupid, but because one artery cannot tell you everything happening inside your brain, and the science isn't there yet.But that's just where this conversation starts.Dr. Neha Pandita is one of India's leading neurologists and movement disorder specialists. She has spent over two decades studying the brain, and she herself was diagnosed with writer's dystonia during her MBBS finals, the very disorder she now treats in others. She saved a passenger's life mid-flight with a newborn in her arms. She has watched a Parkinson's patient sing again after years of silence. And she grew up as a Kashmiri Pandit refugee, starting from zero in Himachal Pradesh.In this episode she breaks down everything you thought you knew about your brain, and most of it is wrong.What you'll learn:— Why heartbreak has nothing to do with your heart— What actually causes laziness, lack of motivation, and brain fog— The truth about Deepinder Goyal's Temple brain device— What Parkinson's disease really looks like inside a family— How deep brain stimulation works, and the sound doctors listen for inside the brain— Whether psychedelics can actually heal trauma— The myth of the male vs female brain— What memory loss really means, and when to see a neurologist— Why a 95-year-old survives when a 40-year-old doesn't— How close we actually are to curing Alzheimer's and Parkinson'sTimestamps00:00 Brain Hacking Hype01:31 Temple Wearable Explained01:51 Why Evidence Matters03:17 Temporal Artery Oversimplified03:57 Tech Claims vs Mental Health06:01 Neurology Basics and Mislabels08:11 Warning Signs to Watch11:05 Motivation Stress Sleep Link13:19 New Discoveries Curable Disorders16:18 Deep Brain Stimulation Story18:50 Inside Awake DBS Surgery22:26 Neuroplasticity and Stimulation Limits23:55 Psychedelics Reality Check25:20 Brain Beyond Final Frontier26:48 In-Flight Medical Emergency31:10 Living With Writer Dystonia34:28 Why Neurology Felt Right38:49 Parkinson's Patient Breakthrough44:09 Near-Death Pregnancy Complication46:55 Science Faith and Letting Go48:15 Closing Gratitude and TakeawaysAbout Dr. Neha Pandita Dr. Neha Pandita is a neurologist and movement disorder specialist based in India. She specialises in Parkinson's disease, dystonia, deep brain stimulation, and neurodegenerative disorders. She completed her MBBS, DNB, DM Neurology, and a fellowship in movement disorders, and has been practising for over fifteen years.Keywords: Deepinder Goyal Temple device, brain hacking India, neurologist reacts, Dr Neha Pandita, xMonks Drive, Gaurav Arora podcast, neurology India, Parkinson's disease India, deep brain stimulation explained, writer's dystonia, brain health tips, movement disorder specialist India, Zomato founder brain device, how the brain works, dopamine serotonin explained, Alzheimer's India, brain myths debunked, Indian podcast, motivation and the brain, Kashmiri Pandit story, Indian neurologist, DBS surgery explained, psychedelics and the brain, ne
Join an expert-led discussion exploring the safety and clinical outcomes of Class 1c antiarrhythmic therapy following percutaneous coronary intervention (PCI) in patients with new-onset atrial fibrillation, based on insights from a nationwide cohort study. Deep Chandh Raja, MBBS, MD, PhD (Australian National University and Kauvery Hospital) hosts a dynamic conversation with Sandeep Gautam, MD, MPH, FHRS (University of Missouri Health) and Deepak Padmanabhan, MD, FHRS (Narayana Institute of Cardiac Sciences, Bengaluru). Together, they examine real-world data on the use of Class 1c agents in a traditionally high-risk population, addressing long-standing concerns about proarrhythmia and ischemic heart disease. The discussion will highlight patient selection, evolving clinical practice patterns, and implications for guideline-directed management, offering clinicians practical insights into optimizing rhythm control strategies in complex post-PCI patients. Learning Objectives Evaluate the safety profile and clinical outcomes associated with Class 1c antiarrhythmic therapy in patients with new-onset atrial fibrillation following PCI. Identify appropriate patient selection criteria and clinical considerations when prescribing Class 1c agents in the context of ischemic heart disease. Apply evidence from nationwide cohort data to inform decision-making and optimize rhythm management strategies in post-PCI atrial fibrillation patients. Link to the Article for Discussion Article AuthorsTing-Chun Huang MD, Po-Hsueh Su MD, Hui-Wen Lin MS, Po-Tseng Lee MD, Yu Liao MD, Chao-Yu Chen MD, Li-Hao Yap MD, Sheng-Hsiang Lin PhD, Yi-Heng Li MD, PhD Podcast ContributorsDeep Chandh Raja, MBBS, MD, PhD Sandeep Gautam, MD, MPH, FHRS Deepak Padmanabhan, MD, FHRS Host and Contributor Disclosure(s): D.C. RajaNothing to disclose. S. Gautam Honoraria/Teaching/Speaking/Consulting: Biosense Webster Fellowship Support: Medtronic Inc., Abbott D. Padmanabhan Nothing to disclose.
For many women, a history of breast cancer has meant an automatic “no” when it comes to menopausal hormone therapy. But is the story really that simple? In this video, we explore a more nuanced and evolving conversation—one grounded in decades of research, including the work of Avrum Z. Bluming, MD, and other leading experts who have closely examined the data on hormone therapy after breast cancer. Across multiple studies and reviews spanning over 40 years, the evidence paints a more complex picture. While certain risks—such as thromboembolism with oral formulations—are well documented, the long-held belief that hormone therapy universally increases breast cancer recurrence or mortality is increasingly being questioned. In fact, most studies have not shown an increase in breast cancer–related death, and only one trial demonstrated a limited increase in local (not distant) recurrence. At the same time, menopausal hormone therapy remains the most effective treatment for symptoms that deeply affect quality of life—while also offering potential benefits for cardiovascular health, bone strength, cognitive function, and longevity. So where does this leave us? This video is not about giving a one-size-fits-all answer. It's about encouraging thoughtful, informed decision-making. It's about moving beyond fear-based assumptions and toward individualized care—where risks and benefits are carefully weighed, and where women feel empowered to ask questions, seek multiple perspectives, and have meaningful conversations with their physicians. Because the most important takeaway is this: you deserve to be fully informed. Resources: Hormone Replacement Therapy After Breast Cancer: It Is Time Avrum Z. Bluming, MD LINK - https://bit.ly/4st0uji Menopausal Hormone Therapy for Breast Cancer Patients: What Is the Current Evidence? Sarah Glynne, MBBS, MSc, MRCP, MRCGP; James Simon, MD; Anthony Branson, FRCP; Stephen Payne, FRCS; Louise Newson, MBChB; Isaac Manyonda, PhD; Susan Cleator, PhD; Michael Douek, MD; Sasha Usiskin, MRCP; Jeffrey S. Tobias, MD; Jayant S. Vaidya, PhD LINK - https://bit.ly/41leKyt
Understand the invisible physics at play! Lorenna Vidal, MD, speaks with host Raisa Amiruddin, MBBS, to demystify the MRI scanner. Explore the unique needs of imaging children and why every moment near an MRI scanner requires a safety-first mindset and a meticulous balance of risk and benefit with expert guidance.