Podcasts about mbbs

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Latest podcast episodes about mbbs

CCO Medical Specialties Podcast
Key PBC Studies From EASL and DDW 2025

CCO Medical Specialties Podcast

Play Episode Listen Later Jul 7, 2025 18:54


In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH​, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/44ySoL3Follow along with the slides: https://bit.ly/3IvwQrjGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

CCO Infectious Disease Podcast
Key PBC Studies From EASL and DDW 2025

CCO Infectious Disease Podcast

Play Episode Listen Later Jul 7, 2025 18:54


In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH​, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/4lKaO2HFollow along with the slides: https://bit.ly/44PPBysGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. 

PeerVoice Clinical Pharmacology Audio
Liz Lightstone, MBBS (Hons), PhD, FRCP - Preventing Flare and Protecting Function: What Progress Is Being Made in Active Lupus Nephritis?

PeerVoice Clinical Pharmacology Audio

Play Episode Listen Later Jul 7, 2025 50:18


Liz Lightstone, MBBS (Hons), PhD, FRCP - Preventing Flare and Protecting Function: What Progress Is Being Made in Active Lupus Nephritis?

Generations of Regeneration
Jasjit Dillon, MBBS, DDS, FDSCRCS, FACS & Lauren Basile, DMD

Generations of Regeneration

Play Episode Listen Later Jul 3, 2025 32:10


In this special episode of Generations of Regenerations, Dr. Lauren Basile sits down with mentor Dr. Jasjit Dillon. Although they are still close to this day and stay in touch often there were a several stories that Dr. Dillon was able to share with Dr. Basile for the first time! Tune in to hear this captivating episode featuring two women in OMFS.

Continuum Audio
Clinical Features and Diagnosis of Normal Pressure Hydrocephalus with Dr. Abhay Moghekar

Continuum Audio

Play Episode Listen Later Jul 2, 2025 20:54


Normal pressure hydrocephalus (NPH) is a clinical syndrome characterized by the triad of gait apraxia, cognitive impairment, and bladder dysfunction in the radiographic context of ventriculomegaly and normal intracranial pressure. Accurate diagnosis requires consideration of clinical and imaging signs, complemented by tests to exclude common mimics. In this episode, Lyell Jones, MD, FAAN speaks with Abhay R. Moghekar, MBBS, author of the article “Clinical Features and Diagnosis of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Moghekar is an associate professor of neurology at Johns Hopkins University School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Clinical Features and Diagnosis of Normal Pressure Hydrocephalus Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr Abhay Moghekar, who recently authored an article on the clinical features and diagnosis of normal pressure hydrocephalus for our first-ever issue of Continuum dedicated to disorders of CSF dynamics. Dr Moghekar is an associate professor of neurology and the research director of the Cerebrospinal Fluid Center at Johns Hopkins University in Baltimore, Maryland. Dr Moghekar, welcome, and thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Moghekar: Thank you, Dr Jones. I'm Abhay Moghekar. I'm a neurologist at Hopkins, and I specialize in seeing patients with CSF disorders, of which normal pressure hydrocephalus happens to be the most common. Dr Jones: And let's get right to it. I think most of our listeners who are neurologists in practice have encountered normal pressure hydrocephalus, or NPH; and it's a challenging disorder for all the reasons that you outline in your really outstanding article. If you were going to think of one single most important message to our listeners about recognizing patients with NPH, what would that be? Dr Moghekar: I think I would say there are two important messages. One is that the triad is not sufficient to make the diagnosis, and the triad is not necessary to make the diagnosis. You know these three elements of the triad: cognitive problems, gait problems, bladder control problems are so common in the elderly that if you pick 10 people out in the community that have this triad, it's unlikely that even one of them has true NPH. On the other hand, you don't need all three elements of the triad to make the diagnosis because the order of symptoms matters. Often patients develop gait dysfunction first, then cognitive dysfunction, and then urinary incontinence. If you wait for all three elements of the triad to be present, it may be too late to offer them any clear benefit. And hence, you know, it's neither sufficient nor necessary to make the diagnosis. Dr Jones: That's a really great point. I think most of our listeners are familiar with the fact that, you know, we're taught these classic triads or pentads or whatever, and they're rarely all present. In a way, it's maybe a useful prompt, but it could be distracting or misleading, even in a way, in terms of recognizing the patient. So what clues do you use, Dr Moghekar, to really think that a patient may have NPH? Dr Moghekar: So, there are two important aspects about gait dysfunction. Say somebody comes in with all three elements of the triad. You want to know two things. Which came first? If gate impairment precedes cognitive impairment, it's still very likely that NPH is in the differential. And of the two, which are more- relatively more affected? So, if somebody has very severe dementia and they have a little bit of gait problems, NPH is not as likely. So, is gait affected earlier than cognitive dysfunction, and is it affected to a more severe degree than cognitive dysfunction? And those two things clue me in to the possibility of NPH. You still obviously need to get imaging to make sure that they have large ventricles. One of the problems with imaging is large ventricles are present in so many different patients. Normal aging causes large ventricles. Obviously, many neurodegenerative disorders because of cerebral atrophy will cause large ventricles. And there's an often-used metric called as the events index, which is the ratio of the bitemporal horns- of the frontal horns of the lateral ventricles compared to the maximum diameter of the skull at that level. And if that ratio is more than 0.3, it's often used as a de facto measure of ventriculomegaly. What we've increasingly realized is that this ratio changes with age. And there's an excellent study that used the ADNI database that looked at how this ratio changes by age and sex. So, in fact, we now know that an 85-year-old woman who has an events index of 0.37 which would be considered ventriculomegaly is actually normal for age and sex. So, we need to start adopting these more modern age- and sex-appropriate age cutoffs of ventriculomegaly so as not to overcall everybody with big ventricles as having possible NPH. Dr Jones: That's very helpful. And I do want to come back to this challenge that we've seen in our field of overdiagnosis and underdiagnosis. But I think most of us are familiar with the concept of how hydrocephalus could cause neurologic deficits. But what's the latest on the mechanism of NPH? Why do some patients get this and others don't? Dr Moghekar: Very good question. I don't think we know for sure. And it for a long time we thought it was a plumbing issue. Right? And that's why shunts work. People thought it was impaired CSF absorption, but multiple studies have shown that not to be true. It's likely a combination of impaired cerebral blood flow, biomechanical factors like compliance, and even congenital factors that play a role in the pathogenesis of NPH. And yes, while putting in shunts likely drains CSF, putting in a shunt also definitely changes the compliance of the brain and affects blood flow to the subcortical regions of the brain. So, there are likely multiple mechanisms by which shunts benefit, and hence it's very likely that there's no single explanation for the pathogenesis of NPH. Dr Jones: We explored this in a recent Continuum issue on dementia. Many patients who have cognitive impairment have co-pathologies, multiple different causes. I was interested to read in your article about the genetic risk profile for NPH. It's not something I'd ever really considered in a disorder that is predominantly seen in older patients. Tell us a little more about those genetic risks. Dr Moghekar: Yeah, everyone is aware of the role genetics plays in congenital hydrocephalus, but until recently we were not aware that certain genetic factors may also be relevant to adult-onset normal pressure hydrocephalus. We've suspected this for a long time because nearly half of our patients who come to us to see us in clinic with NPH have head circumferences that are more than 90th percentile for height. And you know, that clearly indicates that this started shortly at the time after birth or soon afterwards. So, we've suspected for a long time that genetic factors play a role, but for a long time there were not enough large studies or well-conducted studies. But recently studies out of Japan and the US have shown mutations in genes like CF43 and CWH43 are disproportionately increased in patients with NPH. So, we are discovering increasingly that there are genetic factors that underlie even adult onset in patients. There are many more waiting to be discovered. Dr Jones: Really fascinating. And obviously getting more insight into the risk and mechanisms would be helpful in identifying these patients potentially earlier. And another thing that I learned in your article that I thought was really interesting, and maybe you can tell us more about it, is the association between normal pressure hydrocephalus and the observation of cervical spinal stenosis, many of whom require decompression. What's behind that association, do you think? Dr Moghekar: That's a very interesting study that was actually done at your institution, at Mayo Clinic, that showed this association. You know, as we all get older, you know, the incidence of cervical stenosis due to osteoarthritis goes up, but the incidence of significant, clinically significant cervical stenosis in the NPH population was much higher than what we would have expected. Whether this is merely an association in a vulnerable population or is it actually causal is not known and will need further study. Dr Jones: It's interesting to speculate, does that stenosis affect the flow of CSF and somehow predispose to a- again, maybe a partial degree for some patients? Dr Moghekar: Yeah, which goes back to the possible hydrodynamic theory of normal pressure hydrocephalus; you know, if it's obstructing normal CSF flow, you know, are the hydrodynamics affected in the brain that in turn could lead to the development of hydrocephalus. Dr Jones: One of the things I really enjoyed about your article, Abhay, was the very strong clinical focus, right? We can't just take an isolated biomarker or radiographic feature and rely on that, right? We really do need to have clinical suspicion, clinical judgment. And I think most of our listeners who've been in practice are familiar with the use and the importance of the large-volume lumbar puncture to determine who may have, and by exclusion not have, NPH, and then who might respond to CSF diversion. And I think those of us who have been in this situation are also familiar with the scenario where you think someone may have NPH and you do a large-volume lumbar puncture and they feel better, but you can't objectively see a difference. How do you make that test useful and objective in your practice? What do you do? Dr Moghekar: Yeah, it's a huge challenge in getting this objective assessment done carefully because you have to remember, you know, subconsciously you're telling the patients, I think you have NPH. I'm going to do this spinal tap, and if you walk better afterwards, you're going to get a shunt and you're going to be cured. And you can imagine the huge placebo response that can elicit in our subjects. So, we always like to see, definitely, did the patient subjectively feel better? Because yes, that's an important metric to consider because we want them to feel better. But we also wanted to be grounded in objective truths. And for that, we need to do different tests of speed, balance and endurance. Not everyone has the resources to do this, but I think it's important to test different domains. Just like for cognition, you know, we just don't test memory, right? We test executive function, language, visuospatial function. Similarly, walking is not just walking, right? It's gait speed, it's balance, and it's endurance. So, you need to ideally test at least most of these different domains for gait and you need to have some kind of clear criteria as to how are you going to define improvement. You know, is a 5% improvement, is a 10% improvement in gait, enough? Is 20%? Where is that cutoff? And as a field, we've not done a great job of coming up with standardized criteria for this. And it varies currently, the practice varies quite significantly from center to center at the current time. Dr Jones: So, one of the nice things you had in your article was helpful tips to be objective if you're in a lower-resource setting. For you, this isn't a common scenario that someone encounters in their practice as opposed to a center that maybe does a large volume of these. What are some relatively straightforward objective measures that a neurologist or someone else might use to determine if someone is improving after a large-volume LP? Dr Moghekar: Yeah, excellent question, Dr Jones, and very practically relevant too. So, you need to at least assess two of the domains that are most affected. One is speed and one is balance. You know, these patients fall ultimately, right, if you don't treat them correctly. In terms of speed, there are two very simple tests that anybody can do within a couple of minutes. One is the timed “up-and-go” test. It's a test that's even recommended by the CDC. It correlates very well with faults and disability and it can be done in any clinic. You just need about ten feet of space and a chair and a stopwatch, and it takes about a minute or slightly more to do that test. And there are objective age-associated norms for the timed up-and-go test, so it's easy to know if your patient is normal or not. The same thing goes for the 10-meter walk test. You do need a slightly longer walkway, but it's a fairly easy and well-standardized test. So, you can do one of those two; you don't need to do both of them. And for balance, you can do the 30-second “sit-to-stand”; and it's literally, again, 30 seconds. You need a chair, and you need somebody to watch the patient and see how many times they can sit up and stand up from a seated position. Then again, good normative data for that. If you want to be a little more sophisticated, you can do the 4-stage balance test. So, I think these are tests that don't add too much time to your daily assessment and can be done with even trained medical assistants in any clinic. And you don't need a trained physical therapist to do these assessments. Dr Jones: Very practical. And again, something that is pretty easily deployed, something we do before and then after the LP. I did see you mentioned in your article the dual timed up-and-go test where it's a simultaneous gait and executive function test. And I've got to be honest with you, Dr Moghekar, I was a little worried if I would pass that test, but that may be beyond the scope of our time today. Actually, how do you do that? How do you do the simultaneous cognitive assessment? Dr Moghekar: So, we asked them to count back from 100, subtracting 3. And we do it particularly in patients who are mildly impaired right? So, if they're already walking really good, but then you give them a cognitive stressor, you know, that will slow them down. So, we reserve it for patients who are high-performing. Dr Jones: That's fantastic. I'm probably aging myself a little here. I have noticed in my career, a little bit of a pendulum swing in terms of the recognition or acceptance of the prevalence of normal pressure hydrocephalus. I recall when I was a resident, many, many people that we saw in clinic had normal pressure hydrocephalus. Then it seemed for a while that it really faded into the background and was much less discussed and much less recognized and diagnosed, and less treated. And now that pendulum seems to have swung back the other way. What's behind that from your perspective? Dr Moghekar: It's an interesting backstory to all of this. When the first article about NPH was published in the Newman Journal of Medicine, it was actually a combined article with both neurologists and neurosurgeons on it. They did describe it as a treatable dementia. And what that did is it opened up the floodgates so that everybody with any kind of dementia started getting shunts left, right, and center. And back then, shunts were not programmable. There were no antibiotic impregnated catheters. So, the incidence of subdural hematomas and shunt-related infections was very high. In fact, one of our esteemed neurologists back then, Houston Merritt, wrote a scathing editorial that Victor and Adam should lose their professorships for writing such an article because the outcomes of these patients were so bad. So, for a very long period of time, neurologists stopped seeing these patients and stopped believing in NPH as a separate entity. And it became the domain of neurosurgeons for over two or three decades, until more recently when randomized trials started being done early on out of Europe. And now there's a big NIH study going on in the US, and these studies showed, in fact, that NPH exists as a true, distinct entity. And finally, neurologists have started getting more interested in the science and understanding the pathophysiology and taking care of these patients compared to the past. Dr Jones: That's really helpful context. And I guess that maybe isn't rare when you have a disorder that doesn't have a simple, straightforward biomarker and is complex in terms of the tests you need to do to support the diagnosis, and the treatment itself is somewhat invasive. So, when you talk to your patients, Dr Moghekar, and you've established the diagnosis and have recommended them for CSF diversion, what do you tell them? And the reason I ask is that you mentioned before we started recording, you had a patient who had a shunt placed and responded well, but continued to respond over time. Tell us a little bit more about what our patients can expect if they do have CSF diversion? Dr Moghekar: When we do the spinal tap and they meet our criteria for improvement and they go on to have a shunt, we tell them that we expect gait improvement definitely, but cognitive improvement may not happen in everyone depending on what time, you know, they showed up for their assessment and intervention. But we definitely expect gait improvement. And we tell them that the minimum gait improvement we can expect is the same degree of improvement they had after their large-volume lumbar puncture, but it can be even more. And as the brain remodels, as the hydrodynamics adapt to these shunts… so, we have patients who continue to improve one year, two years, and even three years into the course of the intervention. So, we're, you know, hopeful. At the same time, we want to be realistic. This is the same population that's at risk for developing neurodegenerative disorders related to aging. So not a small fraction of our patients will also have Alzheimer's disease, for example, or go on to develop Lewy body dementia. And it's the role of the neurologist to pick up on these comorbid conditions. And that's why it's important for us to keep following these patients and not leave them just to the neurosurgeon to follow up. Dr Jones: And what a great note to end on, Dr Moghekar. And again, I want to thank you for joining us, and thank you for such a wonderful discussion and such a fantastic article on the clinical diagnosis of normal pressure hydrocephalus. I learned a lot reading the article, and I learned a lot more today just in the conversation with you. So, thank you for being with us. Dr Moghekar: Happy to do that, Dr Jones. It was a pleasure. Dr Jones: Again, we've been speaking with Dr Abhay Moghekar, author of a wonderful article on the clinical features and diagnosis of NPH in Continuum's first-ever issue dedicated to disorders of CSF dynamics. Please check it out. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

The afikra Podcast
Mental Healthcare For Children That Have Survived War | Dr Atif Magbool

The afikra Podcast

Play Episode Listen Later Jun 30, 2025 32:38


We're joined by Dr Atif Magbool at Sidra Medicine who talks to us about the immense challenges and efforts in providing mental healthcare to children and women in crisis-affected areas. Dr Magbool shares his journey into pediatric psychiatry – primarily influenced by early experiences in Sudan – and discusses the significant differences between child and adult psychiatry. The conversation explores the Gaza Patient Program initiated by Sidra Medicine, which offers comprehensive medical, surgical, and psychological care to children affected by the ongoing genocide in Gaza. Dr Magbool also touches upon the remarkable resilience observed in children survivors, the continuous trauma faced by Palestinian children, and the critical need for mental health support during and after war. The dialogue sheds light on the importance of providing a safe and supportive environment for affected children and the broader impact of war on the mental health sector in crisis zones.This episode is in collaboration with Qatar Foundation. 00:00 Introduction01:29 Dr Magbool's Journey into Psychiatry04:32 Understanding Pediatric Psychiatry06:47 The Gaza Patient Program18:42 Challenges in Palestinian Healthcare20:49 Personal Reflections and Emotional Impact30:39 Support for Women in Crisis35:36 Call to Action Dr Atif Magbool is the Lead Consultant for the Inpatient Pediatrics Beds Under Psychiatric Coverage (PBUPC) team and a member of the CAMHS outpatient services at Sidra Medicine. He earned his MBBS from Omdurman University in Sudan and completed his psychiatric training in Ireland, obtaining his MRCPsych in 2012. He later specialized in Child and Adolescent Psychiatry in Scotland, receiving his CCT before working as a consultant there. He also holds diplomas in Clinical Psychiatry and Health Services Management and has extensive experience in managing a wide range of psychiatric and behavioral disorders in children and adolescents across inpatient, outpatient, and day hospital settings. He is also active in medical education and is fluent in Arabic and English, with proficiency in Serbo-Croatian. Hosted by: Mikey Muhanna

TALRadio
Why Neurological Awareness Matters | Special Interview With Dr.S.Naresh Kumar

TALRadio

Play Episode Listen Later Jun 28, 2025 31:28


Neurological disorders are rising, yet awareness remains alarmingly low. Join us for a compelling conversation with Dr. S. Naresh Kumar, a distinguished neurologist (MBBS, DNB - General Medicine, DM - Neurology), as he breaks down the importance of early detection, prevention, and public education. From strokes to migraines, neurological health touches every life. Hosted by Suhasini, this episode will empower you with insights that matter. Don't miss this special interview on Spotify & Apple Podcast, only on TALRadio.Host : SuhasiniGuest : Dr.S. Naresh Kumar, a distinguished neurologist #TALRadioEnglish #NeurologicalAwareness #BrainHealthMatters #TALHospitals #DrNareshKumar #NeurologyTalks #NeuroCare #PreventNeurologicalDisorders #HealthEducation #TALRadioSpecial #SuhasiniTalks #KnowYourBrain #MedicalAwareness #TouchALife #TALRadio

Faculty Factory
Integrating Humanities into Medical Education with P. Ravi Shankar, MBBS, MD

Faculty Factory

Play Episode Listen Later Jun 27, 2025 31:56


The vital role of the humanities in shaping empathetic communication skills and critical-minded healthcare professionals is explored today with our guest, P. Ravi Shankar, MBBS, MD. Dr. Shankar, MBBS, MD, currently serves as faculty and program coordinator at the IMU Centre for Education in Kuala Lumpur, Malaysia. He is a Foundation for Advancement of International Medical Education and Research (FAIMER) Institutes Scholar and a prolific researcher. Read more: http://facultyfactory.org/ravi-shankar 

Superintendent's Hangout
#101: Heartbeats Beyond Boundaries: Muhammad M. Mohiuddin, MBBS

Superintendent's Hangout

Play Episode Listen Later Jun 26, 2025 50:55 Transcription Available


Send us a textIn this episode, Dr. Sciarretta speaks with Dr. Muhammad Mohiuddin, a surgeon who specializes in cardiac xenotransplantation (replacing failing human hearts with pig hearts). Listen to hear more about Dr. Mohiuddin's journey, the ethical and structural issues his work presents, and the moments in which his decades of revolutionary work have come to fruition. Support the showIf you enjoyed this episode please give us a five-star rating and consider donating. Your generosity helps our shoe-string budget and allows us to continue producing high-quality content. Click here to donate.

TALRadio
Inside the PICU Stories, Science & Strength | Special Interview Dr.K.Amer Khan

TALRadio

Play Episode Listen Later Jun 21, 2025 44:56


Get ready for an insightful conversation with Dr. K. Amer Khan, Consultant Intensivist and General Pediatrician, as he takes us behind the scenes of pediatric critical care. With an MBBS, MD in Pediatrics, and a Fellowship in Pediatric Critical Care (IDPCCM), Dr. Khan brings over 6 years of hands-on experience from the Pediatric ICU. In this special interview hosted by Suhasini, we explore the clinical challenges, ethical decisions, and emotional resilience required in saving young lives. Catch this insightful episode on TALRadio English on Spotify and Apple Podcast!Host : SuhasiniGuest : Dr.K.Amer Khan#TALRadioEnglish #TALHospitals #DrAmerKhan #PediatricCare #PICUInsights #CriticalCareHeroes #InsideThePICU #ChildHealthMatters #MedicalStories #HealthcareWithHeart #PediatricIntensivist #DoctorDiaries #EthicsInMedicine #TouchALife #TALRadio

In Focus by The Hindu
What are the risks of the government's proposed 'mixopathy' move?

In Focus by The Hindu

Play Episode Listen Later Jun 13, 2025 26:37


The Central government recently proposed starting an integrated course – MBBS and Ayurveda medicine, at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Puducherry. This proposed move has evoked a strong response from the Indian Medical Association who has said this unscientific mixing of various systems of medicine will benefit neither doctors, nor patients. This is not the first move to mix traditional and modern systems of medicine in India – other such measures for instance, have included proposals to allow traditional medical practitioners to prescribe modern medicine after a short course. What are the risks of mixing alternative systems of medicine with the MBBS course? Is there a benefit to integrated systems and if so, how should these be brought in? Has any other country managed to successfully combine alternative systems with modern, evidence based medicine? Guest: Rajeev Jayadevan is the Chairman, Research Cell, Kerala State IMA, Past President, IMA Cochin Host: Zubeda Hamid Edited by Sharmada Venkatasubramanian Learn more about your ad choices. Visit megaphone.fm/adchoices

The Lead Podcast presented by Heart Rhythm Society
The Lead Podcast - Episode 107: A Discussion of Catheter Ablation of AFib in Cardiac Sarcoidosis and Amyloidosis...

The Lead Podcast presented by Heart Rhythm Society

Play Episode Listen Later Jun 12, 2025 12:11


Join HRS Board Member Prashanthan Sanders, MBBS, PhD, FHRS (University of Adelaide) as he discusses this exciting paper, presented at Heart Rhythm 2025. He is joined in the Heart Rhythm Tv Studio in San Diego, California by Louise Segan, MBBS, MPH (Alfred Health), and Takanori Yamaguchi, MD, PhD (Saga University). This discussion took place on-site at Heart Rhythm 2025.   https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)01245-7/fulltext Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical, Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): T. Yamaguchi: Honoraria/Speaking/Consulting: Abbott Japan, Biotronik, Boston Scientific, Abbott Medical, Japan Medtronic, Inc., Daiichi Sankyo, Novartis, Japan Lifeline, Nihon Kohden, Bayer Healthcare Pharmaceuticals Japan, Boehringer Ingelheim L. Segan: Nothing to disclose.

Treating Blood Cancers
Strategies and Advances in AML

Treating Blood Cancers

Play Episode Listen Later Jun 12, 2025 38:02


Uma Borate, MBBS, MS, The Ohio State University, Cleveland, OH Recorded on May 27, 2025 Uma Borate, MBBS, MS Associate Professor, Division of Hematology Acute Leukemia Clinical Research Disease Group Leader The Ohio State University Cleveland, OH What's changing in acute myeloid leukemia (AML)? Join Dr. Uma Borate from The Ohio State University in Columbus, Ohio, as she dives into emerging breakthroughs in AML biology, including molecular drivers, menin inhibitors, and the challenges of developing bispecifics and CAR T-cell therapies. She also shares updates from the LLS Beat AML® Master Clinical Trial and ongoing clinical trials, and reflects on the evolving treatment landscape across age groups. Don't miss this dynamic conversation packed with expertise and hope for the future of AML!

AJR Podcast Series
Welcome to Pediatric Imaging - Pediatric Imaging, an AJR Podcast Series (Trailer)

AJR Podcast Series

Play Episode Listen Later Jun 5, 2025 1:39


Raisa Amiruddin, MBBS, brings to you a brand-new podcast series delving into the fascinating world of pediatric imaging to empower radiologists everywhere to provide the best possible care for our youngest patients. 

The Lead Podcast presented by Heart Rhythm Society
The Lead Podcast - Episode 106: A Discussion of 1st-in-Human Study of a Leadless Pacemaker System...

The Lead Podcast presented by Heart Rhythm Society

Play Episode Listen Later Jun 5, 2025 18:29


Prashanthan Sanders, MBBS, PhD, FHRS, University of Adelaide is joined by Jenish Shroff, MBBS, MD, Australian National University, and Pugazhendhi Vijayaraman, MD, FHRS, Geisinger Heart Institute, to discuss this first-in-human feasibility study evaluated a novel helix-based leadless pacemaker (LPCSP) designed to achieve left bundle branch area pacing (LBBAP), a capability current LPs lack. The device was temporarily implanted via the internal jugular vein into the interventricular septum in 14 patients, with successful implantation in 10. Electrical performance metrics, including pacing threshold, R-wave amplitude, and impedance, were within acceptable clinical ranges. LBBAP capture was achieved in 5 patients, with no serious device-related adverse events in 85.7% of cases. The study supports the acute safety and feasibility of LPCSP for conduction system pacing.    https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)02378-1/fulltext Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical, Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): P. Vijayaraman: Honoraria/Speaking/Consulting: Biotronik, Boston Scientific, Abbott Medical, Medtronic, Inc. Research (Contracted Grants for PIs and Named Investigators only): Medtronic Fellowship Support: Medtronic J. Shroff: Nothing to disclose.

JACC Podcast
ACS Guidelines | MCS in Acute Myocardial Infarction-Cardiogenic Shock | JACC

JACC Podcast

Play Episode Listen Later Jun 3, 2025 11:18


JACC's June 10 issue, focusing on the ACS guideline, features a series of videos with unique perspectives. In this video, JACC: Executive Associate Editor Karthik Murugiah, MBBS, MHS, FACC, introduces his paper discussing the guideline's reliance on four landmark RCTs in AMI-CS. Several sweeping changes in recommendations for MCS use have been codified that should influence practice and improve care for these high-risk patients. While IABP use is expected to decrease, use of mAFP is likely to increase but should be judicious, with caution against overgeneralizing given the narrow selection criteria of DanGer Shock. Evaluating real-world practice patterns and outcomes of patients with AMI-CS based on these recommendations will be paramount.

VJHemOnc Podcast
Recent advances in Hodgkin lymphoma treatment: novel regimens, ongoing trials & treating R/R disease

VJHemOnc Podcast

Play Episode Listen Later May 30, 2025 11:43


In this episode of the VJHemOnc podcast, join us for an insightful conversation with Dr Graham Collins, MA, MBBS, MRCP,... The post Recent advances in Hodgkin lymphoma treatment: novel regimens, ongoing trials & treating R/R disease appeared first on VJHemOnc.

The Gut Doctor
Food as Medicine: Beans with Ruchir Paladiya MBBS

The Gut Doctor

Play Episode Listen Later May 27, 2025 9:51


Beans are a staple in many cuisines around the world. In this episode of the Food as Medicine series, Dr. Parikh interviews Dr. Ruchir Paladiya, a third year medicine resident at the University of Connecticut. Dr. Paladiya details the various nutritional benefits of beans and how you can incorporate them into your diet. 

OPENPediatrics
Building Global Pediatric Research Networks by L. Schlapbach, P. Ramnarayan | OPENPediatrics

OPENPediatrics

Play Episode Listen Later May 26, 2025 34:07


This World Shared Practice Forum Podcast episode features a discussion on the article "Building Global Collaborative Research Networks in Pediatric Critical Care: A Roadmap," published in Lancet Child and Adolescent Health in February 2025. The conversation, led by Dr. Jeff Burns with guests Professor Luregn Schlapbach and Professor Padmanabhan Ramnarayan, explores the challenges and strategies for creating effective global research networks in pediatric critical care. The speakers highlight the importance of collaboration, the need for a robust evidence base, and the potential of large data models to drive the future of precision medicine and improve patient outcomes. LEARNING OBJECTIVES - Understand the current landscape and challenges of pediatric critical care research - Identify the key components and benefits of global collaborative research networks - Learn about the action plans and goals for advancing global pediatric critical care research AUTHORS Luregn Schlapbach, MD, PhD, Prof, FCICM Head, Department of Intensive Care and Neonatology University Children's Hospital in Zurich, Switzerland Padmanabhan "Ram" Ramnarayan, MBBS, MD, FRCPCH, FFICM Professor of Paediatric Critical Care Imperial College London Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: May 26, 2025. ARTICLE REFERENCED Schlapbach LJ, Ramnarayan P, Gibbons KS, et al. Building global collaborative research networks in paediatric critical care: a roadmap. Lancet Child Adolesc Health. 2025;9(2):138-150. doi:10.1016/S2352-4642(24)00303-1 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/7hptjhbmtkv8sqx7m86934/202505_WSP_Schlapbach_and_Ramnarayan_Transcript-3864x5000-258ba60.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Schlapbach LJ, Ramnarayan P, Burns JP. Building Global Pediatric Research Networks. 05/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/building-global-pediatric-research-networks-by-l-schlapbach-p-ramnarayan-openpediatrics.

The HemOnc Pulse
Inside the War on Myeloid Malignancies: Early Clues & Bold Innovations

The HemOnc Pulse

Play Episode Listen Later May 23, 2025 20:32


In this episode of HemOnc Pulse, host Rahul Banerjee, MD, FACP of Fred Hutch Cancer Center is joined by myeloid malignancy expert Uma Borate, MBBS of The Ohio State University, for a high-impact discussion on one of hematology's hottest frontiers: early detection. As aggressive diseases like AML and MDS continue to outpace traditional diagnostics, this conversation dives into why spotting these cancers sooner isn't just helpful—it's lifesaving.  

VJHemOnc Podcast
Gene therapy in sickle cell disease: patient selection, potential complications, & more

VJHemOnc Podcast

Play Episode Listen Later May 23, 2025 21:19


In this episode of the VJHemOnc podcast you will hear from Akshay Sharma, MBBS, MSc, St. Jude Children's Research Hospital,... The post Gene therapy in sickle cell disease: patient selection, potential complications, & more appeared first on VJHemOnc.

AAD's Dialogues in Dermatology
Practice Management Series: Telehealth Coding for 2025 and Beyond

AAD's Dialogues in Dermatology

Play Episode Listen Later May 16, 2025


Trilokraj Tejasvi, MD, MBBS interviewed by Brad P. Glick, DO, MPH, FAAD

Oncology Overdrive
Cultural Adaptability in Global Oncology with Abiola Ibraheem, MD

Oncology Overdrive

Play Episode Listen Later May 15, 2025 29:23


In this episode, host Shikha Jain, MD, speaks with Abiola Ibraheem, MD, about the role culture plays in improving global oncology, launching the Best of ASCO in Africa and more. •    Welcome to another exciting episode of Oncology Overdrive 1:34 •    About Ibraheem 1:42 •    The interview 3:02 •    How did you get where you are today?  3:28 •    Can you tell me more about Aortic Africa and your role within the organization? 5:41 •    What are some challenges you have encountered in doing this work, both locally and internationally? 7:33 •    How have you navigated the nuances of global oncology in other countries?  9:51 •    Did you get any pushback when you decided to create these global relationships and inroads? How did you navigate receiving different perspectives on your work? 12:10 •    What are you hoping to achieve with these efforts in global oncology? 16:28 •    Where did the idea for a Best of ASCO Africa come from, and what do you hope to achieve with the event? 17:41 •    Jain and Ibraheem on the importance of providing other countries with tools to implement and drive global change. 22:54 •    If someone could only listen to the last few minutes of this episode, what would you want listeners to take away? 27:29 •    How to contact Ibraheem 28:09 •    Thanks for listening 29:07 Abiola Ibraheem, MD, is a board-certified medical oncologist and assistant professor at the University of Illinois Chicago. Her journey in medicine began in Nigeria, where she earned her MBBS degree from Olabisi Onabanjo University. She then completed her internal medicine residency at Morehouse School of Medicine, focusing on racial health care disparities. We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X: @ShikhaJainMD. Ibraheem can be reached via email at abiolai@uic.edu. Learn more about Best of ASCO Africa, as well as how to sign up for in-person or virtual attendance, happening June 27 & 28 in Addis Abba, Ethiopia. Disclosures: Jain and Ibraheem report no relevant financial disclosures. 

OncLive® On Air
S13 Ep1: Cancer Vaccines Shake Up Disease Management and Prevention Strategies: With Shubham Pant, MD, MBBS; and Professor Timothy Elliott

OncLive® On Air

Play Episode Listen Later May 15, 2025 24:09


In today's episode, we spoke with Shubham Pant, MD, MBBS, and Professor Timothy Elliott, about ongoing research with cancer vaccines. Dr Pant is a professor in the Department of Gastrointestinal Medical Oncology in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston. Dr Elliott is the Kidani Professor of Immuno-oncology in the Nuffield Department of Medicine at the University of Oxford in the United Kingdom. In our exclusive interview, Pant and Elliott discussed the current landscape of vaccines for cancer treatment, ongoing research seeking to extend the benefits of vaccines as cancer management and prevention strategies, and what the future may hold.

OPENPediatrics
Technology & Innovation in Pediatric ICUs: A Dynamic Look at Asia

OPENPediatrics

Play Episode Listen Later May 7, 2025 44:58


The World Federation of Pediatric Intensive & Critical Care Societies (WFPICCS), in collaboration with OPENPediatrics, recognizes World PICU Awareness Week 2025. This initiative aims to raise global awareness about the importance of PICUs and critical care wards worldwide, emphasizing how healthcare professionals in these units, regardless of resource setting, are driving change. From frugal innovations to digital transformation, this episode highlights how pediatric intensive care is evolving across Asia. Hear from experts in Bangladesh, India, and Indonesia as they share how low-cost technologies, telemedicine, and integrated referral systems are improving outcomes for critically ill children even in the most remote settings. Discover how resilience and resourcefulness are driving change across the region. HOST Arun Bansal, MD, FCCM, FRCPCH Professor in Pediatric Critical Care at PGIMER Chandigarh, India and Chairperson of Pediatric Intensive Care Chapter of India GUESTS Mohammod Joyaber Chisti, MBBS, MMed (Paediatrics), PhD Professor of Pediatrics at icddr,b, Bangladesh Renowned for pioneering low-cost respiratory support technologies like bubble CPAP. Jayashree Muralidharan, MBBS MD Pediatrics FIAP FICCM Head of Pediatric Critical Care at PGIMER, Chandigarh, India A leader in intensive care in India. She had helped in developing and integrating digital health systems into PICU workflows using TelePICU. She also helped in developing a PICU Referral App Kurniawan Taufiq Kadafi, Sp.A(K) Chief of Pediatric Emergency Services, Indonesia, An expert on remote and interfacility pediatric transport across Indonesia's archipelago. DATE Initial publication date: May 7, 2025. TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/at/k7x72vx63hnbvwx6wpwc4xnt/WPAW-25_Asia_Final_English.pdf Spanish - https://cdn.bfldr.com/D6LGWP8S/at/qxkcv5b23xs49tj6z6w6np/WPAW-25_Asia_Final_Spanish.pdf French - https://cdn.bfldr.com/D6LGWP8S/at/v463w7zbhbbpfbbmj8qf8b/WPAW-25_Asia_Final_French.pdf Portuguese - https://cdn.bfldr.com/D6LGWP8S/at/p377fk7m84xmppk9hx6bbq6/WPAW-25_Asia_Final_Portuguese.pdf Italian - https://cdn.bfldr.com/D6LGWP8S/at/gxbshfgg7xcm7rfpx3p5n4vm/WPAW-25_Asia_Final_Italian.pdf German - https://cdn.bfldr.com/D6LGWP8S/at/4px7mgpbf65rbb8n8vv2sjr/WPAW-25_Asia_Final_German.pdf Arabic - https://cdn.bfldr.com/D6LGWP8S/at/64vtqntqj7v99j4ztc2pk5n3/WPAW-25_Asia_Final_Arabic.pdf Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

OPENPediatrics
Technology & Innovation in Pediatric ICUs: A Pioneering Look at the Middle East

OPENPediatrics

Play Episode Listen Later May 5, 2025 49:27


The World Federation of Pediatric Intensive & Critical Care Societies (WFPICCS), in collaboration with OPENPediatrics, recognizes World PICU Awareness Week 2025. This initiative aims to raise global awareness about the importance of PICUs and critical care wards worldwide, emphasizing how healthcare professionals in these units, regardless of resource setting, are driving change. From AI-driven sepsis screening to innovative non-invasive ventilation protocols, this episode delves into the transformative impact of technology and collaboration in pediatric intensive care across the Middle East. Join us as we hear from leading experts who are pioneering data-driven approaches and creative solutions to improve patient outcomes in resource-limited settings. Discover how these advancements are shaping the future of pediatric care in the region HOST Manu Somasundaram Sundaram, MBBS, MD (India), FRCPCH, CPHQ, MBA. Consultant PICU and Medical Director Quality, SIDRA Medicine , Doha, Qatar Assistant Professor , Weill Cornell Medicine - Qatar GUESTS Omar Al Dafaei, MD Consultant PICU Royal Hospital Muscat, Oman Kholoud Said, MD, MRCPCH Consultant –Pediatric ICU, Royal Hospital Muscat, Oman AbdulRahman Zayed Saad AlDaithan, MD Senior Specialist, Pediatric Intensive Care Unit Pediatrics Division General Ahmadi Hospital, Kuwait Oil Company (KOC) Al Ahmadi Area, Kuwait DATE Initial publication date: May 5, 2025. TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/at/rnkk777mrhwhq82w78hm54j4/WPAW-25_Middle_East_Final_English.pages Spanish - https://cdn.bfldr.com/D6LGWP8S/at/q37ww33767cvm527g3t92w5p/WPAW-25_Middle_East_Final_Spanish.pdf French - https://cdn.bfldr.com/D6LGWP8S/at/b58j8mpc4xwpm9mwf537hp/WPAW-25_Middle_East_Final_French.pdf Portuguese - https://cdn.bfldr.com/D6LGWP8S/at/7h4r8xg937364bbzbms9w9/WPAW-25_Middle_East_Final_Portuguese.pdf Italian - https://cdn.bfldr.com/D6LGWP8S/at/fsf97qrks969v9q9spbw9n/WPAW-25_Middle_East_Final_Italian.pdf German - https://cdn.bfldr.com/D6LGWP8S/at/56f5rhgws7ns94r6mgh9z/WPAW-25_Middle_East_Final_German.pdf Arabic - https://cdn.bfldr.com/D6LGWP8S/at/46j3wgv359br2fx6j399xtgk/WPAW-25_Middle_East_Final_Arabic.pdf Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

The Lead Podcast presented by Heart Rhythm Society
The Lead Podcast - Episode 101: A Discussion of Pulsed Field or Cryoballoon Ablation...

The Lead Podcast presented by Heart Rhythm Society

Play Episode Listen Later May 1, 2025 9:43


Join host Prashanthan Sanders, MBBS, PhD, FHRS, and episode guests Jason G. Andrade, MD, FHRS, and Melanie Gunawardene, MD, as they discuss Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation. This discussion was recorded in person at EHRA 2025 in Vienna, Austria. The article under discussion was presented at EHRA 2025 and simultaneously published in the New England Journal of Medicine.   https://www.hrsonline.org/education/TheLead https://www.nejm.org/doi/full/10.1056/NEJMoa2502280   Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical; Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical   Contributor Disclosure(s): M. Gunawrdene: Honoraria/Speaking/Consulting: Farapulse, Abbott Medical, Boston Scientific, Medtronic, Biotronik, Luma Vision, Bristol Myers Squibb J. Andrade: Honoraria/Speaking/Consulting: Boston Scientific, Medtronic, Inc., Biosense Webster, Inc.

Mind Body Peak Performance
#206 Biohacking 2.0 vs 3.0: High Performance Practices for Superconscious Flow State, Stress & More | Dr. Mark Atkinson @ The School of Biohacking

Mind Body Peak Performance

Play Episode Listen Later Apr 24, 2025 70:03


Wondering why your performance plateaus despite doing all the “right” things? Dr. Mark Atkinson joins Nick Urban to lay out the difference between short-term fixes & long-term bioharmonized health. We'll be covering nervous system regulation, flow states without substances, stress alchemy, & what high performers miss when they only focus on physical optimization. In this episode, get actionable strategies to rewire your system from the inside out Meet our guest Dr. Mark Atkinson, MBBS, BSc (Hons), FRSPH is a globally respected integrative & functional medicine doctor, master coach, and human potential expert. He co-founded the UK's first professional training in integrative medicine and served as the former medical director of Bulletproof Dr. Atkinson is co-director of Optimal Mind International and the creator of Human Potential Coaching, through which he has trained over 850 coaches. He also leads the Optimal Health, Longevity & Biohacking Certification Program, equipping professionals to teach personalized health, energy, and longevity strategies Thank you to our partners Outliyr Biohacker's Peak Performance Shop: get exclusive discounts on cutting-edge health, wellness, & performance gear Ultimate Health Optimization Deals: a roundup article of all the best current deals on technology, supplements, systems and more Gain mental clarity, energy, motivation, and focus with the FREE Outliyr Nootropics Mini-Course The simple, guided, and actionable Outliyr Longevity Challenge helps you unlock your longevity potential, slow biological aging, and maximize your healthspan Key takeaways Shift mood, energy & focus instantly without supplements or drugs. Use your mind instead Biohacking evolves into bioharmony by balancing mind, emotions & relationships When routines stop working, inner growth & emotional honesty break health plateaus Joy & contentment often come from releasing internal stress, not chasing achievements Saying “welcome” to all thoughts & feelings keeps the nervous system calm & connected Quiet racing thoughts by practicing presence & the inner smile technique Visualizing a smile from your heart shifts mood, eases anxiety & boosts calm Let emotions flow. Honest expression prevents stress buildup & supports lasting health True growth happens when you let go of control & become more attuned to what matters The Optimal Health, Longevity & Biohacking Program offers real results for all levels Episode Highlights 7:14 The World of "Biohacking 3.0" 16:46 The Complete & Integrated Health Model 24:11 Core Practices for Mind Mastery & Self-Regulation 41:41 Relationship Between Emotional Mastery & Flow States 59:57 The New Program Designed For Coaches & Individuals Links Watch it on YouTube: https://youtu.be/gOeDZXqRWoI  Full episode show notes: mindbodypeak.com/206 Connect with Nick on social media Instagram Twitter YouTube LinkedIn Easy ways to support Subscribe Leave an Apple Podcast review Suggest a guest Do you have questions, thoughts, or feedback for us? Let me know in the show notes above and one of us will get back to you! Be an Outliyr, Nick

Cancer Stories: The Art of Oncology
Writing a Medical Memoir: Lessons From a Long, Steep Road

Cancer Stories: The Art of Oncology

Play Episode Listen Later Apr 22, 2025 29:42


Listen to ASCO's Journal of Clinical Oncology Art of Oncology article, "Writing a Medical Memoir: Lessons From a Long, Steep Road” by David Marks, consultant at University Hospitals Bristol NHS Foundation Trust. The article is followed by an interview with Marks and host Dr. Mikkael Sekeres. Marks shares his challenging journey of writing a memoir describing his patients and career. Transcript Narrator: Writing a Medical Memoir: Lessons From a Long, Steep Road, by David Marks, PhD, MBBS, FRACP, FRCPath  The purpose of this essay is to take hematologist/oncologist readers of the Journal on my challenging journey of trying to write a memoir describing my patients and career. This piece is not just for those who might wish to write a book, it also can be generalized to other creative writing such as short stories or other narrative pieces intended for publication. My experience is that many of my colleagues have considered doing this but do not know where to start and that many embarking on this journey lack the self-confidence most writers require. I also describe other issues that unexpectably arose, particularly my struggle to get the book to its intended target audience, and of writing about myself in such a personal way. In my book of semifiction, I tell the stories of my patients with leukemia, but also describe what it is like to be a physician looking after young patients with curable but life-threatening diseases. I recount my medical career and working in the United Kingdom's National Health Service (NHS), a very different health system to the one I experienced when I worked in Philadelphia during the early 1990s. Telling the stories of my patients with leukemia (and my story) was my main motivation but I also wanted to challenge my creative writing skills in a longer format. As a young person, I wrote essays and some poetry. As a hemato-oncologist, the major outputs of my writing have been over 300 scientific papers and a 230-page PhD thesis. The discipline required to write papers does help with writing a nonfiction book, and as with writing scientific papers, the first step is having a novel idea. I admired the work of Siddhartha Mukherjee (“The Emperor of all Maladies”) and Mikkael Sekeres (“When Blood Breaks Down”), but I wanted to write about my patients and their effect upon me from a more personal perspective. I obtained written consent from the patients I wrote about; nearly all of them were happy for me to use their first name; they trusted me to tell their stories. All of the patients' stories have a substantial basis in fact. I also wrote about colleagues and other people I encountered professionally, but those parts were semifiction. Names, places, times, and details of events were changed to preserve anonymity. For example, one subchapter titled “A tale of two managers” comprises events that relate to a number of interactions with NHS medical managers over 30 years. The managers I wrote about represent a combination of many people, but it would not have been possible to write this while still working at my hospital. I had wanted to write a book for years but like most transplanters never had the sustained free time to jot down more than a few ideas. In the second UK lockdown of 2020 when we were only allowed to go out to work and for an hour of exercise, we all had more time on our hands. A columnist in the Guardian said that people should have a “lockdown achievement”; this would be mine. This is how I went about it. I knew enough about writing to know that I could not just go and write a book. I considered a university writing degree, but they were all online: There was not the nourishment of meeting and interacting with fellow writers. I joined two virtual writing groups and got some private sessions with the group's leader. We had to write something every week, submitted on time, and open for discussion. In one writing group, there was a no negative criticism rule, which I found frustrating, as I knew my writing was not good enough and that I needed to improve. I had no shortage of ideas, stories to tell, and patients and anecdotes to write about. I have a pretty good memory for key conversations with patients but learned that I did not have to slavishly stick to what was said. I also wrote about myself: my emotions and the obstacles I encountered. To understand how I guided my patients' journeys, my readers would need to understand me and my background. I carried a notebook around and constantly wrote down ideas, interesting events, and phrases. Every chapter underwent several drafts and even then much was totally discarded. I was disciplined and tried to write something every day, realizing that if I did not make progress, I might give up. Most days the words flowed; refining and editing what I wrote was the difficult part. Very different to Graham Greene in Antibes. He would go to his local café, write 200-400 words, then stop work for the day and have his first glass of wine with lunch before an afternoon siesta. How would I tell the story? My story was chronological (in the main), but I felt no need for the patient stories to be strictly in time order. The stories had titles and I did not avoid spoilers. “Too late” is the story of a patient with acute promyelocytic leukemia who died before she could receive specialist medical attention. This had a devastating effect on the GP who saw her that morning. So, there were plenty of patient stories to tell, but I needed to learn the craft of writing. Visual description of scenes, plots, and giving hints of what is to come—I had to learn all these techniques. Everything I wrote was looked at at least once by my mentor and beta readers, but I also submitted my work for professional review by an experienced editor at Cornerstones. This person saw merit in my work but said that the stories about myself would only interest readers if I was “somebody like David Attenborough.” Other readers said the stories about me were the most interesting parts. So far, I have focused on the mechanics and logistics of writing, but there is more to it than that. My oncology colleague Sam Guglani, who has successfully published in the medical area, was very useful. I asked him how his second book was progressing. “Not very well.” “Why?” “It takes a lot of time and I'm not very confident.” Sam writes such lovely prose; Histories was positively reviewed yet even he still has self-doubt. Hematologists/oncologists, transplanters, and chimeric antigen receptor T cell physicians are often confident people. Most of the time we know what to do clinically, and when we give medical advice, we are secure in our knowledge. This is because we have undergone prolonged training in the areas we practice in and possess the scientific basis for our decisions. This is not the case when doctors take on creative writing. Few of us have training; it is out of our comfort zone. Nearly all new writers are insecure, in a constant state of worry that our outpourings are not “good enough,” that “nobody will like it.” Even high-quality memoirs may be hard to get published. I did not enter this thinking I would fail, and I have received feedback that I “can write.” But when you look at people who can really write, who have already been published, and earn a living from writing, you think that you will never be as good. Does this matter for a medical memoir? Yes, it does. I came to realize to improve it is important to surround yourself with people who read a lot and preferably with some who are well-regarded published writers. These people should offer unrestrained feedback, and you should take note. However, I learned you do not need to do everything they say—it is not like responding to the reviewers of scientific papers—your book should retain your individual stamp and cover what you think is important. I found there are risks in writing a memoir. Private matters become public knowledge to your family and friends. In a hospital you have lots of work relationships, not all of which are perfect. It can be a tense environment; you often have to keep quiet. Writing about them in a book, even if colleagues and events are disguised or anonymized, runs the risk of colleagues recognizing themselves and not being happy with how they are portrayed. Writing a book's first draft is hard; getting it to its final draft even harder but perhaps not harder than writing a major paper for JCO or Blood. (For me writing the discussion section of a paper was the most difficult task). However, finding an agent is perhaps the hardest of all. Every agent has their own laborious submission system. About a third of agents do not respond at all; they may not even read your book. Another third may send you a response (after up to 3 months) saying that the book is “not for me.” Three agents told me that their own experiences with cancer made it impossible for them to read the book while others said it was a worthwhile project but it was not their area of interest. That encouraged me. It required resilience to get Life Blood published. I did not have the skills to self-publish, but I found a publisher that would accept the book, provided I contributed to the costs of publishing. This was not easy either because my book did not have as much final editing as a conventional publisher provides. Getting the book to its target audience was another major challenge. A number of hematologic journals agreed to consider reviews of the book, and my colleagues were generous in offering to review it. However, I wanted my book to be read by people with cancer and their families: nearly all of us at some point in our lives. A digital marketing consultant helped me publicize the book on social media and construct a user-friendly Web site. I hope this reflection offers some encouragement for budding authors who are hematologists/oncologists. However, as all writers reading this will know, writing is a lonely pursuit; it is something you do on your own for long periods and you cannot be sure your work will ever see the light of day. One of the main ingredients is persistence; this is probably the main difference between people who finish books and those who do not. Of course there may be benefits to physicians from writing per se, even if it is never published, although most hematologists/oncologists I know are quite goal oriented. Was it all worthwhile? Yes, I think so. Writing about my career stirred up lots of memories and has been quite cathartic. Physicians often feel they have insufficient time to reflect on their practice. It made me reflect on my achievements and what I could have done better. Could I have worked harder for my patients (rarely) or thought of therapeutic interventions earlier (sometimes)? What about my professional relationships? In my efforts to do the best for my patients, was I sometimes too impatient (yes)? I hope the book inspires young people contemplating a career in hematology/oncology but also gives them a realistic idea of the commitment it requires; even relatively successful doctors encounter adversity. To all my hematologic/oncologic and transplant colleagues worldwide, if you think you have a book in you, find the time and the intellectual space, start writing but also get help. In telling the story of your patients you honor them; it is a very satisfying thing to do but there are risks. I have had lots of feedback from friends and colleagues, the great majority of it positive, but when my book was published, I prepared myself for more critical reviews. I learned a lot from writing Life Blood; at the end, I was a stronger, more secure writer and hematologist/oncologist, more confident that the story of my patients and career was worth telling and relevant to a wider audience. Dr. Mikkael Sekeres: Hello, and welcome to JCO's Cancer Stories: The Art of Oncology, which features essays and personal reflections from authors exploring their experience in the oncology field. I'm your host, Dr. Mikkael Sekeres. I'm Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. And what a pleasure it is today to be joined by Professor David Marks, a consultant at University Hospitals Bristol NHS Foundation Trust in the UK. In this episode, we will be discussing his Art of Oncology article, "Writing a Medical Memoir: Lessons from a Long, Steep Road." Our guest's disclosures will be linked in the transcript. David, welcome to our podcast, and thanks so much for joining us. Professor David Marks: Thank you very much for inviting me. It's a real honor. Dr. Mikkael Sekeres: David, I really enjoyed your piece. We've never had a "how to write a memoir" sort of piece in Art of Oncology, so it was a great opportunity. And, you know, I think 30 years ago, it was extraordinarily rare to have a doctor who also was a writer. It's become more common, and as we've grown, still among our elite core of doctor-writers, we've also birthed some folks who actually write in long form—actual books, like you did. Professor David Marks: I'd sort of become aware that I wasn't the only person doing this, that there were lots of people who liked creative writing, but they had difficulties sort of turning that into a product. This was the reason for sort of writing this. I'm hardly an expert; I've only written one book, but I sort of hope that my experiences might encourage others. Dr. Mikkael Sekeres: I think it's a terrific idea. And before we get started about the book, I, of course, know you because you and I run in some of the same academic circles, but I wonder if you could tell our listeners a little bit about yourself. Professor David Marks: So, I'm Australian. That's where I did my internal medical and hematology training in Melbourne. And then I did a PhD to do with acute lymphoblastic leukemia at the University of Melbourne. I then moved to London for three years to do some specialist training in bone marrow transplantation and some lab work, before spending three years in Philadelphia, where I did transplant, leukemia, and some more lab work. And then, mainly for family reasons, moved back to the UK to take up a post in Bristol. I have retired from patient-facing practice now, although I still give medical advice, and I'm doing some consulting for a CAR T-cell company based in LA. Dr. Mikkael Sekeres: Great. And can I ask you, what drew you to focus on treating people with leukemia and doing research in that area? Professor David Marks: I think leukemia is just such a compelling disease. From really the first patient I ever looked after, there was a person who is both life-threateningly ill, has had their life turned upside down. Yet, there is—increasingly now—there's an opportunity to cure them or, at the very least, prolong their life significantly. And also, its sort of proximity to scientific research—that was the attraction for me. Dr. Mikkael Sekeres: There is something compelling about cancer stories in general. I think we talk about the privilege of doing what we do, and I think part of that is being invited into people's lives at probably one of the most dramatic moments of those lives. We're, of course, unwelcome visitors; nobody wants a diagnosis of cancer and having to have that initial conversation with an oncologist. But I wonder if, as doctors and as writers, we feel compelled to share that story and really celebrate what our patients are going through. Professor David Marks: So, that absolutely is one of my main motivations. I thought- there aren't, to my mind, all that many books out there that sort of try and tell things from both the patient with leukemia's point of view and the doctors looking after them. And I thought that their stories should be told. It's such a dramatic and frightening time, but I think the struggles that people go through in dealing with this—I think this is something I sort of felt people should have the opportunity to learn about. Dr. Mikkael Sekeres: Yeah, we're really honoring our patients, aren't we? Professor David Marks: Absolutely. When you think of the patients you've looked after, their courage, their steadfastness in dealing with things, of just battling on when they're not well and they're scared of things like dying—you've just got to admire that. Dr. Mikkael Sekeres: Yeah, yeah. David, you have a tremendous number of academic publications and have been transformative in how we treat people who have acute lymphoblastic leukemia. How did you first get into writing narrative medicine? Professor David Marks: Although I have written quite a lot scientifically, although that is incredibly different to creative writing, some of the same sort of care that one needs with a scientific paper, you do need for creative writing. I always liked English at school, and, you know, even as a teenager, I wrote some, you know, some poetry; it frankly wasn't very good, but I had a go. I came to a point where I wanted to write about my patients and a bit about my career. I had trouble finding the time; I had trouble finding the sort of intellectual space. But then COVID and lockdown occurred, and, you know, all of us had a lot more time; you know, we weren't even allowed to leave the house apart from working. So, at that point, I started writing. Prior to that, though, I had sort of kept a notebook, a quite big notebook, about stories I wanted to tell and events in my career and life that I wanted to tell. So there was something of a starting point there to go from. But when I first started writing, I realized that I just didn't know enough about writing. I needed to learn the craft of writing, and so I also joined a couple of writing groups. Dr. Mikkael Sekeres: That's—I find that absolutely fascinating. I think there are a lot of people who want to write, and there are some who have the confidence to go ahead and start writing, right? Whether they know the craft or not. And there are others who pause and say, "Wait a second, I've done a lot of reading, I've done a lot of academic writing, but I'm not sure I know how to do this in a creative way." So, what was your first step? Professor David Marks: I had sort of notes on these stories I wanted to write, and I did just try and write the sort of two- to five-page story, but I then sort of realized that it was just—it just wasn't very good. And I needed to learn really all the basic things that writers need, like developing a plot, like giving hints of what's to come, using visual description. Those things are obviously completely different to scientific writing, and I—it was a bit like going back to school, really. Dr. Mikkael Sekeres: And how did you even find writing groups that were at the right level for someone who was starting on this journey? Professor David Marks: So, I got a recommendation of a sort of local group in Bristol and a very established sort of mentor who has actually mentored me, Alison Powell. But it is difficult because some people on the group had written and published a couple of books; they were way ahead of me. And some people were just really starting out. But there were enough people at my level to give me sort of useful criticism and feedback. But yes, finding the right writing group where there's a free interchange of ideas—that is difficult. And, of course, my—what I was writing about was pretty much different to what everybody else was writing about. Dr. Mikkael Sekeres: So, you joined a writing group that wasn't specific to people in healthcare? Professor David Marks: There was something at my hospital; it was a quite informal group that I joined, and that had a whole number of healthcare professionals, but that didn't keep going. So, I joined a group that was really a mixture of people writing memoirs and also some people writing fiction. And I actually found a lot of the things that people writing fiction write, I needed to learn. A lot of those skills still apply to a sort of non-fictional or semi-fiction book. Dr. Mikkael Sekeres: You write in your Art of Oncology piece—I think a very insightful portion of it—where you're identifying people who can give you feedback about your writing, and you're looking for honest feedback. Because there are a lot of people where you might show them a piece and they say, "Gee, this is David Marks, I better say something nice. I mean, it's David Marks after all.” Right? So, you don't want that sort of obsequiousness when you're handing over a piece of writing because you need truth to be told if it's compelling or if it's not compelling. How did you identify the people who could give you that honest feedback, but also people you trust? Because there are also people who might read a piece and might be jealous and say, "Gee, David's already going on this journey, and I wish I had done this years ago," and they might not give you the right kind of feedback. Professor David Marks: Yeah, I mean, one of the writing groups I joined, there was a sort of "no criticism, no negative criticism" rule, and I did not find that to be useful because I knew my writing, frankly, wasn't good enough. So, funnily enough, my wife—she's very lucky—she has this reading group that she's had for 25 years, and these are—they're all women of her age, and they are just big, big readers. And those were my principal beta readers. And I sort of know them, and they knew that I wanted direction about, you know, what was working and what was not working. And so they were fairly honest. If they liked something, they said it. And if there was a chapter they just didn't think worked, they told me. And I was really very grateful for that. The other thing I did at a sort of critical moment in the book, when I just thought I was not on track, is I sent it to a professional editor at Cornerstones. And that person I'd never met, so they had no—you know, they didn't need to sort of please me. And that review was very helpful. I didn't agree with all of it, but it was incredibly useful. Dr. Mikkael Sekeres: That's fascinating. So, I've submitted pieces in venues where people can post comments, and I always force myself to read the comments. And sometimes that hurts a little bit when you get some comments back and think, "Oh my word, I didn't mean that." Sometimes those comments illuminate things that you never intended for people to take away from the piece. And sometimes you get comments where people really like one aspect, and you didn't even know that would resonate with them. So, any comments you can think of that you got back where you thought, "Oh my word, I never intended that," or the opposite, where the comments were actually quite complimentary and you didn't anticipate it? Professor David Marks: I was reviewed by an independent reviewer for The Lancet Haematology. And you've read my book, so you sort of know that looking after people with leukemia, you do encounter quite a lot of people who die. And she sort of, almost as a criticism, said, "Professor David Marks seems to have encountered an extraordinary number of people who've died." And I thought—almost as a sort of criticism—and I thought, "I'm sort of sorry, but that's the area we occupy, unfortunately." There's lots of success, but there is, you know, sometimes we don't succeed. So I found that—I found that hard to read. But when you open yourself up as a writer, when you talk about your personal things, you've got to develop a bit of a thick skin. And I really haven't ego about my writing. I sort of still feel it's very much in its formative stages, so I'm quite open to criticism. Dr. Mikkael Sekeres: And were there comments that you got that were—you were pleasantly surprised that people liked one aspect of the book, and you didn't know it would really hit with them that way? Professor David Marks: I think they particularly liked the patient stories. There's one thing in the book about a young woman who has this amazing experience of being rescued by CAR T-cell therapy. This young lady's still alive. And that very much sort of captured the imagination of the readers. They really identified her and wanted to sort of know about her and, you know, was she still okay and so on. Dr. Mikkael Sekeres: I remember there was a piece I wrote, and included a patient, and it was an entree to write about a medical topic, and my editor got back to me and said, "What happened to the patient?" Right? People get invested in this. We've done this our entire careers for, for decades for some people who've been in the field for that long, and you forget that it's still a diagnosis, a disease that most people don't encounter in their lives, and they get invested in the patients we describe and are rooting for them and hope that they do okay. Professor David Marks: Yeah, I found people got very involved with the patients, and I've had actually several sort of inquiries; they want to know if the patients are still okay. And I think that I can definitely understand that from a sort of human level. Dr. Mikkael Sekeres: So, you wrote a memoir. How long did it take you? Professor David Marks: I suppose from the time I really started writing properly, I'd say about two and a half years. So, quite a long time. Dr. Mikkael Sekeres: Two and a half years. That can be daunting to some people. What advice would you give them if they're thinking about going down this path? Professor David Marks: I think it's a very rewarding thing to do. It is hard work, as you and I know, and it's sort of extra work. The only way to find out if you can do it is to try to do it. And try and find some time to do it, but get help. You know, seek the company of other people who are more experienced writers and sort of find a mentor. Somehow, you've got to, I guess, believe in yourself, really, and trust yourself that what you're writing about is worthwhile. And yeah, I don't know that I have specific advice for people about that aspect of things. Dr. Mikkael Sekeres: Well, I think that's a great place actually to end: to tell people to believe in themselves and trust in themselves. And I want to encourage everyone listening to this podcast to please check out Professor David Marks' book, Lifeblood: Tales of Leukemia Patients and Their Doctor. It's a terrific read. David, thank you so much for joining us today. Professor David Marks: Thanks very much, Mikkael. It's been a pleasure. Dr. Mikkael Sekeres: It's been delightful from my perspective. Until next time, thank you for listening to JCO's Cancer Stories: The Art of Oncology. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all of ASCO's shows at asco.org/podcasts. Until next time, thank you, everyone.   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. ADD URLhttps://ascopubs.org/journal/jco/cancer-stories-podcast Guest Bio: Professor David Marks is a consultant at University Hospitals Bristol NHS Foundation Trust in the UK.   Additional Reading: Life Blood: Stories of Leukaemia Patients and Their Doctor, by David Marks

The Lead Podcast presented by Heart Rhythm Society
The Lead Podcast - Episode 99: A Discussion of Artificial Intelligence for Individualized Treatment...

The Lead Podcast presented by Heart Rhythm Society

Play Episode Listen Later Apr 10, 2025 16:49


Join host and Digital Education Chair Prashanthan Sanders, MBBS, PhD, FHRS, as he discusses this article from Nature with guests Anand N Ganesan, MBBS, PhD, and Tina Baykaner, MD, MPH. This trial was also presented as a late-breaking clinical trial at Heart Rhythm 2024.   https://www.hrsonline.org/education/TheLead https://www.nature.com/articles/s41591-025-03517-w   Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical; Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): A. Ganesan: Honoraria/Speaking/Consulting: Biosense Webster, Inc. T. Baykaner: Honoraria/Speaking/Consulting: Medtronic, Pacemate, Volta Medical, iRhythm Technologies; Research: NIH   This episode is worth 0.25 ACE credits. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode99

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Olalekan Oluwole, MBBS, MPH - Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Apr 9, 2025 59:23


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/MOC/NCPD information, and to apply for credit, please visit us at PeerView.com/JFE865. CME/MOC/NCPD credit will be available until April 18, 2026.Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences 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, Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC (which are both Johnson & Johnson companies), Legend Biotech, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast
Olalekan Oluwole, MBBS, MPH - Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast

Play Episode Listen Later Apr 9, 2025 59:23


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/MOC/NCPD information, and to apply for credit, please visit us at PeerView.com/JFE865. CME/MOC/NCPD credit will be available until April 18, 2026.Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences 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, Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC (which are both Johnson & Johnson companies), Legend Biotech, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

PeerView Internal Medicine CME/CNE/CPE Video Podcast
Olalekan Oluwole, MBBS, MPH - Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences

PeerView Internal Medicine CME/CNE/CPE Video Podcast

Play Episode Listen Later Apr 9, 2025 59:23


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/MOC/NCPD information, and to apply for credit, please visit us at PeerView.com/JFE865. CME/MOC/NCPD credit will be available until April 18, 2026.Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences 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, Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC (which are both Johnson & Johnson companies), Legend Biotech, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

PeerView Internal Medicine CME/CNE/CPE Audio Podcast
Olalekan Oluwole, MBBS, MPH - Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences

PeerView Internal Medicine CME/CNE/CPE Audio Podcast

Play Episode Listen Later Apr 9, 2025 59:23


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/MOC/NCPD information, and to apply for credit, please visit us at PeerView.com/JFE865. CME/MOC/NCPD credit will be available until April 18, 2026.Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences 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, Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC (which are both Johnson & Johnson companies), Legend Biotech, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast
Olalekan Oluwole, MBBS, MPH - Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences

PeerView Oncology & Hematology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Apr 9, 2025 59:23


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/MOC/NCPD information, and to apply for credit, please visit us at PeerView.com/JFE865. CME/MOC/NCPD credit will be available until April 18, 2026.Unlocking Efficacy, Expanding Access to CAR-T in Lymphoma and Myeloma: From Practice-Changing Evidence to Real-World and Outpatient Experiences 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, Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC (which are both Johnson & Johnson companies), Legend Biotech, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

JAMA Author Interviews: Covering research in medicine, science, & clinical practice. For physicians, researchers, & clinician

The incidence of invasive group A streptococcal infections has risen in the US. Similar observations have been reported in other parts of the world. Authors Joshua Osowicki, MBBS, PhD, of Murdoch Children's Research Institute and Theresa L. Lamagni, MSc, PhD, of the United Kingdom Health Security Agency join JAMA Deputy Editor Preeti Malani, MD, MSJ, to discuss the public health challenge posed by group A strep. Related Content: Invasive Group A Streptococcal Disease in the US Invasive Group A Streptococcal Infections in 10 US States

ON AIR
#619 - Dr. Ramji Ram

ON AIR

Play Episode Listen Later Apr 4, 2025 173:59


Dr. Ramji Ram, a Medical Officer at the Ministry of Education Nepal, defied caste discrimination to achieve his dream of becoming a doctor. His journey to earn an MBBS degree is a testament to resilience and determination, inspiring others to break barriers and pursue their dreams despite the odds.

JACC Podcast
Individual Variation in Tirzepatide Response | JACC | ACC.25

JACC Podcast

Play Episode Listen Later Apr 1, 2025 17:53


Join JACC Associate Editor Khurram Nasir, MBBS, FACC, and author Rohan Khera, MD, FACC, as they discuss the latest study on tirzepatide presented at ACC.25 and published in JACC. Tirzepatide, a dual GIP/GLP-1 receptor agonist, exerts pleiotropic effects on cardiometabolic health. This study evaluated its efficacy in improving cardiometabolic outcomes in individuals with T2D. An individual participant data meta-analysis was conducted, pooling data from seven Phase 3 RCTs comparing tirzepatide with placebo or standard antihyperglycemic agents. The study outcomes included cardiometabolic components of metabolic syndrome (MetS), elevated BMI, and MetS. Tirzepatide significantly reduced the odds of these abnormalities and effectively resolved MetS, with superior efficacy observed in younger individuals and those not on baseline SGLT2is. These findings support the potential of tirzepatide to improve cardiometabolic health in T2D.

JACC Podcast
Small Molecule PCSK9 Inhibitor for Hypercholesterolemia | JACC | ACC.25

JACC Podcast

Play Episode Listen Later Apr 1, 2025 17:49


JACC Associate Editor Khurram Nasir, MBBS, FACC, speaks with author Michael J. Koren, MD, FACC, on his Featured Clinical Research study published in JACC and presented at ACC.25. This randomized, multicenter, double-blind, placebo-controlled, dose-ranging phase 2 study assessed efficacy, safety, and tolerability of AZD0780, a small molecule PCSK9 inhibitor. The study randomized 428 patients (426 started treatment) with hypercholesterolemia on standard-of-care statin therapy to daily oral administrations of AZD0780 1, 3, 10 or 30 mg, or matching placebo for 12 weeks. AZD0780 significantly reduced LDL-C levels versus placebo at all doses (from 35.3% to 50.7%) and demonstrated a safety and tolerability profile similar to placebo. These findings support further development of AZD0780 as part of a simple, oral regimen for lowering LDL-C beyond that achieved with statin therapy.

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Professor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - ALK+ mNSCLC Care Compass: Taking Your Best Shot First—Selecting and Sequencing Targeted Therapy and Teaming Up to Achieve Long-Term Success

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Apr 1, 2025 64:32


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/MOC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PZK865. CME/MOC/NCPD/CPE/AAPA/IPCE credit will be available until March 26, 2026.ALK+ mNSCLC Care Compass: Taking Your Best Shot First—Selecting and Sequencing Targeted Therapy and Teaming Up to Achieve Long-Term Success In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and LUNGevity Foundation. 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 educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Professor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - ALK+ mNSCLC Care Compass: Taking Your Best Shot First—Selecting and Sequencing Targeted Therapy and Teaming Up to Achieve Long-Term Success

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Apr 1, 2025 64:32


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/MOC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PZK865. CME/MOC/NCPD/CPE/AAPA/IPCE credit will be available until March 26, 2026.ALK+ mNSCLC Care Compass: Taking Your Best Shot First—Selecting and Sequencing Targeted Therapy and Teaming Up to Achieve Long-Term Success In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and LUNGevity Foundation. 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 educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast
Professor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - ALK+ mNSCLC Care Compass: Taking Your Best Shot First—Selecting and Sequencing Targeted Therapy and Teaming Up to Achieve Long-Term Success

PeerView Oncology & Hematology CME/CNE/CPE Video Podcast

Play Episode Listen Later Apr 1, 2025 64:32


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/MOC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PZK865. CME/MOC/NCPD/CPE/AAPA/IPCE credit will be available until March 26, 2026.ALK+ mNSCLC Care Compass: Taking Your Best Shot First—Selecting and Sequencing Targeted Therapy and Teaming Up to Achieve Long-Term Success In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and LUNGevity Foundation. 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 educational grant from Pfizer.Disclosure information is available at the beginning of the video presentation.

Continuum Audio
Diversity and Underserved Patient Populations in Epilepsy With Dr. Dave Clarke

Continuum Audio

Play Episode Listen Later Mar 26, 2025 28:16


Despite advances in epilepsy management, disparities and lack of inclusion of many people with epilepsy are associated with increased morbidity and mortality. Improving awareness and promoting diversity in research participation can advance treatment for underserved populations and improve trust. In this episode, Teshamae Monteith, MD, PhD, FAAN speaks Dave F. Clarke, MBBS, FAES, author of the article “Diversity and Underserved Patient Populations in Epilepsy,” in the Continuum® February 2025 Epilepsy issue. Dr. Monteith is a Continuum® Audio interviewer and an associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Clarke is the Kozmetsky Family Foundation Endowed Chair of Pediatric Epilepsy and Chief or Comprehensive Pediatric Epilepsy Center, Dell Medical School at the University of Texas at Austin in Austin, Texas. Additional Resources Read the article: Diversity and Underserved Patient Populations in Epilepsy 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: @HeadacheMD 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, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum Journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Monteith: This is Dr Teshamae Monteith. Today I'm interviewing Dr Dave Clarke about his article on diversity and underserved patient populations in epilepsy, which appears in the February 2025 Continuum issue on epilepsy. So why don't you introduce yourself to our audience? Dr Clarke: Sure. My name is Dr Dave Clarke, as alluded to. I'm presently at the University of Texas in Austin, originating from much farther south. I'm from Antigua, but have been here for quite a while working within the field in epilepsy surgery, but more and more getting involved in outreach, access to care, and equity of healthcare in epilepsy. Dr Monteith: And how did you get involved in this kind of work? Dr Clarke: That's an amazing question. You know, I did it in a bit of a inside out fashion. I initially started working in the field and trying to get access to persons in the Caribbean that didn't have any neurological care or investigative studies, but very quickly realized that persons around the corner here in Texas and wherever I've worked have had the exact same problems, getting access via fiscal or otherwise epilepsy care, or geographically getting access, with so few having neurologists close at hand. Therefore, I started working both on a regional, national, and it transcended to a global scale. Dr Monteith: Wow, so you're just everywhere. Dr Clarke: Well, building bridges. I've found building bridges and helping with knowledge and garnering knowledge, you can expand your reach without actually moving, which is quite helpful. Dr Monteith: Yeah. So why don't you tell us why you think this work is so important in issues of diversity, underserved populations, and of course, access to epilepsy care? Dr Clarke: Sure, not a problem. And I think every vested person in this can give you a different spiel as to why they think it's important. So, I'll add in a few facts pertaining to access, but also tell you about why I think personally that it's not only important, but it will improve care for all and improve what you believe you could do for a patient. Because the sad thing is to have a good outcome in the United States presently, we have over three hundred epilepsy centers, but they have about eight or nine states that don't have any epilepsy centers at all. And even within states themselves, people have to travel up to eight hours, i.e., in Texas, to get adequate epilepsy care. So that's one layer. Even if you have a epilepsy center around the corner, independent of just long wait times, if you have a particular race or ethnicity, we've found out that wait may be even longer or you may be referred to a general practitioner moreso than being referred to an epilepsy center. Then you add in layers of insurance or lack thereof, which is a big concern regardless of who you are; poverty, which is a big concern; and the layers just keep adding more. Culture, etcetera, etcetera. If you could just break down some of those barriers, it has been shown quite a few years ago that once you get to an epilepsy center, you can negate some of those factors. You can actually reduce time to access and you can improve care. So, that's why I'm so passionate about this, because something could potentially be done about it. Dr Monteith: That's cool. So, it sounds like you have some strategies, some strategies for us. Dr Clarke: Indeed. And you know, this is a growth and this is a learning curve for me and will be for others. But I think on a very local, one-to-one scale, the initial strategy I would suggest is you have to be a good listener. Because we don't know how, when, where or why people are coming to us for their concerns. And in order to judge someone, if they may not have had a follow-up visit or they may not have gotten to us after five medications, the onus may not have been on that person. In other words, as we learned when we were in medical school, history is extremely important, but social history, cultural history, that's also just as important when we're trying to create bridges. The second major thing that we have to learn is we can't do this alone. So, without others collaborating with us outside of even our fields, the social worker who will engage, the community worker who will discuss the translator for language; unless you treat those persons with respect and engage with those persons to help you to mitigate problems, you'll not get very far. And then we'll talk about more, but the last thing I'll say now is they have so many organizations out there, the Institute of Medicine or the International League Against Epilepsy or members of the American Epilepsy Society, that have ways, ideas, papers, and articles that can help guide you as to how better mitigate many of these problems. Dr Monteith: Great. So, you already mentioned a lot of things. What are some things that you feel absolutely the reader should take away in reading your article? You mentioned already listening skills, the importance of interdisciplinary work, including social work, and that there are strategies that we can use to help reduce some of this access issues. But give me some of the essential points and then we'll dive in. Dr Clarke: OK. I think first and foremost we have to lay the foundation in my mind and realize what exactly is happening. If you are Native American, of African descent, Hispanic, Latinx, geographically not in a region where care can be delivered, choosing one time to epilepsy surgery may be delayed twice, three, four times that of someone of white descent. If you are within certain regions in the US where they may have eight, nine, ten, fourteen epilepsy centers, you may get to that center within two to three years. But if you're in an area where they have no centers at all, or you live in the Dakotas, it may be very difficult to get to an individual that could provide that care for you. That's very, very basic. But a few things have happened a few years ago and even more recently that can help. COVID created this groundswell of ambulatory engagement and ambulatory care. I think that can help to mitigate time to get into that person and improving access. In saying that, there are many obstacles to that, but that's what we have to work towards: that virtual engagement and virtual care. That would suggest in some instances to some persons that it will take away the one-to-one care that you may get with persons coming to you. But I guarantee that you will not lose patients because of this, because there's too big a vacuum. Only 22% of persons that should actually get to epilepsy centers actually get to epilepsy centers. So, I think we can start with that foundation, and you can go to the article and learn a lot more about what the problems are. Because if you don't know what the problems are, you can't come up with solutions. Dr Monteith: Just give us a few of the most persistent inequities and epilepsy care? Dr Clarke: Time to seeing a patient, very persistent. And that's both a disparity, a deficiency, and an inequity. And if you allow me, I'll just explain the slight but subtle difference. So, we know that time to surgery in epilepsy in persons that need epilepsy surgery can be as long as seventeen years. That's for everyone, so that's a deficiency in care. I just mentioned that some sociodemographic populations may not get the same care as someone else, and that's a disparity between one versus the other. Health equity, whether it be from NIH or any other definition, suggests that you should get equitable care between one person and the other. And that brings in not only medical, medicolegal or potential bias, that we may have one person versus the other. So, there's a breakdown as to those different layers that may occur. And in that I'm telling you what some of the potential differences are. Dr Monteith: And so, you mentioned, it comes up, race and ethnicity being a major issue as well as some of the geographic factors. How does that impact diagnosis and really trying to care for our patients? Dr Clarke: So again, I'm going to this article or going to, even. prior articles. It has been shown by many, and most recently in New Jersey, that if you're black, Hispanic, Latin- Latinx, it takes you greater than two times the time to surgery. Reduced time to surgery significantly increases morbidity. It potentially increases mortality, as has been shown by a colleague of mine presently in Calgary. And independent of that, we don't look at the other things, the other socially related things. Driving, inability to work, inability to be adequately educated, the stigma related to that in various cultures, various countries. So, that deficit not only increased the probability of having seizures, but we have to look at the umbrella as to what it does. It significantly impacts quality of life of that individual and, actually, the individuals around them. Dr Monteith: So, what are some of these drivers, and how can we address them, or at least identify them, in our clinic? Dr Clarke: That's a question that's rather difficult to answer. And not because there aren't ideas about it, but there's actually mitigating those ideas or changing those ideas we're just presently trying to do. Although outlines have been given. So, in about 2013, the federal government suggested outlines to improve access and to reduce these inequities. And I'll just give you a few of them. One of those suggestions was related to language and having more improved and readily available translators. Something simple, and that could actually foster discussions and time to better management. Another suggestion was try to train more persons from underserved populations, persons of color. Reason being, it has been shown in the social sciences and it is known in the medical sciences that, if you speak to a person of similar culture, you tend to have a better rapport, you tend to be more compliant, and that track would move forward, and it reduces bias. Now we don't have that presently, and I'm not sure if we'll have that in the near future, although we're trying. So then, within your centers, if you have trainings on cultural sensitivity, or if you have engagements and lectures about how you can engage persons from different populations, those are just some very simple pearls that can improve care. This has been updated several times with the then-Institute of Medicine in 2012, 2013, they came out with, in my mind, a pretty amazing article---but I'm very biased---in which they outline a number of strategic initiatives that could be taken to improve research, improve clinical care, improve health equity through health services research, to move the field forward, and to improve overall care. They updated this in 2020, and it's a part of the 2030 federal initiative not only for epilepsy, but to improve overarching care. All of this is written in bits and pieces and referenced in the article. To add icing on top, the World Health Organization, through advocacy of neurological groups as well as the International League Against Epilepsy and the AES, came out with the Intersectoral Action Plan on Epilepsy and Other Neurological Diseases, which advocates for parallel improvement in overall global care. And the United States have signed on to it, and that have lit a fire to our member organizations like the American Epilepsy Society, American Academy of Neurology, and others, trying to create initiatives to address this here. I started off by saying this was difficult because, you know, we have debated epilepsy care through 1909 when the International League against Epilepsy was founded, and we have continually come up with ways to try and advance care. But this have been the most difficult and critical because there's social dynamics and social history and societal concerns that have negated us moving forward in this direction. But fortunately, I think we're moving in that direction presently. That's my hope. And the main thing we have to do is try to sustain that. Dr Monteith: So, you talked about the importance of these global initiatives, which is huge, and other sectors outside of neurology. Like for example, technology, you spoke about telemedicine. I think you were referring to telemedicine with COVID. What other technologies that are more specific to the field of epilepsy, some of these monitorings that maybe can be done? Dr Clarke: I was just going to just going to jump on that. Thank you so much for asking. Dr Monteith: I have no disclosures in this field. I think it's important and exciting to think how can we increase access and even access to monitoring some of these technologies. That might be expensive, which is another issue, but…. Dr Clarke: So, the main things in epilepsy diagnosis and management: you want to hear from the patient history, you want to see what the seizures look like, and then you want to find ways in which to monitor those seizures. Hearing from the patient, they have these questionnaires that have been out there, and this is local, regional, global, many of them standardized in English and Spanish. Our colleagues in Boston actually created quite a neat one in English and Spanish that some people are using. Ecuador has one. We have created someone- something analogous. And those questionnaires can be sent out virtually and you can retrieve them. But sometimes seeing is believing. So, video uploads of seizures, especially the cell phone, I think has been management-changing for the field of epilepsy. The thing you have to do however, is do that in a HIPAA-compliant way. And several studies are ongoing. In my mind, one of the better studies here was done on the East Coast, but another similar study, to be unnamed, but again, written out in the articles. When you go into these apps, you can actually type in a history and upload a video, but the feed is not only going to you, it may be going to the primary care physician. So, it not only helps in one way in you educating the patient, but you educate that primary care physician and they become extenders and providers. I must add here my colleagues, because we can't do without them. Arguably in some instances, some of the most important persons to refer patients, that's the APPs, the PAs and the nurse practitioners out there, that help to refer patients and share patients with us. So, that's the video uploads they're seeing. But then the other really cool part that we're doing now is the ambulatory world of EEGs. Ceribell, Zeto, to name of few, in which you could potentially put the EEG leads on persons with or without the EEG technologist wirelessly and utilize the clouds to review the EEGs. It's not perfect just yet, but that person that has to travel eight hours away from me, if I could do that and negate that travel when they don't have money to pay for travel or they have some potential legal issues or insurance-related issues and I could read the EEG, discuss with them via telemedicine their care, it actually improves access significantly. I'm going to throw in one small twist that, again, it's not perfect. We're now trying to monitor via autonomic features, heart rate movement and others, for seizures and alert family members, parents, because although about 100,000 people may be affected with epilepsy, we're talking about 500,000 people who are also affected that are caregivers, affiliates, husbands, wives, etcetera. Just picture it: you have a child, let's say three, four years old and every time they have a seizure- or not every time, but 80% of times when they have a seizure, it alerts you via your watch or it alerts you in your room. It actually gives that child a sense of a bit more freedom. It empowers you to do something about it because you can understand here. It potentially negates significant morbidity. I won't stretch it to say SUDEP, but hopefully the time will come when actually it can prevent not only morbidity, but may prevent death. And I think that's the direction we are going in, to use technology to our benefit, but in a HIPAA-compliant way and in a judicious way in order to make sure that we not only don't overtreat, but at the end of the day, we have the patient as number one, meaning everything is vested towards that patient and do no harm. Dr Monteith: Great. One thing you had mentioned earlier was that there are even some simple approaches, efficiency approaches that we can use to try and optimize care for all in our clinics. Give me what I need to know, or do. Give me what I need to do. Dr Clarke: Yeah, I'll get personal as to what we're trying to do here, if you don't mind. The initial thing we did, we actually audited care and time to care delivery. And then we tried to figure out what we could do to improve that access and time to care, triaging, etcetera. A very, very simple thing that can be done, but you have to look at costs, is to have somebody that actually coordinates getting persons in and out of your center. If you are a neurologist that works in private practice, that could potentially be a nurse being associated directly one-and-one with one of the major centers, a third- or fourth-level center. That coordination is key. Educate your nurses about epilepsy care and what the urgent situations are because it will take away a lot of your headache and your midnight calls because they'll be able to know what to do during the day. Video uploads, as I suggested, regardless of the EMR that you have, figure out a way that a family could potentially send a video to you, because that has significantly helped in reducing investigative studies. Triaging appropriately for us to know what patients we can and cannot see. Extenders has helped me significantly, and that's where I'll end. So, as stated, they had many neurologists and epileptologists, and utilizing appropriately trained nurse practitioners or residents, engaging with them equally, and/or social workers and coordinators, are very helpful. So hopefully that's just some low-hanging fruit that can be done to improve that care. Dr Monteith: So why don't you give us some of your major takeaways to how we can improve epilepsy care for all people? Dr Clarke: I've alluded to some already, but I like counts of threes and fives. So, I think one major thing, which in my mind is a major takeaway, is cultural sensitivity. I don't think that can go too far in improving care of persons with epilepsy. The second thing is, if you see a patient that have tried to adequately use medications and they're still having seizures, please triage them. Please send them to a third- or fourth-level epilepsy center and demand that that third- or fourth-level epilepsy center communicate with you, because that patient will eventually come back and see you. The third thing---I said three---: listen to your patients. Because those patients will actually help and tell you what is needed. And I'm not only talking about listening to them medication-wise. I know we have time constraints, but if you can somehow address some of those social needs of the patients, that will also not only improve care, but negate the multiple calls that you may get from a patient. Dr Monteith: You mentioned a lot already. This is really wonderful. But what I really want to know is what you're most hopeful about. Dr Clarke: I have grandiose hopes, I'll tell you. I'll tell you that from the beginning. My hope is when we look at this in ten years and studies are done to look at equitable care, at least when it comes to race, ethnicity, insurance, we'll be able to minimize, if not end, inequitable care. Very similar to the intersectoral action plan in epilepsy by 2030. I'll tell you something that suggests, and I think it's global and definitely regional, the plan suggests that 90% of persons with epilepsy should know about their epilepsy, 80% of persons with epilepsy should be able to receive appropriate care, and 70% of persons with epilepsy should have adequately controlled epilepsy. 90, 80, 70. If we can get close to that, that would be a significant achievement in my mind. So, when I'm chilling out in my home country on a fishing boat, reading EEGs in ten years, if I can read that, that would have been an achievement that not necessarily I would have achieved, but at least hopefully I would have played a very small part in helping to achieve. That's what I think. Dr Monteith: Awesome. Dr Clarke: I appreciate you asking me that, because I've never said it like that before. In my own mind, it actually helped with clarity. Dr Monteith: I ask great questions. Dr Clarke: There you go. Dr Monteith: Thank you so much. I really- I really appreciate your passion for this area. And the work that you do it's really important, as you mentioned, on a regional, national, and certainly on a global level, important to our patients and even some very simple concepts that we may not always think about on a day-to-day basis. Dr Clarke: Oh, I appreciate it. And you know, I'm always open to ideas. So, if others, including listeners, have ideas, please don't hesitate in reaching out. Dr Monteith: I'm sure you're going to get some messages now. Dr Clarke: Awesome. Thank you so much. Dr Monteith: Thank you. I've been interviewing Dr Dave Clarke about his article on diversity and underserved patient populations in epilepsy, which appears in the most recent issue of Continuum on epilepsy. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this 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.

JACC Podcast
Use of Cardiac Rehab in Older Patients with MI Complicated by Cardiogenic Shock | JACC | ACC.25

JACC Podcast

Play Episode Listen Later Mar 25, 2025 12:02


Dhruv Kazi, MBBS, MS, FACC and first author Mohammed Essa, MD, discuss their newly published JACC Brief Report presented at ACC.25 on cardiac rehabilitation following myocardial infarction, with a focus on patients who experience cardiogenic shock. JACC: Associate Editor Jason H. Wasfy, MD, MPhil, FACC, asks questions to explore the significant underutilization of cardiac rehab, the impact of social determinants of health, and potential policy changes to improve access and outcomes. Join the conversation as they highlight key findings and the need for innovative solutions in cardiovascular care. #jacc #jaccjournals #acc25

JACC Podcast
Use of Cardiac Rehab in Older Patients with MI Complicated by Cardiogenic Shock | JACC | ACC.25

JACC Podcast

Play Episode Listen Later Mar 24, 2025 12:02


Dhruv Kazi, MBBS, MS, FACC, and first author Mohammed Essa, MD, discuss their newly published JACC Brief Report presented at ACC.25 on cardiac rehabilitation following myocardial infarction, with a focus on patients who experience cardiogenic shock. JACC: Associate Editor Jason H. Wasfy, MD, MPhil, FACC, asks questions to explore the significant underutilization of cardiac rehab, the impact of social determinants of health, and potential policy changes to improve access and outcomes. Join the conversation as they highlight key findings and the need for innovative solutions in cardiovascular care.

OPENPediatrics
Pediatric ECMO Cannulation Strategies in Refractory Septic Shock by G. MacLaren | OPENPediatrics

OPENPediatrics

Play Episode Listen Later Mar 23, 2025 25:37


In this World Shared Practice Forum Podcast, Dr. Graeme MacLaren shares his expert insight on the outcomes of central versus peripheral cannulation techniques for Extracorporeal Membrane Oxygenation (ECMO) in pediatric patients with refractory septic shock as published in the February issue of Pediatric Critical Care Medicine. The discussion focuses on the implications of ECMO modality choices, the conditions affecting cannulation strategy, and how institutional resources can impact patient outcomes. LEARNING OBJECTIVES - Differentiate between central and peripheral venoarterial ECMO strategies in pediatric septic shock - Analyze key papers in the literature to provide context for decision-making around ECMO deployment in refractory septic shock - Identify factors influencing the success and outcome of ECMO in refractory pediatric septic shock cases - Apply considerations for patient selection and institutional resource availability in ECMO planning AUTHORS Graeme MacLaren, MBBS, MSc, FRACP, FCICM, FCCM, FELSO Director of Cardiothoracic Intensive Care, National University Hospital, Singapore Clinical Director of ECMO, National University Heart Centre, Singapore Adjunct Professor, Department of Surgery, National University of Singapore Past President, Extracorporeal Life Support Organization Jeffery Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: March 24, 2025. ARTICLES REFERENCED 1) MacLaren, Graeme MBBS, MSc, FELSO, FCCM. Cannulation Strategies for Extracorporeal Membrane Oxygenation in Children With Refractory Septic Shock. Pediatric Critical Care Medicine ():10.1097/PCC.0000000000003707, February 10, 2025. | DOI: 10.1097/PCC.0000000000003707 2) Totapally A, Stark R, Danko M, et al. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. Published online January 23, 2025. doi:10.1097/PCC.0000000000003692 3) Schlapbach LJ, Chiletti R, Straney L, et al. Defining benefit threshold for extracorporeal membrane oxygenation in children with sepsis-a binational multicenter cohort study. Crit Care. 2019;23(1):429. Published 2019 Dec 30. doi:10.1186/s13054-019-2685-1 4) Bréchot N, Hajage D, Kimmoun A, et al. Venoarterial extracorporeal membrane oxygenation to rescue sepsis-induced cardiogenic shock: a retrospective, multicentre, international cohort study. Lancet. 2020;396(10250):545-552. doi:10.1016/S0140-6736(20)30733-9 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/84gbxthfmhvp7v9fsnjb87mh/0320425_WSP_MacLaren_Transcript.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. CITATION MacLaren G, Burns JP. Pediatric ECMO Cannulation Strategies in Refractory Septic Shock. 03/2025. OPENPediatrics. https://soundcloud.com/openpediatrics/pediatric-ecmo-cannulation-strategies-in-refractory-septic-shock-by-g-maclaren-openpediatrics.

OpenAnesthesia Multimedia
QI Methodology, March 2025: Pediatric Anesthesiology Internet-Based Non-Technical Skills

OpenAnesthesia Multimedia

Play Episode Listen Later Mar 17, 2025 14:59


QI Methodology with Rajeev Iyer, MBBS, MD, MS, FASA, Children's Hospital Philadelphia

AJR Podcast Series
Resident Wellness: AJR Podcast Series on Wellness, Episode 12

AJR Podcast Series

Play Episode Listen Later Mar 12, 2025 20:27


In this episode of the AJR Podcast Series on Wellness, Sherry Wang, MBBS, and Jessica T. Wen, MD, PhD, discuss the current state of radiology resident wellness, along with challenges and potential opportunities. https://www.ajronline.org/doi/10.2214/AJR.25.32901

AJR Podcast Series
White Matter Hyperintensities: Biomarker or Incidental Finding? A Radiology Trainee's Perspective on Imaging of Mild Traumatic Brain Injury

AJR Podcast Series

Play Episode Listen Later Mar 11, 2025 6:07


Full article: White Matter Hyperintensities on High-Resolution 3-T MRI: Frequency in Mild Traumatic Brain Injury and Associations with Clinical Markers—A Prospective Controlled Multicenter Study Pranjal Rai, MBBS, discusses the AJR article by Tanwar et al., reporting a prospective multicenter study evaluating the potential role of white matter hyperintensities as a biomarker of mild traumatic brain injury.

AJR Podcast Series
Sustainability in Radiology: Global Perspectives on Greener Healthcare—AJR Podcast Series on Sustainability, Episode 5

AJR Podcast Series

Play Episode Listen Later Mar 5, 2025 24:54


In this episode of the AJR Podcast Series on Sustainability, Sean Woolen, MD, MS, speaks with Christopher Hess, MD, PhD, Elmar Merkle, MD, and Charles Goh, MBBS, about global perspectives on sustainability in radiology. They explore regional challenges, innovative solutions, and collaborative strategies to drive environmentally responsible radiology practices worldwide. https://www.ajronline.org/doi/10.2214/AJR.25.32864