Podcasts about medicine emeritus

JCO PO author Dr. David R. Gandara at UC Davis Comprehensive Cancer Center, shares insights into his JCO PO article, “Plasma Proteome–Based Test for First-Line Treatment Selection in Metastatic Non–Small Cell Lung Cancer,” one of the Top Articles of 2024. Host Dr. Rafeh Naqash and Dr. Gandara discuss how the PROphet® blood test supports first-line immunotherapy treatment decisions for metastatic NSCLC patients. TRANSCRIPT  Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations where we bring you engaging conversations with authors of clinically relevant and highly significant JCOPO articles. I'm your host, Dr. Rafeh Naqash, Podcast Editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma.  Today, we are absolutely thrilled to be joined by Dr. David R. Gandara, Professor of Medicine Emeritus, Co-Director of the Center for Experimental Therapeutics and Cancer and Senior Advisor to the Director at UC Davis Comprehensive Cancer Center and also the senior author of the JCO Precision Oncology article entitled “Plasma Proteome–Based Test for First-Line Treatment Selection in Metastatic Non–Small Cell Lung Cancer.” This was one of the top performing articles of 2024, which is one of the reasons why we wanted to bring it in for a podcast discussion. At the time of this recording, our guest's disclosures will be linked in the transcript.  David, it is an absolute pleasure to have you today. For somebody like you who's led the field of lung cancer over the years, I'm really excited that you are going to be talking to us about this very interesting article, especially given that I think you're one of the big proponents of liquid biopsies and plasma-based testing. So, for the sake of our listeners - which comprises of academic oncologists, community oncologists, trainees - could you tell us where the biomarker landscape for non-small cell lung cancer is currently, and then we can try to take a deeper dive into this article. Dr. David Gandar: Okay. Well, thank you, Rafeh. It's a pleasure to be with you here today. And I think the current landscape for biomarkers for immunotherapy in non-small cell lung cancer is a mess. There's no better way to describe it. That makes this paper describing a new plasma proteomic assay even more important. So I'll just give you a perspective. There are 14 trials, phase three trials, that were done in first line non-small cell lung cancer advanced stage of immunotherapy versus chemotherapy and some other aspects, although they vary tremendously. Some of them were checkpoint monotherapy, some combined with chemotherapy, some combined with CTLA-4 inhibitors and so forth. 12 out of the 14 were positive, 12 got FDA approval. So there are 12 different options that an oncologist could use. Some of them were squamous cell only, some non-squamous, some used PD-L1 as a biomarker driven part of the study. Some used TMB, tumor mutational burden, some were agnostic. So when you put all of this together, an oncologist can pick and choose among all these various regimens. And by and large, it's PD-L1 that is the therapeutic decision maker.  ASCO actually, I think, has done the very best job of making a guideline, and it's, as you well know, called a living guideline, it's dynamic. And it is much easier to interpret, for me and I think for oncologists, than some of the other guidelines. It's got a green light and a red light, it may be kind of orange. And so the green light means this is a strong recommendation by the guideline committee. The orange means it's weak. For this purpose, non-small cell lung cancer, advanced stage, only a very few of the recommendations were green. It's mainly monotherapy and patients with cancers with a PD-L1 over 50%. In our surveys, at our meetings, less than 50% of oncologists in the United States are following these guidelines. Why? Because they don't trust the biomarker. And TMB has the same sort of limitations. They're not bad biomarkers, they're incomplete. They're only looking at a part of the story. So that means we need a new biomarker. And this is one that, I think, the data are quite impressive and we'll discuss it more. Dr. Rafeh Naqash: Absolutely. Like you said, abundance of many therapy options, but not necessarily everything works the same in different subsets of PD-L1 positivity or different subsets of patients with different levels of tumor burden. And like you said, again, difficulty in trying to identify the right biomarker. And that's a nice segue to this PROphet test that you guys ran. So can you tell us a little bit about the plasma proteomic assay? Because to the best of my knowledge, there's not a lot of validated plasma proteomic assays. A lot has been done on the tumor tissue side as far as biomarkers are concerned, but not much on the blood side, except for maybe ctDNA MRD testing. So what was the background for trying to develop a plasma-based proteomic test? And then how did this idea of testing it in the lung cancer setting come into play? And then we can go into the patient population specifics, the cohort that you guys have. Dr. David Gandara: Okay. Well, of course there's a company behind this assay, it's called OncoHost, and I'm a consultant for them. And they came to me two years ago and they said, “We have something different from anyone else.” And they explained the science to me, as well as some other lung cancer experts here in the United States. I'm not a proteomic expert, of course, but they developed an AI machine learning platform to assess plasma proteins in normal people and in people with cancer, and specifically then in people with non-small cell lung cancer. They identified over 7,000 proteins that had cancer implications for therapy, for resistance, for prognosis, etc., and they categorized them based on the literature, TCGA data, etc., and used this machine learning process to figure out which proteins might be most specific for non-small cell lung cancer. And that's where they started. And so out of that 7,000 proteins, where they've identified which ones are angiogenic, which ones are involved with EMT or cell cycle or whatever it might be, they distilled it down to 388 proteins which they thought were worth testing in non-small cell lung cancer. And that's when I became involved.  They had a retrospective cohort of patients that had been treated with various immunotherapies. They looked at the analytic validation first, then applied it to this cohort. It looked good. Then they had a very large cohort, which they split, as you usually do with an assay, into a test set and then a validation set. For the test set, they wanted something more than a response. They wanted some indicator of long term benefit because that's where immunotherapy differentiates itself from chemotherapy and even targeted therapy. And so they picked PFS at 12 months. And I became involved at that point and it looked really good. I mean, if you look at the figures in the manuscript, the AUC is superb about their prediction and then what actually happened in the patient. And then in this paper, we applied it to a validation set of over 500 patients in a prospective trial, not randomized, it's called an observational trial. The investigator got to pick what they thought was the best therapy for that patient. And then in a blinded fashion, the proteomic assay experts did the analysis and applied it to the group.  And so what that means is some of the patients got chemotherapy alone, some got checkpoint immunotherapy monotherapy, some got in combination with chemotherapy. None of the patients in this study got a CTLA-4 inhibitor. That work is ongoing now. But what the study showed was that this assay can be used together with PD-L1 as what I would call a composite biomarker. You take the two together and it informs the oncologist about the meaning of that PD-L1. I'll give you an example. If that patient has a PD-L1 over 50% in their cancer and yet the PROphet test is negative, meaning less than 5 - it's a 0 to 10 scale - that patient for survival is better served by getting chemotherapy and immunotherapy. However, if the PROphet test is positive and the PD-L1 is over 50%, then the survival curves really look equivalent. As I said earlier, even in that group of patients, a lot of oncologists are reluctant to give them monotherapy. So if you have a test and the same sort of example is true for PD-L1 0, that you can differentiate. So this can really help inform the oncologist about what direction to go. And of course then you use your clinical judgment, you look at what you think of as the aggressiveness of the tumor or their liver metastases, etc. So again, that's how this test is being used for non-small cell lung cancer. And maybe I'll stop there and then I'll come back and add some other points. Dr. Rafeh Naqash: I definitely like your analogy of this therapy de-escalation strategy. Like you mentioned for PD-L1 high where the PROphet test is negative, then perhaps you could just go with immunotherapy alone. In fact, interestingly enough, I was invited to a talk at SITC a couple of weeks back and this exact figure that you're referring to was one of the figures in my slide deck. And it happened by chance that I realized that we were doing a podcast on the same paper today.  So I guess from a provocative question standpoint, when you look at the PD-L1 high cohort in the subset where you didn't see a survival difference for chemo plus immunotherapy versus immunotherapy alone, do you think any element of that could have been influenced by the degree of PD-L1 positivity above 50%? Meaning could there have been a cohort that is, let's say PD-L1 75 and above, and that kind of skews the data because I know you've published on this yourself also where the higher the PD-L1 above 50%, like 90% PD-L1 positivity survival curves are much better than 50% to 89%. So could that have somehow played a role? Dr. David Gandara: The first thing to say is that PD-L1 and the PROphet score, there's very little overlap. I know that sounds surprising, but it's also true for tumor mutational burden. There's very little overlap. They're measuring different things. The PD-L1 is measuring a specific regulatory protein that is applicable to some patients, but not all. That's why even in almost all of the studies, people with PD-L1 0 could still have some survival benefit. But in this case they're independent. And not in this paper, but in other work done by this group, the PROphet group, they've shown that the PROphet score does not seem to correlate with super high PD-L1. So it's not like the cemiplimab data where if you have a PD-L1 of greater than 90%, then of course the patient does spectacularly with monotherapy. The other thing that's important here is they had a group of around a little less than 100 patients that got chemotherapy alone. The PROphet score is agnostic to chemotherapy. And so that means that you're not just looking at some prognostic factor. It's actually clinical utility on a predictive basis. Dr. Rafeh Naqash: I think those are very important points. I was on a podcast a couple of days back. I think there's a theme these days we're trying to do for JCO Precision Oncology, we're trying to do a few biomarker based podcasts, and the most recent one that we did was using a tissue transcriptome with ctDNA MRD and you mentioned the composite of the PD-L1 and the PROphet test and they use a composite of the tissue transcriptome. I believe they called it the VIGex test as well as MRD ctDNA. And when your ctDNA was negative at, I believe, the three month mark, those individuals had the highest inflamed VIGex test or highest infiltration of T cells, STING pathway, etc. So are there any thoughts of trying to add or correlate tissue based biomarkers or ctDNA based correlations as a further validation in this research with the company? Dr. David Gandara: Right. So there are many things that are being looked at, various composites looking at the commutations that might affect the efficacy of immunotherapy and how they correlate with profit positivity or negativity. And I'll just give the examples of STK11 and KEAP1. As you know, there's some controversy about whether these are for immunotherapy, whether they're more prognostic or predictive. I'm one of the co-authors among many in the recently published Nature paper by Dr. Skoulidis and the group at MD Anderson which report that for KEAP1 positive especially, but also SDK11 mutated getting immunotherapy, that that's where the CTLA-4 inhibitors actually play the greatest role. So realizing that this is still controversial, there are preliminary data, not published yet, that'll be presented at an upcoming meeting, looking at many of these other aspects, P53, SCK11, KEAP1, other aspects, TMB, that's actually already published, I think in one of their papers. So yes, there's lots of opportunities.  The other cool thing is that this isn't a test, it's a platform. And so that means that the OncoHost scientists have already said, “What if we look at this test, the assay in a group of patients with small cell lung cancer?” And so I just presented this as a poster at the world conference in San Diego. And it turns out if you look at the biology of small cell, where neither PD-L1 nor TMB seem to be very important, if you look at the biology of small cell and you form an assay, it only shares 44 proteins out of the 388 with non-small cell. It's a different biology. And when we applied that to a group of patients with small cell lung cancer, again it had really pretty impressive results, although still a fairly small number of patients. So we have a big phase three study that we're doing with a pharmaceutical company developing immunotherapy where we are prospectively placing the PROphet test in a small cell trial.  The platform can also be altered for other cancer types. And at AACR, Dr. Jarushka Naidoo presented really impressive data that you can modify the proteins and you can predict immunotherapy side effects. So this is not like a company that says, “We have one test that's great for everything.” You know how some companies say, “Our test, you can use it for everything.” This company is saying we can alter the protein structures using AI machine learning assisted process to do it and we can have a very informed assay in different tumor types and different situations. So to me, it's really exciting. Dr. Rafeh Naqash: Definitely to me, I think, combining the AI machine learning aspect with the possibility of finding or trying to find a composite biomarker using less invasive approaches such as plasma or blood, definitely checks a lot of boxes. And as you mentioned, trying to get it to prospective trials as an integral biomarker perhaps would be likely the next step. And hopefully we see some interesting, exciting results where we can try to match or stratify patients into optimal combination therapies based on this test.  So now to the next aspect of this discussion, David, which I'm really excited about. You've been a leader and a mentor to many. You've led ISLC and several other corporate group organizations, et cetera. Can you tell us, for the sake of all the listeners, junior investigators, trainees, what being a mentor has meant for you? How your career has started many years back and how it's evolved? And what are some of the things that you want to tell people for a successful and a more exciting career as you've led over the years? Dr. David Gandara: Well, thank you for the question. Mentoring is a very important part of my own career. I didn't have an institutional mentor when I was a junior investigator, but I had a lot of senior collaborators, very famous people that kind of took me under their wing and guided me. And I thought when I basically establish myself, I want to give back by being a mentor to other people. And you wouldn't believe the number of people that I'm even mentoring today. And some of them are not medical oncologists, they're surgeons, they're radiation oncologists, they're basic scientists. Because you don't have to be an expert in that person's field to be a mentor. It helps, but in other words, you can guide somebody in what are the decision making processes in your career. When is it time to move from this institution onward because you can't grow in the institution you're in, either because it's too big or it's too small? So I established a leadership academy in the Southwest Oncology Group, SWOG. I've led many mentoring courses, for instance, for ISLC, now for International Society Liquid Biopsy, where I'm the executive committee liaison for what's called The Young Committee. So ISLB Society, totally devoted to liquid biopsy, six years old now, we have a Young Committee that has a budget. They develop projects, they publish articles on their own, they do podcasts. So what I'm saying is those are all things that I think opens up opportunities. They're not waiting behind senior people, they are leading themselves.  We just, at our International Lung Cancer Congress, reestablished a fellows program where a group of fellows are invited to that Huntington beach meeting. It's now in its 25th year and we spend a day and a half with them, mentoring them on career building. I'll just give you my first, I have the “Letterman Top 10”. So my first recommendation is if all you have is lemons, make lemonade. And what I'm meaning is find what you can do at your institution if you're a junior person, what you can claim to be your own and make the very best of it. But then as you get further along in my recommendations, one of them is learn when to say ‘no'. Because as a junior investigator the biggest threat to your career is saying ‘yes' to everybody and then you become overwhelmed and you can't concentrate. So I'll stop there. But anyway, yes, mentoring is a big part of my life. Dr. Rafeh Naqash: Well, thank you, David. This is definitely something that I'm going to try to apply to my career as well. And this has been an absolute pleasure, especially with all the insights that you provided, not just on the scientific side but also on the personal career side and the mentorship side. And hopefully we'll see more of this work that you and other investigators have led and collaborated on. perhaps more interesting plasma based biomarkers. And hopefully some of that work will find its home in JCO Precision Oncology. Thank you again for joining us today. Dr. David Gandara: My pleasure. Dr. Rafeh Naqash: And thank you for listening to JCO Precision Oncology Conversations. 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 ASCO shows at asco.org/podcasts.   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.   Dr. David Gandara Disclosures: Consulting or Advisory Role Company: Henlius USA, Foundation Medicine, Janssen Pharma, Merck & Co, Mirati Therapeutics, Regeneron, AstraZeneca, Guardant Health, Genentech, Exact Sciences  Research Funding Company: Amgen, Genentech, Astex Pharma  

Jon Kabat-Zinn is a pioneering figure in the field of mindfulness and its integration into mainstream Western medicine and psychology. He is Professor of Medicine Emeritus at the University of Massachusetts Medical School, where he created both the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society. Kabat-Zinn is widely recognized for developing the Mindfulness-Based Stress Reduction (MBSR) program, which incorporates mindfulness meditation to help people manage stress, pain, and illness and is offered by medical centers, hospitals, and health maintenance organizations around the world. In addition to his academic and research work, he is the bestselling author of books like Wherever You Go, There You Are, and Full Catastrophe Living, the creator of The JKZ Meditations App, and a sought-after speaker who has conducted mindfulness workshops and retreats worldwide. ------ Thank you to the sponsors that fuel our podcast and our team: Squarespace https://squarespace.com/tetra ------ LMNT Electrolytes https://drinklmnt.com/tetra ------ House of Macadamias https://www.houseofmacadamias.com/tetra

Ozlem Goker-Alpan, MD, Founder and President, LDRTC and David G. Warnock, MD. Professor of Medicine (Emeritus) at University of Alabama at Birmingham discuss best practices to identify and treat kidney problems associated with lysosomal disorders.This CME/CE activity describes the pathophysiologies and management options for lysosomal disease patients with kidney problems. This continuing education activity is provided through collaboration between the Lysosomal and Rare Disorders Research and Treatment Center (LDRTC), CheckRare CE, and AffinityCE. This activity provides continuing education credit for physicians, physician assistants, nurses, nurse practitioners, and genetic counselors. A statement of participation is available to other attendees. To receive credit for this program, go to https://checkrare.com/learning/ Speakers Ozlem Goker-Alpan, MD, Founder and President, LDRTC David G. Warnock, MD. Professor of Medicine (Emeritus)University of Alabama at BirminghamDisclosuresAffinityCE staff, LDRTC staff, CheckRare staff, planners, and reviewers, have no relevant financial interests to disclose. All faculty disclosures are listed below and are included in the beginning of each presentation.Dr. Goker-Alpan is a consultant, a principal investigator and /or on the speaker bureau, or has received grant support, from the following pharmaceutical companies: Actelion, Amicus Therapeutics, Sanofi, Takeda, Pfizer/Protalix.Dr. Warnock has had research support and/or consulting arrangements with Genzyme Corporation (Sanofi), Shire LLC (Takeda), Amicus, Protalix and Chiesi, Zebra Bio, Walking Fish, Hanmi, and Vera Therapeutics.Mitigation of Relevant Financial RelationshipsAffinityCE adheres to the ACCME's Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CME activity, including faculty, planners, reviewers, or others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. Conflicts of interest for presenting faculty with relevant financial interests were resolved through peer review of content by a non-conflicted reviewer.Learning ObjectivesAt the end of this activity, participants should be able to:Describe the role of the nephrologist in the team approach to careDescribe best practices to monitor kidney function in lysosomal disordersDescribe best practices to treat kidney disorders lysosomal disordersSupport for this educational activity was provided by Takeda, Sanofi, Amicus Therapeutics and Chiesi USA.

Today, we will discuss the nordic diet and its effectiveness in managing cholesterol and diabetes with Dr. Robert Eckel, Professor of Medicine Emeritus with appointments in the Division of Endocrinology, Metabolism, Diabetes, and Cardiology at the University of Cincinnati College of Medicine. He is also a member of the Scientific Advisory Council of the National Institute of Diabetes, Digestive, and kidney Diseases at the National Institutes of Health. “I think good and bad cholesterol is often confused, and when you have your cholesterol measured…” Question of the Day: Have you checked your Essential Eights recently? In this episode you will learn: Difference between good and bad Cholesterol Dangers of high low-density lipoprotein or LDL Correlation between diabetes and high cholesterol Statin therapy and lowering cholesterol American Heart Association Essential Eights questions Connect with Robert Eckel: Email Additional resource: ADA Connect with Yumlish: Website Instagram Twitter Facebook LinkedIn YouTube Key Points: 00:00 Intro with Shireen! 00:17 Welcome Dr. Eckel 01:07 How Dr. Eckel started working in cardiometabolic diseases 02:26 What is good and bad cholesterol 04:40 Dangers of high LDL or bad cholesterol 05:31 Why diabetes and high cholesterol are linked 06:54 Can genetics contribute to diabetes and cardiovascular disease 07:59 Ways to manage cholesterol 09:11 Complications with statin drugs 10:19 Do statins complicate diabetes 12:34 American Heart Association Essential Eights 13:38 Diet: Quality vs quantity 16:12 Fiber: insoluble vs soluble 20:14 Outro with Shireen! --- Send in a voice message: https://anchor.fm/yumlish/message

In this podcast, Dr Murray Epstein, Professor of Medicine Emeritus in the division of Nephrology and Hypertension at the University of Miami, Miller School of Medicine, discusses Aldosterone and Mineralocorticoid Receptor Antagonists in 2021. This podcast is published open access in Diabetes Therapy and is fully citeable. You can access the original published podcast article through the Diabetes Therapy website and by using this link. All conflicts of interest can be found online.   This podcast is intended for medical professionals only.   Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

I don't know about you, but I felt a lot of anger, fear, and sadness while watching those horrifying images from the United States Capitol on Wednesday. So how do we handle this with some degree of equanimity? That's what we're going to talk about today. It's Friday, which is when we usually post bonus meditations or talks, but given the collective trauma we are living through -- both in the US and around the world -- we wanted to post a special episode. I'll be honest... as a journalist and as a meditation evangelist, I can't sit here and guarantee that everything's going to be alright. I suspect it will be, but -- really -- I don't know. What I do know, though, is that meditation -- taking care of your own mind -- will help you navigate this moment more skillfully. And if enough of us do this, it might impact the course of events.  You know who agrees with me? Jon Kabat-Zinn. He's a towering figure in the world of meditation and mental health. He created Mindfulness-Based Stress Reduction, a way of teaching meditation that brought the practice into the secular mainstream and resulted in an explosion of scientific research demonstrating the benefits of the practice. He's written such books as Wherever You Go, There You Are and Full Catastrophe Living. And he's a Professor of Medicine Emeritus at the University of Massachusetts Medical School. How to join the New Year's Challenge: Join the New Year's Challenge by downloading the Ten Percent Happier app : https://10percenthappier.app.link/install. You should be prompted to join the Challenge after registering your account. If you've already downloaded the app, just open it up or visit this link to join: https://10percenthappier.app.link/NewYearsChallenge21 Full Shownotes: https://www.tenpercent.com/podcast-episode/jon-kabat-zinn-313

I don't know about you, but I felt a lot of anger, fear, and sadness while watching those horrifying images from the United States Capitol on Wednesday. So how do we handle this with some degree of equanimity? That's what we're going to talk about today. It's Friday, which is when we usually post bonus meditations or talks, but given the collective trauma we are living through -- both in the US and around the world -- we wanted to post a special episode. I'll be honest... as a journalist and as a meditation evangelist, I can't sit here and guarantee that everything's going to be alright. I suspect it will be, but -- really -- I don't know. What I do know, though, is that meditation -- taking care of your own mind -- will help you navigate this moment more skillfully. And if enough of us do this, it might impact the course of events.  You know who agrees with me? Jon Kabat-Zinn. He's a towering figure in the world of meditation and mental health. He created Mindfulness-Based Stress Reduction, a way of teaching meditation that brought the practice into the secular mainstream and resulted in an explosion of scientific research demonstrating the benefits of the practice. He's written such books as Wherever You Go, There You Are and Full Catastrophe Living. And he's a Professor of Medicine Emeritus at the University of Massachusetts Medical School. How to join the New Year’s Challenge: Join the New Year's Challenge by downloading the Ten Percent Happier app : https://10percenthappier.app.link/install. You should be prompted to join the Challenge after registering your account. If you've already downloaded the app, just open it up or visit this link to join: https://10percenthappier.app.link/NewYearsChallenge21 Full Shownotes: https://www.tenpercent.com/podcast-episode/jon-kabat-zinn-313

Episode 6 of The Master Clinician Project, featuring Dr. Ken Sack: Rheumatologist, Professor of Medicine Emeritus at the University of California San Francisco School of Medicine, and UCSF Master Clinician.

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Scott Kelly spent a year in the International Space Station while his identical twin Mark Kelly was on earth. UC San Diego and many institutions studied the mental, cardiovascular, immune, genetic, muscular, microbial, bone, and eye changes in both twins to see the effects of long-term space travel. Changes were troubling, so NASA plans several more long-term space flights that will focus on genetic changes, bone loss, loss of vision, brain swelling, and Nutrition. Michael G. Ziegler, MD, is Professor of Medicine Emeritus at UCSD. He has studied astronaut health since 1978. He chaired NASA’s yearly cardiovascular reviews, helped devise current astronaut protocols, and studied physiologic and genomic changes during the Year in Space study.   Series: "Osher UC San Diego Distinguished Lecture Series" [Health and Medicine] [Science] [Show ID: 35085]

Can changes in your psychology create physical symptoms? Is there such a thing as "non-disease"? In this utterly compelling episode, a true medical detective - Dr. Clifton Meador - explains how he came to understand that some symptoms and diseases emerge from the "life narrative" of the patient. If a doctor listens hard enough, the patient will often volunteer the reasons for his or her health struggles. He asserts that all patients should consider their diet, chemical exposures and stress levels, and partner with their doctor in a "medical detective" team in order to uncover the root causes of symptoms and illness. Dr Meador says: "I came to fully understand that the mind and the body were one – not separated, not disconnected. What affected one also affected the other. Sitting above all the molecules, tissues, organs, and mind of the human body was an integrated person. This person was connected to a family and perhaps to a spouse, and the family was connected to some social structure and society at large. All this social structure impinged on the person, and the person impinged on the social structure. There was a continuum all the way from society to the person to the organs and even down to the molecules. There were no separated pockets or islands. There certainly was no mind separated from a body. " ---------- Dr. Clifton K. Meador Biography Dr Clifton K Meador has been practising and teaching medicine for over 60 years. He has written fifteen books and published articles in esteemed medical journals such as NEJM. Fascinated by patients with symptoms of hidden origin and by patients who carried diagnoses of non-existent diseases, he recorded his experiences in his books Symptoms of Unknown Origin, Puzzling Symptoms and Fascionomas – fascinating medical mysteries. A Graduate of Vanderbilt University School of Medicine in 1955, Dr. Meador trained at Columbia Presbyterian Hospital in New York, and Vanderbilt Medical School where he completed a National Institutes for Health fellowship in Endocrinology. After practicing medicine, he joined the faculty of medicine at UAB, where he was Professor of Medicine and then Dean of the University of Alabama School of Medicine at UAB from 1968 – 1973. He returned to Vanderbilt and St. Thomas Hospital, serving as chief of medicine and chief medical officer of Saint Thomas from 1973 to 1998. He then served as the first Executive Director of the Meharry-Vanderbilt Alliance from 1999 to 2012. He is professor of Medicine Emeritus at both Vanderbilt School of Medicine and Meharry Medical College. Dr. Meador lives in Nashville, TN. His wife Ann Cowden, is a well-known portrait artist. He is father of seven children, seven grandchildren and two great grandchildren.

Cheryl Sosnowski is a Master Mindfulness Teacher and the owner of Create Space Studios. She has dedicated her life to teaching people how to become more mindful. For her, it was transformative. On her own since the time she was 15, Sosnowski's path was to emotionally shut down. She was in deep rooted denial after suffering years of abuse. Sosnowski talks about how she went from being “an anxiety ridden, suicidal mother, horrible mess” to a calm, happy and stable person who now has an incredible relationship with her children. It began with an eight week course and studying John Kabat-Zinn, American Professor of Medicine Emeritus and a creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Of her training, Sosnowski says she learned “everyone can transform and rewire. Mindfulness is a different way of being in the world.” IN THIS EPISODE SOSNOWSKI SHARES: HOW MINDFULNESS CHANGED HER LIFE — It has given her curiosity instead of judgement. — She saw a profound difference in the way she handled stress HOW TO BECOME MORE MINDFUL — Learn how to breath in a way that will make you more mindful Notice your breaking and your thought process. Your thoughts are not things unless you make them be things. The only breath you can ever take is the one you take right now. Bodily exercises Paying attention to your thoughts DAILY HABITS THAT HELPED HER TRANSFORM — Get up earlier on purpose every day. — Spend 15 minutes reading something motivational. 15 minutes meditating. Then go exercise. “We have more wealth and more things than we've ever had. But people aren't happy. We are busy all the time, but busy doing what? Are you creating something meaningful in your life? The post How To Transform Your Thinking & Become More Mindful appeared first on Inspired Media 360 TV - Inform | Inspire | Engage.

Through relaxation you can break the vicious circle of pain and stress. This podcast takes you through some easy to learn methods of relaxation, helping it to become part of your daily life and improving your wellbeing. It also lists the benefits of meditation and looks at the supporting scientific evidence, examining why relaxation should be an integral component in your recovery.   Relaxation Relaxation is an integral component of cognitive behavioral treatment programs for chronic pain.1 Taking care of stress and anxiety as a chronic pain patient is crucial for your recovery.   Meditation   Meditation is also a great way to built relaxation into your daily life. There are many different ways of practicing meditation and you have to find what works best for you.   Many people enrich their lives through practicing meditation. When you read interviews with successful CEO´s, entrepreneurs or celebrities who have incorporated meditation routines in their lives it is astonishing to see the huge benefits they experience.   Personal benefits of people who meditate regularly: more happiness having more energy having more creativity living more efficiently a better understanding of ones own emotions more sensitivity to the feelings and emotions of others more control over ones own emotions less pressured by your experiences less stressed feeling more relaxed more calming thoughts control over your sensory filtering improved memory and executive function increased ability to concentrate increased emotional intelligence   Thinking about relaxation, mindfulness and awareness during our recovery can’t be done without looking at some important evidence and thoughts about meditational practices: Mindfulness meditation programs improve anxiety, depression and pain over the course of 2–6 months. The effects are comparable with those you can expect after taking antidepressants for the same period of time, but without the associated toxicities.2 47 placebo-controlled trials all found small to moderate improvements in pain, anxiety and depression. What is really great about this review (Meditation programs for psychological stress and well-being from 2013) is that it demonstrates that the meditation group attained better results compared to the control group undertaking an equally intense treatment regarding focus and time, such as lectures, talks and art therapy sessions. If we consider this evidence, then it seems a good reason to check out mindfulness for yourself and see if meditation could be something for you to try.     A definition of mindfulness Mindfulness has been described as a “non-elaborative, non-judgmental awareness” of present moment experience.3 Maybe you have heard of Zen, it´s very closely related to the mindfulness approach. In general mindfulness techniques can be divided into two styles: focused attention "Focused attention is associated with maintaining focus on a specific object, often the changing sensation or flow of the breath or an external object. When attention drifts from the object of focus to a distracting sensory, cognitive or emotional event, the practitioner is taught to acknowledge the event and to disengage from it by gently returning the attention back to the object of meditation".3 open monitoring "By contrast, open monitoring is associated with a non-directed acknowledgement of any sensory, emotional or cognitive event that arises in the mind. Zen meditation is considered to be one form of open monitoring practice. While practicing open monitoring, the practitioner experiences the current sensory or cognitive ‘event’ without evaluation, interpretation, or preference".3   Many guided meditation programs consist of a mix of those two styles. Often changing from one to the other within a meditation session. I also think that it’s really important to know that clinical research into mindfulness has been going on since the early 1980s. For me this means that there is a good scientific evidence for using meditation techniques detached from religious beliefs or dogma for health purposes.   How to start There is plenty of good content on the Internet available for free, simply search for mindful meditation. Check out some talks about meditation on TED.com and be inspired, or check out www.mindful.org Here are some great resources: Free guided meditations from UCLA: Each week has a different theme, and usually includes some introductory comments, a guided meditation, some silent practice time, and closing comments. Presented by the UCLA Mindful Awareness Research Center. http://marc.ucla.edu/body.cfm?id=107 http://marc.ucla.edu/body.cfm?id=22   UCSD Center for Mindfulness: Guided audio files for practicing Mindfulness-Based Stress Reduction (MBSR) from the UC San Diego Center for Mindfulness. http://health.ucsd.edu/specialties/mindfulness/programs/mbsr/Pages/audio.aspx   Basic meditation with Tara Brach Free meditations that you can stream or download. https://www.tarabrach.com/guided-meditations/   Contemplative Mind in Society Guided practices from Mirabai Bush, the center’s director, Diana Winston from UCLA’s Mindfulness Awareness Research Center, and Arthur Zajonc, president of the Mind & Life Institute. http://www.contemplativemind.org/practices/recordings   Insight Meditation Society  Selected talks, podcasts, and audio streams, including various lengths of guided meditation. http://www.dharma.org/resources/audio#guided   John Kabat Zinn on youtube: Professor of Medicine Emeritus and creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. https://www.youtube.com/watch?v=8HYLyuJZKno   Literature:  Morley S, Williams A. New Developments in the Psychological Management of Chronic Pain. CanJPsychiatry. 2015;6060(44):168-175. Goyal M, Singh S, Sibinga E, et al. Meditation programs for psychological stress and well-being : a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357-368. doi:10.1001/jamainternmed.2013.13018.Meditation. Zeidan F, Grant J., Brown CA, et al. Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain. Neurosci Lett. 2012;520(2):165-173. doi:10.1016/j.neulet.2012.03.082.

Host: Alan S. Brown, MD, FNLA Is there a patient age at which statin therapy should be discontinued? Likewise, what does the current evidence tell us about initiating vs not initiating statin therapy in older patients? Joining Lipid Luminations to discuss these and other important questions is Dr. W. Virgil Brown, Charles Howard Candler Professor of Medicine Emeritus at Emory University School of Medicine in Atlanta, Georgia.

Aired 09/19/10 JON KABAT-ZINN, Ph.D. is Professor of Medicine Emeritus at the University of Massachusetts Medical School, where he was founder of the Center for Mindfulness in Medicine, Health Care, and Society, and founding Director of its world-renowned Stress Reduction Clinic. In 1993, his work in the Stress Reduction Clinic was featured in Bill Moyer's PBS Special, Healing and the Mind. He's the author of Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness; Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life; Coming to Our Senses: Healing Ourselves and the World Through Mindfulness. Dr. Kabat-Zinn's work has contributed to a growing movement of mindfulness within mainstream institutions in medicine, law, education, business, corrections, and sports. Over 200 medical centers and clinics nationwide and abroad now use his Mindfulness-Based Stress Reduction Jon was a guest a couple of times before on this show. On one of those occasions, he was joined by his wife Myla Kabat Zinn, and we talked about mindful parenting and the book they wrote together, Everyday Blessings, which I highly recommend. By the way, the Zinn in both their names is her maiden name. Myla's father is the late historian and activist, Howard Zinn. TRUCY GOODMAN, Ph.D., has trained and practiced in two fields for over 25 years: meditation and psychotherapy. She studied developmental psychology with Jean Piaget, Lawrence Kohlberg, and Carol Gilligan, and trained with psychiatrist/psychoanalyst Richard Chasin, MD. For 20 years, Trudy worked with children, teenagers, couples and individuals in a full psychotherapy practice. Since 1974, Trudy devoted much of her life to practicing Buddhist meditation. She taught mindfulness with Jon Kabat-Zinn in the early days of the MBSR (Mindfulness-Based Stress Reduction) clinic at University of Massachusetts Medical School in Worcester.