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Dr. Linda Duska and Dr. Kathleen Moore discuss key studies in the evolving controversy over radical upfront surgery versus neoadjuvant chemotherapy in advanced ovarian cancer. TRANSCRIPT Dr. Linda Duska: Hello, and welcome to the ASCO Daily News Podcast. I am your guest host, Dr. Linda Duska. I am a professor of obstetrics and gynecology at the University of Virginia School of Medicine.  On today's episode, we will explore the management of advanced ovarian cancer, specifically with respect to a question that has really stirred some controversy over time, going all the way back more than 20 years: Should we be doing radical upfront surgery in advanced ovarian cancer, or should we be doing neoadjuvant chemotherapy? So, there was a lot of hype about the TRUST study, also called ENGOT ov33/AGO-OVAR OP7, a Phase 3 randomized study that compares upfront surgery with neoadjuvant chemotherapy followed by interval surgery. So, I want to talk about that study today. And joining me for the discussion is Dr. Kathleen Moore, a professor also of obstetrics and gynecology at the University of Oklahoma and the deputy director of the Stephenson Cancer Center, also at the University of Oklahoma Health Sciences.  Dr. Moore, it is so great to be speaking with you today. Thanks for doing this. Dr. Kathleen Moore: Yeah, it's fun to be here. This is going to be fun. Dr. Linda Duska: FYI for our listeners, both of our full disclosures are available in the transcript of this episode.  So let's just jump right in. We already alluded to the fact that the TRUST study addresses a question we have been grappling with in our field. Here's the thing, we have four prior randomized trials on this exact same topic. So, share with me why we needed another one and what maybe was different about this one? Dr. Kathleen Moore: That is, I think, the key question. So we have to level-set kind of our history. Let's start with, why is this even a question? Like, why are we even talking about this today? When we are taking care of a patient with newly diagnosed ovarian cancer, the aim of surgery in advanced ovarian cancer ideally is to prolong a patient's likelihood of disease-free survival, or if you want to use the term "remission," you can use the term "remission." And I think we can all agree that our objective is to improve overall survival in a way that also does not compromise her quality of life through surgical complications, which can have a big effect. The standard for many decades, certainly my entire career, which is now over 20 years, has been to pursue what we call primary cytoreductive surgery, meaning you get a diagnosis and we go right to the operating room with a goal of achieving what we call "no gross residual." That is very different – in the olden days, you would say "optimal" and get down to some predefined small amount of tumor. Now, the goal is you remove everything you can see.  The alternative strategy to that is neoadjuvant chemotherapy followed by interval cytoreductive surgery, and that has been the, quote-unquote, "safer" route because you chemically cytoreduce the cancer, and so, the resulting surgery, I will tell you, is not necessarily easy at all. It can still be very radical surgeries, but they tend to be less radical, less need for bowel resections, splenectomy, radical procedures, and in a short-term look, would be considered safer from a postoperative consideration. Dr. Linda Duska: Well, and also maybe more likely to be successful, right? Because there's less disease, maybe, theoretically. Dr. Kathleen Moore: More likely to be successful in getting to no gross residual. Dr. Linda Duska: Right. Yeah, exactly. Dr. Kathleen Moore: I agree with that. And so, so if the end game, regardless of timing, is you get to no gross residual and you help a patient and there's no difference in overall survival, then it's a no-brainer. We would not be having this conversation. But there remains a question around, while it may be more likely to get to no gross residual, it may be, and I think we can all agree, a less radical, safer surgery, do you lose survival in the long term by this approach? This has become an increasing concern because of the increase in rates of use of neoadjuvant, not only in this country, but abroad. And so, you mentioned the four prior studies. We will not be able to go through them completely. Dr. Linda Duska: Let's talk about the two modern ones, the two from 2020 because neither one of them showed a difference in overall survival, which I think we can agree is, at the end of the day, yes, PFS would be great, but OS is what we're looking for. Dr. Kathleen Moore: OS is definitely what we're looking for. I do think a marked improvement in PFS, like a real prolongation in disease-free survival, for me would be also enough. A modest improvement does not really cut it, but if you are really, really prolonging PFS, you should see that-  Dr. Linda Duska: -manifest in OS. Dr. Kathleen Moore: Yeah, yeah. Okay. So let's talk about the two modern ones. The older ones are EORTC and CHORUS, which I think we've talked about. The two more modern ones are SCORPION and JCOG0602. So, SCORPION was interesting. SCORPION was a very small study, though. So one could say it's underpowered. 170 patients. And they looked at only patients that were incredibly high risk. So, they had to have a Fagotti score, I believe, of over 9, but they were not looking at just low volume disease. Like, those patients were not enrolled in SCORPION. It was patients where you really were questioning, "Should I go to the OR or should I do neoadjuvant? Like, what's the better thing?" It is easy when it's low volume. You're like, "We're going." These were the patients who were like, "Hm, you know, what should I do?" High volume. Patients were young, about 55. The criticism of the older studies, there are many criticisms, but one of them is that, the criticism that is lobbied is that they did not really try. Whatever surgery you got, they did not really try with median operative times of 180 minutes for primary cytoreduction, 120 for neoadjuvant. Like, you and I both know, if you're in a big primary debulking, you're there all day. It's 6 hours. Dr. Linda Duska: Right, and there was no quality control for those studies, either. Dr. Kathleen Moore: No quality control. So, SCORPION, they went 451-minute median for surgery. Like, they really went for it versus four hours and then 253 for the interval, 4 hours. They really went for it on both arms. Complete gross resection was achieved in 50% of the primary cytoreduced. So even though they went for it with these very long surgeries, they only got to the goal half the time. It was almost 80% in the interval group. So they were more successful there. And there was absolutely no difference in PFS or OS. They were right about 15 months PFS, right about 40 months OS.  JCOG0602, of course, done in Japan, a big study, 300 patients, a little bit older population. Surprisingly more stage IV disease in this study than were in SCORPION. SCORPION did not have a lot of stage IV, despite being very bulky tumors. So a third of patients were stage IV. They also had relatively shorter operative times, I would say, 240 minutes for primary, 302 for interval. So still kind of short. Complete gross resection was not achieved very often. 30% of primary cytoreduction. That is not acceptable. Dr. Linda Duska: Well, so let's talk about TRUST. What was different about TRUST? Why was this an important study for us to see? Dr. Kathleen Moore: So the criticism of all of these, and I am not trying to throw shade at anyone, but the criticism of all of these is if you are putting surgery to the test, you are putting the surgeon to the test. And you are assuming that all surgeons are trained equally and are willing to do what it takes to get someone to no gross residual. Dr. Linda Duska: And are in a center that can support the post-op care for those patients. Dr. Kathleen Moore: Which can be ICU care, prolonged time. Absolutely. So when you just open these broadly, you're assuming everyone has the surgical skills and is comfortable doing that and has backup. Everybody has an ICU. Everyone has a blood bank, and you are willing to do that. And that assumption could be wrong. And so what TRUST said is, "Okay, we are only going to open this at centers that have shown they can achieve a certain level of primary cytoreduction to no gross residual disease." And so there was quality criteria. It was based on – it was mostly a European study – so ESGO criteria were used to only allow certified centers to participate. They had to have a surgical volume of over 36 cytoreductive surgeries per year. So you could not be a low volume surgeon. Your complete resection rates that were reported had to be greater than 50% in the upfront setting. I told you on the JCOG, it was 30%. Dr. Linda Duska: Right. So these were the best of the best. This was the best possible surgical situation you could put these patients in, right? Dr. Kathleen Moore: Absolutely. And you support all the things so you could mitigate postoperative complications as well. Dr. Linda Duska: So we are asking the question now again in the ideal situation, right? Dr. Kathleen Moore: Right. Dr. Linda Duska: Which, we can talk about, may or may not be generalizable to real life, but that's a separate issue because we certainly don't have those conditions everywhere where people get cared for with ovarian cancer. But how would you interpret the results of this study? Did it show us anything different? Dr. Kathleen Moore: I am going to say how we should interpret it and then what I am thinking about. It is a negative study. It was designed to show improvement in overall survival in these ideal settings in patients with FIGO stage IIIB and C, they excluded A, these low volume tumors that should absolutely be getting surgery. So FIGO stage IIIB and C and IVA and B that were fit enough to undergo radical surgery randomized to primary cytoreduction or neoadjuvant with interval, and were all given the correct chemo. Dr. Linda Duska: And they were allowed bevacizumab and PARP, also. They could have bevacizumab and PARP. Dr. Kathleen Moore: They were allowed bevacizumab and PARP. Not many of them got PARP, but it was distributed equally, so that would not be a confounder. And so that was important. Overall survival is the endpoint. It was a big study. You know, it was almost 600 patients. So appropriately powered. So let's look at what they reported. When they looked at the patients who were enrolled, this is a large study, almost 600 patients, 345 in the primary cytoreductive arm and 343 in the neoadjuvant arm. Complete resection in these patients was 70% in the primary cytoreductive arm and 85% in the neoadjuvant arm. So in both arms, it was very high. So your selection of site and surgeon worked. You got people to their optimal outcome. So that is very different than any other study that has been reported to date. But what we saw when we looked at overall survival was no statistical difference. The median was, and I know we do not like to talk about medians, but the median in the primary cytoreductive arm was 54 months versus 48 months in the neoadjuvant arm with a hazard ratio of 0.89 and, of course, the confidence interval crossed one. So this is not statistically significant. And that was the primary endpoint. Dr. Linda Duska: I know you are getting to this. They did look at PFS, and that was statistically significant, but to your point about what are we looking for for a reasonable PFS difference? It was about two months difference. When I think about this study, and I know you are coming to this, what I thought was most interesting about this trial, besides the fact that the OS, the primary endpoint was negative, was the subgroup analyses that they did. And, of course, these are hypothesis-generating only. But if you look at, for example, specifically only the stage III group, that group did seem to potentially, again, hypothesis generating, but they did seem to benefit from upfront surgery.  And then one other thing that I want to touch on before we run out of time is, do we think it matters if the patient is BRCA germline positive? Do we think it matters if there is something in particular about that patient from a biomarker standpoint that is different? I am hopeful that more data will be coming out of this study that will help inform this. Of course, unpowered, hypothesis-generating only, but it's just really interesting. What do you think of their subset analysis? Dr. Kathleen Moore: Yeah, I think the subsets are what we are going to be talking about, but we have to emphasize that this was a negative trial as designed. Dr. Linda Duska: Absolutely. Yes. Dr. Kathleen Moore: So we cannot be apologists and be like, "But this or that." It was a negative trial as designed. Now, I am a human and a clinician, and I want what is best for my patients. So I am going to, like, go down the path of subset analyses. So if you look at the stage III tumors that got complete cytoreduction, which was 70% of the cases, your PFS was almost 28 months versus 21.8 months. Dr. Linda Duska: Yes, it becomes more significant. Dr. Kathleen Moore: Yeah, that hazard ratio is 0.69. Again, it is a subset. So even though the P value here is statistically significant, it actually should not have a P value because it is an exploratory analysis. So we have to be very careful. But the hazard ratio is 0.69. So the hypothesis is in this setting, if you're stage III and you go for it and you get someone to no gross residual versus an interval cytoreduction, you could potentially have a 31% reduction in the rate of progression for that patient who got primary cytoreduction. And you see a similar trend in the stage III patients, if you look at overall survival, although the post-progression survival is so long, it's a little bit narrow of a margin.  But I do think there are some nuggets here that, one of our colleagues who is really one of the experts in surgical studies, Dr. Mario Leitao, posted this on X, and I think it really resonated after this because we were all saying, "But what about the subsets?" He is like, "It's a negative study." But at the end of the day, you are going to sit with your patient. The patient should be seen by a GYN oncologist or surgical oncologist with specialty in cytoreduction and a medical oncologist, you know, if that person does not give chemo, and the decision should be made about what to do for that individual patient in that setting. Dr. Linda Duska: Agreed. And along those lines, if you look carefully at their data, the patients who had an upfront cytoreduction had almost twice the risk of having a stoma than the patients who had an interval cytoreduction. And they also had a higher risk of needing to have a bowel resection. The numbers were small, but still, when you look at the surgical complications, as you've already said, they're higher in the upfront group than they are in the interval group. That needs to be taken into account as well when counseling a patient, right? When you have a patient in front of you who says to you, "Dr. Moore, you can take out whatever you want, but whatever you do, don't make me a bag." As long as the patient understands what that means and what they're asking us to do, I think that we need to think about that. Dr. Kathleen Moore: I think that is a great point. And I have definitely seen in our practice, patients who say, "I absolutely would not want an ostomy. It's a nonstarter for me." And we do make different decisions. And you have to just say, "That's the decision we've made," and you kind of move on, and you can't look back and say, "Well, I wish I would have, could have, should have done something else." That is what the patient wants. Ultimately, that patient, her family, autonomous beings, they need to be fully counseled, and you need to counsel that patient as to the site that you are in, her volume of disease, and what you think you can achieve. In my opinion, a patient with stage III cancer who you have the site and the capabilities to get to no gross residual should go to the OR first. That is what I believe. I do not anymore think that for stage IV. I think that this is pretty convincing to me that that is probably a harmful thing. However, I want you to react to this. I think I am going to be a little unpopular in saying this, but for me, one of the biggest take-homes from TRUST was that whether or not, and we can talk about the subsets and the stage III looked better, and I think it did, but both groups did really well. Like, really well. And these were patients with large volume disease. This was not cherry-picked small volume stage IIIs that you could have done an optimal just by doing a hysterectomy. You know, these were patients that needed radical surgery. And both did well. And so what it speaks to me is that anytime you are going to operate on someone with ovary, whether it be frontline, whether it be a primary or interval, you need a high-volume surgeon. That is what I think this means to me. Like, I would want high volume surgeon at a center that could do these surgeries, getting that patient, my family member, me, to no gross residual. That is important. And you and I are both in training centers. I think we ought to take a really strong look at, are we preparing people to do the surgeries that are necessary to get someone to no gross residual 70% and 85% of the time? Dr. Linda Duska: We are going to run out of time, but I want to address that and ask you a provocative question. So, I completely agree with what you said, that surgery is important. But I also think one of the reasons these patients in this study did so well is because all of the incredible new therapies that we have for patients. Because OS is not just about surgery. It is about surgery, but it is also about all of the amazing new therapies we have that you and others have helped us to get through clinical research. And so, how much of that do you think, like, for example, if you look at the PFS and OS rates from CHORUS and EORTC, I get it that they're, that they're not the same. It's different patients, different populations, can't do cross-trial comparisons. But the OS, as you said, in this study was 54 months and 48 months, which is, compared to 2010, we're doing much, much better. It is not just the surgery, it is also all the amazing treatment options we have for these patients, including PARP, including MIRV, including lots of other new therapies. How do you fit that into thinking about all of this? Dr. Kathleen Moore: I do think we are seeing, and we know this just from epidemiologic data that the prevalence of ovarian cancer in many of the countries where the study was done is increasing, despite a decrease in incidence. And why is that? Because people are living longer. Dr. Linda Duska: People are living longer, yeah. Dr. Kathleen Moore: Which is phenomenal. That is what we want. And we do have, I think, better supportive care now. PARP inhibitors in the frontline, which not many of these patients had. Now some of them, this is mainly in Europe, will have gotten them in the first maintenance setting, and I do think that impacts outcome. We do not have that data yet, you know, to kind of see what, I would be really interested to see. We do not do this well because in ovarian cancer, post-progression survival can be so long, we do not do well of tracking what people get when they come off a clinical trial to see how that could impact – you know, how many of them got another surgery? How many of them got a PARP? I think this group probably missed the ADC wave for the most part, because this, mirvetuximab is just very recently available in Europe. Dr. Linda Duska: Unless they were on trial. Dr. Kathleen Moore: Unless they were on trial. But I mean, I think we will have to see. 600 patients, I would bet a lot of them missed the ADC wave. So, I do not know that we can say we know what drove these phenomenal – these are some of the best curves we've seen outside of BRCA. And then coming back to your point about the BRCA population here, that is a really critical question that I do not know that we're ever going to answer. There have been hypotheses around a tumor that is driven by BRCA, if you surgically cytoreduced it, and then chemically cytoreduced it with chemo, and so you're starting PARP with nothing visible and likely still homogeneous clones. Is that the group we cured? And then if you give chemo first before surgery, it allows more rapid development of heterogeneity and more clonal evolution that those are patients who are less likely to be cured, even if they do get cytoreduced to nothing at interval with use of PARP inhibitor in the front line. That is a question that many have brought up as something we would like to understand better. Like, if you are BRCA, should you always just go for it or not? I do not know that we're ever going to really get to that. We are trying to look at some of the other studies and just see if you got neoadjuvant and you had BRCA, was anyone cured? I think that is a question on SOLO1 I would like to know the answer to, and I don't yet, that may help us get to that. But that's sort of something we do think about. You should have a fair number of them in TRUST. It wasn't a stratification factor, as I remember. Dr. Linda Duska: No, it wasn't. They stratified by center, age, and ECOG status Dr. Kathleen Moore: So you would hope with randomization that you would have an equal number in each arm. And they may be able to pull that out and do a very exploratory look. But I would be interested to see just completely hypothesis-generating what this looks like for the patients with BRCA, and I hope that they will present that. I know they're busy at work. They have translational work. They have a lot pending with TRUST. It's an incredibly rich resource that I think is going to teach us a lot, and I am excited to see what they do next. Dr. Linda Duska: So, outside of TRUST, we are out of time. I just want to give you a moment if there were any other messages that you want to share with our listeners before we wrap up. Dr. Kathleen Moore: It's an exciting time to be in GYN oncology. For so long, it was just chemo, and then the PARP inhibitors nudged us along quite a bit. We did move more patients, I believe, to the cure fraction. When we ultimately see OS, I think we'll be able to say that definitively, and that is exciting. But, you know, that is the minority of our patients. And while HRD positive benefits tremendously from PARP, I am not as sure we've moved as many to the cure fraction. Time will tell. But 50% of our patients have these tumors that are less HRD. They have a worse prognosis. I think we can say that and recur more quickly. And so the advent of these antibody-drug conjugates, and we could name 20 of them in development in GYN right now, targeting tumor-associated antigens because we're not really driven by mutations other than BRCA. We do not have a lot of things to come after. We're not lung cancer. We are not breast cancer. But we do have a lot of proteins on the surface of our cancers, and we are finally able to leverage that with some very active regimens. And we're in the early phases, I would say, of really understanding how best to use those, how best to position them, and which one to select for whom in a setting where there is going to be obvious overlap of the targets. So we're going to be really working this problem. It is a good problem. A lot of drugs that work pretty well. How do you individualize for a patient, the patient in front of you with three different markers? How do you optimize it? Where do you put them to really prolong survival? And then we finally have cell surface. We saw at ASCO, CDK2 come into play here for the first time, we've got a cell cycle inhibitor. We've been working on WEE1 and ATR for a long time. CDK2s may hit. Response rates were respectable in a resistant population that was cyclin E overexpressing. We've been working on that biomarker for a long time with a toxicity profile that was surprisingly clean, which I like to see for our patients. So that is a different platform. I think we have got bispecifics on the rise. So there is a pipeline of things behind the ADCs, which is important because we need more than one thing, that makes me feel like in the future, I am probably not going to be using doxil ever for platinum-resistant disease. So, I am going to be excited to retire some of those things. We will say, "Remember when we used to use doxil for platinum-resistant disease?" Dr. Linda Duska: I will be retired by then, but thanks for that thought. Dr. Kathleen Moore: I will remind you. Dr. Linda Duska: You are right. It is such an incredibly exciting time to be taking care of ovarian cancer patients with all the opportunities.  And I want to thank you for sharing your valuable insights with us on this podcast today and for your great work to advance care for patients with GYN cancers. Dr. Kathleen Moore: Likewise. Thanks for having me. Dr. Linda Duska: And thank you to our listeners for your time today. You will find links to the TRUST study and other studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers:   Dr. Linda Duska  @Lduska Dr. Kathleen Moore Follow ASCO on social media:     @ASCO on X (formerly Twitter) ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures of Potential Conflicts of Interest:    Dr. Linda Duska:   Consulting or Advisory Role: Regeneron, Inovio Pharmaceuticals, Merck, Ellipses Pharma  Research Funding (Inst.): GlaxoSmithKline, Millenium, Bristol-Myers Squibb, Aeterna Zentaris, Novartis, Abbvie, Tesaro, Cerulean Pharma, Aduro Biotech, Advaxis, Ludwig Institute for Cancer Research, Leap Therapeutics  Patents, Royalties, Other Intellectual Property: UptToDate, Editor, British Journal of Ob/Gyn  Dr. Kathleen Moore: Leadership: GOG Partners, NRG Ovarian Committee Chair Honoraria: Astellas Medivation, Clearity Foundation, IDEOlogy Health, Medscape, Great Debates and Updates, OncLive/MJH Life Sciences, MD Outlook, Curio Science, Plexus, University of Florida, University of Arkansas for Medical Sciences, Congress Chanel, BIOPHARM, CEA/CCO, Physician Education Resource (PER), Research to Practice, Med Learning Group, Peerview, Peerview, PeerVoice, CME Outfitters, Virtual Incision Consulting/Advisory Role: Genentech/Roche, Immunogen, AstraZeneca, Merck, Eisai, Verastem/Pharmacyclics, AADi, Caris Life Sciences, Iovance Biotherapeutics, Janssen Oncology, Regeneron, zentalis, Daiichi Sankyo Europe GmbH, BioNTech SE, Immunocore, Seagen, Takeda Science Foundation, Zymeworks, Profound Bio, ADC Therapeutics, Third Arc, Loxo/Lilly, Bristol Myers Squibb Foundation, Tango Therapeutics, Abbvie, T Knife, F Hoffman La Roche, Tubulis GmbH, Clovis Oncology, Kivu, Genmab/Seagen, Kivu, Genmab/Seagen, Whitehawk, OnCusp Therapeutics, Natera, BeiGene, Karyopharm Therapeutics, Day One Biopharmaceuticals, Debiopharm Group, Foundation Medicine, Novocure Research Funding (Inst.): Mersana, GSK/Tesaro, Duality Biologics, Mersana, GSK/Tesaro, Duality Biologics, Merck, Regeneron, Verasatem, AstraZeneca, Immunogen, Daiichi Sankyo/Lilly, Immunocore, Torl Biotherapeutics, Allarity Therapeutics, IDEAYA Biosciences, Zymeworks, Schrodinger Other Relationship (Inst.): GOG Partners

Drs Joseph Mikhael and Sigurdur Y. Kristinsson discuss whether it is time to screen for multiple myeloma and what we can learn from the iStopMM study. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002717. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Multiple Myeloma https://emedicine.medscape.com/article/204369-overview Screening in Multiple Myeloma and Its Precursors: Are We There Yet? https://pubmed.ncbi.nlm.nih.gov/38175579/ Iceland Screens, Treats, or Prevents Multiple Myeloma (iStopMM): A Population-Based Screening Study for Monoclonal Gammopathy of Undetermined Significance and Randomized Controlled Trial of Follow-Up Strategies https://pubmed.ncbi.nlm.nih.gov/34001889/ Identifying Associations Between Race and Gender in the Incidence and Mortality of Patients With Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.e20052 Revisiting Wilson and Jungner in the Genomic Age: A Review of Screening Criteria Over the Past 40 Years https://pubmed.ncbi.nlm.nih.gov/18438522/ International Myeloma Foundation https://www.myeloma.org/ Prevalence of Monoclonal Gammopathy of Undetermined Significance https://pubmed.ncbi.nlm.nih.gov/16571879/ Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/books/NBK507880/ Prevalence and Risk of Progression of Light-Chain Monoclonal Gammopathy of Undetermined Significance: A Retrospective Population-Based Cohort Study https://pubmed.ncbi.nlm.nih.gov/20472173/ Mode of Progression in Smoldering Multiple Myeloma: A Study of 406 Patients https://pubmed.ncbi.nlm.nih.gov/38228628/ Observation or Treatment for Smoldering Multiple Myeloma? A Systematic Review and Meta-Analysis of Randomized Controlled Studies https://pubmed.ncbi.nlm.nih.gov/40419473/

This inspiring episode focuses on women leading innovation in medicine, as Dr. Hilary Longhurst and Mrinal Shah break down the revolutionary intersection of patient advocacy, clinical courage, and gene-editing technology for rare diseases like Hereditary Angioedema (HAE). Dr. Longhurst shares the moment she felt her voice and vision were challenged as a woman and the critical lesson that her greatest failures were "sins of omission," inspiring her to be brave and always represent the patient. Mrinal Shah discusses the importance of protecting curiosity and creativity in large systems, offering powerful advice to the next generation of women scientists: embrace change and have faith in yourself. The conversation highlights the essential role of women leaders in stepping outside conventional guidelines, forging courageous collaborations, and driving the responsible innovation that makes the impossible happen for patients globally. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities.

This episode features two nurse practitioners, Laura Demuth and Jackie Gianelli, who are not just managing careers but actively carving out new, non-traditional roles that place women's whole-person health at the center of care. Both leaders reflect on the systemic barriers that have slowed progress in women's health—from underfunded research in areas like menopause and endometriosis to flawed reimbursement models—and reveal how their clinical skills, like critical thinking and cross-functional leadership, made the leap to executive roles possible. Ultimately, they offer a collective mantra to clinicians feeling "boxed in": follow your curiosity, know you have options, and don't take the first "no" as gospel. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities.

Drs Joseph Mikhael and Peter Voorhees discuss considerations for treating smoldering multiple myeloma, including recent studies and shared decision-making. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002716. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Observation or Treatment for Smoldering Multiple Myeloma? A Systematic Review and Meta-Analysis of Randomized Controlled Studies https://pubmed.ncbi.nlm.nih.gov/40419473/ Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/books/NBK507880/ From Criteria to Clinic: How Updated Slim CRAB Criteria Influence Multiple Myeloma Diagnostic Activity https://ascopubs.org/doi/pdf/10.1200/JCO.2024.42.16_suppl.7556 International Myeloma Working Group Risk Stratification Model for Smoldering Multiple Myeloma (SMM) https://pubmed.ncbi.nlm.nih.gov/33067414/ Daratumumab or Active Monitoring for High-Risk Smoldering Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/39652675/ Lenalidomide-Dexamethasone Versus Observation in High-Risk Smoldering Myeloma After 12 Years of Median Follow-Up Time: A Randomized, Open-Label Study https://pubmed.ncbi.nlm.nih.gov/36067617/ Long-Term Outcome With Lenalidomide and Dexamethasone Therapy for Newly Diagnosed Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/23648667/ CD38-Directed Therapies for Management of Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/34235096/ Fixed Duration Therapy With Daratumumab, Carfilzomib, Lenalidomide and Dexamethasone for High Risk Smoldering Multiple Myeloma – Results of the Ascent Trial https://ashpublications.org/blood/article/140/Supplement%201/1830/492739/Fixed-Duration-Therapy-with-Daratumumab Curative Strategy for High-Risk Smoldering Myeloma: Carfilzomib, Lenalidomide, and Dexamethasone (Krd) Followed by Transplant, Krd Consolidation, and Rd Maintenance https://pubmed.ncbi.nlm.nih.gov/39038268/ Early Safety and Efficacy of CAR-T Cell Therapy in Precursor Myeloma: Results of the CAR-PRISM Study Using Ciltacabtagene Autoleucel in High-Risk Smoldering Myeloma https://ashpublications.org/blood/article/144/Supplement%201/1027/531466/Early-Safety-and-Efficacy-of-CAR-T-Cell-Therapy-in

Why is menopause care still fragmented? Dr. Alyssa Dweck, Dr. Mary Jane Minkin, and Heather Maurer dig into the “menopause desert,” the WHI legacy, workplace fixes, and how NPs and clinicians can personalize evidence-based care—without the stigma or misinformation. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities. Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002974?ecd=bdc_podcast_libsyn_mscpedu

Welcome to The Mental Breakdown and Psychreg Podcast! Today, Dr. Berney and Dr. Marshall discuss the misinformation in the media about the relationship between Autism, Tylenol, and vaccinations. Read the article from Medscape here. You can now follow Dr. Marshall on twitter, as well! Dr. Berney and Dr. Marshall are happy to announce the release of their new parenting e-book, Handbook for Raising an Emotionally Healthy Child Part 2: Attention. You can get your copy from Amazon here. We hope that you will join us each morning so that we can help you make your day the best it can be! See you tomorrow. Become a patron and support our work at http://www.Patreon.com/thementalbreakdown. Visit Psychreg for blog posts covering a variety of topics within the fields of mental health and psychology. The Parenting Your ADHD Child course is now on YouTube! Check it out at the Paedeia YouTube Channel. The Handbook for Raising an Emotionally Health Child Part 1: Behavior Management is now available on kindle! Get your copy today! The Elimination Diet Manual is now available on kindle and nook! Get your copy today! Follow us on Twitter and Facebook and subscribe to our YouTube Channels, Paedeia and The Mental Breakdown. Please leave us a review on iTunes so that others might find our podcast and join in on the conversation!

Welcome to The Mental Breakdown and Psychreg Podcast! Today, Dr. Berney and Dr. Marshall discuss the misinformation in the media about the relationship between Autism, Tylenol, and vaccinations. Read the article from Medscape here. You can now follow Dr. Marshall on twitter, as well! Dr. Berney and Dr. Marshall are happy to announce the release of their new parenting e-book, Handbook for Raising an Emotionally Healthy Child Part 2: Attention. You can get your copy from Amazon here. We hope that you will join us each morning so that we can help you make your day the best it can be! See you tomorrow. Become a patron and support our work at http://www.Patreon.com/thementalbreakdown. Visit Psychreg for blog posts covering a variety of topics within the fields of mental health and psychology. The Parenting Your ADHD Child course is now on YouTube! Check it out at the Paedeia YouTube Channel. The Handbook for Raising an Emotionally Health Child Part 1: Behavior Management is now available on kindle! Get your copy today! The Elimination Diet Manual is now available on kindle and nook! Get your copy today! Follow us on Twitter and Facebook and subscribe to our YouTube Channels, Paedeia and The Mental Breakdown. Please leave us a review on iTunes so that others might find our podcast and join in on the conversation!

This episode features a powerful discussion with Dr. Padma Mahant, Director of Medical Affairs, CND Life Sciences, and Dr. Indu Subramanian, a Neurologist with UCLA, who are leading the charge to correct the biases in Parkinson's disease care. They expose a critical gap where women's unique, non-motor symptoms are often overlooked, resulting in twice as many women waiting five or more years for a proper diagnosis compared to men. The conversation highlights the imperative to move beyond the "cookie-cutter" approach by leveraging new, objective diagnostic tools to aid early detection, prioritizing women's inclusion in clinical research, and adopting a compassionate, integrative model that places the patient at the center of their own wellness journey. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities. https://www.medscape.org/viewarticle/1002954

EP. 232:  Grab my FREE 4 Part Video Series: GLP1s Uncovered: https://bit.ly/GLP1uncovered In this episode I'm clearing up the confusion and political noise around Tylenol and NSAIDs. These over the counter medications are handed out like candy, yet decades in practice treating pain have shown me how often they backfire: from gut damage and hormone disruption to stalled healing and liver stress. Add in the recent headlines about Tylenol's potential link to autism, and suddenly what was once considered safe has become a lightning rod of controversy. I'll break it down simply: what these meds really do in the body, why long-term reliance can set you up for bigger problems, and how to think critically instead of getting caught in the political crossfire. This is not about fear. It is about facts, context, and giving you tools to make better choices for your health. Plus I let you know what to you can do instead. Topics Discussed:→ Is Tylenol safe for long-term use?→ What are the risks of ibuprofen and other NSAIDs?→ How does Tylenol affect liver and gut health?→ What are safer alternatives for pain relief?→ Why was the Vioxx scandal important for pain management? Sponsored By: → Qualia | Go to qualialife.com/drtyna for up to 50% off at and use code DRTYNA for an extra 15% off.  → Sundays | Go to sundaysfordogs.com/DRTYNA and use code DRTYNA at checkout. → Graza | So head to Graza.co/DRTYNA and use DRTYNA to get 10% off and get to cookin' your next chef quality meal! → Manukora | Head to manukora.com/DRTYNA to save up to 31% & $25 worth of free gifts in the Starter Kit, which comes with an MGO 850+ Manuka Honey jar. On This Episode We Cover:  → 00:00:00 - Introduction → 00:04:44 - Medscape findings and Tylenol → 00:08:16 - Tylenol and neurodevelopment concerns → 00:13:51 - Common sources of acetaminophen → 00:16:31 - Risks of NSAIDs → 00:19:15 - A brief history of pain relief → 00:23:05 - The Vioxx scandal explained → 00:29:12 - Safe NSAID dosing → 00:33:15 - Tylenol PM and its issues → 00:34:12 - Black box warnings → 00:36:54 - Bone health risks and more → 00:39:16 - Gut and pregnancy safety → 00:42:46 - COX pathways and cartilage effects → 00:45:25 - Approaches to pain management → 00:50:02 - Hormones, HRT, and pain relief → 00:53:41 - Liver health considerations → 00:57:04 - Peptides and microdosing → 01:03:26 - Reliable herbal options Show Links:  → Acetaminophen Use During Pregnancy, Behavioral Problems, And Hyperkinetic Disorders → Evaluation Of The Evidence On Acetaminophen Use And Neurodevelopmental Disorders Using The Navigation Guide Methodology Further Listening:  → EP: 227 | How I Broke Free From The Pain Trap | Solo → EP. 221 | The GLP-1 Microdosing Lie: It's NOT a Weight Loss Strategy | Solo → EP. 196 | The Answer Is The Gym | Quick + Dirty → EP. 82: Movement Overrides Pain - Solo Episode → EP. 22: Solo Episode: The Not So Easy Answer to Pain Management → Playlists (Orthopedics, Hormones, Strength Training + More) Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.

Joseph Mikhael, MD, and Krina K. Patel, MD, MSc, discuss considerations for CAR T-Cell therapy in multiple myeloma, including age, access, and bridging therapy. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002715. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Multiple Myeloma https://emedicine.medscape.com/article/204369-overview CARTITUDE-1 Final Results: Phase 1b/2 Study of Ciltacabtagene Autoleucel in Heavily Pretreated Patients With Relapsed/Refractory Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.8009 Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/37272512/ Plain Language Summary of the KarMMa-3 Study of Ide-cel or Standard of Care Regimens in People With Relapsed or Refractory Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38651976/ CAR T-Cell Therapy Toxicity https://www.ncbi.nlm.nih.gov/books/NBK592426/ Immunomodulatory Drugs in Multiple Myeloma: Mechanisms of Action and Clinical Experience https://pubmed.ncbi.nlm.nih.gov/28205024/ Incidence and Outcomes of Cytomegalovirus Reactivation After Chimeric Antigen Receptor T-Cell Therapy https://pubmed.ncbi.nlm.nih.gov/38838226/ Long-Acting Granulocyte Colony-Stimulating Factor in Primary Prophylaxis of Early Infection in Patients With Newly Diagnosed Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/35064823/ Revisiting the Role of Alkylating Agents in Multiple Myeloma: Up-to-Date Evidence and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/37244325/ Bispecific Antibodies for the Treatment of Relapsed/Refractory Multiple Myeloma: Updates and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/38660139/ FDA Eliminates REMS for Approved CAR T-Cell Therapies https://www.aabb.org/news-resources/news/article/2025/06/30/fda-eliminates-rems-for-approved-car-t-cell-therapies

About this Episode Episode 49 of “The 2 View” – New IDSA Complicated UTI Guidelines, Pediatric Nicotine OD, Hepatitis C Screening in the ED, High-Risk Delta Troponins Segment 1A – Pediatric Nicotine Ingestion Madelyn O, Hays HL, Kistamgari S, et al. Nicotine Ingestions Among Young Children: 2010–2023. Pediatrics. 2025;156(2):e2024070522. doi:10.1542/peds.2024-070522. Segment 1B – Finger Thoracostomy and Traumatic Pneumothorax/Hemothorax Blank, J, de Moya MA. Traumatic pneumothorax and hemothorax: What you need to know. J Trauma Acute Care Surg. Published online July 3, 2025. doi:10.1097/TA.0000000000004692 Beyer CA, Ruf AC, Alshawi AB, Cannon JW. Management of traumatic pneumothorax and hemothorax. Curr Probl Surg. 2025;63. doi:10.1016/j.cpsurg.2024.101707. Weingart, S. EMCrit 62 – Needle vs. Knife II: Needle Thoracostomy (Decompression)? EMCrit. Published online December 11, 2011. https://emcrit.org/emcrit/needle-finger-thoracostomy/ Lange C, Sharma M. Podcast #223 - ATLS Episode 4: Thoracic Trauma (Chapter 4). Total EM. October 27, 2020. https://www.totalem.org/emergency-professionals/podcast-223-atls-episode-4-thoracic-trauma-chapter-4 Segment 2A – Hepatitis C Screening in EDs Haukoos J, Rothman RE, Galbraith JW, et al. Hepatitis C Screening in Emergency Departments: The DETECT Hep C Randomized Clinical Trial. JAMA. 2025;334(6):497–507. doi:10.1001/jama.2025.10563 Segment 2B – Serial HS-Troponin Patterns Huggins C, Saltarell Ni, Swoboda TK, et al. Kinetic changes in high-sensitivity cardiac troponin for risk stratification of emergency department chest pain patients. Am J Emerg Med. 2025;93:176-181. doi:10.1016/j.ajem.2025.04.010. Segment 3 - Updated IDSA Guidelines on Complicated Urinary Tract Infections Splete H. IDSA Updates Guidelines on Complicated UTIS. Medscape. Published online July 18, 2025. https://www.medscape.com/viewarticle/idsa-updates-guidelines-complicated-utis-2025a1000j3l Trautner BW, Cortes-Penfield NW, Gupta K, et al. Complicated Urinary Tract Infections (cUTI): Clinical Guidelines for Treatment and Management. IDSA. Published online July 17, 2025. https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections/ Roberts M, Sharma M. 34 - Pertussis, Computer Interpretation of EKGs, Tuberculosis, Fluoroquinolone Side Effects. The 2 View. Published online April 10, 2024. https://2view.fireside.fm/34 Roberts M, Sharma M. 46 - Heat Stroke Tx, A New Virus, Oral Cephalosporins Vs Pyelo, Safe Discharges. The 2 View. Published online June 11, 2025. https://2view.fireside.fm/46 Bonus Reference – Ponytail Headache Blau JN. Ponytail Headache: A Pure Extracranial Headache. Headache. 2004;44(5):411-413. doi: 10.1111/j.1526-4610.2004.04092.x. Recurring Sources Center for Medical Education. http://ccme.org The Proceduralist. http://www.theproceduralist.org The Procedural Pause. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. http://www.thesgem.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to.

Survey Side Hustle Showdown: Real Reviews of Sermo, ZoomRx & MoreEver wondered if those emails about “quick clinical surveys for cash” are legit? In this episode of The PA Is In, I'm diving deep into the top survey platforms for medical professionals—breaking down the pros, cons, and real earning potential of sites like Sermo, ZoomRx, MD4Lives, InCrowd, and more.This episode is your complete guide to turning survey invites into a little side income—and deciding which platforms are worth your time (and which ones to avoid).What You'll Learn:My real earnings from survey platforms like Sermo & ZoomRxWhich sites pay in cash vs. points (and what that really means)Why Sermo is more than just surveys—hello, community!Transparency around MD4Lives paymentIf Medscape ever sends actual surveysHow to stack small streams of income while you scrollLinks: SERMO: https://app.sermo.com:443/?sermoref=39d97a2c-f699-4f8b-b2f9-1eb131e18c75&utm_campaign=tell-a-friendZOOMRX: https://refer.zoomrx.com/tracyb2 Keywords: medical surveys for clinicians, side hustle for PAs, survey income for doctors, Sermo survey review, ZoomRx for healthcare providers, MD4Lives payment delay, Medscape survey payout, InCrowd review, OpinionSite survey cashout, best medical survey sites 2025, clinician side income ideas, non-clinical income for NPs, paid medical surveys, survey platforms for physician associates, how to make money answering surveys

The Skin Real app is officially LIVE! Download it now. Download my Free Guide 'In My Perimenopause Era' Download the Ultimate Affordable Skincare Guide When was the last time you thought about your vulvar health? If your answer is “never,” you're not alone. Most women avoid talking or even thinking about this part of their body, but during perimenopause and menopause, changes in vulvar and vaginal health can have a huge impact on your comfort, confidence, and quality of life. In this episode, I sit down with Dr. Diana Londoño, a urologist who is breaking the silence on intimate health. We talk about the changes estrogen loss brings—from dryness, itching, painful sex, and recurrent UTIs to the lesser-known issues like bladder urgency and vulvar atrophy. She also explains how simple solutions like vaginal estrogen cream, hormone therapy, and lifestyle tweaks can protect your vulvar health and prevent years of suffering. ✨ Key Takeaways: Why vulvar health is central to your bladder, vaginal, and sexual health during menopause. How to know if your symptoms are normal aging or a red flag that needs further evaluation. The connection between UTIs, GSM (genitourinary syndrome of menopause), and vulvar atrophy. Why vaginal estrogen is safe, preventative, and worth considering even if you're not sexually active. How stress and mindset affect bladder symptoms and overall well-being. If you've ever felt embarrassed, ignored, or confused about what's happening “down there,” this episode will give you clarity and confidence. Dr. Diana Londoño is a Board-Certified Urologist and one of the 10% of urologists in the US who are women and the 0.5% who are Latinx and women.  She is originally from Mexico City and attended Claremont McKenna College for her undergraduate studies and then went on to attend UCLA for medical school.  She completed a 6-year residency in Urology at Kaiser Permanente in Los Angeles.   She has experienced burnout twice, which has led her to write and speak about it to raise awareness and help others. She has published multiple articles in prominent medical platforms, including Medscape, Doximity, Kevin MD, Men's Health, Giddy.com, and WebMD, among others. She is also a contributing author to the books “Thriving After Burnout” and “Medic S.O.S.”  She has also been a guest on numerous podcasts, discussing various topics, including wellness, stress, spirituality, and energy.   Her burnout journey led her to become a certified life coach and founder of Physician Coach Support.com, a peer support platform she ran for 3 years. In 2022, she received the Los Angeles County Medical Association Physician Leadership Award for her work.    She is an international speaker and guest on multiple podcasts, discussing topics such as wellness, boundaries, ego, humanity in medicine, mindset, and mindfulness. She has also been featured on TV on Univision, Telemundo, Mundo Fox, CNN Latino, KCET, and ABC News as a health consultant discussing urological topics.   She is also a Reiki Master, a Pranic Healer and the mother of two determined and joyful 7- —and 9-year-old girls, Daniela and Paloma.   Follow Dr. Londoño here:   Website -https://dianalondonomd.com/ LinkedIn - https://www.linkedin.com/in/dianalondonomd/ Instagram - https://www.instagram.com/dianalondonomd/ YouTube - https://www.youtube.com/@dianalondonomd   Want more expert skin advice without the overwhelm? Subscribe to The Skin Real Podcast wherever you listen, and visit www.theskinreal.com for dermatologist-backed tips to help you feel confident in your skin—at every age. Follow Dr. Mina here:-  https://instagram.com/drminaskin https://www.facebook.com/drminaskin https://www.youtube.com/@drminaskin https://www.linkedin.com/in/drminaskin/ Visit Dr. Mina at Baucom & Mina Derm Surgery Website: atlantadermsurgery.com Email: scheduling@atlantadermsurgery.com Call: (404) 844-0496 Instagram: @baucomminamd Thanks for tuning in. And remember—real skin care is real simple when you know who to trust. Disclaimer: This podcast is for entertainment, educational, and informational purposes only and does not constitute medical advice.      

Did you know that the happiest doctors in 2025 don't work in hospitals—and they're not who you think?If you're a physician feeling overwhelmed by call schedules, burnout, or lack of work-life balance, this episode unpacks real data on the medical specialties where doctors are thriving—not just surviving.Discover the top 5 happiest medical specialties based on a 2025 Medscape survey.Learn the common traits these specialties share (hint: they involve zero emergency calls).Find out what this means for your own career shift from corporate to independent practice.Hit play now to uncover which specialties top the physician happiness list and share this episode with a colleague.Source: https://www.inspiraadvantage.com/blog/the-happiest-medical-specialtiesTEXT HERE to suggest a future episode topic Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Kara Pepper, MD, for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Dr. Pepper is an internal medicine physician and former professional ballet dancer. After her residency in internal medicine, Dr. Pepper joined a corporate medical practice. Although she felt it wasn't the perfect fit, she stuck with it. After about seven years, she succumbed to burnout and left on sabbatical. She resumed her job but still wasn't satisfied. The stark reality of the COVID pandemic forced Kara to reassess her priorities. Three years ago, she left corporate medicine to create a solo practice. What began as a telemedicine practice now includes in-person visits as well. She specializes in treating patients with eating disorders. By running her own practice, Dr. Pepper feels she can better serve patients, especially those who feel marginalized by the health care system. Dr. Pepper also discovered a community of physicians who struck out on their own and developed satisfying and successful practices. She happily shares her experience as a physician coach with other doctors who are unhappy in medicine and considering solo practice. She emphasized that "physicians have a voice and autonomy…are not prisoners of their jobs, and can create something new." To learn more about creating a successful solo practice, check out her website: www.karapeppermd.com or contact Kara Pepper, MD: hello@karapeppermd.com  #AI #ambientscribe #locumtenens #solopractice #eatingdisorders #womenentrepreneurPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

Joseph Mikhael, MD, and Surbhi Sidana, MD, discuss the importance of balancing treatment intervals, managing side effects, and maximizing quality of life in multiple myeloma patients. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002713. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients https://pubmed.ncbi.nlm.nih.gov/22222250/ Monitoring, Prophylaxis, and Treatment of Infections in Patients With MM Receiving Bispecific Antibody Therapy: Consensus Recommendations From an Expert Panel https://pubmed.ncbi.nlm.nih.gov/37528088/ Characterization of Dysgeusia and Xerostomia in Patients With Multiple Myeloma Treated With the T-Cell Redirecting GPRC5D Bispecific Antibody Talquetamab https://pubmed.ncbi.nlm.nih.gov/38092979/ Idecabtagene Vicleucel for Relapsed/Refractory Multiple Myeloma: Real-World Experience From the Myeloma CAR T Consortium https://pubmed.ncbi.nlm.nih.gov/36623248/ Incidence, Prognostic Impact and Clinical Outcomes of Renal Impairment In Patients With Multiple Myeloma: A Population-Based Registry https://pubmed.ncbi.nlm.nih.gov/31773154/ International Myeloma Working Group https://www.myeloma.org/international-myeloma-working-group IMWG Scientific and Working Committees https://www.myeloma.org/international-myeloma-working-group/imwg-scientific-working-committees

Drs Joseph Mikhael and Saad Usmani discuss why quadruplet therapy is now the new standard of care for treating newly diagnosed multiple myeloma patients. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002714. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38084760/ Isatuximab, Lenalidomide, Dexamethasone and Bortezomib in Transplant-Ineligible Multiple Myeloma: The Randomized Phase 3 BENEFIT Trial https://pubmed.ncbi.nlm.nih.gov/38830994/ Daratumumab Plus Bortezomib, Lenalidomide and Dexamethasone for Transplant-Ineligible or Transplant-Deferred Newly Diagnosed Multiple Myeloma: The Randomized Phase 3 CEPHEUS Trial https://pubmed.ncbi.nlm.nih.gov/39910273/ Isatuximab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38832972/ A Phase 2 Study of Modified Lenalidomide, Bortezomib and Dexamethasone in Transplant-Ineligible Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/29740809/ Bortezomib With Lenalidomide and Dexamethasone Versus Lenalidomide and Dexamethasone Alone in Patients With Newly Diagnosed Myeloma Without Intent for Immediate Autologous Stem-Cell Transplant (SWOG S0777): A Randomised, Open-Label, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/28017406/ Daratumumab, Lenalidomide, Bortezomib, and Dexamethasone for Transplant-Eligible Newly Diagnosed Multiple Myeloma: The GRIFFIN Trial https://pubmed.ncbi.nlm.nih.gov/32325490/ Carfilzomib Induction, Consolidation, and Maintenance With or Without Autologous Stem-Cell Transplantation in Patients With Newly Diagnosed Multiple Myeloma: Pre-Planned Cytogenetic Subgroup Analysis of the Randomised, Phase 2 FORTE Trial https://pubmed.ncbi.nlm.nih.gov/36528035/ Results of the Phase III Randomized Iskia Trial: Isatuximab-Carfilzomib-Lenalidomide-Dexamethasone Vs Carfilzomib-Lenalidomide-Dexamethasone As Pre-Transplant Induction and Post-Transplant Consolidation in Newly Diagnosed Multiple Myeloma Patients https://www.sciencedirect.com/science/article/abs/pii/S0006497123735416

Send us a textWhy are U.S. health care costs so high—and what does that mean for you and your family? In this episode, I dive into the real reasons behind America's staggering health care bills.We start with a story that hits close to home—a $189,000 outpatient cancer surgery bill followed by $12,000-a-month immunotherapy—and I unpack how even with Medicare coverage, the pricing dynamics can feel shocking. Using my experience as a physician and health policy researcher, I explain why these massive charges happen and where the system is breaking down.At the national level, we now spend over $5 trillion a year on health care—roughly 18% of our GDP—and this number is growing far faster than inflation. This growth threatens the solvency of key programs like Medicare, which is projected to run out of funds by 2033 (Health Affairs). Employers are also feeling the pinch, with average family coverage costs now topping $25,500 annually (WSJ). Individuals, especially those using ACA exchanges, face rising premiums—some increasing by 20–30% next year (Axios)—and deductibles between $3,000 and $5,000 are now typical.Despite all this spending, our health outcomes are among the worst in the developed world. The U.S. ranks 33rd in infant mortality and 32nd in life expectancy out of 38 OECD countries, even though we spend about $12,000 per person annually—nearly three times the OECD average (America's Health Rankings).So, what drives these costs? It boils down to three factors: high prices, high utilization, and high administrative overhead. Prices for common procedures are far above international norms—a CT scan in the U.S. costs around $900 compared to $279 in the Netherlands and just $97 in Canada (Health Imaging). U.S. physicians, nurses, and hospital executives also earn significantly more, contributing to overall spending (Medscape; JAMA).On the utilization front, studies estimate that around 25% of all care may be unnecessary, driven by defensive medicine, patient expectations, and incentive structures that reward more procedures—not necessarily better outcomes (PGPF; Choosing Wisely).Even administrative overhead plays a massive role: nearly 25% of U.S. health care spending goes to bureaucracy—four times what's typical in simpler, single-payer systems (Health System Tracker; Health Affairs%20of%20US%20GDP)).If you're wondering why your doctor spends just 17 minutes with you or why your premiums feel like a second mortgage, this episode offers the context—and data—to help you understand what's really going on.Takeaways: Start asking about cash prices—especially if you're still in your deductible phase. Preventive steps like regular exercise may offer the highest return on investment when compared to costly downstream care. And above all, consider your plan carefully during open enrollment.For deeper insights, links to all the studies mentioned, and access to my newslet

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Rashie Jain for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner!  Rashie is an engineer and Co-Founder of Marvix.AI, her second start-up. Rashie observed that many physicians struggle with high administrative burdens, especially medical specialists who spend more time with patients and deal with complex cases. With the advent of large language models, she created an "ambient scribe" that takes notes during a patient encounter, organizes them, and presents them for review as a finished product. With just a little tweaking, doctors can embed these notes into the electronic medical record (EMR). I tried out Rashie's software at the recent American Academy of Neurology meeting in San Diego, CA. Her Co-Founder played the role of a migraine patient, and we chatted for about 10 minutes. Truth be told, the ambient scribe did a great job capturing the essential details. I could have edited it in just a couple of minutes, which would save time compared to typing it into the EMR myself! To learn more about Marvix.AI, or to try it in your own office, please contact Rashie Jain at https://www.marvixapp.ai#AI #ambientscribe #largelanguagemodel #womenentrepreneurPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Brenda Snow for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner!  Brenda is the Founder and CEO of Snow Companies, which helps engage patients with their healthcare services. Her own life-changing experience with a neurologic disorder, which she experienced as an "identity earthquake," triggered the creation of her business, "Snow Companies." Thirty years ago, Brenda suffered from unexplained symptoms including double vision, dragging her left foot, loss of bladder control, and strange fatigue. After initial misadventures with a couple of neurologists, she was accurately diagnosed with multiple sclerosis. Brenda eventually discovered a supportive medical team. She takes regular multiple sclerosis treatments, maintains a healthy lifestyle, and lives an active and successful life. Brenda started "Snow Companies" nearly 25 years ago. Now with over 400 employees, Snow Companies helps pharmaceutical companies engage with their patients. Brenda also hopes to help patients with her new book, "Diagnosed: The Essential Guide to Navigating the Patient's Journey." Brenda graciously offered to send a free, signed copy of her book to anyone who can't afford it. Just send her an email through her website: https://brendasnow.com #multiple sclerosis #womenentrepreneurs #entrepreneurs #authorPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

What are the leadership skills women need to succeed in medicine today? Shikha Jain, MD, FACP, founder and CEO of the Women in Medicine Summit, says there are many but emphasizes one in particular. And it's not what you think. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities. https://www.medscape.org/viewarticle/1002775?ecd=bdc_podcast_libsyn_mscpedu

Join medical students Binal Patel and Aashka Sheth as they discuss adolescent gynecology with pediatrician Dr. Shreeti Kapoor.  Specifically, they will discuss: What exactly is adolescent gynecology. The proper approach to taking a comprehensive history for a pediatric patient with a gynecologic chief complaint. The various causes of dysmenorrhea in the early menarche period and its presentation. The diagnostic approach to dysmenorrhea in adolescents. The approach to treatment of dysmenorrhea in a pediatric population. And how to approach addressing safe sex practices and sexually transmitted infections with adolescents. References: 21 reasons to see a gynecologist before you turn 21. ACOG. (n.d.). https://www.acog.org/womens-health/infographics/21-reasons-to-see-a-gynecologist-before-you-turn-21   Adams Hillard P. J. (2008). Menstruation in adolescents: what's normal?. Medscape journal of medicine, 10(12), 295.  Breehl L, Caban O. Physiology, Puberty. [Updated 2023 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534827/  Centers for Disease Control and Prevention. (n.d.). About heavy menstrual bleeding. Centers for Disease Control and Prevention. https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html  Primary dysmenorrhea in adolescents. UpToDate. (n.d.). https://www.uptodate.com/contents/primary-dysmenorrhea-in-adolescents?search=Primary+Dysmenorrhea+&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2  professional, C. C. medical. (2024, September 20). Pediatric gynecology. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/24574-pediatric-gynecology  professional, C. C. medical. (2025, February 18). Puberty. Cleveland Clinic. https://my.clevelandclinic.org/health/body/puberty   Sachedin, A., & Todd, N. (2020). Dysmenorrhea, endometriosis and chronic pelvic pain in adolescents. Journal of Clinical Research in Pediatric Endocrinology, 12(1), 7–17. https://doi.org/10.4274/jcrpe.galenos.2019.2019.s0217   Sexuality, Sexual Health, and Sexually Transmitted Infections in Adolescents and Young Adults. (2020). Topics in Antiviral Medicine, 28(2). https://pmc.ncbi.nlm.nih.gov/articles/PMC7482983/pdf/tam-28-459.pdf   UpToDate. (n.d.). Abnormal uterine bleeding in adolescents. https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-adolescents-evaluation-and-approach-to-diagnosis?search=heavy%2Bbleeding&usage_type=default&source=search_result&selectedTitle=3~150&display_rank=3  

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Matt Holgotz-Hetling for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Matt is a journalist and author of "If it Sounds Like a Quack…" His prior book, "A Libertarian Walks into a Bear," received 4.5 stars on Amazon and more than 1,000 reviews. During COVID, Matt took an interest in two conflicting forces he observed in American society. On the one hand, public health officials were trying to protect the public by recommending masks and closing schools. On the other hand, many independent-minded Americans insisted on making their own decisions, often eschewing masks and social distancing.  Matt was intrigued by fringe practitioners offering cures for COVID, which included baking soda, bleach, lasers, and leeches. Many alternative medicine practitioners had faith in their "One True Cure." Of course, it was difficult to eliminate greed and exploitation as supporting motivations. Matt and I had an in-depth conversation for nearly an hour! It was a treat to speak with such an informed and thoughtful author. Matt's newest book, "The Ghost Lab," should be available shortly. You can find all of Matt's books on Amazon. To learn more, please check out Matt's website:https://www.matt-hongoltzhetling.com#concussion #CTE #traumatic brain injury #TBI Please click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

Two leading voices in longevity medicine, Dr. Sandra Kaufmann and Dr. Charlene DeHaven, offer a science-backed, compassionate look at what it really means to age well. They share their personal journeys into medicine, the philosophies guiding their longevity practices, and how modern science is reshaping what's possible for aging and health. From practical lifestyle changes to high-tech biohacks, they say, it's within our power to live longer, and healthier.  This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities.  https://www.medscape.org/viewarticle/1002709?ecd=bdc_podcast_libsyn_mscpedu

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Gregory Hawryluk, MD, for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Dr. Hawryluk is a neurosurgeon with a PhD in stem cell research. He is the Medical Director of the Brain Trauma Foundation. As we began our 30-minute discussion, Dr. Hawryluk described his medical training as a neurosurgeon. He explained the origin and goals of the Brain Trauma Foundation.  According to Dr. Hawryluk, the Brain Trauma Foundation's most significant contribution has been developing clinical practice evidence-based guidelines for traumatic brain injury. These guidelines have been associated with a 50% reduction in head injury mortality. Dr. Hawryluk suggested that the guidelines serve as a basis for individualized care that may lead to even greater benefits. The guidelines are available on the Brain Trauma Foundation's website. We explored the definition of concussion and current approaches to management. Dr. Hawryluk explained that neuroimaging, such as CT and MRI, should be normal in a patient with concussion. He offered his opinion regarding the safety of participating in contact sports, which may result in concussions. We also broached the subject of chronic traumatic encephalopathy (CTE). To learn more, please contact The Brain Trauma Foundation: https://braintrauma.org/#concussion #CTE #traumatic brain injury #TBI@braintraumafoundationPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

We are on the cusp of a major milestone in retinal degenerative diseases, moving beyond just slowing down vision loss to actually restoring sight. What once sounded like science fiction is now taking place in clinical trials. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities. https://www.medscape.org/viewarticle/1002678?ecd=bdc_podcast_libsyn_mscpedu

This is Sara, and I remember the time 20 years ago when I got schooled by a psychoanalyst.  It must have been the fall, because I was supremely agitated that I was having to write, design, and send holiday cards out to a huge list of people all by myself, without the help of my fiancé.  If you know me, you know that cards were a staple of my winter growing up, with cards from my parents' friends stapled onto long felt ribbons hanging down each doorway, surrounding us with love and smiling faces for weeks on end.  The therapist asked if I could just not do them, if it was annoying me so much, and my instant fury was revealed: Are you kidding? I have to send these cards out, it's the nice thing to do!!  Cut to the point, and it's this - nice according to who?  Nice for whom?  Certainly not nice for me if I were going to be resentful and pissy about it.  I came to terms with the fact that I actually just really enjoyed writing and sending cards out to people who warmed my heart that year, and that my partner wasn't a nice person for not agreeing to send these cards out with me.   But it leads us to ask this.  What do we mean by niceness - and what, more importantly, is its not-as-related-as-it-seems and so much more important character trait of kindness?  How can understanding this difference and leaning into kindness help us be better people?   What to listen for: How a medically trained doctor got into a “touchy-feely” thing like kindness The shockingly tremendous impact that kindness has on our individual health and our societal wellbeing What's the difference between niceness vs kindness?  Ways to begin practicing more kindness About our guest:   Kelli Harding, MD, MPH, is dedicated to creating a kinder and healthier world for all. An expert in mental health, medicine, and public health, she teaches at Columbia University's Vagelos College of Physicians and Surgeons (VP&S) in New York City and is a diplomate of the American Board of Psychiatry and Neurology, also boarded in the sub-specialty of consultation-liaison psychiatry or psychosomatic (mind-body) medicine. Known for making complex scientific research understandable to general audiences, she's the author of the critically acclaimed book The Rabbit Effect: Live Longer, Happier, and Healthier with the Groundbreaking Science of Kindness. Dr. Harding has appeared on Today, Good Morning America, BBC, The New York Times, The Washington Post, Prevention, LA Times, Oprah Magazine, Parents, Medscape, Sesame Street Workshop, and The World Economic Forum. Additionally, she has spoken at global events at the United Nations and World Happiness Summits and served on the Boards of Organizations such as the Association of American Medical Colleges (AAMC) and social media platform Nextdoor. Dr. Harding lives in New York City with her husband and three sons—an eleventh-grader, a ninth-grader, and a sixth-grader, and beloved rescue pup, Athena. Her next book, Different, co-authored with Sara Blanchard, will be out in Fall 2026. Website kellihardingmd.com LinkedIn Kelli Harding MD MPH Instagram @kellihardingmd

Drs Carol H. Wysham and Grazia Aleppo discuss how and when to use CGM in clinical type 2 diabetes practice, navigating patient resistance, and benefits in gestational diabetes. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002050. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Standards of Care in Diabetes—2025 https://diabetesjournals.org/care/issue/48/Supplement_1 7. Diabetes Technology: Standards of Care in Diabetes-2024 https://pubmed.ncbi.nlm.nih.gov/38078575/ Hyperglycemia and Adverse Pregnancy Outcomes https://pubmed.ncbi.nlm.nih.gov/18463375/ Diabetes Requires a Village: Northwestern Medicine's Diabetes Tune-up Pathway Program https://breakthroughsforphysicians.nm.org/diabetes-requires-a-village-diabetes-tune-up-pathway-program.html Testing the Real-World Accuracy of the Dexcom G6 Pro CGM During the Insulin-Only Bionic Pancreas Pivotal Trial https://pubmed.ncbi.nlm.nih.gov/37668666/ Continuous Glucose Monitoring for Prediabetes: What Are the Best Metrics? https://pubmed.ncbi.nlm.nih.gov/38629784/ Defining Continuous Glucose Monitor Time in Range in a Large Community-based Cohort Without Diabetes https://pubmed.ncbi.nlm.nih.gov/39257191/

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Justin Nabity, CFP, for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Justin is a Founder and Partner of Physicians Thrive, a wealth planning and financial management service for doctors. Justin explained that optimizing the physician's work contract is the first step in successful financial planning. Physicians Thrive has access to over 100 advisors, attorneys, and negotiating specialists to ensure that physicians receive appropriate compensation, whether employed or self-employed. Next is a financial plan that for many people will include estate planning, a will, an emergency fund, power of attorney, disability, and life insurance options. Once physicians establish these basics, they can consider alternative investments, such as commercial real estate. One step to financial independence is to graduate from trading "time for money," the traditional physician model, to other types of income that pay passively. Justin recommended the book, "Rich Dad, Poor Dad," as required reading for those interested in establishing financial independence. During our 50-minute interview, Justin outlined the steps to become an "accredited investor," which provides access to alternative investments. These high-value real estate investments, such as apartment complexes, are not liquid investments. Investment in residential properties is another alternative, but it tends to have lower yields than commercial properties.  Justin defines "hurdle rate" and provides more insights into commercial property investment. He also explains "opportunity zones." Justin emphasized that physicians should support pending legislation HR10073, which would reverse Medicare reimbursement cuts. Physicians should reach out to their representatives in Congress and underscore the importance of this bill. To learn more, please contact Justin Nabity, please check out the website:https://physiciansthrive.com/ or Email: Please click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

In conversations around women's health it's often assumed that we're talking simply about reproductive care. But that narrow definition overlooks other diseases, chronic, complex conditions and life stages that uniquely, disproportionately, or differently affect women, such as cardiovascular disease, rheumatoid arthritis, chronic pain, migraines, and certain autoimmune diseases. Two Medscape colleagues, Sara Thorpe and Eliza Reshefsky, are spearheading the Innovations in Women's Health Coalition, which unites leaders from; key healthcare organizations in a commitment to address critical gaps in women's health by enhancing the educational training and resources for healthcare professionals across all medical specialties to help drive meaningful change. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities. https://www.medscape.org/viewarticle/1002651?ecd=bdc_podcast_libsyn_mscpedu

Bio:Nadine Pierre Kelly, otherwise known as NPK, is a retired Medical Doctor (pathologist), founder of NPK Health Integration, Experienced Registered Yoga Teacher with Yoga Alliance, Health Integration Coach, former Akimbo Workshops Head Coach (founded by Seth Godin), a contributor to Medscape, and host of the Health Raisers podcast.Social Media Handles:LinkedIn- https://www.linkedin.com/in/dr-nadine-kelly-5a451946/INSTAGRAM - https://www.instagram.com/npkhi/@npkhiFB - https://www.facebook.com/npkhealthintegration ***********Susanne Mueller / www.susannemueller.biz TEDX Talk, May 2022: Running and Life: 5KM Formula for YOUR Successhttps://www.youtube.com/watch?v=oT_5Er1cLvY 700+ weekly blogs / 450+ podcasts / 1 Ironman Triathlon / 5 half ironman races / 26 marathon races / 4 books / 1 Mt. Kilimanjaro / 1 TEDx Talk

About this Episode Episode 46 of “The 2 View” – Heat Stroke Tx, A New Virus, Oral Cephalosporins Vs Pyelo, Safe Discharges Segment 1A – Music Therapy In the ED Edited by Chaphalkar A. Music therapy eases pain and anxiety in the ED. Medscape. May 2, 2025. https://www.medscape.com/viewarticle/music-therapy-eases-pain-and-anxiety-emergency-department-2025a1000apm Episode 1. The 2 View. 2view.fireside.fm. Published January 11, 202. https://2view.fireside.fm/1 Segment 1B – Heat Stroke Guidelines Barletta JF, Palimeri TL, Toomy SA, et al. Society of Critical Care Medicine Guidelines for the Treatment of Heat Stroke. Crit Care Med. 2025; 53(2):p e490-e500. https://journals.lww.com/ccmjournal/fulltext/2025/02000/societyofcriticalcaremedicineguidelinesfor.22.aspx Eifling KP, Gaudio FG, Dumke C, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update. Wildness Environ Med. 2024;35(1_suppl):112S-127S. https://journals.sagepub.com/doi/10.1177/10806032241227924 Hawkins SC, David F. An Evidence-Based Guide to Heat Stress. Image. Raw Medicine. https://rawmedicine.org/episodes/f/episode-6-heat-emergencies-with-tod-schimelpfenig-and-tim-durkin Published July 1, 2018. Segment 2A – Cephalosporins for Outpatient Treatment of Pyelonephritis Gupta K, Hooton TM, Naber, KG, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Inf Dis. 2011;52(5):e103-120. https://academic.oup.com/cid/article/52/5/e103/388285 Koehl J, Spolsdoff D, Negaard B, et al. Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study. Ann Emerg Med. 2025;85(3):240-248. https://www.annemergmed.com/article/S0196-0644(24)01140-5/abstract Segment 2B - Ouropouche Virus Clinical Overview of Oropouche Virus Disease. Centers for Disease Control and Prevention. May 8, 2025. https://www.cdc.gov/oropouche/hcp/clinical-overview/index.html Glatter RD, Sader Neves Ferreira J. Why Is Oropouche Spreading so Fast? Medscape. May 19, 2025. https://www.medscape.com/viewarticle/why-oropouche-spreading-so-fast-2025a1000cgb Segment 3 - Discharging Patients Safe Discharge From The Emergency Department. Ann Emerg Med. 2019;74(5):e95. https://www.annemergmed.com/article/S0196-0644(19)30622-5/abstract Ward, M. When And How Should Clinicians View Discharge Planning as Part of a Patient's Care Continuum? AMA J Ethics. 2023;25(12):e866-872. https://journalofethics.ama-assn.org/article/when-and-how-should-clinicians-view-discharge-planning-part-patients-care-continuum/2023-12 Some Points to Consider Before Discharging a Patient, from Mike and Martha: History / Physical • Abnormal vital signs – treated/explained • Timely repeat vital signs relative to discharge • Addressed all concerns raised in your history-taking and nursing notes • Pertinent history & exam positives/negatives Diagnostics / Decision-Making • Reviewed all diagnostics ordered • Documented abnormalities, explained their significance, & directed follow-up • Adequately considered differential diagnosis • Even in a non-acute setting, adequately ruled out life/limb/organ threats • Appropriately documented communication with staff, consultants, pt's family • Documented patient declining any diagnostics/treatment and their reasons • Documented any reasonable attempts at an alternative plan • Documented assessment of pt's capacity to make informed medical decisions General Documentation • Reviewed “smart phrases” word-for-word to ensure they apply to this pt • Documented use of language services in accordance with institution policies • Documented all appropriate diagnoses (including abnormal vital signs and abnormal diagnostics as appropriate) Discharge Plan • A discharge plan that make sense for this patient, including taking social determinants of health into consideration • Patient can reasonably attend follow-up visits • Follow-up timeframe is appropriate for patient • Patient can afford or obtain essential medications and treatments • Discharge instructions and return precautions, especially for high-risk issues (chest/abdo pain, wounds, infections, fx, splints/casts, controlleds)? Recurring Sources Center for Medical Education. http://ccme.org The Proceduralist. http://www.theproceduralist.org The Procedural Pause. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. http://www.thesgem.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to.

Nadine Pierre Kelly, otherwise known as NPK, is a retired Medical Doctor (pathologist), founder of NPK Health Integration, Experienced Registered Yoga Teacher with Yoga Alliance, Health Integration Coach, former Akimbo Workshops Head Coach (founded by Seth Godin), a contributor to Medscape, and host of the Health Raisers podcast.Social Media Handles:LindedIN: - https://www.linkedin.com/in/dr-nadine-kelly-5a451946/INSTAGRAM - https://www.instagram.com/npkhi/@npkhiFB - https://www.facebook.com/npkhealthintegration ***********Susanne Mueller / www.susannemueller.biz TEDX Talk, May 2022: Running and Life: 5KM Formula for YOUR Successhttps://www.youtube.com/watch?v=oT_5Er1cLvY 700+ weekly blogs / 450+ podcasts / 1 Ironman Triathlon / 5 half ironman races / 26 marathon races / 4 books / 1 Mt. Kilimanjaro / 1 TEDx Talk

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Anjali Rajpal, DMD, for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Dr. Rajpal practices cosmetic dentistry at Beverly Hills Dental Arts. During our 25-minute conversation, we discussed Dr. Rajpal's passion for hands-on creative work, like improving her patients' smiles. She explained that new electric tools vs air-powered ones have made the patient experience more comfortable. I Dr. Rajpal employs AI in her practice, which has many applications. Digital imaging powered by AI has replaced the old-fashioned and not entirely pleasant putty used to take impressions. Aesthetics can be fully realized with improved accuracy and efficiency. AI offers a "second set of eyes" to examine dental X-rays to ensure nothing is missed. Robots also assist with implant surgery. AI can also provide a look into the future for patients to see what their smile will look like after a complete makeover. To contact Dr. Rajpal, please check out her website:https://bhdentalarts.com Instagram, TikTok, YouTube: @beverlyhillsdentalartsPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to journalist Eric Garcia, author of "We're Not Broken: Changing the Autism Conversation," for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner!  I heard Eric speak on another podcast, "Uniquely Human,” named after the best-selling book by autism specialist Barry Prizant. Eric is a successful journalist who covers Washington, DC. He is the Washington Bureau Chief of "The Independent."  Eric knows the political scene inside and out. He's exceptionally knowledgeable about how legislation affects people with disabilities, and more specifically, people like himself who are autistic. Eric has become the "go-to guy" for fellow journalists regarding questions about autism. During our 35-minute conversation, Eric emphasized that autism research should not focus on vaccines, which have already been proven not to cause autism. Instead, funding should be directed to help people with autism lead more fulfilling lives. Eric also self-identifies as a person with autism. Due to sensory processing issues, he doesn't drive a car. Eric also has trouble in noisy, crowded places and consequently waits until after rush hour before taking public transportation to work. He also still struggles with socialization. We also discussed how certain of his autistic traits have facilitated his career.  To hear more about what Eric's thoughts about autism, check out his book, "We're Not Broken: Changing the Autism Conversation."Please click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

This episode of PedsCases will give you an approach to congenital hemangiomas. By the end of this podcast, listeners will be able to 1) define hemangiomas and congenital hemangiomas, 2) explain the genetics and environmental factors associated with congenital hemangiomas, 3) describe the pathogenesis of congenital hemangiomas, 4) classify congenital hemangiomas, and 5) discuss the diagnosis, differential diagnosis, and management strategies for congenital hemangiomas. Today's episode was created by Emilie Wang, a medical student at the University of British Columbia, in collaboration with Dr. Joseph Lam, a pediatric dermatologist at BC Children's Hospital. An author of this podcast has financial support and has received speaker bursaries from Johnson & Johnson, Pierre-Fabre, Pfizer, Valeant, Sanofi Genzyme, Incyte, La Roche Posay Canada, Beiersdorf Canada and serves on advisory committees for Johnson & Johnson, Pierre-Fabre, Pfizer, Valeant, Sanofi Genzyme. They also serve as Associate Editor of Pediatric Dermatology Journal, and have been contributors to UpToDate, Medscape, BMJ Updates, and Eczema Society of Canada.  

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Marc-David Munk, MD, MPH, author of "Urgent Calls from Distant Places: An Emergency Doctor's Notes about Life and Death on the Frontiers of East Africa," for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! He's an unusual doctor who wrote an amazing book! While in college, Dr. Munk began his medical career as an emergency medical technician. His interest in saving lives evolved into an academic career in emergency medicine. Overwhelmed by an imperfect healthcare system that rewarded productivity at the expense of quality, Dr. Munk volunteered for the AMREF Flying Doctors program in East Africa in 2008. He returned for another year in 2012.  Years later, Dr. Munk delved into his journal to write a thoughtful documentary of his time with the Flying Doctors. The stories include life-saving adventures and his response to the widespread health inequities of East Africa. He recounts these experiences in astonishing detail in his book, "Urgent Calls from Distant Places." These exotic volunteer experiences spurred Dr. Munk's further education and practice. He obtained an advanced degree in healthcare management and worked with healthcare models that respect the physician-patient relationship. Currently, Dr. Munk works as a palliative care physician at an academic center in Boston. To learn more about Dr. Munk, please read his book and visit his website: https://www.mdmunk.comPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

This is the 11th episode in my Pharmacist Podcasters Series. My guests and I talk about podcasting to inspire you to start your own podcast, be a podcast guest, or use your voice in general. If you're interested in podcasting, pod-guesting or public speaking, you need to listen to this episode. My guest today is Dr. Danielle Plummer, host of the MaternalRx Podcast on the Pharmacy Podcast Network.    Pharmacists can play a crucial role in maternal health. Advocacy and education are critical in improving maternal care. Listen and learn from Dr. Plummer on the MaternalRx Podcast!    Click to read the FULL show notes: https://www.thepharmacistsvoice.com/podcast (select episode 329)   Bio - Danielle Plummer, PharmD (May 2025) Danielle Plummer, PharmD, is a third-generation pharmacist and host of the MaternalRx podcast on the Pharmacy Podcast Network. She earned her PharmD from Creighton University in 2016 and has since had a broad pharmacy career spanning retail, hospital, consulting, and medical affairs.   Combining clinical expertise with lived experience, Danielle specializes in supporting pregnant patients, particularly those suffering from Hyperemesis Gravidarum (HG). After studying treatments for other diseases of malnutrition in pharmacy school, she became certified in pharmacogenetics and as an antepartum doula. This, along with a community of pharmacy entrepreneurs, inspired her to launch HG Pharmacist©, a blog to share information about HG, which later grew into Obstet-Rx©, a consulting company offering personalized medication management and patient advocacy to women worldwide.   Her subject matter expertise has led to board member appointments, speaking engagements, and media contributions for international magazines. In her work as an MSL, she has supported diagnostics for preeclampsia (sFlt-1/PlGF) and procalcitonin, as well as therapies for iron deficiency anemia and small cell lung cancer.   Through her podcast, Danielle shows how pharmacists play a key role in improving maternal outcomes. (End bio)    Backstory Danielle and I met at Medipreneurs several years ago and have kept in touch. I enjoyed getting to know her better during this interview. She has transformed her career since we first met, and I'm proud of her for starting a podcast.    The Pharmacy Podcast Network is an important part of Danielle's story. They produce and distribute the MaternalRx Podcast on their network. If you'd like to start a podcast on the Pharmacy Podcast Network, please reach out to Todd Eury via email: publisher@pharmacypodcast.com.   Share this episode! If you know someone who might like the MaternalRx Podcast, please share this episode with them. If you would like to be a guest on the MaternalRx Podcast or nominate a guest for the MaternalRx Podcast, please contact Dr. Danielle Plummer through LinkedIn or her other social media channels. She is also open to pod-guesting on other podcasts and speaking at events. Reach out to Dr. Plummer directly through LinkedIn or her other social media channels.   Subscribe to or follow The Pharmacist's Voice ® Podcast on your favorite podcast player and YouTube to get each new episode right when it comes out.   Apple Podcasts   https://apple.co/42yqXOG  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt   Thank you for listening today. Happy Mother's Day if you're a Mom or a Mom-to-Be!   If you need help starting your podcast, I can help. Get my FREE eBook or audiobook version on kimnewlove.com/podcasting or Amazon https://amzn.to/4iAKNBs. I also teach a self-paced, online course and work with clients by-the-hour. Listen to my episodes about podcasting in my back catalog on thepharmacistsvoice.com/podcast.    Links from this episode  Danielle's Blog: https://pregnancyvomiting.com/  Danielle's consulting website: https://hgpharmacist.com/ Facebook Group: Extreme Pregnancy Vomiting Education https://www.facebook.com/groups/hgsolutions MaternalRx Podcast https://maternityrx.podbean.com/  Pharmacy Podcast Network https://pharmacypodcast.com/shows/  Todd Eury's email publisher@PharmacyPodcast.com  Danielle Plummer, PharmD on LinkedIn: https://www.linkedin.com/in/daniellerplummer Connect with Danielle on Instagram @obstet_rx https://www.instagram.com/obstet_rx/  Connect on Facebook https://www.facebook.com/HGClinicalSolutions  Subscribe to Danielle's YouTube Channel https://www.youtube.com/@hgpharmacist  Follow Danielle on Twitter (X) https://x.com/Obstet_Rx  Follow Danielle on Pinterest https://www.pinterest.com/hgpharmacist/    Resources Mentioned HER Foundation https://hyperemesis.org  Preeclampsia Foundation https://www.preeclampsia.org/  Pregnancy Sickness Support (UK) https://pregnancysicknesssupport.org.uk/  PharmGKB (Pharmacogenomics Knowledge Base) https://www.pharmgkb.org/  CPIC (Clinical Pharmacogenetics Implementation Consortium) https://cpicpgx.org/  ACOG (American College of Obstetricians and Gynecologists) https://www.acog.org/  UpToDate (Resource, Retail Pharmacists) https://www.wolterskluwer.com/en/solutions/uptodate/industries/retail-pharmacy  Lexicomp is now Lexidrug  Micromedex https://www.micromedexsolutions.com/home/dispatch  Medscape https://www.medscape.com/  A Dose of Support Podcast on Spotify (April 2021 with Vanessa Kasper DNP, Host) featuring guest Dr. Danielle Plummer, PharmD https://open.spotify.com/episode/5qSIGIQ7lw6yO9rKNwi8Jg?si=9e97101b886f4f26     Kim's websites and social media links: ✅ Guest Application Form (The Pharmacist's Voice Podcast) https://bit.ly/41iGogX  ✅ Monthly email newsletter sign-up link https://bit.ly/3AHJIaF  ✅ LinkedIn Newsletter https://bit.ly/40VmV5B ✅ Business website https://www.thepharmacistsvoice.com ✅ The Pharmacist's Voice ® Podcast https://www.thepharmacistsvoice.com/podcast ✅ Pronounce Drug Names Like a Pro © Online Course https://www.kimnewlove.com  ✅ FREE Podcasting eBook/audiobook combo https://www.kimnewlove.com/podcasting  ✅ Podcasting Online Course https://www.kimnewlove.com/podcasting  ✅ Private Podcasting Coaching or Consulting https://www.kimnewlove.com/private-coaching  ✅ LinkedIn https://www.linkedin.com/in/kimnewlove ✅ Facebook https://www.facebook.com/kim.newlove.96 ✅ Twitter https://twitter.com/KimNewloveVO ✅ Instagram https://www.instagram.com/kimnewlovevo/ ✅ YouTube https://www.youtube.com/channel/UCA3UyhNBi9CCqIMP8t1wRZQ ✅ ACX (Audiobook Narrator Profile) https://www.acx.com/narrator?p=A10FSORRTANJ4Z ✅ Start a podcast with the same coach who helped me get started (Dave Jackson from The School of Podcasting)! **Affiliate Link - NEW 9-8-23**      Thank you for listening to episode 329 of The Pharmacist's Voice ® Podcast.  If you know someone who would like this episode, please share it with them!   Pharmacist Podcasters Series Part 1 with Ola Latala, PharmD (The Pharmacist's Voice Podcast Episode 248) Part 2 with Deeb Eid, PharmD (The Pharmacist's Voice Podcast Episode 253) Part 3 with Justin Cole, PharmD (The Pharmacist's Voice Podcast Episode 257) Part 4 with Christina Fontana, PharmD The Pharmacist's Voice Podcast Episode 262 Part 5 with Tony Dao, PharmD The Pharmacist's Voice Podcast Episode 266 Part 6 with Dr. H (Hussam Hamoush, PharmD) The Pharmacist's Voice Podcast Episode 275 Part 7 with Julie Doan, PharmD The Pharmacist's Voice Podcast Episode 297 Part 8 with Tim Ulbrich, PharmD The Pharmacist's Voice Podcast Episode 306  Part 9 with Zain Syed, PharmD The Pharmacist's Voice Podcast Episode 310 Part 10 with Rachel Gainsbrugh, PharmD The Pharmacist's Voice Podcast Episode 323  Part 11 with Danielle Plummer, PharmD (TODAY!) 

How are 3 women leaders in hematology who are passionate about research and patient care facing the massive cuts to critical healthcare programs? Find out in the new episode of Women in Healthcare Leadership. This podcast is not available for CME/CE/CPD credits. Please visit the Medscape homepage for accredited CME/CE/CPD activities. https://www.medscape.org/viewarticle/11002495?ecd=bdc_podcast_libsyn_mscpedu

Navigating Medicine and Faith: A Conversation with Dr. Sharon Stoll In this episode, Dr. Sharon Stoll discusses her background growing up in a modern Orthodox Jewish community in Philadelphia, her journey to becoming a neuroimmunologist, and her professional experiences working at Yale and now in Philadelphia. The conversation touches on her approach to patient education, especially around COVID-19 and various medications, including GLP-1 agonists like Ozempic and SSRIs for mental health. Dr. Stoll also speaks about her role in JOWMA (Jewish Orthodox Women's Medical Association) and the importance of educating her community on medical issues.    The discussion covers her views on IVF, the ethical considerations of genetic selection, and the interplay of anxiety and genetic predispositions within the Ashkenazi Jewish community. Dr. Stoll shares personal anecdotes and insights into balancing professional and personal life, making this an in-depth and enlightening conversation.   00:00 Introduction and Background 01:19 Professional Journey and Achievements  02:08 Balancing Media and Medicine 03:48 Involvement with Jowma 05:40 Views on Vaccination 14:26 Discussion on SSRIs and Ozempic 28:16 Challenges in the Frum Community  34:38 Debunking Misconceptions About Diabetes 35:07 Educational Gaps and Community Efforts 36:43 Health Education in Schools 39:06 Challenges of Motherhood and Societal Expectations 43:43 Genetic Risks and Mental Health in Ashkenazi Jews 54:38 IVF, Genetic Selection, and Ethical Dilemmas  01:02:34 Concluding Thoughts and Personal Reflections   About Our Guest: Dr. Sharon Stoll is a board-certified neurologist, neuro-immunologist. She currently serves as Director of Neurology at Stoll Medical Group in Philadelphia. For the past 8 years she worked as assistant professor, in the department of neurology at Yale School of Medicine. She completed her neurology residency training at Thomas Jefferson University Hospital in Philadelphia and her Neuroimmunology fellowship at Yale New Haven Hospital. Dr. Stoll played an active role in academic development and continuing medical education. She currently serves on several steering committees and advisory boards. She has been published in numerous peer-reviewed journals and served as Principal Investigator on several clinical trials. Dr. Stoll has received numerous awards, including Top Neurologist, 40 under 40, the Rodney Bell teaching award, and is a national multiple sclerosis society grant recipient. Dr. Stoll is also a medical editor for Medscape and Healthline and previously worked as a medical editor for ABC News. She is also a medical commentator for several national and local news outlets, including ABC, NBC, and CBS News, and has been on a variety of shows, including “The Doctors”. She is an internationally renowned speaker and patient advocate.   https://www.drsharonstoll.com https://www.instagram.com/drsharonstoll/?hl=en https://www.jowma.org  

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Konstantin Vasyukevich, MD, a facial plastic surgeon with a Park Avenue practice a block and a half from Central Park in New York City. Dr. Vasyukevich specializes in rejuvenation rather than reconstructive surgery. In addition to facelifts and other surgeries, he also offers Botox and fillers. These strategies serve to make people look younger and improve their confidence and self-perception. There's no medical indication. During our 25-minute discussion, Dr. Vasyukevich answered all of my questions about plastic surgery and even did a free consultation! Apparently, should I be so inclined, multiple fixes are available for my well-worn visage! Dr. Vasyukevich has patients who come to see him from all over the world, including Australia and Indonesia. For those who can't travel to NYC for their plastic surgery, Dr. Vasyukevich offered tips on choosing the best local plastic surgeon who can offer procedures and surgeries to help achieve a more youthful appearance. To learn more about Dr. Vasyukevich or to schedule an appointment, please go to his website: https://www.facialartistrymd.com/Or call: 212.380.3634Follow on Instagram: @dr_konstantin Bonus Poll Question:1.  Which procedure would you recommend for Dr. Wilner?a) Botox for forehead wrinklesb) Blepharoplasty for eyesc)  Faceliftd) Necklifte) All of the abovef)   None of the abovePlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

Dr. John Wiessman, Associate Dean for Practice at UNC Chapel Hill, remembers his former mentor, Mary Selecky, who passed away on April 7; Finn Lanning, Youth Tobacco Prevention Coordinator for the Kansas Department of Health and Environment, tells us about a successful Take Down Tobacco Day; and ASTHO's Adrianna Evans contributed to an article that was recently published in Medscape. Kansas Department of Health and Environment News Release: Resist and the Tobacco Free Kansas Coalition Host Take Down Tobacco Day at the Capitol Medscape Article: Data Routinely Captured in ED EMRs Can Support People With Disabilities During Public Health Emergencies ASTHO Web Page: Subscribe  

Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Franklyn Rocha, MD, a fellow neurologist and with an unusual locum tenens practice. He is a clinical neurophysiologist and neurohospitalist consultant and Chief Executive Officer/Owner of IRD Neuroanalysis, Inc. Dr. Rocha does in-person neurology consults at Harbor-UCLA Hospital near his home but primarily works as a telemedicine physician from the first floor of his townhouse! Dr. Rocha is also a new father of a healthy, bouncing, baby boy. Prior to his son's birth, Frank had been thinking a lot about fatherhood. He published an essay on KevinMD.com about how difficult it can be for physician fathers to be physically present with a newborn. He cites academic demands, peer pressure from other physicians, lack of paid paternal leave, and the tradition of putting patients first as formidable obstacles that discourage new physician fathers from taking parental leave. It's clear that Frank intends to be a successful physician and entrepreneur, but he also didn't want to miss out on the unique experience of fatherhood. During our 30-minute podcast, Frank explained how owning his own business and working telemedicine allowed him to spend nearly four months of parental leave with his wife and newborn son. For physicians with the added challenge of a special needs child, parenting demands are even greater. For these physicians, David Hirsch's “Special Father's Network” offers valuable resources. To learn more about Dr. Rocha, please visit his Linked-In profile: https://www.linkedin.com/in/franklyn-rocha-cabrero-m-d-67287a27/Please click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...

In this episode of 'Inspire to Lead,' host Talia Mashiach interviews Dr. Sharon Stoll, a board-certified neurologist and neuroimmunologist from Philadelphia. Sharon discusses her upbringing, her unwavering passion for medicine despite societal discouragement, and how she navigated through medical school and residency while managing family life. She shares the pivotal role her supportive husband played in her success and addresses the challenges and triumphs of balancing a demanding career with motherhood. The conversation also delves into the expectations placed on Jewish women in their communities and the importance of pursuing fulfilling careers to maintain overall happiness and effectiveness as both mothers and wives. Sharon's story is an inspiring testament to resilience, determination, and the impact of supportive relationships.   00:00 Introduction to Inspire to Lead Podcast 00:29 Meet Sharon Stoll: A Journey to Medicine 02:38 Balancing Media and Medicine 08:44 Personal Life and Family Dynamics 15:15 Navigating Career and Marriage 37:12 Parenting in Modern Times 39:14 Balancing Career and Family Aspirations 42:43 The Journey to Motherhood 43:16 Navigating Medical School and Motherhood 54:24 Support Systems and Community 01:01:46 Reflections and Advice 01:16:09 Biggest Accomplishments and Lessons Learned     About Dr. Sharon Stoll: Dr. Sharon Stoll is a board-certified neurologist, neuro-immunologist. She currently serves as Director of Neurology at Stoll Medical Group in Philadelphia. For the past 8 years she worked as assistant professor, in the department of neurology at Yale School of Medicine. She completed her neurology residency training at Thomas Jefferson University Hospital in Philadelphia and her Neuroimmunology fellowship at Yale New Haven Hospital. Dr. Stoll played an active role in academic development and continuing medical education. She currently serves on several steering committees and advisory boards. She has been published in numerous peer-reviewed journals and served as Principal Investigator on several clinical trials. Dr. Stoll has received numerous awards, including Top Neurologist, 40 under 40, the Rodney Bell teaching award, and is a national multiple sclerosis society grant recipient. Dr. Stoll is also a medical editor for Medscape and Healthline and previously worked as a medical editor for ABC News. She is also a medical commentator for several national and local news outlets, including ABC, NBC, and CBS News, and has been on a variety of shows, including “The Doctors”. She is an internationally renowned speaker and patient advocate. https://www.drsharonstoll.com   Powered By Roth & Co The JWE For guest suggestions, please email Talia: podcast@thejwe.org

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Learning more about the FDA letter sent to Dexcom, news from ATTD including a bihormonal pump from a Dutch company, time in tight range update, more studies about using insulin and GLP-1 medications, eating chili to prevent gestational diabetes (really!) and more..  Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom   Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Our top story this week: Dexcom Dive Brief: A warning letter posted Tuesday by the Food and Drug Administration revealed quality control issues with Dexcom's continuous glucose monitors. The FDA raised concerns with a design change to a component used in the resistance layer of Dexcom's sensors. The sensors with the new component were less accurate than those with the original component, according to the warning letter. Dexcom has ceased distribution of G7 sensors with the component, but the company's response did not address affected G6 sensors. J.P. Morgan analyst Robbie Marcus wrote in a research note Tuesday that the letter concerns a chemical compound that the sensor wire is dipped in. Dexcom began producing the compound internally to add redundancy to its supply chain.   Dive Insight: Dexcom Chief Operating Officer Jake Leach said in an interview with MedTech Dive last week that the company does not expect the warning letter to affect future product approvals, including a 15-day version of its G7 CGM, and there's no need yet to recall products. Dexcom has submitted the device to the FDA and anticipates a launch in the second half of the year.   Marcus, after speaking to company leadership and a quality control expert, wrote that many of the issues outlined in the letter could be addressed quickly. He added that the warning letter could explain minor delays in approval to the 15-day sensor, but Dexcom is still within the 90-day window for a 510(k) submission.   “While there's always a risk this could impede future product approvals,” Marcus wrote, “we do not expect this to materially delay the 15 day G7 sensor approval.”   The warning letter followed an FDA inspection last year of Dexcom's facilities in San Diego and Mesa, Arizona. Marcus wrote that after the FDA requested additional information and a separate 510(k), Dexcom stopped in-sourcing the compound and reverted back to the external supplier.   Dexcom's devices were misbranded because the company did not submit a premarket notification to the FDA before making major changes to the sensors, according to the warning letter. The sensors with the changed coating “cause higher risks for users who rely on the sensors to dose insulin or make other diabetes treatment decisions,” the letter said.     The FDA raised other concerns in the warning letter, including procedures to monitor the glucose and acetaminophen concentrations used in testing of the G6 and G7 CGMs. The FDA also cited problems with Dexcom's handling last year of a deficiency in its G6 sensors with dissolved oxygen content values, a key input for measuring blood glucose levels. https://www.medtechdive.com/news/dexcom-warning-letter-cgm-coating-change/743597/ XX Lots of studies and info out of the recent ATTD conference. One highlight that has been sort of under the radar: a Dutch company has been using a Bihormonal fully closed-loop system for the treatment of type 1 diabetes in the real world. This is a company called Inreda (in-RAY-duh). The Inreda AP® is an automatic system (closed loop) and independently regulates the blood glucose level by administering insulin and glucagon. The AP5 is certified in Europe and is being used in multiple studies and projects. The AP®6 is currently under development. https://www.inredadiabetic.nl/en/discover-the-ap/ https://pubmed.ncbi.nlm.nih.gov/38443309/ XX Let's talk about time in tight range. If you follow me and diabetes connections on social, you likely saw a video I made about this – it blew up last week. If not.. time in range has been a metric for a short while now.. in 2019 there was a consensus report advising a goal of 70% of time in the 70-180 mg/dL range for most people with type 1 diabetes (T1D) and type 2 diabetes (T2D), with modifications for certain subgroups. Recently we've been hearing more about 70-140 mg/dL — for longer periods as “time in tight range (TiTR).” At ATTD there was more talk about calling that range TING, or “time in normal glycemia.     There's a great writeup that I'll link up from the great Miriam Tucker on Medscape about a debate that happened at ATTD. On March 22, 2025, two endocrinologists debated this question at the Advanced Technologies & Treatments for Diabetes (ATTD) 2025. Anders L. Carlson, MD, medical director of the International Diabetes Center (IDC), Minneapolis, took the positive side, while Jeremy Pettus, MD, assistant professor of medicine at the University of California San Diego, who lives with T1D himself, argued that it's too soon.   https://www.medscape.com/viewarticle/should-time-tight-range-be-primary-diabetes-goal-2025a100073q?form=fpf   XX Sequel Med Tech announces its twist pump will be firs paired with Abbott's FreeStyle Libre 3 Plus. The twist has FDA approval for ages 6 and up and is set to begin its commercial launch by the end of June. The pump—designed by inventor Dean Kamen's Deka Research & Development—also incorporates the FDA-cleared Tidepool Loop software program, to record CGM blood sugar readings, make predictions based on trends and adjust its background insulin levels accordingly. https://www.fiercebiotech.com/medtech/sequel-med-tech-connects-twiist-insulin-pump-abbotts-cgm-ahead-market-debut XX Dexcom's longer-lasting CGM sensor looks promising, based on study results presented at the conference. The trial showed that the new 15-day G7 system is slightly more accurate than the current G7. The accuracy of CGM can be measured using MARD (mean absolute relative difference), which shows the average amount a CGM sensor varies from your actual glucose levels (a lower number is better).  The 15-day G7 has a MARD value of 8.0%, about the same as the Abbott Freestyle Libre 3. The Dexcom G7 15 Day is awaiting FDA approval and is not yet available in the U.S.   XX Little bit of news from Modular Medical.. they plan to submit their patch pump to the FDA late summer or fall of this year. The MODD1 product, a 90-day patch pump, features new microfluidics technology to allow for the low-cost pumping of insulin. Its new intuitive design makes the product simple to use and easier to prescribe. It has a reservoir size of 300 units/3mL. Users can monitor the pump activity with their cell phone and do not require an external controller. The pump uses a provided, single-use, disposable battery. Modular Medical picked up FDA clearance for MODD1 in September. The company also raised $8 million to end 2024. Its founder, Paul DiPerna, previously founded leading insulin pump maker Tandem Diabetes Care. DiPerna invented and designed Tandem's t:slim pump. By developing its patented insulin delivery technologies, the company hopes to improve access to glycemic control. Its founder, Paul DiPerna, previously founded leading insulin pump maker Tandem Diabetes Care. DiPerna invented and designed Tandem's t:slim pump. https://www.drugdeliverybusiness.com/modular-medical-announces-12m-private-placement/ XX More from attd – type 2 news? https://www.drugdeliverybusiness.com/biggest-diabetes-tech-news-attd-2025/ XX Another study that says people with type 1 who use a GLP-1 medication get better outcomes. In this study, those who use GLP-1 with insulin are 55% less likely to have a hyperglycemia-related ED visit, 26% less likely to have an amputation-related visit, and 29% less likely to have a diabetic ketoacidosis (DKA)-related ED visit in the following year compared to those on insulin alone. Although they are not approved for T1D, some patients may receive them off-label or for weight control. Pretty big study for an off label drug: compared 7,010 adult patients with T1D who were prescribed GLP-1s and insulin to 304,422 adult patients with T1D who were on insulin alone.  It is important to note that the rates of new diabetic complications in one year for both groups were around 1%, indicating that these are uncommon outcomes regardless of medication use. https://www.epicresearch.org/articles/some-diabetic-complications-less-likely-among-type-1-diabetics-on-glp-1s   XX Early research here but exposure to antibiotics during a key developmental window in infancy may stunt the growth of insulin-producing cells in the pancreas and boost risk of diabetes later in life The study, is published this month in the journal Science, it's a study in mice. These researchers are working off the idea that when while identical twins share DNA that predisposes them to Type 1 diabetes, only one twin usually gets the disease. She explained that human babies are born with a small amount of pancreatic “beta cells,” the only cells in the body that produce insulin.   But some time in a baby's first year, a once-in-a-lifetime surge in beta cell growth occurs.   “If, for whatever reason, we don't undergo this event of expansion and proliferation, that can be a cause of diabetes,” Hill said.   They found that when they gave broad-spectrum antibiotics to mice during a specific window (the human equivalent of about 7 to 12 months of life), the mice developed fewer insulin producing cells, higher blood sugar levels, lower insulin levels and generally worse metabolic function in adulthood.   in other experiments, the scientists gave specific microbes to mice, and found that several they increased their production of beta cells and boosted insulin levels in the blood. When male mice that were genetically predisposed to Type 1 diabetes were colonized with the fungus in infancy, they developed diabetes less than 15% of the time. Males that didn't receive the fungus got diabetes 90% of the time. Even more promising, when researchers gave the fungus to adult mice whose insulin-producing cells had been killed off, those cells regenerated. Hill stresses that she is not “anti-antibiotics.” But she does imagine a day when doctors could give microbe-based drugs or supplements alongside antibiotics to replace the metabolism-supporting bugs they inadvertently kill.   .   “Historically we have interpreted germs as something we want to avoid, but we probably have way more beneficial microbes than pathogens,” she said. “By harnessing their power, we can do a lot to benefit human health.”     https://www.eurekalert.org/news-releases/1078112 XX Future watch for something called BeaGL - created by researchers at the University of California Davis and UC Davis Health who were inspired by their own personal experiences with managing T1D.   BeaGL is designed to work with CGMs and has security-focused machine learning algorithms to make predictive alerts about anticipated glucose changes, which are sent to a device. In this case, a smartwatch. The end goal is for BeaGL to be completely automated to reduce the cognitive load on the patient, particularly for teens. It's still in research phase but six student with T1D have been using it for almost a year.     https://health.ucdavis.edu/news/headlines/with-ai-a-new-metabolic-watchdog-takes-diabetes-care-from-burden-to-balance/2025/02 XX Investigators are searching for a way forward after two long-term diabetes programs were terminated following the cancellation of their National Institutes of Health (NIH) funding, the result of federal allegations that study coordinator Columbia University had inappropriately handled antisemitism on campus. The programs include the three-decades-old Diabetes Prevention Program (DPP) and its offshoot, the Diabetes Prevention Program Outcomes Study (DPPOS). “We are reeling,” said David Nathan, MD, a previous chair of both the DPP and the DPPOS and an original leader of the landmark Diabetes Control and Complications Trial. Nathan is also founder of the Massachusetts General Hospital Diabetes Center in Boston, one of the 30 DPPOS sites in 21 states. On March 7, the Trump administration cancelled $400 million in awards to Columbia University from various federal agencies. While Columbia University agreed on March 21 to changes in policies and procedures to respond to the Trump administration's charges, in the hopes that the funding would be restored, DPPOS Principal Investigator Jose Luchsinger, MD, told Medscape Medical News that as of press time, the study was still cancelled. https://www.medscape.com/viewarticle/diabetes-prevention-program-cancellation-colossal-waste-2025a100076h XX XX Type 2 diabetes may quietly alter the brain in ways that mimic early Alzheimer's. This was only an animal study – but researchers say the high comorbidity of type 2 diabetes (T2D) with psychiatric or neurodegenerative disorders points to a need for understanding what links these diseases.   https://scitechdaily.com/how-diabetes-quietly-rewires-the-brains-reward-and-memory-system/ XX Eating chili once a month when you're pregnant seems to lower the risk of developing gestational diabetes. This is a real study! While chili showed a link to lower gestational diabetes risk, dried beans and bean soup had no significant effect, even among women who ate them more frequently. Some studies suggest that diets high in beans and legumes, including the Mediterranean diet, reduce GDM risk. While studies link beans to lower diabetes risk, their specific impact on GDM remains unclear. This study analyzed data from 1,397 U.S. pregnant women who participated in the Infant Feeding Practices Study II, conducted between 2005 and 2007. Chili consumption varied significantly by race, education, household size, income, supplemental nutrition status, and region. Non-Hispanic Black mothers consumed the most (0.33 cups/week), while those with higher income and education levels consumed less. Regional differences also influenced chili intake. One possible mechanism for chili's effect is capsaicin, a bioactive compound found in chili peppers, which has been linked to metabolic benefits in other studies. However, further research is needed to confirm this potential role in GDM prevention. Dried bean and bean soup consumption had no clear association with GDM. The study highlights limitations due to self-reported dietary data and the need for more detailed dietary measures. https://www.news-medical.net/news/20250317/Could-a-little-spice-in-your-diet-prevent-gestational-diabetes.aspx XX

Podcast: LAS NOTICIAS CON CALLE DE 14 DE MARZO DE 2025 - Alerta rosa por joven de 24 años desaparecida en Yabucoa - Maestra de Biblia y caso sexual con “menores” puede tener otro ángulo importante - El Nuevo Día - Queman carro con cuerpo dentro en Vega Alta- Accidente cierra autopista de San Juan a Manatí - Putin pide un riñón y un pulmón para la paz con Ucrania - FT- Se entregan demócratas en pelea por presupuesto federal - Punchbowl News - El oro llega a 3 mil billetes - Bloomberg - China hacía trampa y ahora se preocupa por aranceles indirectos - NYT- El costo no hacer algo sobre el cambio climático es mayor que el hacerlo - Metro - Gobe respalda construcción de Rincón que causó protesta tras situación con camiones - El Nuevo Día- Guillito estaba más al garete que Mireddys dirigiendo empresas según DY - El Vocero - Muere Raúl Grijalva de cáncer - Primera Hora- A la venta hotel de Maricao - El Nuevo Día- Otra vez dicen que ahora sí viene reforma de permisos y que esta vez funcionará - El Nuevo Día- Vienen aumento a multas a empresas de energía por incumplimientos con negociado - El Vocero- Jgo pide buscar viviendas sin titularidad bajo el gobierno para pasarle a personas - El Nuevo Día- Gobe va a decidir ciertos ascensos en la policía contrario a DSP - El Nuevo Día- MedScape publica historia de posible relación de la comida y la baja en fertilidad - Gobierno de PR celebra que quiten leyes ambientales federales para moverse a energía fósil con más fuerza - END- Proponen inspeccionar edificios en PR por movimientos de terremotos recientes - El Vocero - Muere la leyenda Matino Clemente - A ciegas para diagnosticar casos de psoriasis en PR - Primera HoraIncluye auspicio

How is Trump's executive order redefining the language permissible in scientific research, and what does it mean for academic freedom? Today, we examine the complexities surrounding scientific research under shifting political landscapes with Ivan Oransky, a seasoned medical journalist and co-founder of Retraction Watch. Oransky discusses the implications of President Trump's executive orders and how it has sent ripples throughout the scientific community, causing researchers to reconsider their work amidst existential uncertainties. Oransky explores the nuanced relationship between government funding and scientific inquiry. This episode unpacks the historical precedents of government involvement in research, tracing back to the 1940s, and examines the mounting challenges faced by scientists under the recent policy changes. Oransky provides a critical analysis of how such directives potentially stifle open inquiry and drive talented researchers away, ultimately impacting the future landscape of scientific discovery. In This Episode:Implications of Trump's executive orders on scientific researchHistorical context of government funding in scientific researchThe impact of political climates on scientific inquiry and transparencyChallenges of anticipatory obedience within research communitiesIvan Oransky's insights on sustaining open and rigorous scientific dialogue About Ivan:Ivan Oransky, MD, is the co-founder of Retraction Watch, the Editor in Chief of The Transmitter, and a Distinguished Journalist in Residence at New York University's Carter Journalism Institute, where he teaches medical journalism. He has held leadership positions at Medscape, MedPage Today, Reuters Health, Scientific American, and The Scientist. A former president of the Association of Health Care Journalists from 2017 to 2021, Oransky earned his bachelor's degree from Harvard and an MD from NYU School of Medicine. His contributions to biomedical communication have earned him accolades, including the John P. McGovern Award and commendation from the John Maddox Prize judges for his work at Retraction Watch. Read HXA's newsletter Free the Inquiry: https://heterodoxacademy.substack.com/Follow Ivan on X: https://x.com/ivanoransky  Follow Heterodox Academy on:Twitter: https://bit.ly/3Fax5DyFacebook: https://bit.ly/3PMYxfwLinkedIn: https://bit.ly/48IYeuJInstagram: https://bit.ly/46HKfUgSubstack: https://bit.ly/48IhjNF

Podcast: LAS NOTICIAS CON CALLE DE 6 DE FEBRERO DE 2025 - El gobierno admite que no ha nombrado a la mayoría de los puestos - El Nuevo Día - Musk estaba siendo investigado por agencia que mandó a cerrar - Gizmodo - LUMA firma acuerdo con empresa de energía renovable para meterle 900 MV al sistema - Guerra PPD entre Alejandro y Jorge Colberg - WUNO - JGo plantea traer un presidente de fuera de la UPR para dirigir universidad - PR repleto de caimanes por todos lados,. ya no están en un área particular - El Vocero - Estudio demuestra que nacimientos prematuros podrían estar vinculados a contaminación ambiental - Metro - PR no pidió millones en fondos para cambio climático aprobado por Biden - CPI - Arrestan en Parguera por anclar ciudadanos extranjeros - Metro - Detenida orden de Trump para que nacidos en USA no sean ciudadanos - NYT - Tarifas de Trump afectarían producción de fármacos en PR y advierten de posibles efectos en GLP-1 - MedScape - 71 muertes por influenza - El Nuevo Día - Un embuste la transición hacia renovables desde el primer plan aprobado, piden extender planta de carbón en Guayama - Cable submarino de RD a PR llevaría luz para PR y para RD a la vez y plantean dos plantas - El Nuevo Día - Gigantes de Carolina se irían a Canóvanas - Primera Hora - Comunidad lgbtiq+ advierte de proyecto de libertad religiosa en su contra - Primera Hora - Gobernadora dice que ahora sí se van a mover proyectos de Vivienda y reconstrucción - El Vocero - Pierde PR contra México y va por tercer lugar en Serie del Caribe Incluye auspicio

Highly processed vegetable oils, derived from seeds and beans, have become a dominant part of modern diets despite significant health concerns. Historical biases in nutrition science, influenced by the vegetable oil industry, have promoted these oils despite evidence from controlled studies showing negative health outcomes. These oils are unstable, prone to oxidation, and can create toxic byproducts, particularly when exposed to heat, contributing to inflammation and chronic diseases. Although they can lower LDL cholesterol, studies have shown that this reduction does not necessarily improve heart health and may increase risks for other conditions like cancer. In contrast, traditional fats like extra virgin olive oil and omega-3-rich foods offer more stability and health benefits, emphasizing the need for a balanced, minimally processed approach to dietary fats. In this episode, I talk with Nina Teicholz and Max Lugavere to explore the health impacts of different types of fats and oils, debunking misconceptions around cooking with extra virgin olive oil and emphasizing the dangers of industrial vegetable oils. Nina Teicholz is a science journalist and author of the New York Times bestseller, The Big Fat Surprise, which upended the conventional wisdom on dietary fat—especially saturated fat—and spurred a new conversation about whether these fats in fact cause heart disease. She is also the founder of the Nutrition Coalition, a non-profit working to ensure that government nutrition policy is transparent and evidence-based—work for which she's been asked to testify before the U.S. Department of Agriculture and the Canadian Senate. Max Lugavere is a health and science journalist and the author of the New York Times best-seller Genius Foods: Become Smarter, Happier, and More Productive While Protecting Your Brain for Life, now published in 10 languages around the globe. His sophomore book, also a best-seller, is called The Genius Life: Heal Your Mind, Strengthen Your Body, and Become Extraordinary and latest book Genius Kitchen. Max is the host of a #1 iTunes health and wellness podcast, called The Genius Life. Max appears regularly on The Dr. Oz Show, The Rachael Ray Show, and The Doctors. He has contributed to Medscape, Vice, Fast Company, CNN, and The Daily Beast, has been featured on NBC Nightly News, The Today Show, and in The New York Times and People Magazine. He is an internationally sought-after speaker and has given talks at South by Southwest, the New York Academy of Sciences, the Biohacker Summit in Stockholm, Sweden, and many others. Full length episodes can be found here: Is Vegetable Oil Good or Bad for You? Nina Teicholz The Best Diet for Your Brain This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%.