Podcasts about Methotrexate

One minute she was the nurse—then she became the emergency. Today, Shenell RN of the All One Nurse podcast shares her story of a ruptured ectopic pregnancy that sent her into emergency surgery on shift — and the second ectopic pregnancy that followed just a year later.We talk through the symptoms she felt that day, how methotrexate treatment impacted her recovery, and the range of symptoms that can make it hard to tell what's really going on. Shenell also opens up about the emotional toll of pregnancy loss, her journey to have her rainbow baby, and how her experience gave her deeper insight into the kind of support patients really need.This episode is a firsthand account of what compassionate care really looks like—and how nurses can better support patients during reproductive emergencies.Topics discussed in this episode:The importance of self-care for nursesHow her experience changed her approach to patient careFirst ectopic pregnancy and emergency surgeryEmotional aftermath and physical recovery Methotrexate treatment for her second ectopic pregnancyHow to support patients through pregnancy lossPatient education and communication tipsWhen patients need to seek careConceiving after ectopic pregnancyConnect with Shenell RN:https://www.instagram.com/allonenurse_shenell/Listen to the All One Nurse Podcast featuring Sarah Lorenzini:https://podcasts.apple.com/us/podcast/navigating-rapid-response-nursing-with-sarah-lorenzini/id1755700754?i=1000693458288Mentioned in this episode:NTI 2025 is in New Orleans May 19th-21st!If you want to learn more about NTI, you can see all that NTI has to offer and get registered here: http://www.aacn.org/25-nti CONNECT

Mike is an IT Infrastructure Manager in Las Vegas, and he's coming up on 1 year of Carnivore in March. He was diagnosed with Mixed Connective Tissue disorder in 2016, and has in the past been on Methotrexate, Prednisone, Enbrel, and Rinvoq. MCTD consists of elements of Sjogens, Rheumatoid Arthritis, and Lupus. Since going Carnivore, the only non-Carnivore thing he still uses that helps is Qunol Tumeric and Ginger gummies to help with inflammation. He has lost 50 pounds, his symptoms are gone until he eats something he shouldn't, and he has more energy and his hands have stopped hurting. Timestamps: 00:00 Trailer 01:18 Introduction 07:49 Sedentary job, unhealthy diet 08:58 Loss of basic functionality 13:34 Keto diet success and weight loss 16:06 Beef-centric meal prep routine 18:35 Rib eye diet cures symptoms 22:30 Couple's weight loss success 24:40 Prioritizing quality meats over extras 29:38 Diet's role in rheumatism neglected 31:43 Air fried rib eyes & snacks 35:06 Curbing cravings with ribeye 38:15 Revitalizing lives through dietary change 40:45 Easing into a carnivore diet 43:10 Mindful eating on vacation 46:34 Where to find Mike Join Revero now to regain your health: https://revero.com/YT Revero.com is an online medical clinic for treating chronic diseases with this root-cause approach of nutrition therapy. You can get access to medical providers, personalized nutrition therapy, biomarker tracking, lab testing, ongoing clinical care, and daily coaching. You will also learn everything you need with educational videos, hundreds of recipes, and articles to make this easy for you. Join the Revero team (medical providers, etc): https://revero.com/jobs ‪#Revero #ReveroHealth #shawnbaker  #Carnivorediet #MeatHeals #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree Disclaimer: The content on this channel is not medical advice. Please consult your healthcare provider.

Americans are more stressed than ever before due to the pandemic, financial situations, medications, overconsumption of alcohol,imbalanced diet, poor gut health, and environmental toxins. As a result, many people are tired, depressed, have poor memory and focus, and have weakened immune systems.According to research, Boosting B vitamin levels quickly improves energy. A deficiency of just one B vitamin will negatively affect the complex production of energy (ATP) in your cells. While people usually think of Supplemental B12 for energy, one will typically get better results with a full spectrum B complex since many of the B's are involved in ATP production.Recently Dr. Mark Stengler, NMD. put out a helpful article that can be found here.Many medications deplete the body of B vitamins. Examples include acid reflux medications such as the Proton Pump Inhibitors (PPIs), Prednisone, Metformin, Antibiotics, Birth Control Pills, Anti-seizure medications, Antidepressants, Chemotherapy drugs such as Methotrexate, and several others. Research has shown that the elderly who take three or more medications are prone to B vitamin deficiencies such as B2, B6, Folate, and B12.Helpful ArticleLearn more about Emerald Labs Listeners of the show can save 20% with the code: Forever 

In episode 596, Mike and James talk in a PREMIUM way about three trials that used methotrexate for osteoarthritis and walking for back pain. Nothing miraculous but there seems to be an effect – so have a listen.

Join Henry, Kate, Mark and Gary as they discuss 4 new POEMs: an RCT of mindfulness for chronic pain, use of methotrexate (huh?) for pain relief in adults with knee DJD, a new way to eradicate H., and oral resveratrol for adults with painful DJD of the knee  (you know, the stuff from red wine). And a quiz: what actually are the benefits of lower BP targets? Links Mindfulness for chronic pain:  https://pubmed.ncbi.nlm.nih.gov/39158851/ Methotrexate for OA:  https://pubmed.ncbi.nlm.nih.gov/39074374/ Eradicating H. pylori: https://pubmed.ncbi.nlm.nih.gov/38906695/ Resveratrol for OA: https://www.ncbi.nlm.nih.gov/pubmed/39137167 Cochrane Review: Blood pressure targets in adults with hypertension.

Qui dit fin d'année dit Gala des grands crus et des piquettes du Pharmascope! Ne manquez pas cette 8e édition du Gala au velours des plus sérieux, le grand retour de Sébastien, des effets sonores entraînants, l'inclusion de nouvelles catégories exotiques… ** Veuillez noter que cet épisode ne rencontre pas les critères d'admissibilité pour l'octroi d'unités de formation continue ou de crédits Mainpro+** Ressources pertinentes en lien avec l'épisode La catégorie « L'éditorial de l'année »van Dijk SHB, Bui M, Eijkelboom AH. Living happily ever after? The hidden health risks of Disney princesses. BMJ. 2024;387:q2497. La catégorie « Nouvelles études de vieilles affaires pour de vieilles maladies »Kingsbury SR, Tharmanathan P, Keding A, et al. Pain Reduction With Oral Methotrexate in Knee Osteoarthritis : A Randomized, Placebo-Controlled Clinical Trial. Ann Intern Med. 2024;177(9):1145-1156. Wang Y, Jones G, Keen HI, et al. Methotrexate to treat hand osteoarthritis with synovitis (METHODS): an Australian, multisite, parallel-group, double-blind, randomised, placebo-controlled trial. Lancet. 2023;402(10414):1764-1772. La catégorie « Patente à gosse incroyable »Bartholdy C, Døssing A, Stisen ZR, et al. Effect of heated mittens on physical hand function in people with hand osteoarthritis: randomised controlled trial. BMJ. 2024;387:e078222. La catégorie « Je pleure tellement je ris »Li J, Liao Y, Zhang SY, et al. Effect of laughter exercise versus 0.1% sodium hyaluronic acid on ocular surface discomfort in dry eye disease: non-inferiority randomised controlled trial. BMJ. 2024;386:e080474. La catégorie « Alimentaire »Hakam N, Guzman Fuentes JL, Nabavizadeh B, et al. Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake: A Systematic Review. JAMA Netw Open. 2024;7(11):e2447621. Hodder RK, O'Brien KM, Wyse RJ, et al. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev. 2024;9(9):CD008552. La catégorie « On n'est plus capable! »Duarte Romero B, Waterhouse M, Baxter C, et al. The effect of three years of vitamin D supplementation on erectile dysfunction: Results from the randomized placebo-controlled D-Health Trial. Clin Nutr ESPEN. 2024;60:109-115. La catégorie « L'étude ayant pris le plus de temps à être publiée »Hammond J, Fountaine RJ, Yunis C, et al. Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19. N Engl J Med. 2024;390(13):1186-1195. La catégorie « Visuospatial »R Patel V, Liu M, Worsham CM, Jena AB. Alzheimer's disease mortality among taxi and ambulance drivers: population based cross sectional study. BMJ. 2024;387:e082194. Published 2024 Dec 17. La catégorie « Hommage »Yndigegn T, Lindahl B, Mars K, et al. Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction. N Engl J Med. 2024;390(15):1372-1381. Silvain J, Cayla G, Ferrari E, et al. Beta-Blocker Interruption or Continuation after Myocardial Infarction. N Engl J Med. 2024;391(14):1277-1286.

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Jason Ingraham, an adult living with eosinophilic fasciitis (EF), and Dr. Catherine Sims, a rheumatologist at Duke University and a Health Services Research Fellow at the Durham Veterans' Affairs Hospital. They discuss Jason's experiences living with EF and Dr. Sims's experience treating EF. They share Jason's journey to diagnosis and the importance of working with a group of specialists. They share tips on medication and physical therapy, how to communicate with your medical team, and manage your activity and mindset. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:50] Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron, and co-host, Holly Knotowicz.   [1:14] Holly introduces today's topic, eosinophilic fasciitis, with guests, Jason Ingraham and Dr. Catherine Sims.   [1:25] Jason is an adult living with eosinophilic fasciitis (EF). Dr. Sims is a rheumatologist at Duke University and a Health Services Research Fellow at the Durham Veterans' Affairs Hospital.   [1:52] Dr. Sims explains what EF is. Patients may present with symptoms of large plaques on their skin, edema of arms and legs, Raynaud's Phenomenon, contractures of arms or legs, limited mobility, or loss of the ability to do tasks they used to do.   [2:42] EF, as with most eosinophilic disorders, doesn't follow the textbook. Some people will present with one symptom and some with multiple symptoms. There is a disconnect between how we diagnose conditions like EF and how patients present.   [3:01] There are major and minor criteria for the diagnosis. As in Jason's case, it takes time for the symptoms to present. Things develop over time. It took multiple specialists to diagnose Jason.   [3:38] Eosinophilic conditions are incredibly different from each other. When Dr. Sims sees a patient with high eosinophils, she thinks of three major buckets: infection, autoimmune diseases, and cancer.   [4:12] Patients will often see many different specialists. In Jason's case, they had done a skin biopsy that wasn't as helpful as they hoped. That led him to get a deep muscle biopsy to collect the lining of the muscle.   [4:47] Fasciitis is the inflammation of the muscle lining or fascia. A sample of the fascia can demonstrate under the microscope if there is a thickening, swelling, or inflammation of the lining of the muscle.   [5:24] Dr. Sims as a rheumatologist treats a number of rare diseases. Eosinophilic fasciitis is an ultra-rare disease.    [5:43] Jason had a local primary care doctor and a rheumatologist who both did a really good job and referred him to Dr. Sims. She had the benefit of their hard work to guide her next steps. Because EF is so rare, she has pitched Jason's case twice in rheumatology grand rounds sessions.   [6:18] During one of these sessions, Dr. Sims was advised to get the fascial biopsy that ultimately led to the diagnosis. She benefited from the intelligence and input of dozens of doctors.   [6:59] In the Fall of 2022, while hiking on vacation with his wife, Jason was extremely fatigued, and his forearms and lower legs swelled. His socks left deep impressions. It was difficult to reach his feet to put socks on. He spent a lot of time uncharacteristically resting.   [8:09] Jason's primary care doctor ran lots of blood tests. He thought it might be a tick bite. Jason started seeing specialists, having tests and hospital visits.   [8:57] Jason worked with a rheumatologist in Wilmington, an infectious disease doctor, and a hematologist/oncologist who reached out to a Duke expert. He also saw a pulmonologist and a dermatologist. He got the referral to Dr. Sims for March of 2023.   [9:57] The first diagnosis Jason received was after his first hospital stay in January of 2023, when he had bone marrow biopsies, CT scans, ultrasound, and other tests. He was deemed to have idiopathic hypereosinophilic syndrome (IHES).   [10:30] It was only a few weeks before his local rheumatologist said his panels were back and one tipped it from an IHES diagnosis to eosinophilic granulomatosis with polyangiitis (EGPA). He joined the Vasculitis Foundation and researched EGPA.   [11:03] Dr. Sims told Jason that EGPA was a working diagnosis but he didn't check all the boxes. There was the underlying thought that maybe it was something else. He had a second flare when he came off of prednisone in June of 2023.   [11:48] Dr. Sims scheduled Jason for a muscle biopsy while he was off steroids. That's how he got the diagnosis of eosinophilic fasciitis (EF). Jason says the disorder is hard for him to pronounce and he can barely spell the words.   [12:52] Jason's wife Michelle encouraged Jason to track his symptoms and medications and keep track of data. Going from specialist to specialist, the first thing he did was give the history.   [13:31] Jason found it helpful to create a spreadsheet of data with blood test results, meds, how he was feeling each day, his weight, and even notes about when he had difficulty putting his socks on. Jason is an advocate of owning your continuity of care as you see different doctors.   [14:42] Jason says the doctors at Duke talk very well between themselves.   [14:49] Jason likes to look back at that spreadsheet and see how far he's come, looking at the dosage he was on during and after flares and the dosage he's on now, or zero, on some of the medications. That's a little bit of a victory.   [15:16] Holly works at a private hospital without Epic or CareEverywhere so she gives physical notes to her patients to give to their doctors. She comments that a great PCP, like the one Jason had, can make all the difference in the world.   [16:18] Jason's PCP, Dr. Cosgrove, referred Jason to Duke for a second opinion. That was where he met Dr. Sims. He's glad to have both Dr. Sims and his PCP accessible.   [17:35] Jason says the number of questions you have with this type of thing is immense. When you look up EF, you find very little and the literature isn't easily digestible by patients. Being able to reach out to your doctors for a quick question is super helpful. [17:56] Jason has been able to do telehealth follow-ups and not always have to travel or take off work, which has been extremely helpful. He has been at Duke a good handful of times for various things but remote follow-ups are helpful.   [18:52] Dr. Sims says people just don't know about EF as it is an ultra-rare diagnosis. Even physicians don't understand what causes it. It's lumped in with all other eosinophilic conditions but these disorders don't all present the same way.   [19:19] EoE doesn't look like EF, even though they're both driven by the same immune cells. Dr. Sims says the first need is educating providers and patients on what the diagnosis is; awareness in general when a patient is having this swelling of extremities.   [19:44] Dr. Sims says at his baseline, Jason is very active with multi-mile hikes. When Dr. Sims met him, he was off from the baseline of what he was able to do. Being aware of your baseline and changes from that is very informative for doctors.   [20:07] Dr. Sims talks about the patient being a liaison between multiple specialists. Bringing data to your subspecialist always helps facilitate care and come up with a bigger picture of what's happening.   [20:23] Jason first went to Dr. Sims with the diagnosis of EGPA. She said, let's treat the EGPA and see what happens but they kept an open mind. With ultra-rare diseases, sometimes it's difficult for patients not to have a label for their condition.   [20:45] Dr. Sims explains to her patients that sometimes we live in the discomfort of not having a label. She keeps an open mind and doesn't limit herself to just one diagnosis. She seeks feedback from providers who have seen this before and know what works.   [21:07] Just as Jason described, you will go through multiple diagnoses. Is this cancer? Is it a parasitic infection? Where did you travel? You will see many subspecialists. It's extremely anxiety-provoking.   [21:31] When Dr. Sims did her grand rounds, she gave a third of the presentation, and the other two thirds were presented by an infectious disease doctor and a hematologist. In these cases, you need more than one subspecialist to complete the workup.   [22:10] Dr. Sims says there are a lot of misconceptions that the patient will get the diagnosis right away and the right therapy and get better. There are multiple therapies, not just medications. There are lifestyle and work modifications; it's a gradual process.   [22:22] One of Dr. Sims's goals for Jason and Michelle is to get back to doing the things that they enjoy, tennis and hiking. That's a measurement of the quality of life that a patient has.   [22:34] Talking to your doctors about how you're feeling and how you're functioning is huge. It may be that this is your new normal, but it may also be that we can make adjustments to maximize your quality of life.   [23:00] There are misconceptions about the journey of diagnosis and treatment. Have a close relationship with your subspecialist. PCPs have a high burden of expectations. As a rheumatologist who treats rare diseases, it's helpful to take on a part of that burden.   [22:31] If you don't have good communication with your providers and they aren't listening to you, you can always go get another opinion. The provider relationship is life-long.   [23:43] It's important for your provider to take what's important to you into consideration when they make treatment decisions.   [25:00] As a rheumatologist, steroids are a first-line therapy for Dr. Sims. Their role is the quick control of inflammation. The goal is always to get you off of the steroids as soon as possible, in the safest way possible.   [25:17] When Jason came to Dr. Sims, he was on mepolizumab for the working diagnosis of EGPA. Mepolizumab is one of the primary therapies for EGPA. They talked about not making treatment changes as they were navigating what was happening.   [25:40] They didn't want to make a change of medication and then have that be mistaken for disease activity. They didn't want too many variables moving at once.   [25:47] Typically, the first-line therapy is steroids, meant to help with the swelling, pain, and tightness that patients will get lining their muscles and give them a bit more functionality and decreased pain.   [26:00] Long-term, Dr. Sims gives immunosuppressant medication. She prescribed methotrexate for Jason. In EF, the immune system is overly activated, attacking the lining of the muscles and causing the symptoms.   [26:51] If you suppress the immune system activity, that leads to decreased inflammation and symptoms in the patient. Steroid use, over a few months, is detrimental, with low bone density, weight gain, high blood pressure, and diabetes.   [27:14] Dr. Sims starts with prednisone and folds in medications like mycophenolate or methotrexate.   [27:19] Mepolizumab is an interleukin 5 blocker. Interleukin 5 is part of the immune system and is necessary for eosinophils to grow, function, and multiply. The goal of using mepolizumab is to lower the eosinophils that are contributing to the disease symptoms.   [27:48] Methotrexate, prednisone, and mepolizumab can work synergistically or independently. Most rheumatologists start with methotrexate or mycophenolate which have fewer side effects and have been around longer. We know how to manage those.   [28:08] If there is no response, we may add something like mepolizumab. As Jason was already on mepolizumab, Dr. Sims added methotrexate.   [28:20] IVIG, an infusion of immunoglobulin, has also been used as a quick way to control inflammation. It is used in other autoimmune diseases like myositis, which is inflammation of the muscle itself.   [29:08] With untreated eosinophilic fasciitis, the lining of the muscle may continue to be inflamed and can lead to fibrosis, damage that cannot be reversed. The patient can become very disabled. Contracture is one result of this.   [30:16] Jason says when he tried a new medication, he monitored if it was a good fit and if the side effects were less impactful than the underlying disease. Dr. Sims adjusted his dosages or tried to get off certain medicines as needed.   [30:59] After his muscle biopsy from his left calf, it took about a month to get back to walking easily. He was already in physical therapy, going many times for a variety of things. He had back pain, potentially related to his EF. His physical therapist was great.   [31:56] The stretches alternated between upper and lower body. Jason bought tools to do the stretches at home. When he's not feeling as well, he goes back to some of those same stretches. When he was on steroids, he took long walks to strengthen his bones.   [32:39] Jason started making phone calls to supportive family and friends on his walks and started listening to podcasts related to his condition or medications. Getting back to tennis and hiking is important to Jason. He's happy to be out there.   [33:20] Jason was open with his employer about his condition. Some of the weekly meds can make him not feel well. His employer gives him some flexibility. He has good days that far outnumber the bad days. He doesn't have to think about EF too much now.   [34:33] It's nothing like when he was in a flare, especially when he was in a flare before being diagnosed. What gets him through a bad day is giving himself some grace and understanding while he waits for his meds to catch up. He rests more than he wants to.   [35:33] Low-impact exercises like walking help Jason. He's trying to find a support network that gets EF. That led him to APFED, to find anyone experiencing something like what he was. He saw a conference that included a session on EF.   [36:09] Jason signed up for the conference and there he met Ryan's mother who has EF. They were each the first person the other had met with EF. They decided to connect after the conference. They talked on the phone for about an hour.   [36:39] She told Jason how she got into APFED and talked a lot about her son who had eosinophilic diseases. Soon after, Jason talked to Ryan as a primer for this podcast.    [38:15] Having a community to relate to, even if it's one person, is massive. It can make you feel less isolated.   [38:42] Holly says it's hard having a chronic illness. She thanks both Jason and Dr. Sims for sharing so much information and their journey and she asks for last words.   [38:58] Dr. Sims believes finding a community is critical. She interviews a lot of patients for research and isolation is a frequent theme. Even the doctor doesn't know what it's like to live with the condition you live with daily. As Jason said, give yourself grace.   [39:33] Dr. Sims tells her patients that they're different from the general population because they have to spend so much time and energy managing their condition that they can't do x, y, or z today, and that is OK. She says to stay motivated and positive.   [40:12] Find what works for you. Walking is good for your physical and mental health. Have the goal of getting back to what makes you happy. Take initiative and find non-medication ways to recuperate. You have control over ways you can feel better.   [40:43] Connect with others and share your story, like Jason did today. It may make someone's journey a little easier and make them feel less alone. Utilize your condition for good, for a bigger purpose.   [41:04] Jason had wished he could meet someone who could tell him what EF would be like over the years. He says to stay positive and find out what you have control over. Jason believes the future is bright for being able to do many things for a long time.   [42:26] For our listeners who would like to learn more about eosinophilic fasciitis, please visit APFED.org and check out the links in the shownotes.   [42:33] If you're looking to find a specialist who treats eosinophilic disorders, like Dr. Sims, you can use APFED's Specialist Finder at APFED.org/specialist.   [42:43] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections/.   [42:55] Ryan thanks Jason and Dr. Sims for joining us for this excellent conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron for supporting this episode.   Mentioned in This Episode: Dr. Catherine Sims, rheumatologist Duke University Hospital Durham VA Medical Center   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, and Regeneron.   Tweetables:   “EF patients may present with large plaques on their skin, edema of arms and legs, Raynaud's Phenomenon, contractures of arms or legs, limited mobility, or loss of the ability to do tasks they used to do.” — Dr. Catherine Sims   “Steroids are … first-line therapy. Their role is the quick control of inflammation. The goal is always to get you off steroids as soon as possible, in the safest way possible.” — Dr. Catherine Sims   “Methotrexate, prednisone, and mepolizumab can work synergistically or independently. Most rheumatologists start with methotrexate or mycophenolate which have fewer side effects and have been around longer.” — Dr. Catherine Sims   “Stay positive and find out what you have control over. The future is bright for being able to do many things for a long time.” — Jason Ingraham

Dr. Cindy Chen describes her group's work on a retrospective review of association of systemic methotrexate therapy and a lower rate of proliferative vitreoretinopathy (PVR) after retinal detachment repair in large cohort of 2674 eligible patients. 

Guest: Corinna Bellizzi, MBA is a natural products industry executive and omega-3 expert who successfully creates new nutrition categories, pioneers brands, and develops educational strategies that disrupt markets.As an avid podcaster, she started a new podcast, Nutrition Without Compromise, to lean into the simple truth that great nutrition and bountiful health are a human right. She is also the host and creator of another great podcast, Care more be better.Last time Corinna joined me we shared a groundbreaking study conducted by an international team of researchers that unveiled a pioneering approach to boosting the production of active vitamin B12 in Spirulina. For those of you who missed that episode it is Ep 553 if you want to listen to it after this show.This study presents Spirulina as a viable, sustainable alternative to traditional animal sources, reducing environmental impacts from livestock farming. Also, a great source for people that don't consume animal-based proteins.Vitamin B12 deficiency affects over a billion people worldwide, leading to serious health issues. This study presents Spirulina as a viable, sustainable alternative to traditional animal sources, reducing environmental impacts from livestock farming.Many medications deplete the body of B vitamins. Examples include acid reflux medications such as the Proton Pump Inhibitors (PPIs), Prednisone, Metformin, Antibiotics, Birth Control Pills, Anti-seizure medications, Antidepressants, Chemotherapy drugs such as Methotrexate, and several others. Research has shown that the elderly who take three or more medications are prone to B vitamin deficiencies such as B2, B6, Folate, and B12.Boosting B vitamin levels quickly helps improve energy. A deficiency of just one B vitamin will negatively affect the complex production of energy (ATP) in your cells.Örlö is the future of nutrition – omega-3s and immune boosting micronutrients that provide all the benefits - without damaging earth's ecosystems - so people and the planet can thrive. Visit orlonutrition.com today.  Get an exclusive 20% discount at Orlonutrition.com when using the code FOREVER at checkout. (Does not work on Subscriptions).

Zoledronic acid is a bisphosphonate that can be used to manage hypercalcemia of malignancy and osteoporosis. Glipizide is an anti-diabetes agent that is classified as a sulfonylurea. Weight gain and hypoglycemia and two big concerns with this agent. Lactulose is classified as a laxative but is more commonly used to reduce ammonia levels in hepatic encephalopathy. Rabeprazole is a PPI used to reduce gastric acid secretions and improve conditions such as GERD, peptic ulcer disease, and Barrett's esophagus. Methotrexate is classically grouped with oncology agents but is frequently used in autoimmune conditions like rheumatoid arthritis and Crohn's disease.

Send us a textIn this week's Taco Bout Fertility Tuesday, Dr. Mark Amols kicks off the "When to Hit the Panic Button" series with a focus on ectopic pregnancies. He explores the risks associated with these high-stakes pregnancies, explains when they occur, and outlines the warning signs that suggest it's time to move on to treatments like IVF. With each ectopic pregnancy, the chance of recurrence rises—so when should you consider more advanced interventions? This episode offers essential guidance for anyone facing repeated ectopics, helping you understand when it's time to take action to protect your health and fertility.Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform. Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com. Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com. Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

The surgical sieve and Occam's razor may sound like familiar diagnostic metaphors, but what about Crabtree's bludgeon? These are just a few of the tools touched on by journal editors editors Prof. Philip Smith and Dr. Geraint Fuller, as they discuss the October 2024 issue of Practical Neurology. They cover recent publications on oligoclonal bands, neurotoxicology, methotrexate, carotid artery disease, epilepsy surgery, and how unsolved cases remain part of the "art of neurology". To finish, there is a conversation on the topic of neurology podcasts themselves.  Read the issue: https://pn.bmj.com/content/24/5   Further reading: The BMJ - What Three Wise Men have to say about diagnosis JNNP - Neurotoxicology: what the neurologist needs to know   Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production by Letícia Amorim and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

Listen to three experts attending EULAR 2024, who provide their recommendations on how to optimise methotrexate therapy use across various arthritis types.

Living with pustular psoriasis is tough. Hear the latest updates about heritable aspects of GPP, diagnosis, management tips, and treatment options such as the IL-36 inhibitor spesolimab, how it works and how effective it is from dermatologist Dr. Laura Ferris, Professor of Dermatology at the University of Pittsburgh and moderator Alan Simmons. This episode is provided with support from our Psoriasis Action Month sponsors. 

At age two, Jon Brent was diagnosed with a type of blood cancer, acute lymphoblastic leukemia.  He underwent an aggressive chemotherapy regimen, including vincristine, dexamethasone, methotrexate and prednisone, but after that still needed a bone marrow transplant.  He has achieved survivorship but is still in pain and expects to some extent he will be for the rest of his life.  Jon can no longer compete in contact sports but is an active participant in ultimate Frisbee.

N Engl J Med 2019;381:2497-2505Background: Inflammation increases the risk of atherosclerosis, and reducing inflammation with canakinumab, a monoclonal antibody that neutralizes interleukin-1β, reduced plasma markers of inflammation and the risk of future myocardial infarctions but was associated with small yet statistically significant increased risk of fatal infections. Methotrexate, in the CIRT trial, did not reduce plasma markers of inflammation or cardiovascular events.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Colchicine, extracted from the plant autumn crocus, is a potent inexpressive anti-inflammatory medication that has been used for centuries, and is used for conditions like gout, familial Mediterranean fever and pericarditis.The Colchicine Cardiovascular Outcomes Trial (COLCOT) sought to test the hypothesis that colchicine is superior to placebo in reducing cardiovascular events in patients with recent myocardial infarction.Patients: Eligible patients were adults who had myocardial infarction within 30 days of enrollment, had any planned revascularization completed, and were on guidelines recommended treatment. Exclusion criteria included severe heart failure, left ventricular ejection fraction

Questions Covered: 22:27 – Do you focus on how liberalism affects sexual ethics only or economics etc in your new book? 28:55 – What is your opinion on how much social media and the availability of information has played into this confusion? 32:14 – Was there a meeting at the Kennedy compound where pro-abortion politicians were given a roadmap to set their agenda? 45:09 – Why doesn’t the USCCB have an official position on Methotrexate, the chemical used in abortion? 49:50 – How do you address questions in regard to the opposite of progressive Catholicism? …

Not sure what Irritable Bowel Disease or Irritable Bowel Syndrome mean or how they relate to psoriasis? Listen as gastroenterologist Dr. Lisa Malter, Professor in the Dept. of Medicine, NYU Langone Health, Grossman School of Medicine, discusses the perfect storm of what it takes to develop IBD, how diagnosis occurs, care, and use of treatments also used with psoriatic disease. This episode is provided with support from Bristol Myers Squibb. 

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. How good (or not) are rheumatologists and what to do about MTX nodulosis?

In this episode Ryan is joined by a guest panel (Dr. Grant Comstock MD, Dr. Joshua Trebach MD, Dr. Emily Kiernan DO, and Dr Frank Paloucek PharmD, DABAT) to review nine of the most interesting or clinically impactful research abstracts that were presented at the 2023 North American Congress of Clinical Toxicology (NACCT) in Montreal Canada. If you didn't get a chance to read all 363 research abstracts from some of Toxicology's best and brightest this year, tune in for a high yield review as well as clinical a break down of the studies and their relevance from the expert panel.  Check the show notes for a link to the published abstracts and the list of all studies discussed in the showAbstracts available here10:40- Abstract 1 (PDF #225) Methotrexate toxicity in the setting of therapeutic error, a multicenter retrospective reviewLead author: Andrew Chambers24:12- Abstract #2 (PDF #251) Oleander seeds in candlenut weight loss product strike againLead author: Masha Yemets31:16- Abstract #3 (PDF #2) Efficacy of sodium tetrathionate when administered intramuscularly for the treatment of acute oral cyanide toxicity in a swine model (Sus scrofa)Lead author: Brooke Lajeunesse39:45- Abstract #4 (PDF #10) Is HOUR enough after out-of hospital naloxone for opioid overdose? Prospective preliminary data from real-world implementation of the modified St. Paul's early discharge ruleLead author: Stephen Douglas49:05- Abstract #5- Poster titles at NACCT 2013–2022: is NACCT experiencing a pun-demic?Lead author: Dayne Laskey52:40- Rivastigmine discussionLead author: none58:40- Abstract #6 (PDF #5)  Randomized controlled trial of ANEB-001 as an antidote for acute cannabinoid intoxication in healthy adultsLead author: Andrew Monte1:08:00- Abstract #7 (PDF#216) Successful use of expired physostigmine to treat anticholinergic delirium in a pediatric patientLead author: Bryan Hayes01:20:00- Abstract #8 (PDF #202) Enough negativity? Clinically significant salicylism with first detectable concentration twelve hours )post-ingestionLead author: Stacey Bangh01:25:24 - Abstract #9 (PDF #267) High sensitivity troponin is frequently elevated after carbon monoxide exposureLead author: Abdullatif Aloumi

This is a follow up to episode 45: “What's it like to be on Methotrexate for Rheumatoid Arthritis or Psoriatic Arthritis?”  Paulina, Jenny, Ali, and Ananthi share what's changed and what has stayed the same with their medications, including whether they're still on methotrexate. They also  reflect on how they've navigated the ups and downs of chronic illness life and share how grief and joy can co-exist. They also highlight the importance of  finding a supportive community with shared experiences. They also discuss their choices around how much to share on social media about their experiences.Paulina, Jenny, Ali, and Ananthi each share wisdom that has guided them along this nonlinear journey; encouraging self-care, advocating, celebrating small victories, and approaching life one day at a time. They conclude with a discussion about how to balance acceptance and adapting with a “fixing” mindset.Medical disclaimer: All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now! For full episode details including a transcript and video:Go to the episode page on the Arthritis Life website. 

“I think that there are certain agents that are so foundational in some diseases that they will remain. Whether they remain first-line, maybe not; maybe they'll go to second line as we see things evolve with new agents. Some of these drugs have been very effective in the diseases in which they are used to treat patients. There's a long term place in therapy for these, and I think that will still be using these,” Rowena Schwartz, PharmD, BCOP, FHOPA, known to many as “Moe,” professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Lenise Taylor, oncology clinical specialist at ONS, during a discussion about what oncology nurses need to know about antimetabolites. This episode is part of a series about drug classes, which we'll include a link to in the episode notes.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD), which may be applied to the oncology nursing practice and treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by December 1, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: The learner will report an increase in knowledge related to antimetabolites.  Episode Notes Complete this evaluation for free NCPD.   Oncology Nursing Podcast: Pharmacology 101 series  ONS Voice oncology drug reference sheets  ONS books:   Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)  Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice  ONS courses:  ONS/ONCC Chemotherapy Immunotherapy Certificate Course  ONS Fundamentals of Chemotherapy Immunotherapy Administration  Clinical Journal of Oncology Nursing article: Chemoprevention: An Overview of Pharmacologic Agents and Nursing Considerations  ONS Huddle Cards:  Antimetabolites  Alkylating Agents  Miscellaneous Agents  Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers:  Oral Chemotherapy Education Sheets  Intravenous Cancer Treatment Education Sheets  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.    To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From Today's Episode  “Antimetabolites are relatively old agents. They are some of the oldest anti-cancer drugs that we have. They were developed to be similar to naturally occurring compounds that are important in cellular production. They are similar but not the same. So, they sometimes will bind to an enzyme important for cell proliferation. And because it binds to an enzyme, does it mean that it helps the enzyme? It may block it and that may cause cell death. And so, they've been used for a long time in oncology.” TS 1:44  “There's different classes of antimetabolites in oncology. If you think of the structure of DNA, there is purines, that's adenine and guanine, there are pyrimidines, which are things like cytosine and limonene, and then in RNA there's uracil. So, some of the antimetabolites are either purine analogues or pyrimidine analogues, meaning they look very much like the natural parts of DNA, and by being incorporated into the DNA they cause cell death. There's also a class of antimetabolites that interfere with how we use folate in the body, such as methotrexate is an obvious one, and these are called folate antagonists.” TS 2:43  “The purine analogs—and those are things like fludarabine or clofarabine—those drugs are very toxic to lymphocytes. And because they're very toxic to lymphocytes, these are drugs that we use in lymphocytic diseases. But that also means that these are drugs that we get immunosuppression because of the toxicity to lymphocytes. So, these patients have risk of infections because of their decreased lymphocyte activity after receiving these drugs.” TS 6:37  “Methotrexate works by blocking an enzyme that decreases the ability to make the folate that we need in our body to make cells. So, one of the things that we do when we use really high doses of methotrexate is we let it work for 24 hours and then we come in and we give leucovorin, which is the thing that we blocked. So, you're coming into rescue cells. And you're rescuing cells because the cancers we use high-dose methotrexate, we know that 24-hour exposure is going to be a really good effect on those cancer cells. So that's why we use leucovorin after methotrexate. We use it to minimize the toxicities that you would see with methotrexate. You decrease GI mucositis; you decrease the bone marrow suppression when you come in and adequately rescue with leucovorin.” TS 12:22   “I think [that's] one of the biggest challenges. I just had a situation that was an antimetabolites drug I'd never used before. I couldn't find in the literature and through resources I normally use, how to manage, so I actually reached out to colleagues to find out, who have used the medications to say, ‘What's your experience? What's worked for you?' It's one of the reasons I really love ONS, because I think it gives a forum for people to ask those questions together.” TS 15:23  “I think developing good patient education tools that people can take home that highlight the most important things about the regimen, including the antimetabolite aspects, making sure patients know what to monitor for so that they can contact their team if they need them. Diarrhea is something I always talk about with patients getting 5-fluorouracil. I do it because otherwise people self-manage and don't actually know what to do, and we really want to make sure that they contact us if they're having problems with diarrhea.” TS 17:14  “I think one of the best things that people can do is work together in the development of the order sets, whether they be electronic or not. And, so, that within the order sets there is clear indications of those things that highlight to patients the strategies to take, to manage. I think that's really helpful, and I think it's best done by a team. And to modify those order sets as things are learned that are helpful so that, you know, the strategy is dose reduction that's clear that that's going to be the strategy. So, I think that in this day and age it's really important that there is collaboration in developing whatever resources that we have.” TS 18:55  “Because gemcitabine is such a good radio sensitizer, when we use it with radiation, we use a very small dose. Very small. We're not talking anything near what we use when we use it in combination chemotherapy. So, when you have a patient getting gemcitabine, if somebody decides that they're going to do radiation, you have to make sure everybody knows they're on gemcitabine because you may hold the drug while they're getting radiation because you don't want to increase in toxicity.” TS 22:31  “I think that there are so many new, exciting agents and there are so many older agents that are still used in practice, that it's becoming very difficult for people to understand the mechanisms of the drugs that we're using and the agent-specific toxicities. So, I think that the education that's needed is the foundation and fundamentals of chemotherapy, because they still are used so much in practice. And I would hate to lose the knowledge that practitioners have because we're excited about the new, exciting therapies that are new and exciting.” TS 25:09 

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we talk to Prof Hazel Everitt, a GP and lead author of a recent Lancet paper exploring whether amitriptyline is effective for IBS, and where it might fit in to general practice management.We also look at research in the Lancet on treating hand osteoarthritis with methotrexate - what's the rationale and does it work? - plus a BMJ paper on using a patient information leaflet to improve lower urinary tract symptoms in men. Are PILS better than pills? ResourcesLancet ATLANTIS paper on IBS & amitriptylineATLANTIS trial website with patient informationGut journal CBT for IBS National Institute for Health and Care Research - how to get involvedNIHR Local research groups - how to get involvedLancet Methotrexate for hand OA with synovitisBMJ Leaflets for LUTSwww.nbmedical.com/podcast

What treatments are effective for uveitic macular edema? Drs. Nisha R. Acharya and Douglas A. Jabs of the MUST Research Group discuss with Dr. Edmund Tsui the landmark findings of the MERIT Trial in their recent Ophthalmology article, “Intravitreal Therapy for Uveitic Macular Edema—Ranibizumab versus Methotrexate versus the Dexamethasone Implant.” Intravitreal Therapy for Uveitic Macular Edema—Ranibizumab versus Methotrexate versus the Dexamethasone Implant. Acharya, Nisha R. et al. Ophthalmology, Volume 130, Issue 9, 914 - 923

Dr. Jabs and Dr. Acharya discuss the results of the MERIT trial that investigated relative efficacy of intrvitreal injections of Dexamethasone implant vs ranibizumab vs methotrexate for the treatment of macular oedema associated with uveitis. Discussed article: Multicenter Uveitis Steroid Treatment Trial (MUST) Research Group, Writing Committee:; Acharya NR, Vitale AT, Sugar EA, Holbrook JT, Burke AE, Thorne JE, Altaweel MM, Kempen JH, Jabs DA. Intravitreal Therapy for Uveitic Macular Edema-Ranibizumab versus Methotrexate versus the Dexamethasone Implant: The MERIT Trial Results. Ophthalmology. 2023 Sep;130(9):914-923. doi: 10.1016/j.ophtha.2023.04.011. Epub 2023 Jun 13. PMID: 37318415; PMCID: PMC10524707.

In this week's episode of "Take a Pain Check," we sit down with Laurie Proulx, who takes us on a journey through her life and experiences dealing with arthritis. Laurie discusses her early years, when arthritis seemed to be taking control of her life, and how she found solace and inspiration in the realms of piano, dance, and voice lessons. Diagnosed with arthritis in 1991, she sheds light on the limited treatment options available at the time, including her experience with gold therapy and crossing the border for medical care. Laurie's story unfolds as she saw the introduction of biologics enter in the field of rheumatology, and she emphasizes the importance of education on medication. Through eight surgeries, she shares her coping strategies for dealing with chronic pain and the role that Methotrexate played in her treatment journey. Laurie also delves into the therapeutic power of music and her personal journey with pregnancy, highlighting the reproductive health resources she has created and collaborated on. Tune in to gain insight into Laurie's inspiring journey and her resilience in the face of chronic pain.Don't forget to subscribe to Take a Pain Check for updates!Laurie's Socials X: @ProulxLaurieInstagram: @capa_arthritisOur socials:Website: https://www.takeapaincheck.com/Instagram: https://www.instagram.com/takeapainch... Twitter: https://twitter.com/takeapaincheck​​​ Tiktok: https://www.tiktok.com/@takeapaincheck Growing Pains, Copyright, 2018, Alessia Cara#juvenilearthritis #chronicillness #juvenilearthritis #research #patientsbelike #arthritis #chronicpain

Dr. Jack Cush discusses the news, journal articles and regulatory actions. This week we discuss JAKne, DLE and SLE and more.

This Tuesday Night Rheumatology panel discussion on "Methotrexate Decisions" featured Drs. Michael Weinblatt, Grace Wright, Richard Conway and Joel Kremer. The​ Panel discussed folate & MTX dosing, side effect management, MTX & lung disease and optimal monitoring, with many audience questions.​Recorded on 9/19/2023

Chapter 1 What's The Emperor of All Maladies"The Emperor of All Maladies: A Biography of Cancer" is a non-fiction book written by Siddhartha Mukherjee, an Indian-American physician and researcher. Published in 2010, the book provides a comprehensive history of cancer, focusing on its origins, treatment methods, and the ongoing battle against the disease. It explores the scientific, social, and personal aspects of cancer, and delves into the stories of patients, researchers, and physicians who have shaped the fight against cancer throughout history. "The Emperor of All Maladies" won the Pulitzer Prize for General Nonfiction in 2011 and has been widely acclaimed for its narrative style and depth of research.Chapter 2 Why is The Emperor of All Maladies Worth ReadThe Emperor of All Maladies by Siddhartha Mukherjee is worth reading for several reasons:1. Comprehensive and engaging storytelling: Mukherjee tells the history of cancer in a captivating and accessible manner. He weaves together personal stories of patients and their struggles with insightful scientific explanations, making the book suitable for both lay readers and those with a scientific background.2. In-depth exploration of a complex disease: Cancer is a multifaceted and elusive disease, and Mukherjee takes the time to explore its many aspects. He discusses its origins, the various treatments developed over the years, the social and political factors surrounding cancer research, and the implications for the future.3. Humanizes the disease: By sharing personal accounts of patients and their experiences, Mukherjee puts a face to the disease. This human perspective helps readers empathize with those affected by cancer and understand the devastating impact it has on their lives.4. Explores the triumphs and failures: The book covers both breakthroughs and setbacks in cancer research, highlighting the perseverance and determination of scientists throughout history. It gives readers a deeper appreciation for the complexities involved in fighting this disease.5. Raises important questions: The Emperor of All Maladies makes readers think about the ethical dilemmas faced by doctors and researchers in the field of cancer. It prompts discussions about the balance between scientific progress and patient welfare, the cost of treatment, and the role of societal attitudes toward cancer.Overall, The Emperor of All Maladies is a thought-provoking and informative book that offers a comprehensive overview of cancer, its history, and the ongoing efforts to understand and combat it.Chapter 3 The Emperor of All Maladies SummaryThe Emperor of All Maladies: A Biography of Cancer is a non-fiction book by Siddhartha Mukherjee published in 2010. The book provides a comprehensive and engaging narrative of the history, biology, and treatment of cancer.Mukherjee begins the book by tracing the origins of cancer, exploring its appearances in ancient civilizations and his own personal encounters with patients as an oncologist. He delves into the roots of cancer research, discussing key breakthroughs such as the discovery of DNA and the first successful treatments of childhood leukemia.The author then navigates through the evolution of cancer treatment, from early surgeries and radiation therapy, to the development of chemotherapy drugs like Methotrexate and Tamoxifen. He also explores the rise of cancer organizations such as the American Cancer Society and the National Cancer Institute, highlighting their impact on research and public awareness.Mukherjee also sheds light on the various challenges and controversies surrounding cancer research and treatment. He discusses the ethical dilemmas faced by...

In Episode 96 of the FSR Sarc Fighter Podcast, fellow Sarc Fighter Royce Robertson returns to talk about his epic adventure while raising money for the cause.  Meanwhile a small study in Japan suggests methotrexate may not be the answer for some Cardiac Sarcoidosis patients.   Show Notes www.kinevant.com www.sarcoidosistrial.com Click here for information on how to sign up for the clinical trial: https://bit.ly/3DaVsR6 ClinicalTrials.gov listing for RESOLVE-Lung: https://clinicaltrials.gov/ct2/show/NCT05314517 ClinicalTrials.gov listing for RESOLVE-Heart: https://clinicaltrials.gov/ct2/show/NCT05351554 The Methotrexate article: https://sarcoidosisnews.com/news/methotrexate-no-better-than-prednisolone-cardiac-sarcoidosis-poor-responders/ Royce's Cycle4Sarc page: https://stopsarcoidosis.rallybound.org/cycle4sarc?tab=Dashboard&fbclid=PAAaa9zWEjpGVyS1Q5Swa8mm5JT0t7JH13dfxVxdW1QlBMmbiRmc00Ol-uu-c Royce Robertsons original interview: https://beatsarc.podbean.com/e/episode-79a-royce-robertson-is-fighting-sarcoidosis-from-the-seat-of-his-bike/ email Royce Robertson  roycelrobertson@gmail.com Help FSR further its mission by becoming an Alliance Volunteer:  www.stopsarcoidosis.org/gsca-leaders/ Become a community outreach leader: https://www.stopsarcoidosis.org/gsca-leaders/ MORE FROM JOHN Cycling with Sarcoidosis http://carlinthecyclist.com/category/cycling-with-sarcoidosis/ Do you like the official song for the Sarc Fighter podcast?  It's also an FSR fundraiser!  If you would like to donate in honor of Mark Steier and the song, Zombie, Here is a link to his KISS account.  (Kick In to Stop Sarcoidosis)  100-percent of the money goes to the Foundation.  https://stopsarcoidosis.rallybound.org/MarkSteier The Foundation for Sarcoidosis Research https://www.stopsarcoidosis.org/ Donate to my KISS (Kick In to Stop Sarcoidosis) fund for FSR  https://stopsarcoidosis.rallybound.org/JohnCarlinVsSarcoidosis?fbclid=IwAR1g2ap1i1NCp6bQOYEFwOELdNEeclFmmLLcQQOQX_Awub1oe9bcEjK9P1E My story on Television https://www.stopsarcoidosis.org/news-anchor-sarcoidosis/ email me  carlinagency@gmail.com  

Prof. Torsten Witte, Director of the Dept. of Rheumatology and Clinical Immunology at the Hannover Medical School in Germany, Prof. Andrea Rubbert-Roth, Chief physician and deputy clinic head at the Clinic of Rheumatology, Canton Hospital, St. Gallen, Switzerland and Dr. Alessandro Giollo, lead of refractory arthritis, synovial biopsy and osteoporosis clinics at the Rheumatology Unit, Department of Medicine, University of Padova, in Italy delve into the latest advancements and offer perspectives in the management of rheumatoid arthritis with a specific focus on optimising methotrexate. This podcast has been funded by Medac Gm-bh.

Dr. Natalie Crawford answers the voicemails you called in. Questions answered: I had an ectopic requiring methotrexate. Is it okay to TTC 2 weeks before the recommended 3 month mark? What are the risks? What can be the reason for Ureaplasma? Could it be contributing to infertility? Can a prior chlamydia infection lead to tubal factor infertility? When do you recommend an HSG? What are treatments or supplements for PCOS that may need more research but looks promising based on research that currently exists? Is it possible to have a long (34 days) cycle and ovulate early around cycle day eleven? Is it okay to fly the day of or after an FET? We have moved Fertility In The News to the weekly newsletter in order to keep the podcast more evergreen. If you want to sign up go to nataliecrawfordmd.com/newsletter to sign up! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Apostrophe- Get your first visit for only five dollars at Apostrophe.com/AAW or use the code AAW at checkout. Nutrisense- Visit nutrisense.io and use code AAW to save $30 and get 1 month of free dietitian support. Athena Club-Go to athenaclub.com and use code AAW for 25% off your first order. Mosie Baby -Go to try.mosiebaby.com/AsAWoman and use code ASAWOMAN for 15% off your order at checkout LMNT-Go to DrinkLMNT.com/AAW to receive a free sample pack with any purchase AG1-Go to drinkAG1.com/asawoman and get a FREE 1-year supply of Vitamin D AND 5 Free AG1 Travel Packs with your first purchase. Quince-go to Quince.com/aaw to get free shipping and 365-day returns on your next order. If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

Episode 146: RA vs OA    Future Dr. Magurany explains how to differentiate rheumatoid arthritis from osteoarthritis.  Written by Thomas Magurany, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.1. Etiology: Rheumatoid Arthritis (RA): RA is an autoimmune disease wherein the immune system mistakenly attacks healthy tissues, particularly the synovial joints, usually between the ages of 30-50. Genetic predisposition, environmental factors such as smoking or infections, hormonal imbalances, and lower socioeconomic status have been associated with an increased risk of developing RA(1).Osteoarthritis (OA): OA primarily arises due to mechanical stress on the joints over time. Factors contributing to OA include age, obesity, joint injury or trauma, repetitive joint use or overuse, genetic abnormalities in collagen structure, and metabolic disorders affecting cartilage metabolism (2).The greatest risk factor for the development of OA is age with most patients presenting after 45 years of age. The greatest modifiable risk factor for OA is weight. People with a BMI >30 were found to have a 6.8 times greater risk of developing OA. (3) Primary OA is the most common and is diagnosed in the presence of associated risk factors such as: older age, female gender, obesity, anatomical factors, muscle weakness, and joint injury (occupation/sports activities) in the absence of trauma or disease. Secondary OA occurs alongside a pre-existing joint deformity including trauma or injury, congenital joint disorders, inflammatory arthritis, avascular necrosis, infectious arthritis, Paget disease, osteopetrosis, osteochondritis dissecans, metabolic disorders (hemochromatosis, Wilson's disease), Ehlers-Danlos syndrome, or Marfan syndrome.2. Pathogenesis:Rheumatoid Arthritis (RA):In some patients, RA is triggered by some sort of environmental factor in a genetically predisposed person. The best example is tobacco use in a patient with HLA-DRB1. The immune response in RA starts at sites distant from the synovial joints, such as the lung, gums, and GI tract. In these tissues, modified proteins are produced by biochemical reactions such as citrullination. (4)In RA, an abnormal immune response leads to chronic inflammation within the synovium lining the joints. The inflammatory cytokines released cause synovitis and lead to the destruction of articular cartilage and bone erosion through pannus formation. Immune cells infiltrate the synovium causing further damage. (4) In summary: formation of antibodies to citrullinated proteins, these antibodies begin attacking wrong tissues.Osteoarthritis (OA):The primary pathological feature of OA is the degeneration of articular cartilage that cushions the joints causing surface irregularity, and focal erosions. These changes progress down the bone and eventually involve the entire joint surface. Mechanical stress triggers chondrocyte dysfunction, leading to an imbalance between cartilage synthesis and degradation that cause cartilage outgrowths that ossify and form osteophytes. This results in the release of enzymes that degrade the extracellular matrix, leading to progressive cartilage loss. As more of the collagen matrix is damaged, chondrocytes undergo apoptosis. Improperly mineralized collagen causes subchondral bone thickening; in advanced disease, bone cysts infrequently occur (5). In summary: Osteophytes formation and cartilage loss.3. Clinical Presentation:Rheumatoid Arthritis (RA):The most common and predominant symptoms include joint pain and swelling, usually starting insidiously over a period of weeks to months. RA typically affects multiple joints symmetrically, commonly involving small joints of the hands, wrists, feet and progresses to involve proximal joints if left untreated. Morning stiffness lasting more than an hour is a characteristic feature. The affected joint will be painful if pressure is applied to the joint or on movement with or without joint swelling. Synovial thickening with a "boggy" feel on palpation will be noted. The classical physical findings of ulnar deviation, metacarpophalangeal joint subluxation, swan neck deformity, Boutonniere deformity, and the "bowstring" sign (prominent and tight tendons on the dorsum of the hand) are seen in advanced chronic disease. (4) Around ¼ of patients with RA may present with rheumatoid noduleswhich are well demarcated, flesh-colored subcutaneous lumps. They are usually described as being doughy or firm and are not typically tender unless they are inflamed. They are usually found on areas susceptible to repeated trauma or pressure and include the elbows, fingers and forearms. Osteoarthritis (OA):OA primarily affects weight-bearing joints such as knees, hips, spine, and hands. Symptoms include joint pain aggravated by activity and relieved with rest, morning stiffness lasting less than 30 minutes, joint swelling due to secondary inflammation, and occasionally the formation of bony outgrowths called osteophytes (6). Tenderness may be present at joint lines, and there may be pain upon passive motion. Classic physical exam findings in hand OA include Heberden's nodes (posterolateral swellings of DIP joints), Bouchard's nodes (posterolateral swellings of PIP joints), and “squaring” at the base of the thumb (first Carpal-Metarcapal or CMC joints), bony enlargement, crepitus, effusions (non-inflammatory), and a limited range of motion. Patients may also experience bony swelling, joint deformity, and instability (patients complain that the joint is “giving way” or “buckling,” a sign of muscle weakness). (5)4. Lab findings:Rheumatoid Arthritis: Laboratory testing often reveals anemia of chronic disease (increased ferritin, decreased iron and TIBC) and thrombocytosis. Neutropenia may be present if Felty syndrome is present. RF is present in 80-90% of patients with a sensitivity of 69%. In patients who are asymptomatic or those that have arthralgias, a positive RF and especially CCP predicts the onset of clinical RA. Patients with RA with RF, ACPA, or both are designated as having seropositive RA. About 10% of RA patients are seronegative. ESR and levels of CRP are usually elevated in patients with active disease and can be used to assess disease activity. The synovial fluid in RA will also reveal low C3 and C4 levels despite elevated serum levels.(4) Some non-specific inflammatory markers such as ESR, CRP can help you guide your diagnosis of RA.Osteoarthritis:Lab findings are not significant. Clinical diagnosis if the following are present: 1) pain worse with activity and better with rest, 2) age more than 45 years, 3) morning stiffness lasting less than 30 minutes, 4) bony joint enlargement, and 5) limitation in range of motion. Blood tests such as CBC, ESR, rheumatoid factor, ANA are usually normal but usually ordered to rule out an inflammatory process. Synovial fluid should show a white blood cell count less than 2,000/microL, predominantly mononuclear cells (non-inflammatory). X-rays of the affected joint can show findings consistent with OA, such as marginal osteophytes, joint space narrowing, subchondral sclerosis, and cysts; however, radiographic findings do not correlate to the severity of the disease and may not be present early in the disease. (5)5. Treatment Approaches:Rheumatoid Arthritis (RA):There is no cure for RA.The goal of treatment in RA is inducing remission and optimizing quality of life. This is initially done by beginning DMARDs, include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide. Methotrexate is the initial DMARD of choice. Anti-TNF-alpha inhibitors include etanercept, infliximab, adalimumab, golimumab, and certolizumab may be used if DMARDs fail. NSAIDs are used to control joint pain and inflammation. Corticosteroids may be used as a bridge therapy to DMARDs in a newly diagnosed patient with a very active disease. (7) Coronary artery disease has a strong association with RA. RA is an independent risk factor for the development of coronary artery disease (CAD) and accelerates the development of CAD in these patients. Accelerated atherosclerosis is the primary cause of morbidity and mortality. There is increased insulin resistance and diabetes mellitus associated with RA and is thought to be due to chronic inflammation. When treated with specific DMARDs such as hydroxychloroquine, methotrexate, and TNF antagonists, there was a marked improvement in glucose control in these patients. (8) RA is not just a disease of the joints, it is able to affect multiple organ systems.Osteoarthritis (OA):OA treatment aims at reducing pain and improving joint function through a combination of non-pharmacological interventions like exercise programs tailored to strengthen muscles around affected joints, weight management strategies, and assistive devices like braces or walking aids if required (9). Medications including analgesics or nonsteroidal anti-inflammatory drugs may be prescribed for pain relief when necessary. Duloxetine has modest activity in relieving pain associated with OA. Intraarticular glucocorticoid joint injections have a variable response but are an option for those wanting to postpone surgical intervention. In severe cases where conservative measures fail, surgical options like joint replacement may be considered (9). Weight loss is a critical intervention in those who have overweight and obesity; each pound of weight loss can decrease the load across the knee 3 to 6-fold. (5) Summary: Medications (NSAIDs, topical, duloxetine), weight loss, PT, intraarticular injections of corticosteroids, and joint replacement.________________________________Conclusion: Now we conclude episode number 146, “RA vs. OA.” Future Dr. Magurany explained that rheumatoid arthritis is an autoimmune disease that presents with joint pain and inflammation, mostly on hands and small joints, accompanied by morning stiffness longer than 1 hour. The rheumatoid factor and ACPA may be positive in a percentage of patients but not always. The base of treatment is early treatment with disease-modifying antirheumatic drugs to induce remission of the disease. OA affects weight-bearing joints with little to no inflammation, treatment is mainly lifestyle modifications, analgesics, intraarticular injections, and joint replacement.This week we thank Hector Arreaza and Thomas Magurany. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Myasoedova E, Crowson CS & Gabriel SE et al. (2010). Is the incidence of rheumatoid arthritis rising?: Results from Olmsted County, Minnesota, 1955-2007. Arthritis and Rheumatism, 62(6), 1576-1582.Goldring MB & Goldring SR. (2007). Osteoarthritis. Journal of Cellular Physiology, 213(3), 626-634.King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185-93. PMID: 24056594; PMCID: PMC3788203.Chauhan K, Jandu JS, Brent LH, et al. Rheumatoid Arthritis. [Updated 2023 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Sen R, Hurley JA. Osteoarthritis. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Hunter DJ, Bierma-Zeinstra S. & Eckstein F. (2014). OARSI Clinical Trials Recommendations: Design and conduct of clinical trials for primary hip and knee osteoarthritis: An expert consensus initiative of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Task Force in collaboration with the Osteoarthritis Research Society International (OARSI). Osteoarthritis Cartilage, 22(7), 363-381.van Everdingen AA, Jacobs JW, Siewertsz Van Reesema DR, Bijlsma JW. Low-dose prednisone therapy for patients with early active rheumatoid arthritis: clinical efficacy, disease-modifying properties, and side effects: a randomized, double-blind, placebo-controlled clinical trial. Ann Intern Med. 2002 Jan 1;136(1):1-12. doi: 10.7326/0003-4819-136-1-200201010-00006. PMID: 11777359.Nicolau J, Lequerré T, Bacquet H, Vittecoq O. Rheumatoid arthritis, insulin resistance, and diabetes. Joint Bone Spine. 2017 Jul;84(4):411-416.Fernandes L, Hagen KB, Bijlsma JWJ et al. (2019). EULAR recommendations for non-pharmacological core management of hip and knee osteoarthritis. Annals of Rheumatic Diseases, 79(6), 715-722.Royalty-free music used for this episode: "Driving the Point." Downloaded on July 29, 2023, from https://www.videvo.net/ 

Dr. Jack Cush reviews the CV advantage to walking, the OA risk with running and the eczema-OA connection; these articles and journal reports from the past week on RheumNow.com

Cheryl C. and Cheryl K. share key tools for thriving with arthritis, like finding ways to ask for help, developing health literacy, practicing self-compassion, and getting support. They also discuss the safety of modern medicine and how to balance it with complementary therapies to create an individualized plan for managing rheumatoid arthritis.  Additionally, they delve into the mental health techniques that have helped them cope, including: reframing exercises, and working past bias. Cheryl K. shared how she used her experiences to form Arthritis Consumer Experts, a patient-led and science-based organization with the goal of providing better education to people with arthritis.Episode at a glance:Navigating chronic illness when the internet was just starting: Cheryl Koehn had an athletic background, but when symptoms struck she went to the library to do her own research and advocated for herself despite medical gaslighting.Trialing treatment options: Cheryl K. initially denied Western Medicine before she ended up with 36 active swollen joints within a year and progressively worsening quality of life. Following this, she received gold injections and other conventional DMARDs initially, adding in Methotrexate and later transitioning to newer medications like biologics as they became available.Coping with peer pressure: People trying to convince her that “natural is better” and to avoid medications, however natural isn't inherently better at controlling disease and newer medications are backed by research. Cheryl C. and Cheryl K. discuss how a balance of complementary therapies and medication help people safely manage their conditions. Koen practices reframing exercises, works on explicit and implicit bias, and considers “what can I learn from this person today” with an open mind.Wisdom for newly diagnosed patients: Find ways to ask for help! Develop health literacy as a tool for advocating for yourself and to guide decision making.What does it mean to thrive with rheumatic disease: Practice self-love and self-compassion, love what you do, and give yourself room to breathe.Arthritis Consumer Experts (ACE): Cheryl K. used her experiences of running her own consulting firm, volunteering, and being on the board at the Arthritis Society to form this organization. Her goal is to provide better education to people with arthritis, and to not be the only person with arthritis with a say in arthritis organizations.Medical disclaimer:All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now!For Full Episode Details Including Transcript:Go to the Arthritis Life website

Tune in to hear Drs Stanley Cohen and Alexis Ogdie dive into new research on switching vs cycling medications in caring for patients with psoriatic arthritis, tight control in axSpA, and more. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984265). The topics and discussions are planned, produced, and reviewed independently of the advertisers. This podcast is intended only for US healthcare professionals. Resources 1600: The Impact of Second-Line Therapeutic on Disease Control After Discontinuation of First Line TNF Inhibitor in Patients With PsA: Analysis From the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry https://www.eventscribe.net/2022/ACRConvergence/index.asp?presTarget=2189995 Cycling or Swap Biologics and Small Molecules in Psoriatic Arthritis: Observations From a Real-life Single Center Cohort https://pubmed.ncbi.nlm.nih.gov/33879661/ Baseline Disease Activity Predicts Achievement of cDAPSA Treatment Targets With Apremilast: Phase III Results in DMARD-naïve Patients With Psoriatic Arthritis https://pubmed.ncbi.nlm.nih.gov/35428720/ Etanercept and Methotrexate as Monotherapy or in Combination for Psoriatic Arthritis: Primary Results From a Randomized, Controlled Phase III Trial https://pubmed.ncbi.nlm.nih.gov/30747501/ EULAR 2023. European Congress of Rheumatology https://congress.eular.org/ GRAPPA Treatment Recommendations: 2021 Update https://pubmed.ncbi.nlm.nih.gov/35293339/ Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis https://pubmed.ncbi.nlm.nih.gov/30499246/ Effect of a Treatment Strategy of Tight Control for Rheumatoid Arthritis (the TICORA Study): A Single-blind Randomised Controlled Trial https://pubmed.ncbi.nlm.nih.gov/15262104/ Aiming at Low Disease Activity in Rheumatoid Arthritis With Initial Combination Therapy or Initial Monotherapy Strategies: The BeSt Study https://pubmed.ncbi.nlm.nih.gov/17083767/ Long-term Follow-up of Patients in the TIght COntrol of Inflammation in Early Psoriatic Arthritis (TICOPA) Trial https://pubmed.ncbi.nlm.nih.gov/31504996/ Efficacy of a Tight-control and Treat-to-target Strategy in Axial Spondyloarthritis: Results of the Open-label, Pragmatic, Cluster-randomised TICOSPA Trial https://pubmed.ncbi.nlm.nih.gov/33958325/ ASAS Health Index: The "All in One" for Spondyloarthritis Evaluation? https://pubmed.ncbi.nlm.nih.gov/33004479/ Central Sensitization Has Major Impact on Quality of Life in Patients With Axial Spondyloarthritis https://pubmed.ncbi.nlm.nih.gov/35033996/ ASAS-EULAR Recommendations for the Management of Axial Spondyloarthritis: 2022 Update https://pubmed.ncbi.nlm.nih.gov/36270658/ Treatment of Ankylosing Spondylitis by Primary Care Physicians and Rheumatologists: A Retrospective Study in Three Health Systems https://acrabstracts.org/abstract/treatment-of-ankylosing-spondylitis-by-primary-care-physicians-and-rheumatologists-a-retrospective-study-in-three-health-systems/ Multimorbidity in Psoriasis as a Risk Factor for Psoriatic Arthritis: A Population-Based Study https://acrabstracts.org/abstract/multimorbidity-in-psoriasis-as-a-risk-factor-for-psoriatic-arthritis-a-population-based-study/ Comorbidities, Pain and Fatigue in Psoriatic Arthritis, Psoriasis and Healthy Controls: A Clinical Cohort Study https://pubmed.ncbi.nlm.nih.gov/33325531/

Dr. Natalie Crawford explains different types of contraception, how they work, and what you should know if you are planning to get pregnant in the near future. She also discusses the many myths surrounding birth control. When you are making decisions about your family planning, it is important to understand your options and decide what works best for you.  We have decided to move Fertility In The News to the weekly newsletter in order to keep the podcast more evergreen. If you want to sign up go to nataliecrawfordmd.com/newsletter to sign up! Finally, Natalie answers your social media questions during her segment FFS—For Fertility's Sake. Are you more fertile after a miscarriage? Does being overweight decrease your fertility? What causes a blighted ovum? My AMH is so high they said I was immune to Clomid. What does that mean? How long do you have to wait to have an embryo transfer after taking Methotrexate? Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Green Chef- Go to GreenChef.com/aaw60 and use code aaw60 to get 60% off plus free shipping. Apostrophe- Get your first visit for only five dollars at Apostrophe.com/AAW or use the code AAW at checkout. If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Does a 4th dose of vaccine significantly reduce COVID-19 risk in patients with rheumatic diseases? Find out about this and more in today's PVRoundup podcast.

Professor Roy Fleischmann, Clinical Professor of Medicine at the University of Texas Southwestern Medical Centre. In this addition Professor Fleischmann discusses his recent paper 'Analysis of Disease Activity Metrics in a Methotrexate Withdrawal Study among Patients with Rheumatoid Arthritis Treated with Tofacitinib plus Methotrexate.'

Dupilumab for perforating dermatoses - AESOP syndrome - Ulcerations in aortic occlusion - Xylazine-induced ulcers - IVIG in dermatomyositis - Methotrexate and melanoma - Thanks to Hawaii Derm for supporting this episode! Earn the credits you need by joining your colleagues at the 45th Annual Hawaii Dermatology Seminar (https://www.hawaiidermseminar.com/) in Honolulu, HI February 19-24, 2023. Discover the latest advancements in psoriasis, hair, atopic dermatitis, facial rejuvenation, cutaneous malignancies, and more! Enjoy conference activities including live-patient sessions, workshops, Q&A's, an immersive room, guided hike, luau and a very special keynote presentation! Register now with the exclusive discount code DERMASPHERE to receive 40% off your pass! Connect with us! Web: https://dermaspherepodcast.com/ Twitter: @DermaspherePC Instagram: @dermaspherepodcast Facebook: https://www.facebook.com/DermaspherePodcast/ Check out Luke and Michelle's other podcast, SkinCast! https://healthcare.utah.edu/dermatology/skincast/ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: Kikoxp.com (a social platform for doctors to share knowledge) https://www.levelex.com/games/top-derm (A free dermatology game to learn more dermatology!) The University of Utah Dermatology Echo: https://physicians.utah.edu/echo/dermatology-primarycare

Bouncebackability portends increased risk of adverse outcomes in RA Can I stop Methotrexate in RA? Fat and bone are never alone: osteoporotic fracture in RA JAK inhibitors in rheumatic diseases RA: Steroids are bad, again Reproductive health in a post-Roe world Sensor-engineered glove evaluates hand function in RA Tapering Methotrexate with Biologics or JAK Inhibitors in RA Tofacitinib and RA-ILD

Breakthrough COVID infection in RMD patients treated with Evusheld Dr. Yuz Yusof talks with Dr. Chris Podgorski at ACR22 Convergence. Lung Involvement in VEXAS Dr. Yuz Yusof and Dr. Marta Casal Moura discusses abstract 1569 presented at ACR22 Convergence.  Abstract 1569: Lung Involvement in VEXAS Syndrome Reproductive health in a post-Roe world Dr. Robert Chao discusses abstract 1673 and L09 presented at ACR22 Convergence.  Abstract 1673: Preconceptional NSAID Treatment Exposure Is Associated with a Significantly Longer Time-to-conception in Women with Spondyloarthritis: Analysis of the Prospective GR2 Cohort Abstract L09: Impact on Access to Methotrexate in the Post-Roe Era Stop Ordering Repeat ANAs! Dr. Kathryn Dao reviews abstracts 1278, 0228, and 0058 presented at ACR22 Convergence. Ultrasound in PsA Dr. Arthur Kavanaugh discusses abstract 2206 presented at ACR22 in Philadelphia. Abstract 2206: Understanding Inter-rater Variability in Scoring of Entheseal Lesions: Results from the Diagnostic Ultrasound Enthesitis Tool (DUET) Study What Happens after you stop biologics? Dr. Robert Chao discusses abstract 0427 presented at ACR22 convergence.  Abstract 0427: Recapture Rates with Ixekizumab After Withdrawal of Therapy in Patients with Axial Spondyloarthritis: Results at Week 104 from a Randomized Placebo-controlled Withdrawal Study Which is better for AxSpA? IL-17i or TNFi? Dr. Robert Chao discusses abstract L15 presented at ACR22 Convergence.

AI Future of Sacroiliitis Assessment Dr. Rachel Tate speaks with Dr. Fabian Proft about Abstract 0383 at ACR22 Convergence. Can I stop Methotrexate in RA? Dr. Janet Pope and Dr. Charis Meng discuss Abstract 0916 at ACR22 Convergence.  Abstract 0916: Should RA Patients with Controlled Disease Taper Methotrexate from Targeted Therapy or Continue It? Risk Differences in Sustaining Remission from a Systematic Review and Meta-analysis CAR-T Therapies in Antiphospholipid Antibody Syndrome Dr. Michael Putman and Dr.  Maximilian Konig discuss abstract 1677 at ACR22 Convergence.  Abstract 1677: Chimeric Autoantigen-T Cell Receptor (CATCR)-T Cell Therapies to Selectively Target Autoreactive B Cells Copays Reduce Adherence to SLE Medications Dr. Michael Putman reports on abstract 1115 at ACR22 Convergence in Philadelphia, PA. Copays Reduce Adherence to SLE Medications Dr. Michael Putman reports on abstract 1115 at ACR22 Convergence in Philadelphia, PA. Does Race play a role in Mycophenolate Response in Scleroderma? Dr. Eric Dein speaks with Dr. Lauren Smith about abstract 0521 at ACR22 Convergence in Philadelphia, PA. Abstract 0521: Examination of Differential Response to Treatment with Mycophenolate Mofetil in Black and White Patients with Systemic Sclerosis Fertility issues in SpA Dr. Sheila Reyes speaks with Dr. Sabrina Hamroun about abstract 1673 at ACR22 Convergence.  Abstract 1673: Preconceptional NSAID Treatment Exposure Is Associated with a Significantly Longer Time-to-conception in Women with Spondyloarthritis: Analysis of the Prospective GR2 Cohort Opioid use in PsA and SpA Dr. Eric Dein discusses Abstract 1012 at ACR22 Convergence PsA and SPA: Cyclers, Switchers, Who is the Winner? Dr. Aurelie Najm discusses abstracts 1499 and 1600 at ACR22 Convergence in Philadelphia, PA. Remibrutinib in Sjogren's Syndrome Dr. Michael Putman reports on abstract 1113 presented at ACR22 Convergence meeting in Philadelphia, PA. Abstract 1113: Remibrutinib (LOU064) in Sjögren's Syndrome: Safety and Efficacy Results from a 24‑Week Placebo-controlled Proof-of-Concept Study      

Advancing Telehealth in Rheumatology Dr. Cush at ACR22 Convergence in Philadelphia, PA. Artificial Intelligence in Detecting Sacroiliitis Dr. Akhil Sood discusses Abstract 0383 at ACR22 Convergence. Abstract 0383: Analysis of the Performance of an Artificial Intelligence Algorithm for the Detection of Radiographic Sacroiliitis in an Independent Cohort of axSpA Patients Including Both Nr-axSpA and r-axSpA COVID HighlightsDr. Leonard Calabrese and Dr. Cassandra Calabrese share highlights on COVID data being presented at ACR22 Convergence Abstract 0793: Autonomic Nervous System Dysfunction Common Among Patients with Long COVID: An Exploratory Evaluation Abstract L08: Breakthrough Acute COVID-19 Infection During the US Omicron Surge Following Administration of Tixagevimab/Cilgavimab in Immunocompromised Patients with Rheumatologic Disorders Impact of COVID 19 on Pregnancies in Women with RMD Dr. Cassy Sims discusses abstract 0950 at ACR22 Convergence. Abstract 0950: Obstetric Outcomes in Women with Rheumatic Disease and COVID-19 in the Context of Vaccination Status: Data from the COVID-19 Global Rheumatology Alliance Registry Photovoice: A New Visual Research Method in Lupus Dr. Bella Mehta talks with Dr. Candace Feldman about Abstract 1099 at ACR22 Convergence. Abstract 1099: Empowering Patients with Lupus Through Their Photographs: Application of the Photovoice Method to Understand Social Determinants of Health Prescribing Methotrexate in Post-Roe Era Dr. Cassy Sims reports live from ACR22 Convergence in Philadelphia, PA.3 L09: Impact on Access to Methotrexate in the Post-Roe Era Treatment Persistence and Switching Patterns of an Adalimumab Biosimilar Dr. Julian Segan discusses Abstract 1425 at ACR22 Convergence. Abstract 1425: Treatment Persistence and Switching Patterns of ABP 501 (AMGEVITA®) in German Patients with Rheumatic Diseases          

Advancing Telehealth in Rheumatology Dr. Cush at ACR22 Convergence in Philadelphia, PA. Artificial Intelligence in Detecting Sacroiliitis Dr. Akhil Sood discusses Abstract 0383 at ACR22 Convergence. Abstract 0383: Analysis of the Performance of an Artificial Intelligence Algorithm for the Detection of Radiographic Sacroiliitis in an Independent Cohort of axSpA Patients Including Both Nr-axSpA and r-axSpA COVID Highlights Dr. Leonard Calabrese and Dr. Cassandra Calabrese share highlights on COVID data being presented at ACR22 Convergence. Abstract 0793: Autonomic Nervous System Dysfunction Common Among Patients with Long COVID: An Exploratory Evaluation Abstract L08: Breakthrough Acute COVID-19 Infection During the US Omicron Surge Following Administration of Tixagevimab/Cilgavimab in Immunocompromised Patients with Rheumatologic Disorders Impact of COVID 19 on Pregnancies in Women with RMD Dr. Cassy Sims discusses abstract 0950 at ACR22 Convergence. Abstract 0950: Obstetric Outcomes in Women with Rheumatic Disease and COVID-19 in the Context of Vaccination Status: Data from the COVID-19 Global Rheumatology Alliance Registry Photovoice: A New Visual Research Method in Lupus Dr. Bella Mehta talks with Dr. Candace Feldman about Abstract 1099 at ACR22 Convergence. Abstract 1099: Empowering Patients with Lupus Through Their Photographs: Application of the Photovoice Method to Understand Social Determinants of Health PreRA to Treat or Not! Dr. Janet Pope discusses the Great Debate at ACR22 Convergence in Philadelphia.  Prescribing Methotrexate in Post-Roe Era   Dr. Cassy Sims reports live from ACR22 Convergence in Philadelphia, PA. L09: Impact on Access to Methotrexate in the Post-Roe Era To Switch or Not: Biosimilars in Inflammatory Arthritis Dr. Jonathan Kay reports on abstract 1112 at ACR22 Convergence.   Women vs. Men: Response to Treatment in Seronegative Arthritis Dr. Janet Pope discusses abstracts 1614 and 1601 at ACR22 Convergence in Philadelphia, PA        

In this episode Emily shares the details of her challenging ectopic pregnancy which was treated with a strong medication called methotrexate. Unfortunately the pregnancy hormone levels stayed in her body for five months which extended her grief and contributed to an anxiety diagnosis. She immediately sought professional help from a psychologist and psychiatrist and went into her second pregnancy with tangible skills to navigate her OCD and overwhelm. She was induced at 39 weeks and after opting for the epidural she required an emergency caesarean. Emily admits she felt really prepared for the birth and recovery thanks to the caesarean module in . 

In his most optimistic outlook since declaring COVID-19 a public health emergency of international concern in January 2020, the World Health Organization's Director-General, Tedros Adhanom Ghebreyesus, stated last week that "We are not there yet. But the end is in sight." The rollout of vaccines and therapies have undeniably helped curb deaths and hospitalization rates, but with protective measures being eased and over 1 million deaths this year alone, COVID-19 remains a cause for concern while governments explore how best to manage it going forward. Among the highlights in this episode: 1:19: Listener comment 2:08: The FDA has authorized 2 boosters: who's eligible and why get the updated booster shot 3:22: The CDC shared that a national survey showed 72% of respondents are likely to get the updated booster. However, this may depend on how easily accessible boosters are and the extent to which people know about their benefits. 3:57: A tool built by the CDC can help inform people on when someone is eligible to get a booster shot: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fbooster-shot.html 5:18: The importance of being an advocate Become a 50-State Network advocate: https://www.50statenetwork.org/become-a-50-state-network-advocate/ 5:36: Methotrexate: an update on access issues and what it is used for 7:25: Where do we stand with restrictions and protective measures against COVID-19? 8:42: What are some positive, valuable learnings that emerged from the pandemic and what things are still causes for concern? 11:18: 67% of the U.S. population is considered fully vaccinated and only 32% have received a booster shot 12:22: Vaccination from general guidelines to individual timelines 14:10: World Health Organization's Director-General delivers his most optimistic assessment on the pandemic since January 2020 14:55: What our hosts learned from this episode Contact Our Hosts Steven Newmark, Director of Policy at GHLF: snewmark@ghlf.org Zoe Rothblatt, Associate Director, Community Outreach at GHLF: zrothblatt@ghlf.org We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to thehealthadvocates@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.

The FDA received an application for the first ever over the counter birth control. Timmerie examines 9 things everyone should know about how birth control impacts women's bodies (2:44). She debunks the Women's March argument from the DC Summer of Rage rally (24:03). You won't want to miss one woman's story of how sterilization/having her tubes tied impacted her (41:49). Resources mentioned :  Podcast on the side effects of the pill  https://omny.fm/shows/trending-with-timmerie-catholic-principles-applied/the-pill-side-effects-3-principles-for-choosing-a Podcast on side effects of a vasectomy  https://relevantradio.com/2022/07/why-shouldnt-i-get-a-vasectomy-the-medical-fallout/ Cancer studies on birth control  – The pill is a cancer-causing carcinogen recognized by the U.N. – Cancer Research UK:  “breast cancer is more common among women who take HRT (Hormone Replacement Therapy) and the Pill for long periods” – Time Health and Family Study  “A Curious Link Between Birth Control Pills and Prostate Cancer" https://healthland.time.com/2011/11/15/study-a-curious-link-between-birth-control-pills-and-prostate-cancer/ – Journal of the National Cancer Institute:  “Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women.”   – 2003 Columbia University Study:  “National Institute of Environmental Health Sciences (NIEHS) added estrogen to its list of known cancer-causing agents” List of “birth control” that can also function as an early abortion (not all inclusive)  The Pill Ella Norplant Depo-Provera Plan B/Morning After Pill Preven  The Patch Ortho Evra IUD Nuvaring Lunelle The Late Period Pill RU-486 (mifepristone) Methotrexate & misoprostol (used together)

Want an attractive face? Enlarge your eyes; shrink your nose and mouth. - Eruptive pseudoangiomatosis - Why does methotrexate hate the liver? - Goodbye Ryan; hello Morgan! Connect with us! - Web: https://dermaspherepodcast.com/ - Twitter: @DermaspherePC - Instagram: dermaspherepodcast - Facebook: https://www.facebook.com/DermaspherePodcast/ - Check out Luke and Michelle's other podcast, SkinCast! https://healthcare.utah.edu/dermatology/skincast/ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: Kikoxp.com (a social platform for doctors to share knowledge) https://www.levelex.com/games/top-derm (A free dermatology game to learn more dermatology!)

Imagine living life in constant physical pain, not knowing whether it will get better or worse the next day. Living with rheumatoid arthritis (RA) isn't always easy. Everyday chores can become a challenge as the disease progresses. Fortunately, there are various treatments and strategies to better manage the condition. Today's guest developed rheumatoid arthritis at age 31, becoming incapacitated by the disease. It was food poisoning that set him on a true healing journey.  Clint Paddison is an Australian comedian, motivational coach, and health strategist with a science background and a giant dose of positive expectations. He was asked to give a TEDx talk on How To Reverse RA Naturally at Bond University, Queensland, Australia. He also spoke to over 200 naturopaths at the International Convention of Integrative Medicine to explain the connection between our digestive system and autoimmune diseases. What we discuss in this episode:   - First, let's listen to an excerpt from Dotsie's book   - Clint shares his battle with RA and how food poisoning led him to his healing journey   - What you need to know about RA and its symptoms   - The dilemma between taking a drug with adverse side effects and living in pain   - Clint talks about gut health and autoimmune diseases    - What steps can you take to lower inflammation?   - Food and autoimmune disease - the effects of dairy and meat plus fat intake   - How to exercise and move your body even when you are experiencing pain   - The effects of Humira, Methotrexate, NSAIDS, and other drugs for RA   - Book Recommendation - The Enzyme Factor by Dr. Hiromi Shinya   - Watch Clint Paddison's TEDx Talk: https://paddisonprogram.com/clint-paddison-tedx-talk/   - Connect with Clint Paddison on Instagram and Facebook   - Check out Clint Paddison's website - https://paddisonprogram.com/   - The Paddison Program For Rheumatoid Arthritis - https://paddisonprogram.com/rheumatoid-arthritis/   - Subscribe to The Rheumatoid Solutions Podcast   - Use code SWITCH for 25% off your order at MaxinesHeavenly.com   - Purality B12 Deal: http://puralityhealth.com/SWITCHb12 to buy one B12 and get one free plus 35% off the rest of Purality's products   Connect with Switch4Good - YouTube - https://www.youtube.com/channel/UCQ2toqAmlQpwR1HDF_KKfGg   - Facebook - https://www.facebook.com/Switch4Good/   - Instagram - https://www.instagram.com/switch4good/   - Twitter - https://twitter.com/Switch4GoodOrg   - Website - https://switch4good.org/