Podcasts about mgh

Dr. Ben Kleinstiver, whose lab is located at the Center for Genomic Medicine at Mass General Hospital, joins us to talk about programmable nucleases, genome editing, and the applications of this technology in the future of healthcare.

Another nasty day as the ASX 200 fell 96 points to 8323 (1.2%) as results and bank falls dominated. WBC fell another % and ANZ joined in too falling 3.1% with the Big Bank Basket down to $251.27 (-2.4%). MQG dropped 1.0% with financial sunder a little pressure. REITs fell as GMG returned to trade down 5.0% after the $4bn capital raise. Industrials were mixed, ALL dropped 4.3% despite a new buy back, WES rose 1.3% on good results, TLS also did well, up 5.6% after announcing a buy back. Retail stocks suffered, JBH down 4.2% and BRG falling 3.0%. CTD continued the positive vibes from the results up 4.7%. UNI did very well on results up 9.7%. In healthcare, PME dropped 3.7% and CSL down 2.3%. Resources suffered as RIO cut its dividend, falling 1.5% and BHP fell 2.0% as FMG were savaged on results, down 6.2%. Lithium stock surprisingly rose after PLS results, up 6.0% and oil and gas stocks rose, WDS up 1.0% and STO rising 2.1%. Coal stocks gained 8.9% on WHC results. Uranium stocks were mildly lower. In corporate news, MAF rose 8.7% on good numbers, WTC in a trading halt on governance issues. MP1 had stellar gains on beating expectations. Casualties included, SUL, MFG, and MGH. On the economic front, jobs data came in as expected at 4.1% unemployment and record participation. Asian markets fell, Japan under pressure on proposed car tariffs. Down 1.5%, HK off 1.4% and China down 0.4%. 10-year yields steady at 4.53%. Want to invest with Marcus Today? The Managed Strategy Portfolio is designed for investors seeking exposure to our strategy while we do the hard work for you.If you're looking for personal financial advice, our friends at Clime Investment Management can help. Their team of licensed advisers operates across most states, offering tailored financial planning services.Why not sign up for a free trial? Gain access to expert insights, research, and analysis to become a better investor.

In this episode, we visit the Bulfinch Building at the Massachusetts General Hospital to examine one of the most, if not the most, significant discoveries in modern medicine. Sarah Alger, the Director of the Paul S. Russell, MD Museum of Medical History and Innovation, shows us the hospital's Ether Dome where the first public surgery using an anesthetic was performed. Back at the MHS, we sit down with Chief Historian Peter Drummey and Curator of Art and Artifacts Emerita Anne Bentley to learn more about the contentious history of this innovation. Learn more about episode objects here: https://www.masshist.org/podcast/season-4-episode-3-painless-revolution Email us at podcast@masshist.org. Episode Special Guest: Sarah Alger is the George and Nancy Putnam Director of Mass General Hospital's Paul S. Russell, MD Museum of Medical History and Innovation. She was a founding editor of Proto, a thought leadership publication that was sponsored by MGH for 17 years. This episode uses materials from: The Bond (Instrumental) by Chad Crouch (Attribution-NonCommercial 4.0 International)        Psychic by Dominic Giam of Ketsa Music (licensed under a commercial non-exclusive license by the Massachusetts Historical Society through Ketsa.uk)        Curious Nature by Dominic Giam of Ketsa Music (licensed under a commercial non-exclusive license by the Massachusetts Historical Society through Ketsa.uk)

Mass General Brigham, the largest health care system in Massachusetts, announced its plan to lay off hundreds of workers, citing a roughly $250 million budget gap. MGH said the layoffs will focus on “non-clinical and non-patient facing roles.” What are some of the challenges MGB is facing that might have led to the layoffs? How will MGH's restructuring impact the hospital system?Ask Alexa to play WBZ NewsRadio on #iHeartRadio and listen to NightSide with Dan Rea Weeknights From 8PM-12AM!

Mass General Brigham, the largest health care system in Massachusetts, announced its plan to lay off hundreds of workers, citing a roughly $250 million budget gap. MGH said the layoffs will focus on “non-clinical and non-patient facing roles.” What are some of the challenges MGB is facing that might have led to the layoffs? How will MGH's restructuring impact the hospital system?Ask Alexa to play WBZ NewsRadio on #iHeartRadio and listen to NightSide with Dan Rea Weeknights From 8PM-12AM!

Host Eric Marcus welcomes listeners to MGH's “Nazi Era” series by going back in time to 1980 and a darkened Broadway theater where his interest in LGBTQ Holocaust history was kindled. Join Eric as we embark on a 12-episode journey and honor Holocaust Remembrance Day. Visit our episode webpage for a transcript of the episode. For exclusive Making Gay History bonus content, join our Patreon community. ——— -1993 interview with Pierre Seel courtesy of Là-Bas Si J'y Suis.  -RG-50.030.0019, oral history interview with Frieda Belinfante, courtesy of the Jeff and Toby Herr Oral History Archive, United States Holocaust Memorial Museum, Washington, D.C. For more information about the United States Holocaust Memorial Museum, go here.   -Lucy Salani footage courtesy of Matteo Botrugno and Daniele Coluccini, directors of C'è un soffio di vita soltanto (2021), produced by Blue Mirror and Kimerafilm, distributed by True Colours.  ——— To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Making Gay History (MGH) is a nonprofit addressing the absence of substantive, in-depth LGBTQ+-inclusive American history from the public discourse and the classroom. For it's 14th season, the acclaimed MGH podcast debuts a 12-episode series delving into the often-overlooked experiences of LGBTQ+ people during the rise of the Nazi regime, World War II, and the Holocaust, shining a spotlight on a vital but under-discussed chapter of history. Our guest is Eric Marcus, author, founder and host of Making Gay History. For more, visit MakingGayHistory.org

Host Eric Marcus welcomes listeners to MGH's “Nazi Era” series by going back in time to 1980 and a darkened Broadway theater where his interest in LGBTQ Holocaust history was kindled. Join Eric as we embark on a 12-episode journey and honor Holocaust Remembrance Day. Visit our episode webpage for a transcript of the episode. For exclusive Making Gay History bonus content, join our Patreon community. ——— -1993 interview with Pierre Seel courtesy of Là-Bas Si J'y Suis.  -RG-50.030.0019, oral history interview with Frieda Belinfante, courtesy of the Jeff and Toby Herr Oral History Archive, United States Holocaust Memorial Museum, Washington, D.C. For more information about the United States Holocaust Memorial Museum, go here.   -Lucy Salani footage courtesy of Matteo Botrugno and Daniele Coluccini, directors of C'è un soffio di vita soltanto (2021), produced by Blue Mirror and Kimerafilm, distributed by True Colours.  ——— To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Ryan Goff, Executive VP Chief Marketing Officer and Social Media Marketing Director at MGH said, content creators and businesses alike should take note of the opportunity the TikTok platform presents. The impact of compelling content and reviews have on purchasing decisions as we dive head first into the competitive holiday season. So if you're a merchant looking for a way to create awareness and drive direct sales, look to social media platforms like TikTok and others to do just that this holiday season

El laboratorio puede ser un lugar de grandes descubrimientos, pero también de grandes desafíos emocionales. ¿Sabías que un tercio de las personas que trabajan en ciencia enfrentan problemas como ansiedad, estrés o depresión? ¿Cómo es lidiar con tanta presión o con situaciones de abuso en una estructura jerárquica?  En este episodio, Carmen Morcelle, conductora del podcast, conversa con Magdalena Sevilla sobre experiencias personales, reflexionando sobre cómo han afrontado desafíos de salud mental como ansiedad, depresión, síndrome de la impostora y situaciones de abuso de poder a lo largo de sus carreras científicas. Carmen es Chair de la Comisión de Mujer en Ciencia de ECUSA (MECUSA) y trabaja como investigadora postdoctoral en el Ragon Institute del Hospital General de Massachusetts (MGH), MIT y Harvard. Magdalena es instructora en la Unidad de Epidemiología Clínica y Traslacional del MGH y Harvard Medical School. Magdalena forma parte del programa “Creating Opportunities for Underrepresented Researchers to Achieve Growth and Excellence” (COURAGE). Durante el episodio, también se menciona el curso “Becoming a Resilient Scientist”, un recurso del National Institutes of Health (NIH) de Estados Unidos diseñado para fomentar el bienestar de los científicos.  Si trabajas en investigación y estás pasando por un mal momento, recuerda que no estás sola/o. Te animamos a hablar con personas de confianza y explorar las herramientas de apoyo disponibles en tu institución o en organismos públicos.

ASX 200 pushed 38 points higher to fresh highs of 8444. Up 0.5%. Banks back in charge with the Big Bank Basket up to $263.13 (0.7). CBA up 0.6% and NAB up 0.9%. Other financials also strong, MQG up 0.4% and insurers firm, QBE post its update rising 1.2%. IAG up 3.6% on acquisition news, ASX bouncing back too. REITS steady. Industrials are also steady but uninspiring. WOW up 0.5% and ALL up 0.3% with healthcare stocks doing very well, PME up 8.7% on a new $330m contract. CSL up 1.6%. Iron ore miners better, BHP up 0.7% with gold miners under a little pressure in places. SPR up % on drill results. In energy, STO continue to fall, PDN down 5.0% and WDS up 0.1%. In corporate news, AVJ caught a bid from PE, SGR held its AGM and fell 7.1% to all-time lows, as new CEO urged patience. MGH in a capital raise and WJL in the sights of the ACCC on pricing. FPH fell 2.1% on profits growing less than hoped. Guidance an issue. HUM rattled on lower dividend warning. In economic news, Private new capital expenditure (capex) rose 1.1% in September quarter 2024. Asian markets mixed, China down 0.8%, HK down 1.3% and Japan up 0.7%. 10-year yields down to 4.36%.Why not sign up for a free trial? Get access to expert market insights and manage your investments with confidence. Ready to invest in yourself? Join the Marcus Today community. 

The pancreatic anastomosis is often regarded as the “Achilles Heel” of the Whipple operation, as technical failure and leakage is a significant source of perioperative morbidity and mortality. In this episode from the HPB team at Behind the Knife listen in as we discuss the standard techniques for the anastomosis, alternative techniques for the pancreatic anastomosis in patients with aberrant anatomy and/or physiology, key factors to consider when selecting the ideal approach/technique for the anastomosis, and mitigation strategies for leaks.  Hosts Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He previously completed his general surgery residency at Massachusetts General Hospital, and will be returning to MGH as faculty at the conclusion of his fellowship.    Monica M. Dua (@MonicaDuaMD) is a Clinical Professor of Surgery and the Associate Program Director of the HPB Surgery Fellowship at Stanford University. She also serves as also serves as the regional HPB Surgeon at the VA Palo Alto Health Care System. Learning Objectives · Develop an understanding of the standard technical approaches to the pancreatic anastomosis during a Whipple (pancreatoduodenectomy) operation · Develop an understanding of the alternative technical approaches to the pancreatic anastomosis during the Whipple when the standard approaches may not be feasible · Develop an understanding of the key anatomic and physiologic factors in the decision making when selecting the optimal approach for the pancreatic anastomosis · Develop an understanding of possible mitigation strategies in the event of a pancreatic anastomotic leak. Suggested Reading Jon Harrison, Monica M. Dua, William V. Kastrinakis, Peter J. Fagenholz, Carlos Fernandez-del Castillo, Keith D. Lillemoe, George A. Poultsides, Brendan C. Visser, Motaz Qadan. “Duct tape:” Management strategies for the pancreatic anastomosis during pancreatoduodenectomy. Surgery. Volume 176, Issue 4, 2024, Pages 1308-1311, https://pubmed.ncbi.nlm.nih.gov/38796390/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Join us for the 5th Annual JOWMA Conference: Transforming Healthcare Through Innovation & Research on January 5, 2025, from 8am to 5pm in NYC! Spend the day immersed in expert-led scientific sessions, hands-on surgical simulations, specialty roundtables, and a networking lunch tailored for healthcare professionals and students. PLUS, we're offering a full premed program with panels, roundtables, and networking dedicated to aspiring medical students.

Above is a brief video snippet from our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The audios are also available on Apple and Spotify.Transcript with links to audio and external citationsEric Topol (00:06):Well, hello it's Eric Topol with Ground Truths, and I'm really delighted to welcome Dr. Rachael Bedard, who is a physician geriatrician in New York City, and is actually much more multidimensional, if you will. She's a writer. We're going to go over some of her recent writings. She's actually quite prolific. She writes in the New Yorker, New York Magazine, New York Times, New York Review of Books. If it has New York in front of it, she's probably writing there. She's a teacher. She works on human rights, civil rights, criminal justice in the prison system. She's just done so much that makes her truly unique. That's why I really wanted a chance to meet her and talk with her today. So welcome, Rachael.Rachael Bedard (00:52):Thank you, Dr. Topol. It's an honor to be here.Eric Topol (00:55):Well, please call me Eric and it's such a joy to have a chance to get acquainted with you as a person who is into so many different things and doing all of them so well. So maybe we'd start off with, because you're the first geriatrician we've had on this podcast.Practicing Geriatrics and Internal MedicineEric Topol (01:16):And it's especially apropos now. I wanted maybe to talk about your practice, how you got into geriatrics, and then we'll talk about the piece you had earlier this summer on aging.Rachael Bedard (01:32):Sure. I went into medicine to do social justice work and I was always on a funny interdisciplinary track. I got into the Mount Sinai School of Medicine through what was then called the Humanities and Medicine program, which was an early acceptance program for people who were humanities focused undergrads, but wanted to go into medicine. So I always was doing a mix of politics and activist focused work, humanities and writing, that was always interested in being a doctor. And then I did my residency at the Cambridge Health Alliance, which is a social medicine program in Cambridge, Massachusetts, and my chief residency there.(02:23):I loved being an internist, but I especially loved taking care of complex illness and I especially loved taking care of complex illness in situations where the decision making, there was no sort of algorithmic decision-making, where you were doing incredibly sort of complex patient-centered shared decision making around how to come up with treatment plans, what the goals of care were. I liked taking care of patients where the whole family system was sort of part of the care team and part of the patient constellation. I loved running family meetings. I was incredibly lucky when I was senior resident and chief resident. I was very close with Andy Billings, who was one of the founders of palliative care and in the field, but also very much started a program at MGH and he had come to work at Cambridge Hospital in his sort of semi-retirement and we got close and he was a very influential figure for me. So all of those things conspired to make me want to go back to New York to go to the Sinai has an integrated geriatrics and palliative care fellowship where you do both fellowships simultaneously. So I came to do that and just really loved that work and loved that medicine so much. There was a second part to your question.Eric Topol (03:52):Is that where you practice geriatrics now?Rachael Bedard (03:55):No, now I have ever since finishing fellowship had very unusual practice settings for a geriatrician. So right out of fellowship, I went to work on Rikers Island and then New York City jail system, and I was the first jail based geriatrician in the country, which is a sort of uncomfortable distinction because people don't really like to think about there being a substantial geriatric population in jails. But there is, and I was incredibly lucky when I was finishing fellowship, there was a lot of energy around jail healthcare in New York City and I wrote the guy who was then the CMO and said, do you think you have an aging problem? And he said, I'm not sure, but if you want to come find out, we'll make you a job to come find out. And so, that was an incredible opportunity for someone right out of fellowship.(04:55):It meant stepping off the sort of academic track. But I went and worked in jail for six years and took care of older folks and people with serious illness in jail and then left Rikers in 2022. And now I work in a safety net clinic in Brooklyn that takes care of homeless people or people who have serious sort of housing instability. And that is attached to Woodhull Hospital, which is one of the public hospitals in New York City. And there I do a mix of regular internal medicine primary care, but I preferentially see the older folks who come through, which is a really interesting, painful, complicated patient population because I see a fair amount of cognitive impairment in folks who are living in the shelter system. And that's a really hard problem to address.Frailty, The Aged, and LongevityEric Topol (05:54):Well, there's a theme across your medical efforts. It seems to me that you look after the neglected folks, the prisoners, the old folks, the homeless people. I mean that's kind of you. It's pretty impressive. And there's not enough of people like you in the medical field. Now, no less do you do that, but of course you are a very impressive author, writer, and of many topics I want to get into with you, these are some recent essays you've written. The one that piqued my interest to start to understand who you were and kind of discover this body of work was the one that you wrote related to aging and President Biden. And that was in New York Times. And I do want to put in a quote because as you know very well, there's so much interest in longevity now.Eric Topol (06:51):Interrupting the aging process, and this one really stuck with me from that op-ed, “Time marches forward, bodies decline, and the growing expectation that we might all live in perfect health until our 100th birthdays reflects a culture that overprizes longevity to the point of delusion.” So maybe if you could tell us, that was a rich piece, you got into frailty, you related it to the issues that were surrounding President Biden who at that time had not withdrawn from the race. But what were you thinking and what are your thoughts about the ability to change the aging process?Rachael Bedard (07:36):I am very interested in, I mean, I'm incredibly interested in the science of it. And so, I guess I think that there are a few things.(07:49):One thing is that the framework that, the part that gives me pause the most is this framework that anything less than perfect health is not a life worth living. So if you're going to have a long life, life should not just be long and sort of healthy in relative terms to your age cohort, but healthy that when you're 80 you should feel like you have the health of a 45-year-old is my understanding of the culture of longevity science. And while I understand why that's aspirational and everybody worry about my body's decline, I think it's a really problematic thing to say that sick bodies are bodies that have disability or people who have cognitive difference are somehow leading lesser lives or lives that are not meaningful or not worth living. I think it's a very, very slippery slope. It puts you in a place where it sort of comes up against another trend or another emerging cultural trend, which is really thinking a lot about physician-assisted suicide and end of life choices.(09:04):And that in some ways that conversation can also be very focused on this idea that there's just no way that it's worth living if you're sick. And that's just not true, I think, and that's not been true for many, many, many of my patients, some of whom have lived with enormous disability and incredible burden of illness, people who are chronically seriously ill and are still leading lives that for them and for the people who love them are filled with meaning. So that's my concern about the longevity stuff. I'm interested in the science around the longevity stuff for sure. I'm interested in, I think we're living in this really interesting moment where there's so much happening across so many of the chronic disease fields where the things that I think have been leading to body decay over the last several decades for the majority of the population, we're sort of seeing a lot of breakthroughs in multiple fronts all at once. And that's really exciting. I mean, that's really exciting. And so, certainly if it's possible to make it to 100 in wonderful health, that's what I'd wish for all of us. But to hold it up as the standard that we have to achieve, I think is both unrealistic and a little myopic.Eric Topol (10:28):Yeah. Well, I certainly agreed with that and I think that that particular essay resonated so well and you really got into frailty and the idea about how it can be potentially prevented or markedly delayed. And I think before we move on to one of those breakthroughs that you were alluding to, any comments about the inevitability of frailty in people who are older, who at some point start to get the dwindles, if you will, what do you have to say about that?Rachael Bedard (11:11):Well, from a clinical standpoint, I guess the caveat versus that not everybody becomes frail and dwindles exactly. Some people are in really strong health up until sort of their final years of life or year of life and then something happens, they dwindle quickly and that's how they die. Or some people die of acute events, but the vast majority of us are going to become more frail in our final decades than we are in our middle decades. And that is the normal sort of pattern of wear and tear on the body. And it is an extraordinary framework, I think frailty because the idea of this sort of syndrome of things where it's really not a disease framework, it is a syndrome framework and it's a framework that says many, many small injuries or stressors add up to create a lot of stress and change in a body and trauma for our body. And once you are sort of past a tipping point of an amount of stress, it's very hard to undo those things because you are not sort of addressing one pathologic process. You're addressing, you're trying to mitigate many processes all at once.(12:31):When I wrote that piece, it was inspired by the conversation surrounding President Biden's health. And I was particularly struck by, there was a huge amount of clinical speculation about what was going on with him, right? I'm sure you remember there were people, there was all of this talk about whether he had Parkinson's and what his cognitive status was. And it felt to me like there was an opportunity to do some public education around the idea that you need not have one single sort of smoking gun illness to explain decline. What happens to most of us is that we're going to decline in many small ways sort of simultaneously, and it's going to impact function when it tips over a little bit. And that pattern of decline is not going to be steady day over day worsening. It's going to be up and down. And if you slept better the night before, you might have a better day the next day. And if you slept badly, you might have a worse day. And without knowing anything specific about his clinical situation, it felt like a framework that could explain so much of what we were seeing in public. And it was important also, I think to say that nothing was necessarily being hidden from anybody and that this is the kind of thing that, this has accumulated stress over time that then presents suddenly all at once after having been submerged.Eric Topol (14:01):Yeah, you reviewed that so well about the wear and tear and everything related to that. And before I move on to the second topic, I want to just circle back to something you alluded to, which is when Peter Attia wrote about this medicine 3.0 and how you would be compressed and you'd have no comorbidities, you'd have no other illnesses and just fall off the cliff. As a geriatrician, do you think that that is even conceivable?Rachael Bedard (14:35):No. Do you think it is?Eric Topol (14:37):No, but I just wanted to check the reality. I did challenge on an earlier podcast and he came up with his pat answer. But no, there's no evidence of that, that maybe you can delay if there ever was a way to do that. But I think there's this kind of natural phenomena that you just described, and I'll refer people also to that excellent piece that you get into it more.Rachael Bedard (15:06):Peter Attia, I mean, he is certainly the sort of standard bearer in my mind of that movement and that science or that framework of thinking about science. And there's stuff in there that's really valuable. The idea of thinking about lifestyle in your middle decades is having meaningful impact on how you will age, what your final years will look like. That seems intuitively true, I think. And so, thinking about his emphasis on exercise, I mean, his emphasis on exercise is particularly intense and not super achievable for the average person, but the idea that you should sort of be thinking about keeping your body strong because it will decline eventually. And so, you want to do that from a higher peak. That makes a lot of sense to me. The idea that where we sort of draw pathologic disease cutoffs is obviously a little bit arbitrary. And so, wanting to think about optimizing pre-disease states and doing prevention, that's obviously, I think pretty appealing and interesting. It's just really in an evidence free zone.Ozempic for the IndigentEric Topol (16:18):Yeah, that's what I confronted him with, of course, he had a different perspective, but you summed that up really well. Now let's switch to a piece you had in New York magazine. It was entitled, What If Ozempic Is Just a Good Thing? And the reason, of course, this ties into the first thing we're discussing. There's even talk now, the whole GLP-1 family of drugs with the dual triple receptors, pills to come that we're going to be able to interrupt a path towards Alzheimer's and Parkinson's. Obviously you've already seen impact in heart disease, liver disease, kidney disease way before that, diabetes and obesity. So what are your thoughts? Because you wrote a very interesting, you provided a very interesting perspective when you wrote that one.Rachael Bedard (17:11):So that piece I wrote because I have this unbelievably privileged, interesting clinical practice. In New York City, there is public health insurance basically available to anybody here, including folks who are undocumented. And the public hospital system has pharmacies that are outpatient pharmacies that have, and New York Medicaid is very generous and they arranged through some kind of brilliant negotiating. I don't quite know how to make Ozempic to make semaglutide available to people who met criteria which meant diabetes plus obesity, but that we could prescribe it even for our very, very poor patients and that they would be able to get it reliably, that we would have it in stock. And I don't know how many other practices in the country are able to reliably provide GLP-1s to marginalized folks like that. I think it feels like a really rare opportunity and a very distinct perspective.(18:23):And it has just been the most amazing thing, I think to have this class of drugs come along that, as you say, addresses so many problems all at once with at least in my prescribing experience, a relatively mild tolerable side effect profile. I have not had patients who have become incredibly sick with it. And for folks where making that kind of impact on their chronic illness is so critical to not just their longevity, but their disease status interacts so much with their social burden. And so, it's a very meaningful intervention I think around poverty actually.(19:17):I really feel that almost all of the popular press about it has focused very much on use amongst the wealthy and who's getting it off label and how are they getting it and which celebrities are taking it, and what are the implications for eating and diet culture and for people who have eating disorders. And that's a set of questions that's obviously sort of interesting, but it's really interesting in a very rarefied space. There's an unbelievable diabetes epidemic in this country, and the majority of people who have diabetes are not the people who are getting written about over and over again in those pieces. It's the patients that I take care of, and those people are at risk of ending up on dialysis or getting amputations. And so, having a tool this effective is really miraculous feeling to me.Eric Topol (20:10):Well, it really gives me some hope because I don't know any program like that one, which is the people who need it the most. It's getting provided for them. And we have been talking about a drug that costs a thousand dollars a month. It may get down to $500 a month, but that's still a huge cost. And of course, there's not much governmental coverage at this point. There might be some more for Medicare, Medicaid, whatever in the future, but it's really the original criteria of diabetes, and it took almost 20 years to get to where we are right now. So what's so refreshing here is to know that there's at least one program that is helping to bridge the inequities and to not make it as was projected, which was, as you say, for celebrities and wealthy people more exclusively, so that's great. And we still don't know about the diverse breadth of these effects, but as you well know, there's trials in Alzheimer's. I spoke to Steve Horvath recently on the podcast and he talked about how it's reset the epigenetic clock, GLP-1.Rachael Bedard (21:24):Does he think so?Eric Topol (21:26):Whoa. Yeah, there was evidence that was just presented about that. I said, well, if that does correspond to aging, the thing that we spoke about first, that would be very exciting.Rachael Bedard (21:37):It's so wild. I mean, it's so exciting. It's so exciting to me on so many levels. And one of them is it's just exploding my mental model of disease pathogenesis, and it's making me think, oh my goodness, I have zero idea actually how metabolism and the brain and sort of cardiovascular disease, all of those things are obviously, what is happening in the interplay between all of those different systems. It's really so much more complicated and so much more interdependent than I understood it to be. I am really optimistic about the Alzheimer's trial. I am excited for those results, and I think we're going to keep seeing that it prevents different types of tumors.Eric Topol (22:33):Yeah, no, and that's been shown at least certainly in obese people, that there's cancers that gets way reduced, but we never had a potent anti-inflammatory that works at the brain and systemically like this before anyone loses the weight, you already see evidence.Long Covid and ME/CFS(22:50):It is pretty striking. Now, this goes back to the theme that was introduced earlier about looking after people who are neglected, who aren't respected or generally cared for. And I wanted to now get into Long Covid and the piece you wrote in the New Yorker about listening to patients, called “what would it mean for scientists to listen to patients?” And maybe you can talk about myalgic encephalitis/chronic fatigue (ME/CFS), and of course Long Covid because that's the one that is so pervasive right now as to the fact that these people don't get respect from physicians. They don't want to listen to their ailments. There's no blood tests, so there's no way to objectively make a diagnosis supposedly. And they're basically often dismissed, or their suffering is discounted. Maybe you can tell us again what you wrote about earlier this year and any updated thoughts.Rachael Bedard (24:01):Have you had my friend Harlan Krumholz on the show to talk about the LISTEN study?Eric Topol (24:04):Not yet. I know Harlan very well. Yes.Eric Topol (24:11):I know Akiko Iwasaki very well too. They're very, very close.Rachael Bedard (24:14):So, Akiko Iwasaki and Harlan Krumholz at Yale have been running this research effort called the LISTEN study. And I first learned about it sometime in maybe late 2021. And I had been really interested in the emerging discourse around chronic illness in Long Covid in the 2021. So when we were past the most acute phase of the pandemic, and we were seeing this long tail of sequelae in patients, and the conversation had really shifted to one that was about sort of trying to define this new syndrome, trying to understand it, trying to figure out how you could diagnose it, what were we seeing sort of emerge, how are we going to draw boxes around it? And I was so interested in the way that this syndrome was really patient created. It came out of patients identifying their own symptoms and then banning together much, much faster than any kind of institutional science can ever work, getting into message boards together or whatever, and doing their own survey work and then coming up with their own descriptive techniques about what they were experiencing.(25:44):And then beyond that, looking into the literature and thinking about the treatments that they wanted to try for themselves. Patients were sort of at the forefront of every step of recognizing, defining, describing this illness presentation and then thinking about what they wanted to be able to do for themselves to address it. And that was really interesting to me. That was incredibly interesting to me. And it was also really interesting because by, I don't know exactly when 2021 or 2022, it was already a really tense landscape where it felt like there were real factions of folks who were in conflict about what was real and what wasn't real, how things ought to be studied, who ought to be studying them, what would count as evidence in this realm. And all of those questions were just really interesting to me. And the LISTEN study was approaching them in this really thoughtful way, which was Harlan and Akiko sort of partnering really closely with patients who enrolled.(26:57):And it's a decentralized study and people could enroll from all over the world. There's a portion of patients who do have their blood work evaluated, but you can also just complete surveys and have that data count towards, and those folks would be from anywhere in the world. Harlan did this amazing, amazing work to figure out how to collect blood samples from all over the country that would be drawn at home for people. So they were doing this decentralized study where people from their homes, from within the sort of circumstances of their lives around their chronic illness could participate, which that was really amazing to me. And then they were partnering really thoughtfully with these patients just to figure out what questions they wanted to ask, how they wanted to ask them, and to try to capture a lot of multimodal data all at once.(27:47):Survey data, journaling so people could write about their own experience in a freeform journal. They were collecting blood samples, and they were holding these town halls. And the town halls were on a regular basis, Harlan and Akiko, and anybody who was in the study could come on, could log onto a Zoom or whatever, and Harlan and Akiko and their research staff would talk about how things were going, what they were working on, what questions they had, what the roadblocks were, and then they would answer questions from their participants as the study was ongoing. And I didn't think that I had ever heard of something quite like that before. Have you ever heard of anything?Eric Topol (28:32):No. I mean, I think this is important to underscore, this was the first condition that was ever patient led, patient named, and basically the whole path was laid by the patient. So yes, and everything you summarize is so well as to the progress that's been made. Certainly, Harlan and Akiko are some of the people that have really helped lead the way to do this properly as opposed to, unfortunately one and a half billion dollars that have been put to the NIH for the RECOVER efforts that haven't yet led to even a significant clinical trial, no less a validated treatment. But I did think it was great that you spotlighted that just because again, it's thematic. And that gets me to the fourth dimension, which is you're the first prison doctor I've ever spoken to. And you also wrote a piece about that called, “the disillusionment of a Rikers Island Doctor” in the New Yorker, I think it was. And I wonder if you could tell us, firstly, now we're four years into Covid, you were for a good part of that at Rikers Island, I guess.The Rikers Island Prison Doctor During CovidRachael Bedard (30:00):I was, yeah.Eric Topol (30:00):Yeah. And what could be a more worrisome spot to be looking after people with Covid in a prison? So maybe you could just give us some insight about all that.Rachael Bedard (30:17):Yeah, it was really, I mean, it was the wildest time, certainly in my career probably that I'll ever have. In the end of February and beginning of March of 2020, it became very apparent to my colleagues and I that it was inevitable that this virus that was in Wuhan and in Italy was coming to the US. And jails are, we sort of jokingly described them as the worst cruise ships in the world. They are closed systems where everybody is eating, sleeping, going to the bathroom, everything on top of each other. There's an incredible amount of excess human contact in jails and prisons because people don't have freedom of movement and they don't get to do things for themselves. So every single, somebody brings you your mail, somebody brings you your meals, somebody brings you your medications. If you're going to move from point A to point B, an officer has to walk you there. So for a virus that was going to spread through what we initially thought was droplets and then found out was not just droplets but airborne, it was an unbelievably high-risk setting. It's also a setting where folks tend to be sicker than average for their age, that people bring in a lot of comorbidity to the setting.(31:55):And it's not a setting that does well under stress. I mean, jails and prisons are places that are sort of constitutionally violent, and they're not systems that adapt easily to emergency conditions. And the way that they do adapt tends to be through repressive measures, which tends to be violence producing rather than violence quelling. And so, it was just an incredibly scary situation. And in mid-March, Rikers Island, the island itself had the highest Covid prevalence of anywhere in the country because New York City was the epicenter, and Rikers was really the epicenter within New York. It was a wild, wild time. Our first seriously ill patient who ended up getting hospitalized. That was at that time when people were, we really didn't understand very much about what Covid looked like. And there was this guy sitting on the floor and he said, I don't know. I can't really get up.(32:59):I don't feel well. And he had an O2 stat of 75 or something. He was just incredibly hypoxic. It's a very scary setting for that kind of thing, right? It's not a hospital, it's not a place where you can't deliver ICU level care in a place like that. So we were also really worried about the fact that we were going to be transferring all of these patients to the city hospitals, which creates a huge amount of extra burden on them because an incarcerated patient is not just the incarcerated patients, the officers who are with that person, and there are special rules around them. They have to be in special rooms and all of these things. So it was just a huge systems crisis and really painful. And we, early on, our system made a bunch of good guesses, and one of our good guesses was that we should just, or one of our good calls that I entirely credit my bosses with is that they understood that we should advocate really hard to get as many people out as we could get out. Because trying to just manage the population internally by moving people around was not going to be effective enough, that we really need to decant the setting.(34:18):And I had done all of this work, this compassionate release work, which is work to get people who are sick out of jail so that they can get treatment and potentially die in a free setting. And so, I was sort of involved in trying to architect getting folks who were sort of low enough security risks out of jail for this period of time because we thought that they would be safer, and 1500 people left Rikers in the matter of about six weeks.Rachael Bedard (34:50):Which was a wild, wild thing. And it was just a very crazy time.Eric Topol (34:56):Yeah. Well, the word compassion and you go together exceptionally well. I think if we learn about you through your writings, that really shines through and what you've devoted your care for people in these different domains. This is just a sampling of your writings, but I think it gives a good cross section. What makes you write about a particular thing? I mean, obviously the Rikers Island, you had personal experience, but why would you pick Ozempic or why would you pick other things? What stimulates you to go after a topic?Rachael Bedard (35:42):Sometimes a lot of what I write about relates to my personal practice experience in some way, either to geriatrics or death and dying or to the criminal justice system. I've written about people in death row. I've written about geriatrics and palliative care in sort of a bunch of different ways. I am interested in topics in medicine where things are not yet settled, and it feels very of the moment. I'm interested in what the discourse is around medicine and healthcare. And I am interested in places where I think the discourse, not just that I'm taking a side in that discourse, but where I think the framework of the discourse is a little bit wrong. And I certainly feel that way about the Ozempic discourse. And I felt that way about the discourse around President Biden, that we're having not just a conversation that I have a strong opinion about, but a conversation that I think is a little bit askew from the way that we ought to be thinking about it.Eric Topol (36:53):And what I love about each of these is that you bring all that in. You have many different points of view and objective support and they're balanced. They're not just trying to be persuasive about one thing. So, as far as I know, you're extraordinarily unique. I mean, we are all unique, but you are huge standard deviations, Rachael. You cover bases that are, as I mentioned, that are new to me in terms of certainly this podcast just going on for now a couple of years, that is covering a field of both geriatrics and having been on the corrections board and in prison, particularly at the most scary time ever to be working in prison as a physician. And I guess the other thing about you is this drive, this humanitarian theme. I take it you came from Canada.Rachael Bedard (37:59):I did.Eric Topol (37:59):You migrated to a country that has no universal health.Rachael Bedard (38:03):That's right.Eric Topol (38:03):Do you ever think about the fact that this is a pretty pathetic situation here?Rachael Bedard (38:08):I do. I do think about it all the time.Eric Topol (38:10):In our lifetime, we'll probably never see universal healthcare. And then if you just go a few miles up north, you pretty much have that.Rachael Bedard (38:18):Yeah, if you've lived in a place that has universal healthcare and you come here, it's really sort of hard to ever get your mind around. And it has been an absolute possessing obsession of my entire experience in the US. I've now been here for over 20 years and still think it is an unbelievably, especially I think if you work with marginalized patients and how much their lack of access compounds the difficulty of their lives and their inability to sort of stabilize and feel well and take care of themselves, it's really frustrating.Advice for Bringing Humanities to Medicine in a CareerEric Topol (39:14):Yeah, yeah. Well, I guess my last question to you, is you have weaved together a career that brings humanities to medicine, that doesn't happen that often. What's your advice to some of the younger folks in healthcare as to how to pull that off? Because you were able to do it and it's not easy.Rachael Bedard (39:39):My main advice when people ask me about this, especially to students and to residents who are often the people who are asking is to write when you can or pursue your humanities interests, your critical interests, whatever it is that you're doing. Do it when you can, but trust that your career is long and that you have a lot of time. Because the thing that I would say is I didn't start publishing until I was in fellowship and before that I was busy because I was learning to become a doctor. And I think it's really important that my concern about being a doctor who's a hybrid, which so many of us are now. A doctor or something else is you really do want to be a good doctor. And becoming a good doctor is really hard. And it's okay if the thing that is preoccupying you for the first 10 years of your training is becoming a great clinician. I think that's a really, really important thing to do. And so, for my first 10 years for med school and residency and chief residency and fellowship, I would write privately on the side a fair amount, but not try to publish it, not polish that work, not be thinking in sort of a careerist way about how I was going to become a doctor writer because I was becoming a doctor. And that was really preoccupying.(41:08):And then later on, I both sort of had more time and mental space to work on writing. But also, I had the maturity, I think, of being a person who was comfortable in my clinical identity to have real ideas and insights about medicine that felt different and unique to me as opposed to, I barely understand what's going on around me and I'm trying to pull it together. And that's how I would've been if I had done it more, I think when I was younger. Some people are real prodigies and can do it right out the gate, but I wasn't like that.Eric Topol (41:42):No, no, I think that's really sound advice because that's kind of the whole foundation for everything else. Is there a book in the works or will there be one someday?Rachael Bedard (41:53):There may be one someday. There is not one now. I think about it all the time. And that same advice applies, which is I believe in being a late bloomer and taking your time and figuring out what it is you really want to do.Eric Topol (42:10):Yeah. Well, that's great. Have I missed anything? And obviously we only can get to know you in what, 40 minutes to some extent, but have I not touched on something that you want to bring up?Rachael Bedard (42:23):No, I don't think so. Thank you for this conversation. It's been lovely.Eric Topol (42:28):No, I really enjoyed it. I'll be following your career. It's extraordinary already and you've got decades ahead to make an impact and obviously thinking of all these patients that you look after and have in the past, it's just extraordinary. So what a joy to talk with you, Rachael, and I hope we'll have a chance to do that again in the times ahead.Rachael Bedard (42:51):Me as well. Thank you so much for inviting me.**********************************************Thank you for listening, reading or watching!The Ground Truths newsletters and podcasts are all free, open-access, without ads.Please share this post/podcast with your friends and network if you found it informative!Voluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly help fund our education and summer internship programs.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff for audio and video support at Scripps Research.Note: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in. Get full access to Ground Truths at erictopol.substack.com/subscribe

In this 293rd episode I interview Dr. Keith Baker in another master clinician episode. Dr. Baker is a professor at Harvard Medical School, the Vice Chair for Education at MGH and was formerly the residency program director there for 15 years.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In fellowship, one of the leaders at MGH used to quote Balfour Mount as saying, “You say you've worked on teams? Show me your scars.”  Scars, really?  Yes. I've been there. You probably have too. On the one hand, I don't think interprofessional teamwork needs to be scarring. On the other hand, though it goes against my middle-child “can't we all get along” nature, disagreement is a key aspect of high functioning teams.  The key is to foster an environment of curiosity and humility that welcomes and even encourages a diversity of perspectives, including direct disagreement. Today we talk with DorAnne Donesky, Michelle Milic, Naomi Saks, & Cara Wallace about the notion that we should revolutionize our education programs, training programs, teams, incentive structures, and practice to be intentionally interprofessional in all phases.  The many arguments, theories, & approaches across settings and conditions are explored in detail in the book they edited, “Intentionally Interprofessional Palliative Care” (discount code AMPROMD9). Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. And they begin on today's podcast with one clinical ask: everyone should be a generalist and a specialist. In other words, in addition to being a specialist (e.g. social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. Many more approaches to being interprofessional on today's podcast.  But how about you! What will you commit to in order to be more intentionally interprofessional? If we build this dream together, standing strong forever, nothing's gonna stop us now… -@AlexSmithMD    Interprofessional organizations that are not specific to palliative care are doing excellent work National Center for Interprofessional Practice and Education: https://nexusipe.org/ National Collaborative for Improving the Clinical Learning Environment https://ncicle.org/ Interprofessional Education Collaborative (home of the IPEC Competencies) https://www.ipecollaborative.org/ American Interprofessional Health Collaborative (sponsor of the biennial meeting "Collaborating Across Borders") https://aihc-us.org/index.php/ Health Professions Accreditors Collaborative https://healthprofessionsaccreditors.org/

In this 292nd episode I play the audio from the live episode we did at the Northeast Anesthesia Resident Conference in Boston on 9/14/24. I interviewed Aalok Agarwala, Associate CMO at MGH, Joanne Conroy, President and CEO of Dartmouth Health, and Sunil "Sunny" Eappen, CEO of UVM Health. We discuss their careers, and their tips for aspiring leaders in healthcare. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Today we are joined by Susan Fasoli. In addition to being an active member of AOTA and the American Congress of Rehabilitation Medicine, Susan is a Professor Emerita of occupational therapy at MGH institute of health professions where she has conducted, published, and disseminated research related to robot assisted therapy and cognitive skills training, the importance of interprofessional collaboration, and the rehabilitation treatment specification system (RTSS). She shares information related to RTSS and gives recommendations on how students, practitioners, educators, and researchers can enhance their practice by applying the RTSS.  Additional Resources: American Congress of Rehabilitation Medicine: Improving Lives Through Interdisciplinary Rehabilitation Research | ACRM ACRM Rehabilitation Treatment Specification Networking Group (RTS-NG)  Follow ACRM on X at @ACRMRTS

The 2024 World Conference on Lung Cancer brings together leading experts, researchers, and oncologists to showcase the latest advancements in lung cancer research and celebrate IASLC's 50th anniversary. To reach a global audience, IASLC has recorded podcast episodes on WCLC 2024 in world languages. In this episode, host Dr. Coral Olazagasti moderates a discussion in Spanish about highlights from the conference with Dr. Maria Velez and Dr. Rossana Ruiz. Guests: Dr. Coral Olazagasti Assistant Professor at the Sylvester Cancer Center, University of Miami at Miami, Florida. Dr. Rossana Ruiz Medical Oncologist from Universidad Peruana Cayetano Heredia Global Health Fellowship at MGH in Boston, Massachusetts Thoracic Medical Oncologist, Instituto Nacional de Enfermedades Neoplasicas and AUNA-Oncosalud in Lima, Peru Dr. Maria Velez Clinical Instructor, Division of Hematology-Oncology UCLA David Geffen School of Medicine in Los Angeles, California

We kicked off the program with four news stories and different guests on the stories we think you need to know about!'Boy Meets World' actress reveals breast cancer diagnosis – MGH's Dr. Matthew Strickland discussed breast cancer types, importance of screenings, and more. It's hard to have much confidence in the Patriots when Eliot Wolf doesn't project it. With Ben Volin – Boston Globe NFL writer.We're joined by Ryan Roy - Production Director/ Office Manager of King Richard's Faire  – The New England Renaissance Festival opens its season on August 31st in Carver, MA.Conquer Self-Sabotage By Overcoming These 5 Hazardous Attitudes with Ricky Brown – Author, Speaker, Coach.Ask Alexa to play WBZ NewsRadio on #iHeartRadio!

YOGA IS MY TRUE PASSION... The practice found me over ten years ago and has followed me around with nurturing love ever since. My yoga experience began at Charlestown Yoga in Boston, Massachusetts while volunteering for a non-profit organization that offered alternative healing services to veterans. In exchange, I was able to take yoga classes at the studio. I soon became a regular, sometimes taking two, even three classes each day. Simultaneously, I experienced a couple of unexpected lay-offs from my jobs in online advertising sales and this opened up some space to make what was initially a physical practice a very spiritual journey for me. With the completion of my 200-hour yoga teacher certification in 2007, I began to pursue my teaching career in yoga. First, managing the studio part-time and then, teaching as many classes as I could in and around Boston. This journey through my practice has paved the path for many of the challenges I would face later on in a way that nothing else could have prepared me for. In 2011, at age 35, I was teaching yoga and running a Bed & Breakfast on Martha's Vineyard when I was diagnosed with stage 2/3 triple-negative breast cancer. My life turned upside down. Planning a wedding turned into deciding on a treatment plan for the following year. 16 chemo treatments, two surgeries and 30 days of radiation is what followed. That is what my treatment looked like on paper, but I believe I was saved because of yoga, the community at MGH, and my 'tribe'. Students would pop up with messages of love and support when I least expected it, at hospitals, on the street, along with various other places and in moments that you couldn't predict if you tried. I practiced hot power yoga the day after chemo with a bald head, surrounded by my tribe. This is what yoga is, a place where we can turn things off and look inside ourselves, without judgment or ego but with vulnerability and humble love. I am 7 years cancer-free, a wife and a mother of two small children. I have faith and hope and yoga taught me that. My students and colleagues continually inspire and teach me so much about myself. This is what I hope to share with you - on and off the mat. Namaste. ⁠CONTACT ME⁠ I am continually honored to represent KiraGrace as a Warrior Ambassador. KiraGrace is a  leader in Yoga Clothing Apparel and all of their clothing is responsibly manufactured in the USA. I was chosen as a Brand Ambassador because of my leadership on and off of the mat, community involvement, and seva, or service. I continually try to exercise leadership through my commitment to the betterment of this community and my teachings of yoga. To check out this amazing company, please go to ⁠www.kiragrace.com⁠. SIGN UP FOR my Better Divorce Blueprint PROGRAM: https://betterdivorceblueprint.com/ WEBSITE - resources for those in need of Certified Divorce Coaching and Private Mediation Services : https://betterdivorceacademy.com/ SOCIAL MEDIA - bit.ly/betterdivorceacademy Buy my book and workbook: Better Divorce Blueprint https://betterdivorceblueprint.com/ RESOURCES - https://betterdivorceacademy.com/reso... AUDIOBOOK FROM AUDIBLE - https://www.audible.com/pd/Better-Div... Are you looking for answers and guidance? BOOK a 30 minute assessment consultation: https://calendly.com/betterdivorceaca... Disclaimer: All statements made in this audio/video are expressions of the opinion of the speaker, and should be regarded as such. The audio/video is made to serve a therapeutic purpose for the speaker or speakers and to assist others in recognizing and dealing with matters in their own lives which they believe may be similar. #divorce #mediation #coaching #lifeafterdivorce #divorcesupport

On today's special episode of Hot Topics and Kidney Health we're sharing audio from a recent webinar hosted by National Kidney Foundation on kidney xenotransplantation. Stay tuned to hear from the experts and learn about the latest updates on animal-to-human transplantation.   Dr. Tatsuo Kawai is a professor of surgery at Harvard Medical School and the A. Benedict Cosimi Chair in Transplant Surgery at Massachusetts General Hospital. He is also director of the Legorreta Center for Clinical Transplantation Tolerance. He was awarded the Martin Research Prize at MGH in 2009 and the New Key Opinion Leader Award by the Transplantation Society in 2010 for this work. In the field of xenotransplantation, he has collaborated extensively with eGenesis over the past five years, achieving over two years of survival for genetically edited kidney xenografts in nonhuman primates, which was published in Nature in 2023. In March 2024, he successfully performed the world first kidney xenotransplantation from the pig with 69 genomic edits in a living patient with end stage renal disease.  Vineeta Kumar MD, FAST, FASN  is the lead nephrologist for the Living Kidney Donor and Incompatible Kidney Transplant programs at the University of Alabama in Birmingham. She is an expert in kidney transplantation, living kidney donation, incompatible kidney transplant, kidney paired donation and cardiovascular outcomes after kidney transplantation. Peter Reese, MD, PhD, is an NIH-funded transplant nephrologist and epidemiologist. His research focuses on: a) developing effective strategies to increase access to solid organ transplantation; b) improving the process of selecting and caring for living kidney donors; c) determining outcomes of health policies on vulnerable populations with renal disease, including the elderly; d) testing strategies to improve important health behaviors such as medication adherence; and e) transplant ethics. He was a recipient of a Presidential Early Career Award for Scientists and Engineers, was elected member of the American Society of Clinical Investigation, and was a Greenwall Faculty Scholar in bioethics. He is a past chair of the Ethics Committee for the United Network for Organ Sharing (UNOS), which oversees organ allocation and transplant regulation in the US, and is an Associate Editor for the American Journal of Kidney Diseases. He co-led the THINKER, USHER, MYTHIC, and SHELTER trials involving transplanting HCV-infected donor organs into uninfected recipients. His work has been generously funded by foundations and the NIH, including a K-24 to support mentoring.   Do you have comments, questions, or suggestions? Email us at NKFpodcast@kidney.org. Also, make sure to rate and review us wherever you listen to podcasts.  

Full videos of all Ground Truths podcasts can be seen on YouTube here. The audios are also available on Apple and Spotify.Thank you for reading Ground Truths. This post is public so feel free to share it.Transcript with audio and external linksEric Topol (00:05):Hello, it's Eric Topol with Ground Truths, and I am really thrilled to have with me Professor Faisal Mahmood, who is lighting it up in the field of pathology with AI. He is on the faculty at Harvard Medical School, also a pathologist at Mass General Brigham and with the Broad Institute, and he has been publishing at a pace that I just can't believe we're going to review that in chronological order. So welcome, Faisal.Faisal Mahmood (00:37):Thanks so much for having me, Eric. I do want to mention I'm not a pathologist. My background is in biomedical imaging and computer science. But yeah, I work very closely with pathologists, both at Mass General and at the Brigham.Eric Topol (00:51):Okay. Well, you know so much about pathology. I just assume that you were actually, but you are taking computational biology to new levels and you're in the pathology department at Harvard, I take it, right?Faisal Mahmood (01:08):Yeah, I'm at the pathology department at Mass General Brigham. So the two hospitals are now integrated, so I'm at the joint department.Eric Topol (01:19):Good. Okay. Well, I'm glad to clarify that because as far as I knew you were hardcore pathologist, so you're changing the field in a way that is quite unique, I should say, because a number of years ago, deep learning was starting to get applied to pathology just like it was and radiology and ophthalmology. And we saw some early studies with deep learning whereby you could find so much more on a slide that otherwise would be not even looked at or considered or even that humans wouldn't be able to see. So maybe you could just take us back first to the deep learning phase before these foundation models that you've been building, just to give us a flavor for what was the warmup in this field?Faisal Mahmood (02:13):Yeah, so I think around 2016 and 2017, it was very clear to the computer vision community that deep learning was really the state of the art where you could have abstract feature representations that were rich enough to solve some of these fundamental classification problems in conventional vision. And that's around the time when deep learning started to be applied to everything in medicine, including pathology. So we saw some earlier cities in 2016 and 2017, mostly in machine learning conferences, applying this to very basic patch level pathology dataset. So then in 2018 and 2019, there were some studies in major journals including in Nature Medicine, showing that you could take large amounts of pathology data and classify what's known to us and including predicting what's now commonly referred to as non-human identifiable features where you could take a label and this could come from molecular data, other kinds of data like treatment response and so forth, and use that label to classify these images as responders versus non-responders or having a certain kind of mutation or not.(03:34):And what that does is that if there is a morphologic signal within the image, it would pick up on that morphologic signal even though humans may not have picked up on it. So it was a very exciting time of developing all of these supervised, supervised foundation models. And then I started working in this area around 2019, and one of the first studies we did was to try to see if we can make this a little bit more data efficient. And that's the CLAM method that we published in 2021. And then we took that method and applied it to the problem of cancers of unknown primary, that was also in 2021.Eric Topol (04:17):So just to review, in the phase of deep learning, which was largely we're talking about supervised with ground truth images, there already was a sign that you could pick up things like the driver mutation, the prognosis of the patient from the slide, you could structural variations, the origin of the tumor, things that would never have been conceived as a pathologist. Now with that, I guess the question is, was all this confined to whole slide imaging or could you somehow take an H&E slide conventional slide and be able to do these things without having to have a whole slide image?Faisal Mahmood (05:05):So at the time, most of the work was done on slides that were fully digital. So taking a slide and then digitizing the image and creating a whole slide image. But we did show in 2021 that you could put the slide under a microscope and then just capture it with a camera or just with a cell phone coupled to a camera, and then still make those predictions. So these models were quite robust to that kind of domain adaptation. And still I think that even today the slide digitization rate in the US remains at around 4%, and the standard of care is just looking at a glass light under a microscope. So it's very important to see how we can further democratize these models by just using the microscope, because most microscopes that pathologists use do have a camera attached to them. So can we somehow leverage that camera to just use a model that might be trained on a whole slide image, still work with the slide under a microscope?Eric Topol (06:12):Well, what you just said is actually a profound point that is only 4% of the slides are being reviewed digitally, and that means that we're still an old pathology era without the enlightenment of machine eyes. I mean these digital eyes that can be trained even without supervised learning as we'll get to see things that we'll never see. And to make, and I know we'll be recalling back in 2022, you and I wrote a Lancet piece about the work that you had done, which is very exciting with cardiac biopsies to detect whether a heart transplant was a rejection. This is a matter of life or death because you have to give more immunosuppression drugs if it's a rejection. But if you do that and it's not a rejection or you miss it, and there's lots of disagreement among pathologists, cardiac pathologists, regarding whether there's a transplant. So you had done some early work back then, and because much of what we're going to talk about, I think relates more to cancer, but it's across the board in pathology. Can you talk about the inner observer variability of pathologists when they look at regular slides?Faisal Mahmood (07:36):Yeah. So when I first started working in this field, my kind of thinking was that the slide digitization rate is very low. So how do we get people to embrace and adapt digital pathology and machine learning models that are trained on digital data if the data is not routinely digitized? So one of my kind of line of thinking was that if we focus on problems that are inherently so difficult that there isn't a good solution for them currently, and machine learning provides, or deep learning provides a tangible solution, people will be kind of forced to use these models. So along those lines, we started focusing on the cancers of unknown primary problem and the myocardial biopsy problem. So we know that the Cohen's kappa or the intra-observer variability that also takes into account agreement by chance is around 0.22. So it's very, very low for endomyocardial biopsies. So that just means that there are a large number of patients who have a diagnosis that other pathologists might not agree with, and the downstream treatment regimen that's given is entirely based on that diagnosis. The same patient being diagnosed by a different cardiac pathologist could be receiving a very different regimen and could have a very, very different outcome.(09:14):So the goal for that study is published in Nature of Medicine in 2022, was to see if we could use deep learning to standardize that and have it act as an assistive tool for cardiac pathologists and whether they give more standardized responses when they're given a machine learning based response. So that's what we showed, and it was a pleasure to write that corresponding piece with you in the Lancet.Eric Topol (09:43):Yeah, no, I mean I think that was two years ago and so much has happened since then. So now I want to get into this. You've been on a tear every month publishing major papers and leading journals, and I want to just go back to March and we'll talk about April, May, and June. So back in March, you published two foundation models, UNI and CONCH, I believe, both of these and back-to-back papers in Nature Medicine. And so, maybe first if you could explain the foundation model, the principle, how that's different than the deep learning network in terms of transformers and also what these two different, these were mega models that you built, how they contributed to help advance the field.Faisal Mahmood (10:37):So a lot of the early work that we did relied on extracting features from a resonant trained on real world images. So by having these features extracted, we didn't need to train these models end to end and allowed us to train a lot of models and investigate a lot of different aspects. But those features that we used were still based on real world images. What foundation models led us do is they leveraged self supervised learning and large amounts of data that would be essentially unlabeled to extract rich feature representations from pathology images that can then be used for a variety of different downstream tasks. So we basically collected as much data as we could from the Brigham and MGH and some public sources while trying to keep it as diverse as possible. So the goal was to include infectious, inflammatory, neoplastic all everything across the pathology department while still being as diverse as possible, including normal tissue, everything.(11:52):And the hypothesis there, and that's been just recently confirmed that the hypothesis was that diversity would matter much more than the quantity of data. So if you have lots and lots of screening biopsies and you use all of them to train the foundation model, there isn't enough diversity there that it would begin to learn those fundamental feature representations that you would want it to learn. So we used all of this data and then trained the UNI model and then together with it was an image text model where it starts with UNI and then reinforces the feature representations using images and texts. And that sort of mimics how humans learn about pathology. So a new resident, new trainee learning pathology has a lot of knowledge of the world, but it's perhaps looking at a pathology image for the first time. But besides looking at the image, they're also being reinforced by all these language cues from, whether it's from text or from audio signals. So the hope there was that text would kind of reinforce that and generate better feature representation. So the two studies were made available together. They were published in Nature Medicine back in March, and with that we made both those models public. So at the time we obviously had no idea that they would generate so much interest in this field, downloaded 350,000 times on Hugging Face and used for all kinds of different applications that I would've never thought of. So that's been very exciting to see.Eric Topol (13:29):Can you give some examples of some of the things you wouldn't have thought of? Because it seems like you think of everything.Faisal Mahmood (13:35):Yeah, people have used it to when there was a challenge for detecting tuberculosis, I think in a very, very different kind of a dataset. It was from the Nightingale Foundation and they have large data sets. So that was very interesting to see. People have used it to create newer data sets that can then be used for training additional foundation models. It's being used to extract rich feature representations from pathology images, corresponding spatial transcriptomic data, trying to predict spatial transcriptomics directly from histology. And there's a number of other options.Eric Topol (14:27):Well, yeah, that was March. Before we get to April, you slipped in the spatial omics thing, which is a big deal that is ability to look at tissue, human tissue over time and space. I mean the spatial temporal, it will tell us so much whether an evolution of a cancer process or so many things. Can you just comment because this is one of the major parts of this new era of applying AI to biology?Faisal Mahmood (15:05):So I think there are a number of things we can do if we have spatial data spatially resolved omic data with histology images. So the first thing that comes to my mind as a computer scientist would be that can we train a joint foundation model where we would use the spatially resolved transcriptomics to further enforce the pathology signal as a ground truth in a contrastive manner, similar to what we do with text, and can we use that to extract even richer feature representation? So we're doing that. In fact, we made a data set of about a thousand pathology images with corresponding spatial transcriptomic information, both curated from public resources as well as some internal data publicly available so people could investigate that question further. We're entrusted in other aspects of this because there is some indication including a study from James Zou's group at Stanford showing that we can predict histology, predict the spatial transcriptomic signal directly from histology. So there's early indications that we might also be able to do that in three dimensions. So yeah, it's definitely very interesting. More and more of that data is becoming available and how machine learning can sort of augment that is very exciting.Eric Topol (16:37):Yeah, I mean, most of the spatial omics has been a product of single cell sequencing, whether it's single nuclei and different omics, not just DNA, of course, RNA and even methylation, whatnot. So the fact that you could try to impute that from the histologies is pretty striking. Now, that was March and then in April you published to me an extraordinary paper about demographic bias and how generative AI, we're in the generative AI year now since as we discussed with foundation models, here again that gen AI could actually reduce biases and enhance fairness, which of course is so counterintuitive to everything that's been written to date. So maybe you can take us through how we can get a reduction in bias in pathology.Faisal Mahmood (17:34):Yeah, so in the study, the study was about, this had been investigated in other fields, but what we try to show is that a model trained on large, diverse, publicly available data. When that's applied internally and we stratify it based on demographic differences, race and so forth, we see these very clear disparities and biases. And we investigated a lot of different solutions that were out there to equalize the distribution of the data to balance the distribution using or sampling and some of these simple techniques. And none of them worked quite well. And then we observed that using foundation models or just having richer feature representations eliminates some of those biases. In parallel, there was another study from Google where they use generative AI to synthesize additional images from those underrepresented groups and then use those images to enhance the training signal. And then they also showed that you could reduce those biases.(18:49):So I think the common denominator there is that richer feature representations contribute to reduced biases. So the biases not because there is some inherent signal tied to these subgroups, but the bias is essentially there because the feature representations are not strong enough. Another general observation is that there's some kind of a confounder often there that leads to the bias. And one example would be that patients with socioeconomic disparities might just be diagnosed late and there might not be enough advanced cases in the training dataset. So quite often when you go in and look at what your training distribution looks like and how it varies from your test distribution and what that dataset shift is, you're able to figure out where the bias inherently comes from. But as a general principle, if you use the richest possible feature representation or focus on making your feature representations richer by using better foundation models and so forth, you are able to reduce a lot of the bias.Eric Topol (19:58):Yeah, that's really another key point here is about the richer features and the ability counterintuitively to actually reduce bias. And what is important in interrogating data inputs, as you said before, you wind up with a problem with bias. Now, then it comes May since we're just March and April, in May you published TriPath, which is now bringing in the 3D world of pathology. So maybe you can give us a little skinny on that one.Faisal Mahmood (20:36):Yeah. So just looking at the spectrum of where pathology is today, I think that we all agree in the community that pathologists often look at extremely sampled tissue. So human tissue is inherently three-dimensional, and by the time it gets to a pathologist, it's been sampled and cut so many times that it often would lack that signal. And there are a number of studies that have shown that if you subsequently cut sections, you get to a different outcome. If you look at multiple slides for a prostate biopsy, you get to a different Gleason score. There are all of these studies that have shown that 3D pathology is important. And with that, there's been a growing effort to build tools, microscopes, imaging tools that can image tissue in 3D. And there are about 10 startups who've built all these different technologies, open-top light-sheet microscopy, microCT and so forth that can image tissue really well in three dimensions, but none of them have had clinical adoption.(21:39):And we think that a key reason is that there isn't a good way for a pathologist to examine such a large volume of tissue. If they spend so much time examining this large volume of tissue, they would never be able to get through all the, so the goal here really was to develop a computational tool that would look through the large volume and highlight key regions that a pathologist can then examine. And the secondary goal was that does using three dimensional tissue actually improve patient stratification and does using, essentially using three 3D deep learning, having 3D convolutions extract richer features from the three dimensions that can then be used to separate patients into distinct risk groups. So that's what we did in this particular case. The study relied on a lot of data from Jonathan Liu's group at University of Washington, and also data that we collected at Harvard from tissue that came from the Brigham and Women's Hospital. So it was very exciting to show that what the value of 3D pathology can be and how it can actually translate into the clinic using some of these computational tools.Eric Topol (22:58):Do you think ultimately someday that will be the standard that you'll have a 3D assessment of a biopsy sample?Faisal Mahmood (23:06):Yeah, I'm really convinced that ultimately 3D would become the standard because the technology to image these tissue is becoming better and better every year, and it's getting closer to a point where the imaging can be fast enough to get to clinical deployment. And then on the computational end, we're increasingly making a lot of progress.Eric Topol (23:32):And it seems, again, it's something that human eyes couldn't do because you'd have to look at hundreds of slides to try to get some loose sense of what's going on in a 3D piece of tissue. Whereas here you're again taking advantage, exploiting the digital eyes. Now this culminates to your June big paper PathChat in Nature, and this was a culmination of a lot of work you've been doing. I don't know if you do any sleep or your team, but then you published a really landmark paper. Can you take us through that?Faisal Mahmood (24:12):Yeah, so I think that with the foundation models, we could extract very rich feature representation. So to us, the obvious next step was to take those feature representations and link them with language. So a human would start to communicate with a generative AI model where we could ask questions about what's going on in a pathology image, it would be capable of making a diagnosis, it would be capable of writing a report, all of those things. And the reason we thought that this was really possible is because pathology knowledge is a subset of the world's knowledge. And companies like OpenAI are trying to build singular, multimodal, large language models that would harbor the world's information, the world knowledge and pathology is much, much more finite. And if we have the right kind of training data, we should be able to build a multimodal large language model that given any pathology image, it can interpret what's going on in the image, it can make a diagnosis, it can run through grading, prognosis, everything that's currently done, but also be an assistant for research, analyzing lots of images to see if there's anything common across them, cohorts of responders versus non-responders and so forth.(25:35):So we started by collecting a lot of instruction data. So we started with the foundation models. We had strong pathology image foundation models, and then we collected a lot of instruction data where we have images, questions, corresponding answers. And we really leveraged a lot of the data that we had here at Brigham and MGH. We're obviously teaching hospitals. We have questions, we have existing teaching training materials and work closely with pathologists at multiple institutions to collect that data. And then finally trained a multimodal large language model where we could give it a whole slide image, start asking questions, what was in the image, and then it started generating all these entrusting morphologic descriptions. But then the challenge of course is that how do you validate this? So then we created validation data sets, validated on what multiple choice questions on free flowing questions where multiple pathologists, we had a panel of seven pathologists look through every response from our model as well as more generic models like the OpenAI, GPT-4 and BiomedCLIP and other models that are publicly available, and then compare how well this pathology specific model does in comparison to some of those other models.(26:58):And we found that it was very good at morphologic description.Eric Topol (27:05):It's striking though to think now that you have this large language model where you're basically interacting with the slide, and this is rich, but in another way, just to ask you, we talk about multimodal, but what about if you have electronic health record, the person's genome, gut microbiome, the immune status and social demographic factors, and all these layers of data, environmental exposures, and the pathology. Are we going to get to that point eventually?Faisal Mahmood (27:45):Yeah, absolutely. So that's what we're trying to do now. So I think that it's obviously one step at a time. There are some data types that we can very easily integrate, and we're trying to integrate those and really have PathChat as being a binder to all of that data. And pathology is a very good binder because pathology is medicine's ground truth, a lot of the fundamental decisions around diagnosis and prognosis and treatment trajectory is all sort of made in pathology. So having everything else bind around the pathology is a very good idea and indication. So for some of these data types that you just mentioned, like electronic medical records and radiology, we could very easily go that next step and build integrative models, both in terms of building the foundation model and then linking with language and getting it to generate responses and so forth. And for other data types, we might need to do some more specific training data types that we don't have enough data to build foundation models and so forth. So we're trying to expand out to other data types and see how pathology can act as a binder.Eric Topol (28:57):Well if anybody's going to build it, I'm betting on you and your team there, Faisal. Now what this gets us to is the point that, was it 96% or 95% of pathologists in this country are basically in an old era, we're not eking out so much information from slides that they could, and here you're kind of in another orbit, you're in another world here whereby you're coming up with information. I mean things I never thought really the prognosis of a patient over extended period of time, the sensitivity of drugs to the tumor from the slide, no less the driver mutations to be able to, so you wouldn't even have to necessarily send for mutations of the cancer because you get it from the slide. There's so much there that isn't being used. It's just to me unfathomable. Can you help me understand why the pathology community, now that I know you're not actually a pathologist, but you're actually trying to bring them along, what is the reason for this resistance? Because there's just so much information here.Faisal Mahmood (30:16):So there are a number of different reasons. I mean, if you go into details for why digital pathology is not actively happening. Digitizing an entire department is expensive, retaining large amounts of slides is expensive. And then the value proposition in terms of patient care is definitely there. But the financial incentives, reimbursement around AI is not quite there yet. It's slowly getting there, but it's not quite there yet. In the meantime, I think what we can really focus on, and what my group is thinking a lot about is that how can we democratize these models by using what the pathologists already have and they all have a microscope and most of them have a microscope with a camera attached to it. Can we train these models on whole slide images like we have them and adapt them to just a camera coupled to a microscope? And that's what we have done for PathChat2.(31:23):I think one of the demos that we showed after the article came out was that you could use PathChat on your computer with the whole slide image, but you can also use it with a microscope just coupled to a camera and you put a glass light underneath. And in an extreme lower source setting, you can also use it with just a cell phone coupled to a microscope. We're also building a lighter weight version of it that wouldn't require internet, so it would just be completely locally deployed. And then it could be active in lower source settings where sometimes sending a consult can take a really, really long time, and quite often it's not very easy for hospitals in lower source settings to track down a patient again once they've actually left because they might've traveled a long distance to get to the clinic and so forth. So the value of having PathChat deployed in a lower source setting where it can run locally without internet is just huge because it can accelerate the diagnosis so much. In particular for very simple things, which it's very, very good at making a diagnosis for those cases.Eric Topol (32:33):Oh, sure. And it can help bridge inequities, I mean, all sorts of things that could be an outgrowth of that. But what I still having a problem with from the work that you've done and some of the other people that well that are working assiduously in this field, if I had a biopsy, I want all the information. I don't want to just have the old, I would assume you feel the same way. We're not helping patients by not providing the information that's there just with a little help from AI. If it's going to take years for this transformation to occur, a lot of patients are going to miss out because their pathologists are not coming along.Faisal Mahmood (33:28):I think that one way to of course solve this would be to have it congressionally mandated like we had for electronic medical records. And there are other arguments to be made. It's been the case for a number of different hospitals have been sued for losing slides. So if you digitize all your slides and you're not going to lose them, but I think it will take time. So a lot of hospitals are making these large investments, including here at the Brigham and MGH, but it will take time for all the scanners, all the storage solutions, everything to be in place, and then it will also take time for pathologists to adapt. So a lot of pathologists are very excited about the new technology, but there are also a lot of pathologists who feel that their entire career has been diagnosing cases or using a microscope and slide. So it's too big of a transition for them. So I think there'll obviously be some transition period where both would coexist and that's happening at a lot of different institutions.Eric Topol (34:44):Yeah, I get what you're saying, Faisal, but when I wrote Deep Medicine and I was studying what was the pathology uptake then of deep learning, it was about 2% and now it's five years later and it's 4% or 5% or whatever. This is a glacial type evolution. This is not keeping up with how the progress that's been made. Now, the other thing I just want to ask you before finishing up, there are some AI pathology companies like PathAI. I think you have a startup model Modella AI, but what can the companies do when there's just so much reluctance to go into the digital era of pathology?Faisal Mahmood (35:31):So I think that this has been a big barrier for most pathology startups because around seven to eight years ago when most of these companies started, the hope was that digital pathology would happen much faster than it actually has. So I think one thing that we're doing at Modella is that we understand that the adoption of digital pathology is slow. So everything that we are building, we're trying to enable it to work with the current solutions that exist. So a pathologist can capture images from a pathology slide right in their office with a camera with a microscope and PathChat, for example, works with that. And then the next series of tools that we're developing around generative AI would also be developed in a manner that it would be possible to use just a camera coupled to a microscope. So I think that I do feel that all of these pathology AI companies would have been doing much, much better if everything was digital, because adopting the tools that they developed would very straightforward. Right now, the barrier is that even if you want to deploy an AI driven solution, if your hospital is not entirely digital, it's not possible to do that. So it requires this huge upfront investment.Eric Topol (37:06):Yeah, no, it's extraordinary to me. This is such an exciting time and it's just not getting actualized like it could. Now, if somebody who's listening to our conversation has a relative or even a patient or whatever that has a biopsy and would like to get an enlightened interpretation with all the things that could be found that are not being detected, is there a way to send that to a center that is facile with this? Or if that's a no go right now?Faisal Mahmood (37:51):So I think at the moment it's not possible. And the reason is that a lot of the generic AI tools are not ready for this. The models are very, very specific for specific purposes. The generalist models are just getting started, but I think that in the years to come, this would be a competitive edge for institutions who do adopt AI. They would definitely have a competitive edge over those who do not. We do from time to time, receive requests from patients who want us to run their slides on the cancers of unknown primary tool that we built. And it depends on whether we are allowed to do so or not, because it has to go through a regular diagnostic first and how much information can we get from the patient? But it's on a case by case basis.Eric Topol (38:52):Well, I hope that's going to change soon because you have been, your team there has just been working so hard to eke out all that we can learn from a path slide, and it's extraordinary. And it made me think about what we knew five years ago, which already was exciting, and you've taken that to the fifth power now or whatever. So anyway, just to congratulate you for your efforts, I just hope that it will get translated Faisal. I'm very frustrated to learn how little this is being adopted here in this country, a rich country, which is ignoring the benefits that it could provide for patients.Faisal Mahmood (39:40):Yeah. That's our goal over the next five years. So the hope really is to take everything that we have developed so far and then get it in aligned with where the technology currently is, and then eventually deploy it both at our institution and then across the country. So we're working hard to do that.Eric Topol (40:03):Well, maybe patients and consumers can get active about this and demand their medical centers to go digital instead of living in an analog glass slide world, right? Yeah, maybe that's the route. Anyway, thank you so much for reviewing at this pace of your publications. It's pretty much unparalleled, not just in pathology AI, but in many parts of life science. So kudos to you, Richard Chen, and your group and so many others that have been working so hard to enlighten us. So thanks. I'll be checking in with you again on whatever the next model that you build, because I know it will be another really important contribution.Faisal Mahmood (40:49):Thank you so much, Eric. Thanks.**************************Thanks for listening, reading or watching!The Ground Truths newsletters and podcasts are all free, open-access, without ads.Please share this post/podcast with your friends and network if you found it informativeVoluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly helped fund our summer internship programs for 2023 and 2024.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff for audio and video support at Scripps Research.Side note: My X/twitter account @erictopol was hacked yesterday, 27 July, with no help from the platform to regain access despite many attempts. Please don't get scammed! Get full access to Ground Truths at erictopol.substack.com/subscribe

In Season 7's final episode, Dr. Ron Hirschberg sits with Dr. Ali Raja, MGH's Executive Vice Chair of Emergency Medicine, in his office in the heart of the Bulfinch Building at Massachusetts General Hospital, est. 1811... 159 years prior to establishing Emergency Medicine training programs in 1970. Dr. Raja's life and work are discussed, from growing up in Houston looking towards an Air Force career - a family legacy - to a journey into medicine, business, service, and leadership - while along the way juggling all the balls in the air with his eye always on the most important (and delicate) "glass ball" - his family.Thanks very much for joining today on our final episode of Season 7 of Home Base Nation. Many thanks to Dr. Ali Raja for your service and ongoing service to your staff at MGH and of course the patients who come in every day to the ED who may be unlucky to be there, but lucky to have you and your team at the bedside. Learn more about Dr. Ali RajaAnd on behalf of Home Base, thank you to all who've served. Hoping to see you at the 15th Annual Run To Home Base on July 27th at Fenway Park. You can still Run virtually with us and donations are accepted and appreciated – Go To: www.runtohomebase.org.____Home Base Nation is the official podcast for Home Base Program for Veterans and Military Families – Our team sees veterans, servicemembers and their families addressing the invisible wounds of war at no cost. This is all made possible thanks to a grateful nation – And if you want to learn more on how you can help, visit us at www.homebase.org, or if you or anyone you know would like to connect to care, you can also reach us at 617-724-5202.Theme music for Home Base Nation: "Rolling the Tree" by The Butler FrogsFollow Home Base on Twitter, Facebook, Instagram, LinkedInThe Home Base Nation Team is Steve Monaco, Army Veteran Kelly Field, Justin Scheinert, Chuck Clough, with COO Michael Allard, Brigadier General Jack Hammond, and Peter Smyth.Producer and Host: Dr. Ron HirschbergAssistant Producer, Editor: Chuck CloughChairman, Home Base Media Lab: Peter SmythThe views expressed by guests to the Home Base Nation podcast are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Views and opinions expressed by guests are those of the guests and do not necessarily reflect the view of the Massachusetts General Hospital, Home Base, the Red Sox Foundation or any of its officials.

CardioNerds Co-Founder Dr. Daniel Ambinder, Series Co-Chair Dr. Giselle Suero Abreu (FIT at MGH), and Episode Lead Dr. Iva Minga (FIT at the University of Chicago) discuss the use of multi-modality cardiovascular imaging in cardio-oncology with expert faculty Dr. Nausheen Akhter (Northwestern University). Show notes were drafted by Dr. Sukriti Banthiya and episode audio was edited by CardioNerds Intern and student Dr. Diane Masket. They use illustrative cases to discuss: Recommendations on the use of multimodality imaging, including advanced echocardiographic techniques and cardiac MRI, in patients receiving cardiotoxic therapies and long-term surveillance. Role of nuclear imaging (MUGA scan) in monitoring left ventricular ejection fraction. Use of computed tomography to identify and/or monitor coronary disease. Imaging diagnosis of cardiac amyloidosis. This episode is supported by a grant from Pfizer Inc. This CardioNerds Cardio-Oncology series is a multi-institutional collaboration made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Giselle Suero Abreu, Dr. Dinu Balanescu, and Dr. Teodora Donisan.  CardioNerds Cardio-Oncology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! References -  Multi-modality Imaging in Cardio-Oncology Baldassarre L, Ganatra S, Lopez-Mattei J, et al. Advances in Multimodality Imaging in Cardio-Oncology. J Am Coll Cardiol. 2022 Oct, 80 (16) 1560–1578.

In this episode of Sick Health, Dr. Kevin Ban explores the intricate world of teen mental health and the often volatile, crushing, and nuanced world of adolescent anxiety and depression. In this eye-opening episode, special guest and child psychiatrist Dr. Mona Potter reveals the profound impact of both genetic predispositions and environmental factors on teen anxiety. While certain emotional experiences are still universal, growing up with anxiety in the modern world is different and can have lasting negative consequences if caregivers miss certain signals.But breathe easy. You're about to learn how different habits and therapeutic approaches can make a significant difference. So whether you're the one experiencing the overwhelming pressure of teen life or the caregiver of someone who's going through it, there is help. There is relief. There is a light at the end of the tunnel. In the next 40 minutes, you'll learn about proven methods to quell all those sleepless nights, explosive behaviors, feelings of hopelessness, mood swings, and so much more. ABOUT MONA POTTER:Mona Potter, MD is a board-certified child and adolescent psychiatrist and co-founder and Chief Medical Officer of InStride Health, an innovative program that serves children and adolescents (and their families) diagnosed with anxiety and OCD. She also serves as Associate Director of the Division of Professional and Public Education at MGH. Prior to co-founding InStride, Dr. Potter spent nearly two decades in the MGH/McLean/Harvard Medical School system and ultimately served as Medical Director of the McLean Child and Adolescent Psychiatry Outpatient Services (including McLean Anxiety Mastery Program, McLean School Consultation Service, and McLean Child and Adolescent Outpatient DBT Program), Assistant Professor of Psychiatry at Harvard Medical School, and sat on the Executive Committee of the McLean Institute of Technology in Psychiatry. She earned a Bachelor of Music from Vanderbilt University and stayed on at Vanderbilt University School of Medicine for her Medical Degree. When she's not tackling the mental health crisis, she enjoys summiting mountains with her family, coaching her daughter's soccer team, and keeping the music alive through playing piano and clarinet.FIND MONA AT:LinkedIn: https://www.linkedin.com/company/80333229/admin/feed/posts/Facebook: https://www.facebook.com/Instride.Health SHARING BEAUTYhttps://www.youtube.com/watch?v=hkmvuV6PK20To watch this as a video with additional diagrams of the brain, find us on Youtube at: https://www.youtube.com/@SickHealthwithKevinBanMDPlease leave us a comment on our YouTube channel with any questions you may have, and we'll be sure to answer them in subsequent episodes.

As Eric notes at the end of today's podcast, we talk about many difficult issues with our patients.  How long they might have to live. Their declining cognitive abilities. What makes their lives meaningful, brings them joy, a sense of purpose.  But one issue we're not as good at discussing with our patients is sexual health. On today's podcast Areej El-Jawahri, oncologist specializing in blood cancers at MGH, says that sexual health is one of the top if not the top issue among cancer survivors.  Clearly this issue is important to patients.  Sharon Bober, clinical psychologist at DFCI, notes that clinicians can get caught in an anxiety cycle, in which they are afraid to ask, don't ask, then have increased anxiety about not asking.  Like any other conversation, you have to start, and through experience learn what language is comfortable for you.  Don Dizon, oncologist specializing in pelvic malignancies at Brown, suggests speaking in plain language, starting by normalizing sexual health issues, to paraphrase, “Many of my patients experience issues with intimacy and sexual health. Is that an issue for you? I'm happy to talk about it at any time.”  All guests agree that clinicians feel they need to have something they can do if they open Pandora's box.  To that end, we talk about practical advice, including: The importance of intimacy over and above physical sexual function for many patients Common causes and differential diagnoses of sexual concerns in patients with cancer and survivors Treatments for erectile dysfunction - first time the words “cock ring” have been uttered on the GeriPal Podcast - and discuss daily phosphodiesterase 5 inhibitor therapy vs prn The importance of a pelvic exam for women experiencing pain What is “pelvic physical therapy?” Treatments for vaginal dryness and atrophy ACS links, NCCN links, Cancersexnetwork, and a great handout that Areej created And I get to sing Lady Gaga, also a first for GeriPal!  And let me tell you, there's nothing like the first time (sorry, I couldn't help it!).

Today on the Beat Club Podcast, we chop it up with a "producer's producer" and New England Music Awards Producer of the year...Mel Go Hard!Tap in as we learn more about her journey, where it began and where it is going next; We also get a chance to preview some tracks off her debut complication album, as well as put MGH to the test as  she takes on the BCP community in our first every R&B Beat Battle. All this and more, while listening to beats sent in from around the globe!Beat Club Podcast | Where producers are heard. Be sure to check out more exclusive content on our Patreon page: patreon.com/beatclubpodcast Upload your beats www.beatclubpodcast.com | #whereproducersareheardFind out about our next LIVE episode by following us on https://www.instagram.com/beatclubpodcastSubscribe & watch exclusive clips on our Youtube https://www.youtube.com/@BeatClubPodcastAnd don't forget to follow our hosts on social media:@Doitallloopz | @MotivateMerren | @Trenchgotgame

The National Memorial Day Concert features Marine Veteran Kirstie Ennis and others and a conversation with Yuliia Matvieieva, working with Ukrainian Veteran Amputees on mental and physical health - Nearly 60,000 people have lost limbs over the the past two years since the Russian envarion of Ukraine in February 2022, the vast majority being servicemembers. Yuliia came to Home Base during a two week Ukrainian physician visit to MGH, a collaboration with Global Response Medicine, the W.H.O. and our colleague at MGH Center for Global Health, Dr. Jarone Lee. Yuliia finished medical school in Ukraine in 2013, and has been in the US for the past 8 years – now focusing on the mental and physical health for this massive group of veterans with limb loss. Yuliia and Ron sat for a conversation about life before the War in 2014, and how the Big War in 2022 changed everything. As a military-mental health specialist, she runs peer support for Ukrainian veteran amputees with non-profit Volia Fund, who's mission is the protect and boost wellbeing in Ukraine.Many thanks Yuliia Matvieieva for you ongoing service to those who've served. And thank you for telling your story about perseverance and your new chapter, while helping so many others get back to a new normal life and reintegrate back to their own.Thank you Dr. Jarone Lee of MGH Center for Global Health and Health Tech without borders, and Deputy Director of Global Response Medicine Andrea Leiner for making this special visit from Kharkiv to Boston possible.Thanks for joining us everyone. And on Memorial Day - Today and every day we honor our fallen heroes and the families who have supported them. Have a great couple weeks folks and see you next time. This is Ron Hirschberg at Home Base. ____And of course, Home Base Nation will continue to share episodes every two weeks up through the Run to Home Base this coming July 27th. Please sign up to join us there to support all veterans, servicemembers and families, and as we celebrate and honor women in the military this year in 2024.Home Base Nation will be sharing episodes every two weeks up through the Run To Home Base this coming July 27th. Please sign up to join us there to support all veteran, servicemember and family care, and as we celebrate women in the military this year. Home Base Nation is the official podcast for Home Base Program for Veterans and Military Families – Our team sees veterans, servicemembers and their families addressing the invisible wounds of war at no cost. This is all made possible thanks to a grateful nation – And if you want to learn more on how you can help, visit us at www.homebase.org, or if you or anyone you know would like to connect to care, you can also reach us at 617-724-5202.Theme music for Home Base Nation: "Rolling the Tree" by The Butler FrogsFollow Home Base on Twitter, Facebook, Instagram, LinkedInThe Home Base Nation Team is Steve Monaco, Army Veteran Kelly Field, Justin Scheinert, Chuck Clough, with COO Michael Allard, Brigadier General Jack Hammond, and Peter Smyth.Producer and Host: Dr. Ron HirschbergAssistant Producer, Editor: Chuck CloughChairman, Home Base Media Lab: Peter SmythThe views expressed by guests to the Home Base Nation podcast are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Views and opinions expressed by guests are those of the guests and do not necessarily reflect the view of the Massachusetts General Hospital, Home Base, the Red Sox Foundation or any of its officials.

In this episode, we explore nutrition support in patients with brain injury. Our guest is registered dietitian nutritionist, Carmen Lo, MS, RD, LDN, CNSC. Carmen has worked at different teaching hospitals and is currently a Senior Clinical Nutritionist at Massachusetts General Hospital (MGH). For the past 10 years at MGH, she has covered the Neurosciences ICU and assumed a team lead role in the adult metabolic nutrition support team. She is also the nutritionist for the MGH neurorecovery clinic for post-brain injury patients.  This episode was recorded on 4/20/24 and is hosted by Christina Rollins, MBA, MS, RDN, LDN, FAND, CNSC.

Dr. Kelly is the Elizabeth R. Spallin Professor of Psychiatry in Addiction Medicine at Harvard Medical School. He is the Director of the Recovery Research Institute at the Massachusetts General Hospital (MGH), the Associate Director of the Center for Addiction Medicine at MGH, and the Program Director of the Addiction Recovery Management Service. Dr. Kelly is a former President of the American Psychological Association's (APA) Society of Addiction Psychology, and is a Fellow of the APA and a Diplomate of the American Board of Professional Psychology. He has served as a consultant to U.S. federal agencies and non-federal institutions, as well as foreign governments and the United Nations. Dr. Kelly has published over 200 peer-reviewed articles, chapters, and books in the field of addiction medicine. His work has focused on addiction treatment and the recovery process, mechanisms of behavior change, and reducing stigma and discrimination among individuals suffering from addiction. In this Episode: What initially sparked his interest in studying Alcoholics Anonymous and 12-step programs? What were the the key findings of the Cochrane review regarding the efficacy of AA and 12-step approaches? How effective is AA compared to professionally-delivered addiction treatments like cognitive behavioral therapy? Why does AA work for some people but not others? How well does AA work for diverse populations? Are there certain groups for whom it works better or worse? Could these findings be applied to other recovery communities? i.e. Sweet Sobriety, Smart Recovery, LifeRing? What role can AA play within a modern system of clinical addiction treatment and recovery support? His thoughts on harm reduction Why he thinks that sometimes in the addiction field it's either a harm reduction model OR an abstinence model instead of both offered. The research on average recovery trajectories (ie 4 – 5 years before they decide to stop even though the use is very problematic due to stigma or fear and trying moderation, then 7 or 8 years and multiple treatment interventions before they get one full year of abstinence, then 5 years of continuous remission before people are no longer at an elevated risk versus the normal population) People with addiction ned to be given permission to practice recovery instead of just being expected to just stop immediately  Does he believe in Food Addiction ? His thoughts on what our next steps should be to get Food Addiction Recognized   Follow John Kelly and the Recovery Research Institute: https://www.recoveryanswers.org The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.

“Neuroinflammation causes neuronal dysfunction by destabilizing excitatory synapses” and “Antigen-specific T cells in autoimmune inflammatory diseases of the central nervous system” The Anne Klibanski Visiting Lecture Series was created to support and advance the careers of women. These lectures bring together faculty from institutions that have hosted Anne Klibanski Scholars with MGH scholars, on topics that overlap both research areas. Dr. Gillani presented on “Neuroinflammation causes neuronal dysfunction by destabilizing excitatory synapses.”  Dr. Hastermann presented on “Antigen-specific T cells in autoimmune inflammatory diseases of the central nervous system.” Presenters: Rebecca L. Gillani, MD, PhD, Instructor, Neurology, MGH/HMS Maria Hastermann, MD, PhD, Max Delbrück Center, Berlin Learning Objectives for Dr. Gillani's talk: Upon completion of this activity, participants were able to: Understand the contribution of neuronal dysfunction to neurologic disability in people living with multiple sclerosis. Recognize the scope of synaptic dysfunction in people living with multiple sclerosis. Identify potential mechanisms for neuronal dysfunction due to neuroinflammation. Learning Objectives for Dr. Hastermann' talk: Upon completion of this activity, participants were able to: Describe neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Recognize the role of T cells in central nervous system (CNS) inflammation. Review the longitudinal prospective registry study (example BERLimmun). Click here to watch webinar.

Ham it up with attorneys Nick Bonds and Jen McCormick from the Phia Group as they dive into the groundbreaking world's first successful genetically engineered pig kidney transplant at MGH in Boston. Explore the details of this medical breakthrough, its implications for the healthcare industry, and the considerations for the future of dialysis, plan language, and stop loss provisions. Tune in to gain invaluable insights into the intersection of law, healthcare, and cutting-edge medical advancements.

Welcome to Monday Night Talk podcast for March 18, 2024! Guests and topics for this podcast includes a county update with Plymouth County Commissioner Greg Hanley plus a State House Report with State Senator Sue Moran. Chris DiOrio, local defense attorney calls in to discuss the latest developments in the Karen Read murder case along with his pending participation in the upcoming Boston Marathon to raise money for the MGH's Pediatric Cancer Clinic. Finally, John Berger, author of Solving the Climate Crisis talks about ways to save our planet by changing how we use energy for transportation and construct buildings. Do you have a topic for a future show or info on an upcoming community event? Email us at mondaynighttalk@gmail.com.  If you're a fan of the show and enjoy our segments, you can either download your favorite segment from this site or subscribe to our podcasts through iTunes & Spotify today!  Monday Night Talk with Kevin Tocci, Copyright © 2024.

Welcome back to Season Two of "On Pump," where we delve into the heart of perfusion, exploring the latest trends, innovations, and insights in the field. In this highly anticipated episode, we have the privilege of sitting down with Nathan Minie and Joseph Catricala from Massachusetts General Hospital (MGH), renowned for its prestigious perfusion program and clinical rotation opportunities. Our guests provide an exclusive inside look into MGH, offering invaluable perspectives on what sets it apart as one of the nation's premier perfusion clinical rotation sites and top employers for new graduates. Throughout the episode, Nathan and Joseph illuminate MGH's pioneering approach to culture, simulation, research, and leadership in perfusion. They share firsthand experiences and anecdotes that highlight how MGH is not only shaping the future of perfusion but also fostering an environment conducive to growth and excellence. As seasoned professionals in the field, our guests discuss the significance of MGH's emphasis on simulation training, which equips students and practitioners with the skills and confidence needed to navigate complex perfusion scenarios effectively. Moreover, they shed light on MGH's commitment to cutting-edge research initiatives, illustrating how these endeavors contribute to advancing the science and practice of perfusion, ultimately benefiting patients worldwide. Beyond technical proficiency, Nate and Joe emphasize MGH's dedication to cultivating strong leadership qualities among its perfusionists, empowering them to thrive in diverse clinical settings and take on leadership roles within the healthcare ecosystem. Listeners will gain invaluable insights into the inner workings of MGH's perfusion program, discovering why it stands out as a beacon of excellence and a coveted destination for aspiring perfusionists. Join us as we embark on this enlightening journey into the heart of Massachusetts General Hospital's perfusion program, where innovation, expertise, and passion converge to shape the future of cardiovascular care.

The teen years can be a time for experimenting with alcohol and other drugs. But a recent CDC study found the reason why teens use substances today isn't just for experimentation, but also to stop worrying about problems, and even to help with depression or anxiety. Today, Gene and Khadijah discuss how to approach your teen if you've discovered they are using alcohol, marijuana, or a prescription or over-the-counter drug, and what health risks to know about for each of these.These are hard conversations to have. We hope that ours will help you to have yours.Media ListWhen to Worry, What to Do PDF Library (MGH Clay Center)CDC Report Indicates Teens are Seeking to Escape Worries and Stress Through Drug Use (HuffPost)Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health (US Dept of Health & Human Services)Alcohol & Adolescents, featuring John F. Kelly, PhD, ABPP (Podcast) Alcohol - Conversation Starters with Dr. Gene Beresin (YouTube)Asking Adolescents About Alcohol with Dr. Khadijah Booth Watkins (YouTube)Cannabis and the Teen Brain, featuring Jodi Gilman, PhD (Podcast)Once You Have Discovered Your Teen Is Using Pot, What's the Next Step? (MGH Clay Center) Commonly Abused Prescription and OTC Drugs (WebMD)NARCAN's Available Over the Counter, Should I Carry It? (MGH, Psychiatry)Addiction Recovery Management Services (MGH, ARMS)When to Worry, What to Do PDF Library (MGH Clay Center)Myths About the 12-Step Program (MGH Clay Center)Find a Treatment Facility (SAMHSA)If you have a question that we didn't cover, please get in touch. Write to Gene or Khadijah at mghclaycenter@mgb.org. Music by Gene BeresinEpisode produced by Sara Rattigan and Spenser Egnatz Hosted on Acast. See acast.com/privacy for more information.

Dr. Helen Riess is Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of Empathy Research and Training in the Psychotherapy Research Group at Massachusetts General Hospital. She is also Founder and Chief Executive Officer at Empathetics, a company that provides science-based empathy and interpersonal skills training for healthcare professionals. Her research focuses on improving empathy and relational skills in physicians.00:00 Introduction01:14 Defining Empathy03:38 Empathy and Burnout05:00 Care for the Caregiver07:52 Exquisite Empathy and Burnout09:18 Building Empathy and Avoiding Overburden10:45 Developing Boundaries in Clinical Practice11:45 Training and Teaching Empathy13:42 Model for Recognizing Emotion in Others15:11 Becoming Emotion Detectives19:31 Leadership's Role in Creating Supportive Workplaces23:22 Benefits of Empathy Training29:07 Technology and Empathy Training34:18 Research on MDMA-Assisted Psychotherapy37:43 Building Empathy and Compassion40:07 Taking Small Steps Towards Empathy42:32 Resources for Building Empathy43:28 Future of Empathy TrainingThe Empathy Effect (Dr. Riess's book)The Power of Empathy (TEDx Talk)Visit our website for more insights on psychiatry.Podcast producer: Jon Earle

Today's guest on the She Impacts Culture podcast is Wendy Puffer, Owner and Chief Executive Officer of Marion Design Co., a social design studio committed to the revitalization of downtown Marion through empowering community assets. Her story is a testament to the transformative power of faith in action, the significance of presence, and breathing new life into cities! In this episode, we specifically chat through:Designing a life of purposeThe transformative power of presenceReshaping perceptionsNurturing authentic connections within communities Friends, if you find yourself in a season of wanting to revitalize your city, community, or work, this episode is a must-listen. Wendy's insights and experiences offer a roadmap to inspire change and impact. Wendy's journey of faith intersecting with design to breathe new life into Marion, Indiana, will encourage you! Her story is a testament to the transformative power of faith in action to nurture stronger communities.Connect with Wendy:Website: https://www.mariondesign.co/Facebook: https://www.facebook.com/mariondesigncoInstagram: https://www.instagram.com/mariondesignco/Wendy Puffer, NCIDQ, is the Owner and Chief Executive Officer of Marion Design Co., social design studio committed to the revitalization of downtown Marion through empowering community assets. Her design staff of professionals and interns have created design throughout the city such as the Marion City Brand and Marion Health's (MGH) recent rebrand and hosted events such as the Marion Made Fashion Show and Market. As a licensed interior designer, her design is scattered throughout Grant County and beyond. She launched two design programs at IWU; Interior Design and Design for Social Impact. As a professor, she led teams to paint murals on the Sweetser Cafe and on Converse Mainstreet, directed eight teams to build temporary facade designs on the downtown square, and co-launched Marion Design Co. with design colleagues in 2016. She earned a Design Thinking MFA in 2016 which expanded her collaborative offerings to empowering business and organizations to creatively solve “wicked problems” through innovative solutions. She's been married to Dr. Keith Puffer, IWU Psychology Professor for 36 years and has three adult children located in New York, Los Angeles, and Indianapolis.

In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special guest Amy Colwell, MD, discuss the following articles from the January 2024 issue: “Measuring Outcomes in Aesthetic Surgery by Board-Certified Plastic Surgeons” Colwell, Ramly, and Chung. Read the article for FREE: https://bit.ly/MeasuringAesthOutcomes Special guest Amy Colwell, MD, from Massachusetts General Hospital (MGH) and Harvard University. Dr. Colwell is a plastic surgeon specializing in breast reconstruction, aesthetic breast surgery, and body contouring at MGH while also serving as a Co-editor for PRS Journal. She completed her general surgery training at the Brigham and Women's Hospital followed by plastic surgery training in the Harvard combined training program. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCJan24Collection

In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special guest Amy Colwell, MD, discuss the following articles from the January 2024 issue: “Clinical Practice Patterns and Evidence-Based Medicine in Abdominoplasty: 16-Year Analysis of Continuous Certification Tracer Data from the American Board of Plastic Surgery” by Stein, Weissman, Harrast, et al. Read the article for FREE: https://bit.ly/16YearAbdplastyPatterns Special guest Amy Colwell, MD, from Massachusetts General Hospital (MGH) and Harvard University. Dr. Colwell is a plastic surgeon specializing in breast reconstruction, aesthetic breast surgery, and body contouring at MGH while also serving as a Co-editor for PRS Journal. She completed her general surgery training at the Brigham and Women's Hospital followed by plastic surgery training in the Harvard combined training program. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCJan24Collection 

In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special guest Amy Colwell, MD, discuss the following articles from the January 2024 issue: “Assessing the Efficacy of the S-PECS Block in Breast Augmentation Surgery: A Randomized, Double-Blind, Controlled Trial” by Sforza, Saghir, Saghir, et al. Read the article for FREE: https://bit.ly/S-PECSBlock Special guest Amy Colwell, MD, from Massachusetts General Hospital (MGH) and Harvard University. Dr. Colwell is a plastic surgeon specializing in breast reconstruction, aesthetic breast surgery, and body contouring at MGH while also serving as a Co-editor for PRS Journal. She completed her general surgery training at the Brigham and Women's Hospital followed by plastic surgery training in the Harvard combined training program. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCJan24Collection    

Eric is joined in conversation by Dr. Laura Erickson-Schroth and Dr. Ilan H. Meyer to delve into the past and present of mental health for LGBTQ people.  They discuss historical stigma, the ramifications of the American Psychiatric Association's declassification of homosexuality as a mental disorder 50 years ago, and shifting psychiatric understandings of LGBTQ mental health in relation to societal pressures and prejudice. They also explore the continued pathologization of trans people, and the barriers that exist to finding accessible, safe, and informed care.  The MGH episode about Dr. Magnus Hirschfeld mentioned in the episode can be found here. Visit our episode webpage for additional resources and a transcript of the episode. For exclusive Making Gay History bonus content, join our Patreon community. ——— To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Calling all those with a passion for cardiovascular prevention! In this episode of the CardioNerds Cardiovascular Prevention Series, we take a deep dive into the world of glucagon-like peptide-1 (GLP-1) receptor agonists. Along the way, you'll hear about the biology of the GLP-1 molecule and its related peptides, learn more about how GLP-1 agonists promote glycemic control, weight loss, and cardiometabolic health, and explore the current body of literature supporting the individualized application of these medications to patients with diabetes, obesity, and/or ASCVD. Join Dr. Christian Faaborg-Andersen (CardioNerds Academy Fellow and Internal Medicine Resident at MGH), Dr. Gurleen Kaur (Director of the CardioNerds Internship, Chief of House Einthoven, and Internal Medicine resident at BWH), and Dr. Rick Ferraro (CardioNerds Academy House Faculty and Cardiology Fellow at JHH) for a wide-ranging discussion on GLP-1 and GIP agonists with Dr. Dennis Bruemmer (Cardiologist and Director of the Center for Cardiometabolic Health in the section of Preventive Cardiology at the Cleveland Clinic). Show notes were drafted by Dr. Christian Faaborg-Andersen. Audio editing was performed by CardioNerds Academy Intern, student Dr. Tina Reddy. This episode was produced in collaboration with the American Society of Preventive Cardiology (ASPC) with independent medical education grant support from Novo Nordisk. See below for continuing medical education credit. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - GLP-1 Agonists: Mechanisms to Applications The selection and dosing of GLP-1 and GIP agonists (GLP-1s and GIPs) depends on their intended use as an anti-glycemic or anti-obesity agent. The cardiovascular benefits of GLP-1s and GIPs may be independent of improvements in glycemic control, and in part be driven by reduction in inflammation, a key driver of arterial plaque formation. In patients with comorbid coronary artery disease, obesity, and diabetes, GLP-1 agonists and SGLT-2 inhibitors should be used as first-line agents, over metformin. Tirzepatide is a dual agonist that activates GIP and GLP-1 receptors. GIP is highly expressed in the brain, which may mediate satiety, promote energy expenditure, and enhance peripheral glucose metabolism. Caution should be used with GLP-1 agonists in patients with long-standing diabetes complicated by gastroparesis, as well as incompletely treated diabetic retinopathy. GI upset is not uncommon with GLP-1/GIP agonists, and switching to a different agonist is unlikely to help.  Show notes - GLP-1 Agonists: Mechanisms to Applications What are the mechanisms of action by which GLP-1 and GIP controls blood sugar and body weight? Glucagon-like peptide-1 (GLP-1) is an endogenous hormone that is secreted in response to an oral glucose load. It promotes insulin release, inhibits glucagon secretion, and slows gastric emptying via the brain-intestine axis, leading to satiety. GLP-1 agonists are medications that mimic the effect of this hormone and, on average, lower hemoglobin A1C by 0.8% to 1.5%. These medications include semaglutide, liraglutide, and dulaglutide. Glucose-dependent insulinotropic polypeptide (GIP) is also an endogenous hormone, similarly secreted by the body in response to an oral glucose load such as a meal. GIP is highly expressed in the arcuate nucleus and hypothalamus, which may mediate satiety, promote energy expenditure, and enhance peripheral glucose metabolism. Tirzepatide is a dual GLP-1/GIP agonist. What is the role of GLP-1/GIP agonists in patients with overweight/obesity and/or type 2 diabetes? How does the dosing of GLP-1/GIP medications change with their intended disease target?

In this episode, host Shikha Jain, MD, speaks with Laura Petrillo, MD, about navigating patients through changes and goals in palliative care, understanding patients living with and surviving advanced cancer and more. •    Welcome to another exciting episode of Oncology Overdrive :58 •    About Petrillo 1:03 •    The interview 1:40 •    How did you find yourself in medicine, specifically in palliative care and geriatrics? 2:04 •    How has the evolution of cancer care and technology impacted the way you engage and deliver palliative care? 6:46 •    Jain and Petrillo on the effect changes in palliative care can have on patients. 12:47  •    How do you communicate the distinctions between palliative care and hospice care to patients and physicians? 17:19 •    Do you think that there are ways for people outside of palliative care can incorporate intentional communication with patients in their care? … When should you refer someone to palliative care? 23:45 •    Petrillo and Jain on advanced cancer survivorship and living with advanced cancer.  30:54 •    Jain and Reynolds on the progress made in this space and the road ahead. 29:43 •    If someone could only listen to the last two minutes of this episode, what would you want them to take away? 36:41 •    How to contact Petrillo 38:30 •    Thanks for listening 38:58 Laura Petrillo, MD, is a palliative care physician-investigator in the Division of Palliative Care and Geriatrics at MGH and an assistant professor of medicine at Harvard Medical School. We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X, formerly known as Twitter, and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X, formerly known as Twitter: @ShikhaJainMD. Petrillo can be reached on X, formerly known as Twitter, @lpetrillz.  Disclosures:  Jain and Petrillo report no relevant financial disclosures.

How can we identify kids at risk for eating disorders  in pediatrics? How can we promote healthy relationships with food and with eating?  Our guest, Dr. Jennifer Leah Goetz, a double board-certified psychiatrist specializing in eating disorders, discusses:·      the variety of eating disorders in kids, ·      the prevalence, and risk factors for developing an eating disorder·       how eating disorders come in bodies of all shapes and sizes ·       questions that pediatric clinicians can ask to see if a child/teen is at risk of developing an eating disorder·      Positive ways to talk about food with children to mitigate their risk of developing an eating disorderJennifer Leah Goetz, MD: is double board certified in general psychiatry and child and adolescent psychiatry. She completed her internship in pediatrics at Massachusetts General Hospital and her general psychiatry and child/adolescent psychiatry training at MGH and McLean. She previously served as medical director of the child and adolescent inpatient unit at Johns Hopkins Hospital and helped run the eating disorder clinical service. She is an attending psychiatrist at McLean hospital and an Instructor in Psychiatry at Harvard Medical School. She specializes in the care and treatment of those with eating disorders. Check out our website PsychEd4Peds.com for more resources.Follow us on Instagram @psyched4peds

Dr. Leslie Chang, a hospitalist at Massachusetts General Hospital (MGH), discusses an approach to diuresis with host Dr. Joyce Zhou, a resident at MGH and core Run the List podcast member. Together, they discuss determining a patient's volume status via history, physical exam, and labs in order to guide inpatient diuresis decision-making.

Academy Award and Golden Globe nominee Mariel Hemingway is known for her iconic roles in Lipstick, Manhattan, and Star 80. But did you know she created a Mental Health Foundation, and that she is from a military family? Her dad enlisted in WWII just after Pearl Harbor, was in the OSS which would become the CIA. Her grandfather, the great American writer Ernest Hemingway was denied enlistment for visual impairment but served the frontline in Italy with the Red Cross as an ambulance driver in 1917. Ron and Mariel talk about service, wellness, mental health, about her 2015 memoir "Out Came The Sun," and being able to tell your story no matter the challenge, and never being afraid to let that story go. Many thanks Mariel Hemingway for joining us on Home Base Nation. Thanks for your passion for mind body health, and helping others through your work with the Foundation and the collaboration with partner Bobby Williams on all things wellness. Your family story and legacy are remarkable and at the same time as you say, there is nothing unique about many of these challenges and triumphs we all share. Please check out the memoir Out Came the Sun: Overcoming the Legacy of Mental Illness, Addiction, and Suicide in My Family which is also read by the author on Audible. And of course, follow our friend's Melissa and Mariel's great podcast Out Comes The Sun Podcast and for wellness and mental health resources, please check out Mariel Hemingway Foundation. Special thanks to Dr. Rudy Tanzi, MGH scientist and artist for the introduction to our guest. If you are your loved one is experiencing any emotional, mental health struggles, you are not alone and please contact Home Base at (617) 724-5202, or visit www.homebase.org.To Donate to Home Base where every dollar goes to the care of veterans and military families that is cost to them, go to: www.homebase.org/donate.Theme music for Home Base Nation: "Rolling the Tree" by The Butler FrogsFollow Home Base on Twitter, Facebook, Instagram, LinkedInThe Home Base Nation Team is Steve Monaco, Army Veteran Kelly Field, Justin Scheinert, Chuck Clough, with COO Michael Allard, Brigadier General Jack Hammond, and Peter Smyth.Producer and Host: Dr. Ron HirschbergAssistant Producer, Editor: Chuck CloughChairman, Home Base Media Lab: Peter SmythHome Base Nation is the official podcast of Home Base Program for Veterans and Military Families, a partnership of the Massachusetts General Hospital and the Red Sox Foundation. To learn more and connect with us at Home Base Nation: www.homebase.org/podcastThe views expressed by guests to the Home Base Nation podcast are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Views and opinions expressed by guests are those of the guests and do not necessarily reflect the view of the Massachusetts General Hospital, Home Base, the Red Sox Foundation or any of its officials.

On this episode of Liver Talks, Alex and Adam are joined by Amit Singal, HCC expert and Chief of Hepatology at UT Southwestern, for a fascinating conversation about the latest and greatest in HCC. Then, a new segment is born featuring Rob Wilechansky, a transplant hepatology fellow at MGH and Hepatology's editorial fellow, in which they discuss an exciting new article from a recent issue of the journal. AASLD HCC Guideline: https://journals.lww.com/hep/fulltext/9900/aasld_practice_guidance_on_prevention,_diagnosis,.441.aspx Tropifexor plus cenicriviroc combination versus monotherapy in non-alcoholic steatohepatitis: Results from the Phase 2b TANDEM study: https://pubmed.ncbi.nlm.nih.gov/37162151/ Hosts Adam Winters @adam_c_winters Alex Vogel @AlexSVogel Guests: Amit Singal @docamitgs Robert Wilechansky @WilechanskyMD Edited by: Taylor Gouterman Music Credits: “Tropkicks”, Broke for Free “Something Elated”, Broke for Free “Take Me Higher”, Jahzzar “RSPN,” Blank & Kytt All music furnished by https://freemusicarchive.org/ under Creative Commons licensing. http://brokeforfree.com/ https://jahzzar.bandcamp.com/ https://blankkytt.bandcamp.com/

Emma Foley joins the show to discuss the woke calendar MGH sent to their donor list. Columbus Day has been scratched completely, and several other Leftist additions have been made. Then, John Fetterman is at it again. This time, he's talking about red pandas. As always, tune in for the Chump Line to start off the hour.

The following question refers to Section 6.1 of the 2021 ESC CV Prevention Guidelines. The question is asked by MGH internal medicine resident Dr. Christian Faaborg-Andersen, answered first by UCSD early career preventive cardiologist Dr. Harpreet Bhatia, and then by expert faculty Dr. Eugenia Gianos. Dr. Gianos specializes in preventive cardiology, lipidology, cardiovascular imaging, and women's heart disease; she is the Director of Women's Heart Health at Lenox Hill Hospital and Director of Cardiovascular Prevention for Northwell Health. The CardioNerds Decipher The Guidelines Series for the 2021 ESC CV Prevention Guidelines represents a collaboration with the ACC Prevention of CVD Section, the National Lipid Association, and Preventive Cardiovascular Nurses Association. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #30 A 65-year-old woman with a history of hypertension, type 2 diabetes mellitus, and coronary artery disease with remote PCI to the RCA presents for follow-up. She has stable angina symptoms that are well controlled with metoprolol tartrate 25 mg BID and are not lifestyle limiting. She takes aspirin 81 mg daily and atorvastatin 40 mg daily. Her LDL-C is 70 mg/dL, hemoglobin A1c is 7.0%, and eGFR is >60. In clinic, her BP is 118/80 mmHg. What is the next step in management?AIncrease atorvastatin for goal LDL-C < 55 mg/dLBNo change in managementCAdd isosorbide mononitrate 30 mg dailyDStop aspirinEStart a sulfonylurea Answer #30 Explanation The correct answer is A – increase atorvastatin for goal LDL-C < 55 mg/dL.In patients with established ASCVD, the ESC guidelines advocate for an LDL goal of < 55 mg/dL with at least a 50% reduction from baseline levels (Class I, LOE A). This patient has stable angina which is not lifestyle limiting; as such, further anti-anginal therapy is not necessary. She has known CAD with prior PCI, so aspirin therapy is appropriate for secondary prevention (Class I, LOE A). There is no indication for a sulfonylurea as her diabetes is well controlled. Notably, in persons with type 2 DM and ASCVD, the use of a GLP-1RA or SGLT2 inhibitor with proven outcome benefits is recommended to reduce CV and/or cardiorenal outcomes (Class I, LOE A).Main TakeawayFor people with established ASCVD, the ESC-recommended LDL-C goal is < 55 mg/dL with a goal reduction of at least 50%.Guideline Loc.Section 6.1 CardioNerds Decipher the Guidelines - 2021 ESC Prevention SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor RollCardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron!