Podcasts about mras

We take a closer look at the online world known as the manosphere—a loose network of communities including incels, Men Going Their Own Way (MGTOW), men's rights activists (MRAs), and pick-up artists (PUAs).These groups may look different on the surface, but they share a common core: resentment toward feminism, nostalgia for traditional masculinity, and a belief that men are the new victims of modern society. With guidance from researcher Havana Mohr-Ramirez, we unpack how these subcultures operate, where they overlap, and why they've become such powerful forces in shaping how young men see themselves and their place in the world.Drawing on insights from Laura Bates, author of Men Who Hate Women, and sociologist Ellis Cashmore, the episode examines whether the manosphere is an organized movement or something more elusive that still influences real attitudes, politics, and violence.This documentary episode goes beyond headlines and outrage to ask deeper questions about identity, belonging, and what happens when online spaces built around grievance start reshaping the world outside the screen.Text me your feedback and leave your contact info if you'd like a reply (this is a one-way text). Thanks, DavidUp The Middle PromoSupport the showShow Notes:https://outrageoverload.net/ Follow me, David Beckemeyer, on Twitter @mrblog or email outrageoverload@gmail.com. Follow the show on Twitter @OutrageOverload or Instagram @OutrageOverload. We are also on Facebook /OutrageOverload.HOTLINE: 925-552-7885Got a Question, comment or just thoughts you'd like to share? Call the O2 hotline and leave a message and you could be featured in an upcoming episodeIf you would like to help the show, you can contribute here. Tell everyone you know about the show. That's the best way to support it.Rate and Review the show on Podchaser: https://www.podchaser.com/OutrageOverload Intro music and outro music by Michael Ramir C.Many thanks to my co-editor and co-director, Austin Chen.

Please visit answersincme.com/QWE860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in cardiology discusses the evolving role of mineralocorticoid receptor antagonists (MRAs) to treat patients with heart failure. Upon completion of this activity, participants should be better able to: Identify the evolving role of mineralocorticoid receptor antagonists (MRAs) to treat patients with heart failure; Evaluate clinical implications of the latest data on nonsteroidal MRAs for the treatment of heart failure and mildly reduced ejection fraction (HFmrEF) or heart failure and preserved ejection fraction (HFpEF), in the context of current standard-of-care; and Describe strategies to incorporate nonsteroidal MRAs into the treatment plans of patients with HFmrEF or HFpEF.

In this focus issue on Heart Failure in Practice, JACC Editor-in-Chief Dr. Harlan Krumholz examines how contemporary research continues to refine and at times challenge our understanding of heart failure management. This week's episode features a first-of-its-kind trial on dual therapy with SGLT2 inhibitors and MRAs, new real-world data on heart failure with improved EF, and sobering insights into what happens when foundational therapies are withdrawn. Also explored: sex-specific risks in genetic cardiomyopathies, the limitations of standard stroke prediction tools, and the case for modernizing ICD eligibility criteria. As always, the episode concludes with a synthesized summary of key takeaways for clinicians.

In this Ten-Minute Talk, Senior Partner Sarah Chilton and Senior Associate Wonu Sanda discuss mandatory retirement ages (MRAs) in partnerships and takeaways from the Scott v Walker Morris LLP case that has reignited interest in this topic. If you are a partner facing a mandatory retirement policy or a firm leader wanting a quick overview of this area, this is a must listen. Key discussion points from this Ten-Minute Talk include: - What are the MRA trends we are seeing in firms? - Can firms really force partners to retire and can a partner challenge an MRA? - How to determine if an MRA crosses the line into discrimination - What evidence is needed to justify an MRA and lessons from the Walker Morris LLP case. - Are there better alternatives to MRAs and do they carry the same discrimination risks? - Practical strategies for partners and partnerships navigating this complex issue. If you would like to discuss any aspect of mandatory retirement, or if you have any questions arising from this recording, please contact Senior Partner Sarah Chilton, Senior Associate Wonu Sanda or Managing Partner Clare Murray.

CME credits: 1.00 Valid until: 20-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/expert-perspectives-on-nonsteroidal-mras-and-cardiorenal-protection/32990/ Heart failure with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) represent a significant and growing burden for patients and the healthcare system, not only in cardiovascular medicine, but also in the context of cardio-kidney-metabolic (CKM) syndrome. Trials are underway evaluating new therapies that may offer benefits to patients with HFmrEF/HFpEF and may also have broader, multisystem effects. Tune in to stay up to date! =

CME credits: 1.00 Valid until: 20-06-2026 Claim your CME credit at https://reachmd.com/programs/cme/expert-perspectives-on-nonsteroidal-mras-and-cardiorenal-protection/32990/ Heart failure with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) represent a significant and growing burden for patients and the healthcare system, not only in cardiovascular medicine, but also in the context of cardio-kidney-metabolic (CKM) syndrome. Trials are underway evaluating new therapies that may offer benefits to patients with HFmrEF/HFpEF and may also have broader, multisystem effects. Tune in to stay up to date! =

In this podcast, Ty J. Gluckman, MD, MHA, discusses the pivotal phase III FINEARTS-HF trial and how the treatment landscape is evolving for patients with heart failure (HF) with mildly reduced or preserved ejection fraction, including:The emerging role of mineralocorticoid receptor antagonists in HF careFinerenone's efficacy in reducing composite cardiovascular death and worsening HF events Why safety must be monitored, especially considering hyperkalemia riskWhere HF guideline recommendations lack compared with the current evidence PresenterTy J. Gluckman, MD, MHAMedical Director, Center for Cardiovascular Analytics, Research, and Data Science (CARDS)Providence Heart InstituteProvidence Health SystemPortland, OregonProgram page: https://bit.ly/448XcH0

Targeting the cardiovascular (CV)-kidney-metabolic (CKM) axis may improve outcomes in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) by addressing interconnected metabolic, kidney, and CV risks.   Credit available for this activity expires: 5/30/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002559?ecd=bdc_podcast_libsyn_mscpedu

CME credits: 0.25 Valid until: 30-05-2026 Claim your CME credit at https://reachmd.com/programs/cme/shifting-treatment-paradigm-in-hfmrefhfpef-steroidal-and-nonsteroidal-mras/29908/ Join Drs. John McMurray and Faiez Zannad as they explore the evolving role of MRAs in heart failure management. From RALES and TOPCAT to the recent FINEARTS-HF trial, they highlight key findings that shape how steroidal and nonsteroidal MRAs are used in clinical practice. Discover how the nonsteroidal MRA finerenone is expanding treatment options for patients with HFmrEF and HFpEF.=

CME credits: 0.25 Valid until: 30-05-2026 Claim your CME credit at https://reachmd.com/programs/cme/shifting-treatment-paradigm-in-hfmrefhfpef-steroidal-and-nonsteroidal-mras/29908/ Join Drs. John McMurray and Faiez Zannad as they explore the evolving role of MRAs in heart failure management. From RALES and TOPCAT to the recent FINEARTS-HF trial, they highlight key findings that shape how steroidal and nonsteroidal MRAs are used in clinical practice. Discover how the nonsteroidal MRA finerenone is expanding treatment options for patients with HFmrEF and HFpEF.=

This episode of Don't Miss a Beat, recorded at the American College of Cardiology (ACC) 2025 Annual Scientific Sessions, explores the evolving landscape of heart failure with preserved ejection fraction (HFpEF) treatment, focusing on the implementation of combination therapies. Hosts Steve Greene, MD, and Muthiah Vaduganathan, MD, MPH, discuss the transition from a previously limited treatment landscape to a new era with multiple proven therapeutic options. To open the episode, Greene argues in favor of rapid-sequence implementation of HFpEF therapies, drawing parallels to the established 4-pillar guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF). He highlights 3 key classes of medications—SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists (MRAs), and incretin-based therapies—as the foundation of HFpEF treatment. He emphasizes the importance of early and aggressive therapy initiation to maximize clinical benefits and reduce the risk of delayed or missed treatment opportunities among this population. Vaduganathan acknowledges the strength of the data supporting combination therapy but suggests a more risk-based approach, considering the broad clinical variability among HFpEF patients. He advocates for prioritizing rapid implementation in high-risk patients, such as those recently hospitalized, while allowing a more measured approach for lower-risk individuals. The discussion also touches on the role of phenotyping in tailoring treatment decisions, with GLP-1 receptor agonists being particularly relevant for patients with obesity and ARNi potentially benefiting those with mildly reduced ejection fraction. Looking ahead, the hosts preview upcoming trials, including CONFIDENCE and CONFIRMATION, which will evaluate combination therapy strategies in chronic kidney disease and HFpEF populations. They also discuss the potential of fixed-dose combination therapies to simplify implementation and improve adherence. The episode closes with both experts agreeing on the need for a structured, evidence-based approach to HFpEF treatment while emphasizing the importance of translating trial data into real-world practice. Relevant disclosures for Vaduganathan include Amgen, AstraZeneca, Bayer AG, Boehringer Ingelheim Pharmaceuticals, Cytokinetics, Lexicon, and others. Relevant disclosures for Greene include Amgen, AstraZeneca, Bayer Healthcare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, Cytokinetics, and others. Chapters 00:00-Intro 02:30-Argument for Rapid Sequencing 05:32-Argument Against Rapid Sequencing 10:00-Argument for Risk-Based Sequencing 14:25-Pillars of GDMT in HFpEF

Is low blood pressure hindering your heart failure treatment? How do you balance life-saving medications with hypotension? We explore the definitions, causes, and practical solutions to optimize patient care. Learn how to navigate ARNI, beta-blockers, SGLT2 inhibitors, and MRAs effectively.

In this episode, Dr. Valentin Fuster discusses a study on sodium zirconium cyclosilicate (SZC) for managing hyperkalemia in heart failure patients on mineralocorticoid receptor antagonists (MRAs) like spironolactone. While SZC effectively reduced hyperkalemia and allowed higher spironolactone doses, concerns over worsening heart failure events highlight the complex balance between treatment benefits and risks.

Our podcast show today features John Culhane and Mike Kilgarriff, partners in Ballard Spahr's Consumer Financial Services group. They discuss what supervision and enforcement will look like under a new acting director/director appointed by President Trump. This episode is a repurposing of the second half of a webinar that was produced on January 6. On January 23, we released the first half of the webinar, which consisted of Alan Kaplinsky's “fireside chat” with Kathy Kraninger, the former Director of the CFPB during Trump 1.0., linked here. With respect to supervision, we consider, among others, the following issues with respect to the CFPB's leadership under Trump 2.0: (a) Will it be business as usual or more relaxed? (b) Will it focus on compliance with the Federal consumer financial services laws and less on UDAAP? (c) Will there be reduced staffing and fewer exams? (d) Will there be fewer PAAR letters and more use of MRAS and MRIAs? With respect to enforcement, we consider, among others, the following issues with respect to the CFPB's leadership under Trump 2.0: (a) Will there be an exhaustive review of all existing investigations and lawsuits and a dismissal of those which involve “regulation by enforcement” or “pushing the envelope”? (b) Will they focus more on fraud and scams and less on UDAAP? (c) What position will they take on whether the CFPB has been unlawfully funded because the Federal Reserve Banks have had no combined earnings since September 2022? Alan Kaplinsky, Senior Counsel and former chair for 25 years of the Consumer Financial Services Group, hosts the discussion.

CME credits: 1.25 Valid until: 10-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/ns-mras-and-biomarkers-the-nt-probnp-connection/30064/ Discover the transformative potential of nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs) in optimizing care for patients with the Cardiovascular-Kidney-Metabolic syndrome. Emerging data presented at EASD, HFSA, ASN and AHA, highlight their ability to improve cardiorenal outcomes in the spectrum of the Cardiovascular-Kidney-Metabolic syndrome. By integrating ns-MRAs into individualized treatment plans, healthcare professionals can offer their patients advanced care backed by cutting-edge research.

CME credits: 1.25 Valid until: 10-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/elevating-hf-care-with-ns-mras-the-future-is-now/30065/ Discover the transformative potential of nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs) in optimizing care for patients with the Cardiovascular-Kidney-Metabolic syndrome. Emerging data presented at EASD, HFSA, ASN and AHA, highlight their ability to improve cardiorenal outcomes in the spectrum of the Cardiovascular-Kidney-Metabolic syndrome. By integrating ns-MRAs into individualized treatment plans, healthcare professionals can offer their patients advanced care backed by cutting-edge research.

CME credits: 1.25 Valid until: 10-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/elevating-hf-care-with-ns-mras-the-future-is-now/30065/ Discover the transformative potential of nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs) in optimizing care for patients with the Cardiovascular-Kidney-Metabolic syndrome. Emerging data presented at EASD, HFSA, ASN and AHA, highlight their ability to improve cardiorenal outcomes in the spectrum of the Cardiovascular-Kidney-Metabolic syndrome. By integrating ns-MRAs into individualized treatment plans, healthcare professionals can offer their patients advanced care backed by cutting-edge research.

CME credits: 1.25 Valid until: 10-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/ns-mras-and-biomarkers-the-nt-probnp-connection/30064/ Discover the transformative potential of nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs) in optimizing care for patients with the Cardiovascular-Kidney-Metabolic syndrome. Emerging data presented at EASD, HFSA, ASN and AHA, highlight their ability to improve cardiorenal outcomes in the spectrum of the Cardiovascular-Kidney-Metabolic syndrome. By integrating ns-MRAs into individualized treatment plans, healthcare professionals can offer their patients advanced care backed by cutting-edge research.

The FiltrateJoel TopfSwapnil HiremathAC GomezJordy CohenNayan AroraSpecial Guest Brendon NuenEditing bySimon Topf and Nayan AroraShow NotesFINEARTS-HF in NEJM FINEARTS Kidney outcomes in JACCFINE-HEART pooled analysis of cardiovascular, kidney and mortality outcomes in Nature Medicine discussion in NephJC BARACH-D: Low-dose spironolactone and cardiovascular outcomes in moderate stage chronic kidney disease: a randomized controlled trial (Nature Medicine)Live Freely Filtered at KidneyWkSwapnil comes out as a SpiroStan post to NephJC TOPCATTOPCAT primary publication TOPCAT North American results TOPCAT funny business explained AHA/ACC/HFSA Heart Failure Guidelines (PDF)SGLT2i are 2aMRA are a 2bARBs are a 2bARNI are a 2bClinical Phenogroups in Heart Failure With Preserved Ejection Fraction: Detailed Phenotypes, Prognosis, and Response to SpironolactoneKansas city cardiomyopathy questionnaire in patients with CKD without a diagnosis of heart failure: https://pubmed.ncbi.nlm.nih.gov/21187260/GFR slope with steroidal MRAs in HF: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2635Why Has it Been Challenging to Modify Kidney Disease Progression in Patients With Heart Failure? (JACC)Tubular SecretionsSwap: Disclaimer on Apple TVAC: Duo Lingo Plushy (Amazon)Nayan: The Puzzle BoxJordy: Project Hail MaryBrendon has a podcast, The Kidney Compass with Shikha Wadhwani. And he recommends singer-songwriter, Maggie Rogers (YouTube)Joel: The Singularity Is Nearer: When We Merge with AI by Ray KurzweilClosing music, Tim Yau with The Kidney Connection

Please visit answersincme.com/YTP860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, experts in cardiology and nephrology discuss the latest evidence and guidance on the use of nonsteroidal mineralocorticoid receptor antagonist (MRA) for the treatment of cardio-renal-metabolic conditions. Upon completion of this activity, participants should be better able to: Identify patients with type 2 diabetes (T2D) who are at high risk for chronic kidney disease (CKD) progression and cardiovascular events; Outline the clinical implications of updated CKD guidelines regarding the use of nonsteroidal MRA therapy in patients with T2D and CKD; and Describe the latest evidence on the use of nonsteroidal MRA therapies in individuals with cardio-renal-metabolic conditions.

On today's Rantzerker Karen, Alison and Brian will be continuing to look at the latest from Jubilee which once again pits MRAs against feminists. Are women really oppressed? Does killing your unborn child equate to true freedom? Should men just cry more? Should we just tear down the concept of sex altogether? Join us at 4pm Eastern!

On today's Rantzerker Karen, Alison and Brian will be continuing to look at the latest from Jubilee which once again pits MRAs against feminists. Are women really oppressed? Does killing your unborn child equate to true freedom? Should men just cry more? Should we just tear down the concept of sex altogether? Join us at 12pm Eastern!

On today's Rantzerker Karen, Alison and Brian will be continuing to look at the latest from Jubilee which once again pits MRAs against feminists. Are women really oppressed? Does killing your unborn child equate to true freedom? Should men just cry more? Should we just tear down the concept of sex altogether? Join us at 12pm Eastern!

CME credits: 0.50 Valid until: 18-10-2025 Claim your CME credit at https://reachmd.com/programs/cme/new-horizons-unraveling-novel-therapies-for-enhanced-cardiovascular-outcomes-in-patients-with-heart-failure/26966/ There are limited therapeutic options for patients with heart failure with mid-range or preserved ejection fraction (HFmrEF/HFpEF). Recently, new data were released on the efficacy and safety of nonsteroidal mineralocorticoid receptor antagonists (MRAs) in patients with HFmrEF/HFpEF. What are the outcomes of the FINEARTS-HF trial with finerenone in this patient population, and what do these findings mean for clinical practice? Three cardiologists discuss the topic of novel therapies, with a focus on nonsteroidal MRAs, to improve cardiovascular outcomes in patients with HFmrEF/HFpEF. =

ESC TV Today brings you concise analysis from the world's leading experts, so you can stay on top of what's happening in your field quickly. This episode covers: Cardiology This Week: A concise summary of recent studies Which MRA to use in which heart failure patient Managing electrical storm Mythbusters: garlic protects from the heart Host: Perry Elliott Guests: Carlos Aguiar, Sana Al-Khatib, Rudolf de Boer Want to watch that episode? Go to: https://esc365.escardio.org/event/1792 Disclaimer ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Sana Al-Khatib and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Sanofi Aventis, Novo Nordisk, Terumo. Rudolf de Boer has declared to have potential conflicts of interest to report: direct research funding from European Research Council (ERC), Netherlands Heart Foundation, Fondation leDucq, Netherlands Organization for Scientific Research. Research funding to department or institution: AstraZeneca, Abbott, Boehringer Ingelheim, Cardior Pharmaceuticals GmbH, NovoNordisk. Direct fees from Abbott, AstraZeneca, Cardior Pharmaceuticals GmbH, NovoNordisk, Roche Diagnostics. Fees to department or institution: NovoNordisk. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc., Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

On today's Rantzerker Karen, Alison and Brian will be looking at the latest from Jubilee which once again pits MRAs against feminists. Are women really oppressed? Does killing your unborn child equate to true freedom? Should men just cry more? Should we just tear down the concept of sex altogether? Join us at 1pm Eastern!

MRAs in HF with renal dysfunction, coronary autoregulation, the hubris of US doctors, NSTEMI in older patients, survival after STEMI, and new leaders at JACC are discussed by John Mandrola, MD. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback Combined analysis (Matsumoto) II Coronary artery autoregulation with increasing stenosis NEJM Paper https://www.nejm.org/doi/full/10.1056/NEJMc2402216 III RECOVER IV Trial Gregg Stone, MD Tweet https://x.com/GreggWStone/status/1803583552354742416 DANGER-Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 Impella Saves Lives in Cardiogenic Shock, but Patient Selection Key https://www.medscape.com/viewarticle/1000659 IV NSTEMI Elderly Main Paper Datamethods https://discourse.datamethods.org/t/random-vs-fixed-effects-meta-analysis/7361 O'Fee Paper https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560 V MI Survival Danish Paper https://doi.org/10.1016/j.jacc.2024.04.025 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Listener Feedback ASPIRE AF https://classic.clinicaltrials.gov/ct2/show/NCT03968393 Butala paper: Stroke After TAVR With and Without EPD https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013697 PROTECTED TAVR Heuts meta-analysis: EPD During TAVR https://heart.bmj.com/content/110/11/757 II. Statin Eligibility JAMA-IM: Data Analytic Choices and Predicting Vascular Events https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819821 Zeraatker Specification Analysis Paper https://doi.org/10.1016/j.jclinepi.2024.111278 PCE https://www.mdcalc.com/calc/3398/ascvd-atherosclerotic-cardiovascular-disease-2013-risk-calculator-aha-acc III. Heterogenous Treatment Effect Weisberg and Dailey-Higgs DANISH IV. Heart Failure and MRAs  RALES https://www.nejm.org/doi/full/10.1056/NEJM199909023411001 EMPHASIS https://www.nejm.org/doi/full/10.1056/NEJMoa1009492 Combined analysis (Matsumoto) You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

This is a free preview of a paid episode. To hear more, visit www.louiseperry.co.ukMy guest today is Cassie Jaye, a filmmaker best known for the hugely controversial 2016 documentary 'The Red Pill' which followed Cassie's journey from feminism to becoming (partially) persuaded by men's rights activism. We spoke about how she feels about the film – and about MRAs – eight years on.In the extended part of the episode, we also spoke about…

In the sequel to last week's episode, we are back with Dr. Jonathan Davis, Director of the Heart Failure program from San Francisco General. We continue our tour of GDMT for HF, by covering SGLT2-i, MRAs, as well as some AKI and outpatient considerations. This is part 1 of 2 parts which will cover an overview of GDMT medications, and dive into Beta-blockers and ARNIs. Part 2 to come out next week! | 00.33 - Previously on Booster Shots | | 01.31 - Chapter 3: SGLT2-i | The now famous EMPA-REG OUTCOME trial [NEJM 2015] Empagliflozin in HFpEF (not discussed in this episode [NEJM 2021] | 04.24 - Chapter 4: MRAs | RALES trial demonstrating benefit in Morbidity/Mortality [NEJM 1999] | 10.04 - Organizing follow up | | 11.51 - Issues with AKI | | 15.10 - Some fun questions about Fun questions | | 16.54 - Summary of All The Things! | [The appearance of external hyperlinks does not constitute endorsements by UCSF of the linked websites, or the information, products, or services contained therein. UCSF does not exercise any editorial control over the information found therein, nor does UCSF make any representation of their accuracy or completeness. All information contained in this episode are the opinions of the respective speakers and not necessarily the views their respective institutions or UCSF, and is only provided for information purposes, not to diagnose or treat.] Music by Amit Apte. Medical Heart Vectors by Vecteezy

A deep dive into the manosphere, with the scholar who knows it best, Louis Bachaud. The manosphere is a constellation of 5 loosely affiliated communities, including pick-up artists (PUAs), men's rights activists (MRAs), "Men Going Their Own Way" (MGTOW), incels (the "Black Pill" communiy), and the "Red Pill" community. Louis details the history of the manosphere, describes the current factions and their differences, and guides us through their use and misuse of science, especially evolutionary psychology. The episode opens with a systematic critique of the manosphere, and the interview starts around 34 minutes in. Enjoy. Recommended background, especially for critiques of the manosphere: - Bachaud, L., & Johns, S. E. (2023). The use and misuse of evolutionary psychology in online manosphere communities: The case of female mating strategies. Evolutionary Human Sciences, 5, e28.  For the size and direction of sex differences, see: - Archer, J. (2019). The reality and evolutionary significance of human psychological sex differences. Biological Reviews, 94(4), 1381-1415.  - Stewart-Williams, S., Butler, C. A., & Thomas, A. G. (2017). Sexual history and present attractiveness: People want a mate with a bit of a past, but not too much. The Journal of Sex Research, 54(9), 1097-1105.  - Schmitt, D. P. (2005). Sociosexuality from Argentina to Zimbabwe: A 48-nation study of sex, culture, and strategies of human mating. Behavioral and Brain sciences, 28(2), 247-275.  - Buss, D. M. (1989). Sex differences in human mate preferences: Evolutionary hypotheses tested in 37 cultures. Behavioral and brain sciences, 12(1), 1-14.  For extra-pair paternity: - Wolf, M., Musch, J., Enczmann, J., & Fischer, J. (2012). Estimating the prevalence of nonpaternity in Germany. Human Nature, 23, 208-217.  - Anderson, K. (2006). How well does paternity confidence match actual paternity? Evidence from worldwide nonpaternity rates. Current anthropology, 47(3), 513-520. - Bellis, M. A., Hughes, K., Hughes, S., & Ashton, J. R. (2005). Measuring paternal discrepancy and its public health consequences. Journal of Epidemiology & Community Health, 59(9), 749-754.  For age gaps: - Conroy-Beam, D., & Buss, D. M. (2019). Why is age so important in human mating? Evolved age preferences and their influences on multiple mating behaviors. Evolutionary Behavioral Sciences, 13(2), 127.  - Antfolk, J., Salo, B., Alanko, K., Bergen, E., Corander, J., Sandnabba, N. K., & Santtila, P. (2015). Women's and men's sexual preferences and activities with respect to the partner's age: Evidence for female choice. Evolution and Human Behavior, 36(1), 73-79.  - Buunk, B. P., Dijkstra, P., Kenrick, D. T., & Warntjes, A. (2001). Age preferences for mates as related to gender, own age, and involvement level. Evolution and Human Behavior, 22(4), 241-250.

Feminists like to accuse men in general, especially men in the men's rights movement, of basing their values and intentions on controlling & violent impulses & ideology. In the past, when MRAs have documented evidence of female behavior that constitutes a serious men's issue, feminists have accused those maintaining the documentation of stalking, harassment, and threatening women just for having that documentation. So what are they doing with the “Are we dating the same guy” website?

In evaluating Michael Flood's army of strawman arguments, we've run into a consistent problem with his answers. He seems to think Australia is representative of the world. This week, we're going to examine his arguments about filicides, and look at another data set for comparison. Let's see how Flood's claims hold up.

It came from the manosphere. . . In part 1 we learn about pickup artists, or PUAs — a group of men who've designed manipulative strategies in an attempt to attract women. In part 2, we explore the community of men's rights advocates, or MRAs — a group that feels men are the oppressed gender. The Sad Girls were not a fan of either. lolwtfbbq ig: @sadgap.podcast / @misandristmemes / @txgothgf / music producer @iamjonnibrooks.eth

You do NOT want to miss this powerful conversation with the amazing and unapologetic Michelle Mras.   Unapologetically You with special guest - Michelle Mras on the Life At Full Blast Podcast Award-winning International TEDx Keynote Speaker, Executive Speaking Coach, co-host of the Denim & Pearls podcast, a 12X Bestselling Author and co-author of 27 books. Michelle is the Host of the MentalShift show on The New Channel (TNC), Philippines. She also has speaking parts in a few SyFy movies check the IMDB.com database for her and has a newly released music EP album, link is on MichelleMras.com Michelle is a survivor of multiple life challenges including a Traumatic Brain Injury and her current battle with Breast Cancer. She guides her clients to recognize the innate gifts within them, to stop apologizing for what they are not and to step into who they truly are. She accomplishes this through one-on-one and group coaching, Training events, Keynote talks, her books, Podcasts and MentalShift television show.   Her background is in engineering, marketing management, banking, quality systems management, benefit-auctioneering, fundraising, political campaigning and a plethora of life experiences. She has lived and traveled around the world as a military child and spouse. Throughout her travels she has studied and incorporated the cultures into her life.  Michelle's driving thought is that every day is a gift. Tomorrow is never promised. Every moment is an opportunity to be the best version of you… Unapologetically! Learn more about Michelle Mras and her work here - https://michellemras.com/  Learn more about Cindy and her work here - https://fullblastcoaching.com  --- Send in a voice message: https://podcasters.spotify.com/pod/show/cindy-van-arnam/message

On social media, the term “fact check” has gotten a bad name due to its bad faith use by woke elitists who often imply that articles containing irrelevant or unrelated claims were written to correct factual information that is being passed around. As we began reading feminist spokesperson Michael Flood's page on “fact-checking MRAs,” it became apparent that he has taken a page from their book. So far, he's offered almost, but not quite, as much substance as one can see between bright objects in the cold vacuum of space. This week, we'll continue with our critique.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/4148711/advertisement

ou know how much we just love male feminists here at HBR, especially the one who use the cult to make a career for themselves out of browbeating other men. We're looking at you, professor. No, I'm not capitalizing your choice to make a lot of claims about MRAs and our work, by going through and ripping them apart. Enjoy!This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/4148711/advertisement

Sponsor Link:- Red Pill Ring- https://www.redpillring.com/Transmaxxing - Why Are Incels Turning Themselves Into Girls? - https://unherd.com/thepost/why-are-in...Transmaxxers article 2: https://www.piratewires.com/p/transma...Mystery Link: https://www.youtube.com/shorts/V1aW4Q...Rumble: https://rumble.com/c/c-2039428Odysee.TV: https://odysee.com/@SandmanMGTOW:cBitchute Link: https://www.bitchute.com/channel/YIxe...SubscribeStar.com: https://www.subscribestar.com/sandmanPaypal / Email: Sandmanmgtow @ Gmail.comBitcoin Address: bc1qtkeru8ygglfq36eu544hxw6n9hsh22l7fkf8uvHi Everyone Sandman Here, This video is brought to you by a donation from Kim and he wants me to cover the Korean term Sampo Generation which means a generation that gives up on dating, marriage and having children. I had heard about the dishwashers in South Korea going their own way. But this term is new to me. Part of the wikipedia entry about the Sampo Generation says this and I quote: "Many of the young generation in South Korea have given up those three things because of social pressures and economic problems such as increasing cost-of-living, tuition payments, and affordable housing scarcity. There is also the opo sedae, or "five giving-up generation", which takes the same three and adds employment and home ownership. The chilpo sedae ("seven giving-up generation") further includes interpersonal relationships and hope, while the gupo sedae ("nine giving-up generation") extends to physical health and appearance. Finally, the sippo sedae ("ten giving-up generation") or wanpo sedae ("total giving-up generation") culminates in giving up life. The Sampo generation is similar to the Satori generation in Japan." unquote. This all kind of reminds me of the four or five levels of MGTOW. But that only goes as far as living as a reclusive self sufficient hermit in the woods. Not offing yourself. So I did a bit more research on this and discovered a mix race couple's YouTube channel called 2 heart 1 seoul spelled Seoul where the guy is Korean and his partner she's Canadian. They made a video about the Sampo generation and that's how I found them. They reminded me of all the mixed race couples with white whamen and Indian guys. Again he looks tall and looks like a Liu Kang instead an Incel no one wants to bang. Seems like western whamen are poaching the best men from foreign lands and geomaxxing too. In their video about the Sampo Generation they say the reason many guys are checking out is because it costs too much financially to get married and start a family. Also that it doesn't apply to people who actively choose to go their own way. Only those that have been sent their own way becauase they can't afford dating, marriage and children. Sure blame it on money when it's also a feminism and gynocentrism thing. Remember that Korea has the highest rates of feminism out of China, Japan and Korea and when you stop being a Christian it's not like you give up on your faith completely. You start falling for the feminist faith instead. It's easy to just blame money for the reason why guys are checking out in Korea. Remember that there are tons of MRAs in Korea fighting for men's rights. Guys are learning how to fight back against feminism in Korea better than any other country in the world and are going after companies that promote feminism and boycott them and as a result woke companies have to bend the knee instead of the other way around. I'll discuss more in a moment but let me first tell everyone about today's sponsor The Red Pill Ring:Support this podcast at — https://redcircle.com/mgtow/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

The following question refers to Section 7.2 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. The question is asked by Cleveland Clinic internal medicine resident and CardioNerds Intern Akiva Rosenzveig, answered first by UPMC Harrisburg cardiology fellow and CardioNerds Academy House Faculty Leader Dr. Ahmed Ghoneem, and then by expert faculty Dr. Randall Starling. Dr. Starling is Professor of Medicine and an advanced heart failure and transplant cardiologist at the Cleveland Clinic where he was formerly the Section Head of Heart Failure, Vice Chairman of Cardiovascular Medicine, and member of the Cleveland Clinic Board of Governors. Dr. Starling is also Past President of the Heart Failure Society of America in 2018-2019. Dr. Staring was among the earliest CardioNerds faculty guests and has since been a valuable source of mentorship and inspiration. Dr. Starling's sponsorship and support was instrumental in the origins of the CardioNerds Clinical Trials Program.  The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #27 Which of the following sentences regarding diuretics in the management of heart failure is correct? A In HF patients with minimal congestive symptoms, medical management with diuretics alone is sufficient to improve outcomes. B Prescribing a loop diuretic on discharge after a HF hospitalization may improve short term mortality and HF rehospitalization rates. C The combination of thiazide (or thiazide-like) diuretics with loop diuretics is preferred to higher doses of loop diuretics in patients with HF and congestive symptoms. D The maximum daily dose of furosemide is 300 mg. Answer #27 Explanation Choice B in correct. The guidelines give a Class 1 recommendation for diuretics in HF patients who have fluid retention to relieve congestion, improve symptoms, and prevent worsening heart failure. Recent data from the non-randomized OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) registry revealed reduced 30-day all-cause mortality and hospitalizations for HF with diuretic use compared with no diuretic use after hospital discharge for HF. Choice A is incorrect. With the exception of mineralocorticoid receptor antagonists (MRAs), the effects of diuretics on morbidity and mortality are uncertain. As such, diuretics should not be used in isolation, but always combined with other GDMT for HF that reduce hospitalizations and prolong survival. Choice C is incorrect. The use of a thiazide or thiazide-like diuretic (e.g., metolazone) in combination with a loop diuretic inhibits compensatory distal tubular sodium reabsorption, leading to enhanced natriuresis. In a propensity-score matched analysis in patients with hospitalized HF, the addition of metolazone to loop diuretics was found to increase the risk for hypokalemia, hyponatremia, worsening renal function, and mortality, whereas use of higher doses of loop diuretics was not found to adversely affect survival. The guidelines recommend that the addition of a thiazide (e.g., metolazone) to treatment with a loop diuretic should be reserved for patients who do not respond to moderate- or high-dose loop diuretics to minimize electrolyte abnormalities (Class...

Grifty Pod Episode 8: Boys Don't Cry Boy's don't cry, and that is precisely the problem. On this episode of Grifty, all the gang is back in town for our back-to-school episode of exploring the Manosphere – an interconnected echo chamber of men and boys where the themes of toxic masculinity, misogyny, and homophobia are platformed and normalized in online forums, podcasts, and articles all over the web. A large part of the appeal of the manosphere is that it acknowledge the increasing rates of depression, suicide, and incarceration among men. However,  they take this sliver of truth and leverage it into a fear-mongering grift where they make the false link that these issues plaguing our boys and men are the result of some global conspiracy. Find us on all social media platforms @griftypod Learn more www.grifty.org   IN THIS EPISODE  On the History of the Manosphere: “The Evolution of the Manosphere Across the Web,” Proceedings of the Fifteenth International AAAI Conference on Web and Social Media (ICWSM 2021) The Evolution of the Manosphere across the Web “To Learn About the Far Right, Start With the ‘Manosphere',” The Atlantic https://www.theatlantic.com/international/archive/2019/08/anti-feminism-gateway-far-right/595642/ On the Ideology and Content of the Manosphere: “Glitz, Glam & Violent Misogyny: The Toxic Ideology of the Manosphere,” International Socialist Alternative https://internationalsocialist.net/en/2023/05/socialist-feminism “Jordan Peterson and the Return of the Men's Rights Movement,” The Washington Post https://www.washingtonpost.com/news/made-by-history/wp/2018/07/24/before-jordan-peterson-there-were-mens-rights-activists/  “The Liver King and the Problematic rise of Primal Manhood,” Huck Magazine  https://www.huckmag.com/article/liver-king-and-the-problematic-rise-of-primal-manhood   On the Radicalization of men and boys caused by the Manosphere: “The “Manosphere” Is Getting More Toxic As Angry Men Join the Incels,” MIT Technology Review  https://www.technologyreview.com/2020/02/07/349052/the-manosphere-is-getting-more-toxic-as-angry-men-join-the-incels/ “The Misogynist Incel Movement is Spreading. Should it be Classified as a Terror Threat?,” The Guardian https://www.theguardian.com/lifeandstyle/2021/mar/03/incel-movement-terror-threat-canada “ Mass Violence and Terrorism since Santa Barbara,” New America https://www.newamerica.org/political-reform/reports/misogynist-incels-and-male-supremacism/mass-violence-and-terrorism-since-santa-barbara “Elliot Rodger: How misogynist killer became 'incel hero',” BBC.com https://www.bbc.com/news/world-us-canada-43892189 “Plymouth Shooter Fascinated By Serial Killers and ‘Incel' Culture, Inquest Hears,” The Guardian  https://www.theguardian.com/uk-news/2023/jan/18/plymouth-shooter-jake-davison-fascinated-by-mass-shootings-and-incel-culture-inquest-hears On the grifts, scams, and charlatans of the Manosphere: “Andrew Tate Wants Everyone To Get In On the Grift,” Jacobin https://jacobin.com/2023/03/andrew-tate-capitalism-scam-misogyny-alienation-hustle  “Generation Tate: How can we stop losing vulnerable men to the ‘manosphere'?,” The Independent https://www.independent.co.uk/life-style/andrew-tate-manosphere-influencers-b2261515.html?utm_source=flipboard&utm_content=Independent%2Fmagazine%2FLife+%26+Style   The manosphere consists of 5 main groups: Men's rights activists (MRAs) advocate political changes that will benefit men. However, much of their activism consists of harassment and abuse towards feminists and other female public figures. (example: Jordan Peterson, Joe Rogan)   Men going their own way (MGTOW) argue that women are so toxic that men should avoid them altogether. Some MGTOW will date women but avoid anything serious like getting married, while others won't even be friends with women. (example: youtube channels like Hooman TV and Fresh & Fit Clips that aim to portray woman as selfish gold diggers that ‘use' men for their wealth)   Pick-up artists (PUAs) teach men seduction strategies so that they can be more successful in attracting women. Many of these techniques involve mistreating women, such as insulting them (“negging”) or disregarding consent.   (example: Andrew Tate and his ‘hustler university' scam)   Involuntary celibates (incels) believe they are entitled to a relationship with a woman, but are incapable of finding a partner. Multiple acts of extreme violence and even murder have been attributed to this group. (example: Elliot Rodger 2014 Isla Vista shooting, Jake Davidson Plymouth Shooter 2021)   Primal Manhood Alphas These masculinity influencers champion a hyper-masculine version of self actualization that seeks to revert to an ‘ancestral' lifestyle with their diet and workouts as well as reverting to a time when women were confined to the home and subservient to men.  (example: Liver King) The history of the manosphere dates back to the Men's Liberation movement that began in the 1960s and went on through the 80s.  Existed within the context of the Vietnam war and it was essentially a critique of traditional male gender roles. These were the hippies that were raised by their WW2 veteran fathers and homemaker mothers who pushed a very traditional binary for gender roles which these men within the liberation movement saw as toxic. They rejected the notion that the main role for men is to produce money and this essentially anti-capitalist view was tied together with second-wave feminism. Pretty reasonable in those early years. but this honeymoon if you will ended by the mid 70s. As inflation and gas prices went up and employment and faith in politicians went down, a new group branched off from the Men's Liberation movement called Men's Rights advocates. They placed blame the problems of the time on feminism and women's liberation. They focused on what they felt were men's issues like divorce and custody issues,  health problems, etc.   They went from a sympathetic tone of this whole system is fucked up and we support the empowerment of both women and men. But then capitalism stops working and with less money and opportunities they're like “umm actually we think giving women rights and power is actually the problem so we'd like to take that back, please” But some would say that even before the 1960s, the seed was planted for the manosphere by pop culture trends that  broke away from traditional male gender roles. The launch of Playboy Magazine in the early 1950s created this window into an aspirational world for men who sought a life more liberating than the college-job-wife-suburbs-kids pipeline. Playboy provided young men of the post war era an alternative view of masculinity. You can be a complete person without having a family and being the bread winner. This is a good thing. But what was suggested to essentially fill that spot was stuff – a nice place full of cool furniture, a stocked bar to bring over the ladies that you also treat like an object. He essentially invented and popularized the concept of the bachelor pad. Ironically, this alternative vision was still a fully capitalistic one, just changing the rewards from a family in the suburbs to the bachelor pad in the city   1950s culture was toxic so it's not that unreasonable to want to break from it; but as we all know Hugh took this to an extreme that became even more toxic than the culture it was critiquing. He took the same tactic that we are seeing today with the manosphere – instead of saying hey we don't have to live up to these toxic gender roles that are making you feel detached and frustrated. No, instead he blames women for those troubles. The very first issue of Playboy included an article warning men on “money hungry, gold-digging women” and went on to talk about the magazine's love for “long legged big breasted women” and their hate for wives    

Join experts Drs Matthew Sparks and James Matthew Luther as they discuss how and why they're using mineralocorticoid receptor antagonists to treat patients with diabetic kidney disease in their practice. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/991189). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Chronic Kidney Disease (CKD) https://emedicine.medscape.com/article/238798-overview Physiology, Aldosterone https://www.ncbi.nlm.nih.gov/books/NBK470339/ Angiotensin II https://www.ncbi.nlm.nih.gov/books/NBK499912/ Primary Aldosteronism https://emedicine.medscape.com/article/127080-overview Epithelial Sodium Channel (ENaC) and the Control of Blood Pressure https://pubmed.ncbi.nlm.nih.gov/24721652/ Hypertension Treatment & Management https://emedicine.medscape.com/article/241381-treatment Hypertension Medication https://emedicine.medscape.com/article/241381-medication#2 Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease - Mechanistic and Therapeutic Effects https://pubmed.ncbi.nlm.nih.gov/34675379/ Malignant Hypertension https://emedicine.medscape.com/article/241640-overview Androgenetic Alopecia https://emedicine.medscape.com/article/1070167-overview Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/33264825/ Cardiovascular Events With Finerenone in Kidney Disease and Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/34449181/ Regression to the Mean https://www.britannica.com/topic/regression-to-the-mean Sodium-glucose Transport Protein 2 (SGLT2) Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK576405/ Potassium Binders for Chronic Hyperkalaemia in People With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/32588430/

Michelle Mras is an award-winning, internationally recognized inspirational speaker, published #1 Best Selling Author, intuitive leader, wife, and mother who has been stirring audiences and individuals to action through her compelling message of self-leadership, resilience, and living a life of intention. Michelle's infectious presentations and coaching inspire her clients to rise above negative self-talk to reclaim their inner grit. Michelle encourages you to be your best version every day and live unapologetically. Her fiery spirit and passion drive her to candidly share the key moments that transformed her into the irresistible force she is today. This episode is titled “Be The Best You… Unapologetically!” because Michelle empowers people to be your best version every day and to always live unapologetically. Jr and Michelle take a deep dive into how to be the best version of yourself by identifying your true gifts and deep desires. If all business leaders truly served others by leading with their true gifts, the world can become a better place. Michelle encourages you to be you and to never apologize for who you truly are! In this episode, business strategist and consultant, JR Spear, will teach you how to become the best version of yourself by being your most authentic and true self. Pull up a seat because this is a conversation you do not want to miss! Learn more about Michelle and her writing at www.MichelleMras.com. Connect with Business Leaders Network www.businessleadersnetworking.com    grow@businessleadersnetworking.com

Amy is joined by Dr. Srimati Basu to discuss her book The Trouble With Marriage: Feminists Confront Law and Violence in India and explore the complicated gender politics behind divorce.Srimati Basu is a Professor of Gender and Women's Studies and Anthropology, and a member of the Committee on Social Theory. She serves as the President of the Association for Feminist Anthropology, 2021-2023. Srimati has an Interdisciplinary Ph.D. from Ohio State University in Cultural Studies/ Anthropology/ Women's Studies, and her teaching, research and community work interests include Global Feminisms, Law, Gender-Based Violence, Social Movements, Feminist Methodologies, and Masculinities. At present, she is writing a monograph on anti-feminist men's rights groups, following a 2013-14 Fulbright Fellowship to conduct fieldwork with MRAs across Indian cities. She has recently begun a research project on Indian women private detectives with fellowships from National Endowment for Humanities/ American Institute of Indian Studies and from Sisters in Crime.

Michelle Mras is an award-winning, internationally recognized speaker. She is a number one bestselling author, an intuitive leader, a wife and mother who has been stirring audiences into action through a compelling message of self-leadership, resilience and living a life of intention. Listen in as we discuss embracing the toddler mindset, rising up after a fall, and how Michelle is known for creating clarity for others as the conductor of clarity. Please enjoy, subscribe, and share. https://buildcs.net brianb@buildcs.net https://michellemras.com

We demystify primary aldosteronism, MRAs (mineralocorticoid receptor antagonists), non-steroidal MRAs, and how to recognize and treat renovascular hypertension with nephrologist/hypertension expert, Dr. Matt Luther (@DrJMLuther) as part of the NephMadness  PodCrawl 2023. Fill out a bracket for NephMadness and check out all eight NephMadness PodCrawl participants at NephMadness.com/podcrawl (list below) and the MRA region write-up by Micah Schub (@AcidBassMD). The Curbsiders gets the skinny on mineralocorticoid receptor antagonists Core IM will be covering Kidney Transplant in their classic Five Pearl format The CardioNerds will be covering the effect of Heart Failure Devices on Kidney Health Freely Filtered will try to understand thrombotic microangiopathy ISN Global Kidney Care goes deep on IgA nephropathy The Cribsiders look at transitions, first the Pediatrics to Adult nephrology transition and then from living to death with palliative nephrology  Fellow on Call will be covering Onconephrology And finally, The Nephron Segment looks at Transgender Health and CKD Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | Contact | Swag | CME Show Segments Intro Diagnosis and Management of Primary Aldosteronism (PA) MRAs vs non-steroidal MRAs (mineralocorticoid receptor antagonists) NephMadness MRA region picks Renovascular Hypertension Outro Credits Writer and Producer: Matthew Watto MD Show Notes: Matthew Watto MD Cover Art & Infographic: Matthew Watto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: J. Matthew Luther MD Sponsor: Locumstory Get a comprehensive view of locums, and decide if it;s right for you, at locumstory.com Sponsor: indeed Visit indeed.com/internalmedicine to start hiring now. 

The following question refers to Section 7.3.1 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.  The question is asked by Palisades Medical Center medicine resident & CardioNerds Intern Dr. Maryam Barkhordarian, answered first by MedStar Washington Hospital Center cardiology hospitalist & CardioNerds Academy Graduate Dr. Luis Calderon, and then by expert faculty Dr. Robert Mentz.  Dr. Mentz is associate professor of medicine and section chief for Heart Failure at Duke University, a clinical researcher at the Duke Clinical Research Institute, and editor-in-chief of the Journal of Cardiac Failure. Dr. Mentz is a mentor for the CardioNerds Clinical Trials Network as lead principal investigator for PARAGLIDE-HF and is a series mentor for this very 2022 heart failure Decipher the Guidelines Series. For these reasons and many more, he was awarded the Master CardioNerd Award during ACC22. Welcome Dr. Mentz!  The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #7 Ms. Valarie Sartan is a 55-year-old woman with a history of HFrEF (EF 35%) and well controlled, non-insulin dependent diabetes mellitus who presents to heart failure clinic for routine follow up. She is currently being treated with metoprolol succinate 200mg daily, lisinopril 10mg daily, empagliflozin 10mg daily, and spironolactone 50mg daily. She notes stable dyspnea with moderate exertion, making it difficult to do her yardwork. On exam she is well appearing, and blood pressure is 115/70 mmHg with normal jugular venous pulsations and trace bilateral lower extremity edema. On labs, her potassium is 4.0 mmol/L and creatinine is 0.7 mg/dL with an eGFR > 60 mL/min/1.73m2. Which of the following options would be the most appropriate next step in heart failure therapy?  A  Increase lisinopril to 40mg daily  B  Increase spironolactone to 100mg daily  C  Add sacubitril-valsartan to her regimen  D  Discontinue lisinopril and start sacubitril-valsartan in 36 hours  E  No change  Answer #7 Explanation   The correct answer is D – transitioning from an ACEi to an ARNi is the most appropriate next step in management.   The renin-angiotensin aldosterone system (RAAS) is upregulated in patients with chronic heart failure with reduced ejection fraction (HFrEF). Blockade of the RAAS system with ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), or angiotensin receptor neprilysin inhibitors (ARNi) have proven mortality benefit in these patients.   The PARADIGM-HF trial compared sacubitril-valsartan (an ARNi) with enalapril in symptomatic patients with HFrEF. Patients receiving ARNi incurred a 20% relative risk reduction in the composite primary endpoint of cardiovascular death or heart failure hospitalization. Based on these results, the 2022 heart failure guidelines recommend replacing an ACEi or ARB for an ARNi in patients with chronic symptomatic HFrEF with NYHA class II or III symptoms to further reduce morbidity and mortality (Option D). This is a class I recommendation with level of evidence of B-R and is also of high economic value. Making no changes at this time would be inappropriate (Option E).  While it would be reasonable to increase the dose of lisinopril to 40mg (Option A), this should be pursued only if ARNi therapy is not tolerated.   Mineralocorticoid receptor antagonists (MRAs) have a class I (LOE A...

Award Winning Global TEDx Speaker, Executive Speaker Coach, Leadership Trainer, 7x Best Selling Author and multi-platform Media Host. Internationally acclaimed Author of Eat, Drink and Be Mary: A Glimpse Into a Life Well Lived and It's Not Luck: Overcoming You. Co-Author of the best selling book series: 13 Steps to Riches, Lead Author of HOLD MY CROWN - Women of grit share stories of resilience. Co-Creator of Amplifluence: 3 pillars to speak, publish and convert your message. Michelle is the co-Host of the Amplifluence podcast and Host of MentalShift on The New Channel (TNC), Philippines. She amplifies your presence and guides you through the professional speaker process of core message development and signature talks. Michelle's bonus service is to orchestrate the delivery and framework of your multi-faceted presentation. Michelle is a survivor of multiple life challenges to include a Traumatic Brain Injury and Breast Cancer. She guides others to recognize their innate gifts, stop apologizing for what they aren't and step into who they truly are… Unapologetically. Connect with Michelle : www.MichelleMras.com Facebook: https://www.facebook.com/profile.php?id=1342939359 LinkedIn: https://www.linkedin.com/in/michellemras Instagram: @michellemras Link tree: https://linktr.ee/MichelleMras Let's Connect: https://www.instagram.com/jr.spear/ Facebook: https://www.facebook.com/jr.spear.3 CREED CONSULTING : https://www.facebook.com/groups/1750459338428570 Please subscribe, like, and share. I appreciate the support and look forward to serving you further in the future. Semper Fi