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Normal pressure hydrocephalus (NPH) is a clinical syndrome of gait abnormality, cognitive impairment, and urinary incontinence. Evaluation of CSF dynamics, patterns of fludeoxyglucose (FDG) uptake, and patterns of brain stiffness may aid in the evaluation of challenging cases that lack typical clinical and structural radiographic features. In this episode, Katie Grouse, MD, FAAN, speaks with Aaron Switzer, MD, MSc, author of the article “Radiographic Evaluation of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Switzer is a clinical assistant professor of neurology in the department of clinical neurosciences at the University of Calgary in Calgary, Alberta, Canada. Additional Resources Read the article: Radiographic Evaluation of Normal Pressure Hydrocephalus Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr. Switzer: Thanks so much for having me, Katie. I'm a neurologist that's working up in Calgary, Alberta, Canada, and I have a special interest in normal pressure hydrocephalus. So, I'm very happy to be here today to talk about the radiographic evaluation of NPH. Dr Grouse: I'm so excited to have you here today. It was really wonderful to read your article. I learned a lot on a topic that is not something that I frequently evaluate in my clinic. So, it's really just a pleasure to have you here to talk about this topic. So, I'd love to start by asking, what is the key message that you hope for neurologists who read your article to take away from it? Dr. Switzer: The diagnosis of NPH can be very difficult, just given the clinical heterogeneity in terms of how people present and what their images look like. And so, I'd like readers to know that detailed review of the patient's imaging can be very helpful to identify those that will clinically improve with shunt surgery. Dr Grouse: There's another really great article in this edition of Continuum that does a really great job delving into the clinical history and exam findings of NPH. So, I don't want to get into that topic necessarily today. However, I'd love to hear how you approach a case of a hypothetical patient, say, where you're suspicious of NPH based on the history and exam. I'd love to talk over how you approach the imaging findings when you obtain an MRI of the brain, as well as any follow-up imaging or testing that you generally recommend. Dr. Switzer: So, I break my approach down into three parts. First, I want to try to identify ventriculomegaly and any signs that would support that, and specifically those that are found in NPH. Secondly, I want to look for any alternative pathology or evidence of alternative pathology to explain the patient's symptoms. And then also evaluate any contraindications for shunt surgery. For the first one, usually I start with measuring Evans index to make sure that it's elevated, but then I want to measure one of the other four measurements that are described in the article, such as posterior colossal angle zed-Evans index---or z-Evans index for the American listeners---to see if there's any other features that can support normal pressure hydrocephalus. It's very important to identify whether there are features of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, which can help identify patients who may respond to shunt surgery. And then if it's really a cloudy clinical picture, it's complicated, it's difficult to know, I would usually go through the full evaluation of the iNPH radscale to calculate a score in order to determine the likelihood that this patient has NPH. So, the second part of my evaluation is to rule out evidence of any alternative pathology to suggest another cause for the patient's symptoms, such as neurodegeneration or cerebrovascular disease. And then the third part of my evaluation is to look for any potential contraindications for shunt surgery, the main one being cerebral microbleed count, as a very high count has been associated with the hemorrhagic complications following shunt surgery. Dr Grouse: You mentioned about your use of the various scales to calculate for NPH, and your article does a great job laying them out and where they can be helpful. Are there any of these scales that can be reasonably relied on to predict the presence of NPH and responsiveness to shunt placement? Dr. Switzer: I think the first thing to acknowledge is that predicting shunt response is still a big problem that is not fully solved in NPH. So, there is not one single imaging feature, or even combination of imaging features, that can reliably predict shunt response. But in my view and in my practice, it's identifying DESH, I think, is really important---so, the disproportionately enlarged subarachnoid space hydrocephalus---as well as measuring the posterior colossal angle. I find those two features to be the most specific. Dr Grouse: Now you mentioned the concept of the NPH subtypes, and while this may be something that many of our listeners are familiar with, I suspect that, like myself when I was reading this article, there are many who maybe have not been keeping up to date on these various subtypes. Could you briefly tell us more about these NPH subtypes? Dr. Switzer: Sure. The Japanese guidelines for NPH have subdivided NPH into three different main categories. So that would be idiopathic, delayed onset congenital, and secondary normal pressure hydrocephalus. And so, I think the first to talk about would be the secondary NPH. We're probably all more familiar with that. That's any sort of pathology that could lead to disruption in CSF dynamics. These are things like, you know, a slow-growing tumor that is obstructing CSF flow or a widespread meningeal process that's reducing absorption of CSF, for instance. So, identifying these can be important because it may offer an alternative treatment for what you're seeing in the patient. The second important one is delayed onset congenital. And when you see an image of one of these subtypes, it's going to be pretty different than the NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. Clinically, you may see that the patients have a higher head circumference. So, the second subtype to know about would be the delayed onset congenital normal pressure hydrocephalus. And when you see an image of one of these subtypes, it's going to be a little different than the imaging of NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. And there are two specific subtypes that I'd like you to know about. The first would be long-standing overt ventriculomegaly of adulthood, or LOVA. And the second would be panventriculomegaly with a wide foramen of magendie and large discernomagna, which is quite a mouthful, so we just call it PAVUM. The importance of identifying these subtypes is that they may be amenable to different types of treatment. For instance, LOVA can be associated with aqueductal stenosis. So, these patients can get better when you treat them with an endoscopic third ventriculostomy, and then you don't need to move ahead with a shunt surgery. And then finally with idiopathic, that's mainly what we're talking about in this article with all of the imaging features. I think the important part about this is that you can have the features of DESH, or you can not have the features of DESH. The way to really define that would be how the patient would respond to a large-volume tap or a lumbar drain in order to define whether they have this idiopathic NPH. Dr Grouse: That's really helpful. And for those of our listeners who are so inclined, there is a wonderful diagram that lays out all these subtypes that you can take a look at. I encourage you to familiarize yourself with these different subtypes. Now it was really interesting to read in your article about some of the older techniques that we used quite some time ago for diagnosing normal pressure hydrocephalus that thankfully we're no longer using, including isotope encephalography and radionuclide cisternography. It certainly made me grateful for how we've come in our diagnostic tools for NPH. What do you think the biggest breakthrough in diagnostic tools that are now clinically available are? Dr. Switzer: You know, definitely the advent of structural imaging was very important for the evaluation of NPH, and specifically the identification of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, in the late nineties has been very helpful for increasing the specificity of diagnosis in NPH. But some of the newer technologies that have become available would be phase-contrast MRI to measure the CSF flow rate through the aqueduct has been very helpful, as well as high spatial resolution T2 imaging to actually image the ventricular system and look for any evidence of expansion of the ventricles or obstruction of CSF flow. Dr Grouse: Regarding the scales that you had referenced earlier, do you think that we can look forward to more of these scales being automatically calculated and reported by various software techniques and radiographic interpretation techniques that are available or going to be available? Dr. Switzer: Definitely yes. And some of these techniques are already in development and used in research settings, and most of them are directed towards automatically detecting the features of DESH. So, that's the high convexity tight sulci, the focally enlarged sulci, and the enlarged Sylvian fissures. And separating the CSF from the brain tissue can help you determine where CSF flow is abnormal throughout the brain and give you a more accurate picture of CSF dynamics. And this, of course, is all automated. So, I do think that's something to keep an eye out for in the future. Dr Grouse: I wanted to ask a little more about the CSF flow dynamics, which I think may be new to a lot of our listeners, or certainly something that we've only more recently become familiar with. Can you tell us more about these advances and how we can apply this information to our evaluations for NPH? Dr. Switzer: So currently, only the two-dimensional phase contrast MRI technique is available on a clinical basis in most centers. This will measure the actual flow rate through the cerebral aqueduct. And so, in NPH, this can be elevated. So that can be a good supporting marker for NPH. In the future, we can look forward to other techniques that will actually look at three-dimensional or volume changes over time and this could give us a more accurate picture of aberrations and CSF dynamics. Dr Grouse: Well, definitely something to look forward to. And on the topic of other sort of more cutting-edge or, I think, less commonly-used technologies, you also mentioned some other imaging modalities, including diffusion imaging, intrathecal gadolinium imaging, nuclear medicine studies, MR elastography, for example. Are any of these modalities particularly promising for NPH evaluations, in your opinion? Do you think any of these will become more popularly used? Dr. Switzer: Yes, I think that diffusion tract imaging and MR elastography are probably the ones to keep your eye out for. They're a little more widely applicable because you just need an MR scanner to acquire the images. It's not invasive like the other techniques mentioned. So, I think it's going to be a lot easier to implement into clinical practice on a wide scale. So, those would be the ones that I would look out for in the future. Dr Grouse: Well, that's really exciting to hear about some of these techniques that are coming that may help us even more with our evaluation. Now on that note, I want to talk a little bit more about how we approach the evaluation and, in your opinion, some of the biggest pitfalls in the evaluation of NPH that you've found in your career. Dr. Switzer: I think there are three of note that I'd like to mention. The first would be overinterpreting the Evans index. So, just because an image shows that there's an elevated Evans index does not necessarily mean that NPH is present. So that's where looking for other corroborating evidence and looking for the clinical features is really important in the evaluation. Second would be misidentifying the focally enlarged sulci as atrophy because when you're looking at a brain with these blebs of CSF space in different parts of the brain, you may want to associate that to neurodegeneration, but that's not necessarily the case. And there are ways to distinguish between the two, and I think that's another common pitfall. And then third would be in regards to the CSF flow rate through the aqueduct. And so, an elevated CSF flow is suggestive of NPH, but the absence of that does not necessarily rule NPH out. So that's another one to be mindful of. Dr Grouse: That's really helpful. And then on the flip side, any tips or tricks or clinical pearls you can share with us that you found to be really helpful for the evaluation of NPH? Dr. Switzer: One thing that I found really helpful is to look for previous imaging, to look if there were features of NPH at that time, and if so, have they evolved over time; because we know that in idiopathic normal pressure hydrocephalus, especially in the dash phenotype, the ventricles can become larger and the effacement of the sulci at the convexity can become more striking over time. And this could be a helpful tool to identify how long that's been there and if it fits with the clinical history. So that's something that I find very helpful. Dr Grouse: Absolutely. When I read that point in your article, I thought that was really helpful and, in fact, I'm guessing something that a lot of us probably aren't doing. And yet many of our patients for one reason or other, probably have had imaging five, ten years prior to their time of evaluation that could be really helpful to look back at to see that evolution. Dr. Switzer: Yes, absolutely. Dr Grouse: It's been such a pleasure to read your article and talk with you about this today. Certainly a very important and helpful topic for, I'm sure, many of our listeners. Dr. Switzer: Thank you so much for having me. Dr Grouse: Again, today I've been interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
In this podcast we speak about all the action on Day 8 at Wimbledon 2025. Sinner went through to the quarter finals after Grigor Dimitrov was forced to retire injured while 2 sets up against the Italian. Sinner is facing an MRI scan for his elbow before his next match against Shelton. Djokovic started badly, but defeated De Minaur in 4 sets. Iga Swiatek continued her good run beating Tauson 6-4 6-1. Mirra Andreeva looked super confident after defeating Emma Navarro 6-2 6-3. We also give our predictions for each of the quarter finals, tell us yours in the comments! ❤️ SUBSCRIBE TO GTL: https://bit.ly/35JyOhz ▶️ JOIN YOUTUBE MEMBERSHIP: https://bit.ly/3Fk9rSr
We love to hear from our listeners. Send us a message. This week's episode is one from the road, recorded in front of a live audience in Boston's Seaport neighborhood during the BIO conference (special thanks to MasterControl for making it happen). Amber Salzman, Ph.D., CEO of Epicrispr Biotechnologies (aka 'Epic Bio') explains how epigenetic editing is revolutionizing genetic medicine by controlling gene expression, without cutting DNA like traditional CRISPR technologies. Amber talks about FSHD, a progressive muscular dystrophy, how the company raised $68 million in Series B funding despite challenging market conditions, her partnership with Springbok Analytics for AI analysis of MRI images, working with a CDMO to manufacture a new treatment modality, and navigating the FDA during a time of disruption. Access this and hundreds of episodes of the Business of Biotech videocast under the Business of Biotech tab at lifescienceleader.com. Subscribe to our monthly Business of Biotech newsletter. Get in touch with guest and topic suggestions: ben.comer@lifescienceleader.comFind Ben Comer on LinkedIn: https://www.linkedin.com/in/bencomer/
Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Gregory Hawryluk, MD, for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Dr. Hawryluk is a neurosurgeon with a PhD in stem cell research. He is the Medical Director of the Brain Trauma Foundation. As we began our 30-minute discussion, Dr. Hawryluk described his medical training as a neurosurgeon. He explained the origin and goals of the Brain Trauma Foundation. According to Dr. Hawryluk, the Brain Trauma Foundation's most significant contribution has been developing clinical practice evidence-based guidelines for traumatic brain injury. These guidelines have been associated with a 50% reduction in head injury mortality. Dr. Hawryluk suggested that the guidelines serve as a basis for individualized care that may lead to even greater benefits. The guidelines are available on the Brain Trauma Foundation's website. We explored the definition of concussion and current approaches to management. Dr. Hawryluk explained that neuroimaging, such as CT and MRI, should be normal in a patient with concussion. He offered his opinion regarding the safety of participating in contact sports, which may result in concussions. We also broached the subject of chronic traumatic encephalopathy (CTE). To learn more, please contact The Brain Trauma Foundation: https://braintrauma.org/#concussion #CTE #traumatic brain injury #TBI@braintraumafoundationPlease click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. You'll learn about new episodes and other interesting programs I host on Medscape.com, ReachMD.com, and RadioMD.com. Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com Finally, this production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwilnerpodcast_ph...
In this episode, Brant converses with Dr. Todd Dorfman, a Boulder-based concierge physician, to explore the future of preventative health care. They discuss the differences between concierge and traditional primary care, including why structural and economic constraints prevent most doctors from practicing truly individualized medicine. Dr. Dorfman breaks down powerful diagnostic tools like CT coronary angiography and full-body MRI, explaining the benefits and limitations of early screening for heart disease and cancer. They also cover emerging longevity treatments like metformin and GLP-1 agonists, and how Dr. Dorfman tailors these for patients long before they're in crisis. It's a compelling look at what personalized medicine can really do when it's practiced on your own terms. Hope you enjoy.
Segment one - comedy complaints, show diversity, we need more women in comedy, don't b*tch, comedy cruises are a thing, uncool fashion, yacht rock, nothing is lame anymore except billionaires, nicknames, dads are badass, MRI's are a nightmare... Segment two - Jonathan & Jordan on the road, McDonald's guys? Really?, drunk Mr Williams, privilege breaks, WYR eagle vs monkey, it gets complicated, WYR scary places, China doesn't scare me, this big gig is scary, country love - it's complicated, American superfans, Jordan auditions... @jordancentry @mrwilliamscomedy @kingjasonallen podcastzoningout@gmail.com Jason Allen King Headlining Goodnights Comedy Club Room 861 - July 19th https://www.goodnightscomedy.com/shows/316750 Three's Comedy Tour at Copper Fox Distillery in Sperryville, VA - July 18th & 19th https://www.eventbrite.com/e/threes-comedy-tour-at-copper-fox-distillery-tickets-1337312119549?aff=erelpanelorg
The pop song that sounds like an MRI machine.Why do we forget things when we walk into a room?See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Join host Geoffrey Rubin, MD, MBA, FACR, for a candid and wide-ranging conversation with Mitchell D. Schnall, MD, PhD, FACR—Professor of Radiology and Senior Vice President for Data and Technology Solutions at Penn Medicine. A highly accomplished radiology researcher and leader, Dr. Schnall served for 12 years as Vice Chair for Research in the Department of Radiology at the University of Pennsylvania, followed by another 12 years as Chair. His national leadership includes serving as Chair of ACRIN and the ACR Commission on Research, as well as President of the Academy for Radiology and Biomedical Imaging Research. His research contributions have earned him election to the American Society for Clinical Investigation, the Association of American Physicians, and the National Academy of Medicine. In this episode, Dr. Schnall reflects on his journey—from a curious kid with a ham radio license and an Ivy League gymnast to a nationally recognized leader in academic radiology. He shares how his background in physics and engineering shaped his hands-on approach to problem-solving, innovation, and leadership—including his early work developing MRI coils and his unexpected path into breast imaging research. Dr. Schnall also discusses lessons from his time leading Penn Radiology, his philosophy on team building and faculty development, and why embracing discomfort, trusting others, and taking smart risks are essential traits for effective leadership. With humility, clarity, and a touch of humor, Dr. Schnall offers valuable insights into the realities of leading in academic medicine, the importance of intellectual generosity, and the power of staying curious throughout one's career. Don't miss this thoughtful conversation with a leader who continues to shape the future of radiology—while never losing sight of the joy in figuring things out. Behind the Mic! Dr. Schnall and his wife have been married for 37 years. Together, they have a 32-year-old daughter, a 29-year-old son, and an 11-month-old granddaughter! When he's not working, Dr. Schnall loves to take things apart and put them back together. He is a serious “DIYer”, having renovated his own kitchen and multiple bathrooms at his home. He also enjoys riding his bicycle and eating spicey hot peppers!
What an incredible episode with an incredible health hero Dr Sean O'Mara. Dr O'Mara gives a no nonsense, no prisoners-taken masterclass on visceral fat and adipose tissue, and how it's killing you and turning on the “ugly button”. What sets this episode apart is not only Dr O'Mara's knowledge, but his use of incredible visual images to tell the story of visceral fat and how it is creating disease and death. This is one of the most important episodes I've ever done. Dr. Sean O'Mara works with business executives, professional performers and athletes motivated to optimize through innovative techniques of performance enhancement. He was a founder of an innovative medical startup in Minneapolis, MN called Lantu, focusing on health and performance optimization. In 2016, Lantu was awarded a National Science Foundation research grant to reverse chronic disease. Dr. O'Mara and his team used cutting-edge data analytics to glean insights to both identify and leverage innovative biometrics/biomarkers of health, the human genome as well as the microbiome. He has over a decade of experience evaluating and, more importantly, reversing chronic disease. He innovatively provides his clients with practical solutions to optimize their overall appearance, performance, health, and quality of life. No risky pharmaceuticals, hormones, or surgical interventions are needed for better optimizing results.Join us as we explore:Visceral fat, adipose tissue, is any amount healthy, where it comes from , how to get rid of it and how it's the #1 risk most directly causal to cardiovascular disease.Why your face is a picture of your health, especially as you age and how visceral fat and adipose tissues affects everything from hormones to cancer and even your beauty.The number one (by far) most important thing everyone needs to do to get rid of visceral fat, including visual proof of how it can radically change your body composition in less than 6 months!Why the “MRI ends the lie” and is the best tool available to literally see where your visceral fat is hiding and creating 24/7 inflammatory disease.Terrifying photos of young children's visceral fat, and the massive changes to their health and face when the fat is vanquished.Contact:Website: https://drseanomara.comInstagram: @drseanomaraMention:Programs - The Alpha Plan, https://drseanomara.com/plansSupport the showFollow Steve's socials: Instagram | LinkedIn | YouTube | Facebook | Twitter | TikTokSupport the show on Patreon:As much as we love doing it, there are costs involved and any contribution will allow us to keep going and keep finding the best guests in the world to share their health expertise with you. I'd be grateful and feel so blessed by your support: https://www.patreon.com/MadeToThriveShowSend me a WhatsApp to +27 64 871 0308. Disclaimer: Please see the link for our disclaimer policy for all of our content: https://madetothrive.co.za/terms-and-conditions-and-privacy-policy/
Scientists from the University of Otago have helped to develop a new way of reading MRI scans. It was trained using data from more than a thousand people in Dunedin in the 1970s. Dunedin Study director, professor Moana Theodore spoke to Ingrid Hipkiss.
Is it vasculitis, vasospasm, or ICAD? Sounds like it's time for some vessel wall imaging! In this episode, Frank catches up with neuroradiologist Christine Glastonbury to talk all things neurovascular MRI. Plus, Frank delivers another fake-meat update, and Andrew unleashes a rare caffeine-fueled rant. Radiopaedia 2025 Virtual Conference ► https://radiopaedia.org/courses/radiopaedia-2025-virtual-conference "Forged gras" ► https://www.forgedbyvow.com/flavours/forged-gras Become a supporter ► https://radiopaedia.org/supporters Get an All-Access Pass ► https://radiopaedia.org/courses/all-access-course-pass Radiopaedia Community chat ► http://radiopaedia.org/chat Ideas and Feedback ► podcast@radiopaedia.org The Reading Room is a radiology podcast intended primarily for radiologists, radiology registrars and residents.
Got a meniscus tear? Feeling confused, nervous, or stuck? In this episode, Hannah – physical therapist and movement expert – breaks down what your MRI really means, when surgery is (and isn't) necessary, and why pain doesn't always mean damage.Learn how to stop the rest–reinjury cycle, what movements you don't need to avoid forever, and the exact step-by-step rehab approach Hannah uses with clients to restore strength, rebuild confidence, and return to sport or daily life pain-free.Links: Meniscus Tear Rehab & Exercise GuideWelcome to the "Healthy Charleston Podcast," your ultimate guide to taking charge of your health and wellness journey. In a world where health information can be overwhelming and confusing, we strive to be your trusted source of accurate, evidence-based knowledge. Our goal is to equip you with the tools and resources you need to lead a healthier lifestyle. Tune in to each episode as we connect with inspirational community leaders in Charleston and Summerville, SC. These individuals are dedicated to creating a healthier community and they share their perspective on what health means to them. Join us as we embark on an exploration into the realms of health, well-being, and community empowerment!@healthycharleston@made2movept DON'T spend another day in pain! Request an appointment at https://www.made2movept.com/contact and get 10% off your Initial Evaluation when you mention the podcast.
Are you enjoying this? Are you not? Tell us what to do more of, and what you'd like to hear less of. The Reykjavík Grapevine's Iceland Roundup brings you the top news with a healthy dash of local views. In this episode, Grapevine publisher Jón Trausti Sigurðarson is joined by Heimildin journalist Aðalsteinn Kjartansson, and Grapevine friend and contributor Sindri Eldon to roundup the stories making headlines in recent weeks. On the docket this week are: ✨ A Silicon Factory near Húsavík, North-East Iceland, PCC are laying off 30 people and at least temporarily closing down production. We talk about how this is not the first such factory in Iceland to go belly up.✨ Socialist Party infighting continues. We half-heartedly explore the Icelandic Socialist Party's journey towards self-destruction.✨Moomins in Akureyri. A new set-to-be-open soon Moomin themed outdoor area near Akureyri runs into copyright issues. ✨MRI scanner problems in Landspítali Hospital. One of the few MRI machines in Iceland went offline as a floor cleaning machine got stuck on its exterior a couple of weeks ago. The floor cleaning machine has now been (finally) separated from the MRI machine, but the MRI machine is still broken.✨Heart shaped traffic lights in Akureyri are to be removed. Now the President of Iceland has intervened on the behalf of the traffic lights. ✨We discuss a 2023 door bell prank with consequences. ------------------------------------------------------------------------------------------SHOW SUPPORTSupport the Grapevine's reporting by becoming a member of our High Five Club: https://steadyhq.com/en/rvkgrapevine/You can also support the Grapevine by shopping in our online store: https://shop.grapevine.is------------------------------------------------------------------------------------------ This is a Reykjavík Grapevine podcast.The Reykjavík Grapevine is a free alternative magazine in English published 18 times per year, biweekly during the spring and summer, and monthly during the autumn and winter. The magazine covers everything Iceland-related, with a special focus culture, music, food and travel. The Reykjavík Grapevine's goal is to serve as a trustworthy and reliable source of information for those living in Iceland, visiting Iceland or interested in Iceland. Thanks to our dedicated readership and excellent distribution network, the Reykjavík Grapevine is Iceland's most read English-language publication. You may not agree with what we write or publish, but at least it's not sponsored content.www.grapevine.is
Master precision magnetic resonance imaging (MRI) techniques using liver-specific contrast agents. Credit available for this activity expires: 6/26/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/precision-imaging-liver-mri-2025a1000guj?ecd=bdc_podcast_libsyn_mscpedu
Would you tell your friend if they were ugly? Keke would, listen to the crew debate! And Jason get's his first MRI and he was unware of the procedure!See omnystudio.com/listener for privacy information.
Jason had to get an MRI for his knee that's been bothering him and he had no idea what would go down during this process!See omnystudio.com/listener for privacy information.
Jason went to get an MRI for his hurt knee! Find out why John got ghosted on Waiting by the Phone! And, do you think Shelly can continue her win streak? Find out!See omnystudio.com/listener for privacy information.
Yusei Kikuchi is racking up strikeouts (2:33)! ... Jacob Misiorowski outdueled Paul Skenes (8:03). ... Jacob Lopez looks like a must-add pitcher at the moment (15:49). ... News (24:21): Zach Neto's shoulder MRI came back negative. ... Let's bow our heads and bury Zac Gallen (30:07). ... Max Scherzer was solid in his Blue Jays debut (34:36). ... Jo Adell hit yet another homer (36:07). ... Edward Cabrera continues to pitch well (42:16). ... We have rankings questions on Jacob deGrom, Max Fried, Nick Kurtz and others (45:59). ... We had some pitchers duels in San Diego and Minnesota (58:18). ... We wrap up with leftovers, bullpen updates and streamers (1:01:58). Fantasy Baseball Today is available for free on the Audacy app as well as Apple Podcasts, Spotify and wherever else you listen to podcasts. Subscribe to our YouTube channel: youtube.com/FantasyBaseballToday Download and Follow Fantasy Baseball Today on Spotify: https://sptfy.com/QiKv Get awesome Fantasy Baseball Today merch here: http://bit.ly/3y8dUqi Follow FBT on TikTok: https://www.tiktok.com/@fbtpod?_t=8WyMkPdKOJ1&_r=1 Follow our FBT team on Twitter: @FBTPod, @CPTowers @CBSScottWhite, @Roto_Frank Join our Facebook group at https://www.facebook.com/groups/fantasybaseballtoday Sign up for the FBT Newsletter at https://www.cbssports.com/newsletters/fantasy-baseball-today/ For more fantasy baseball coverage from CBS Sports, visit https://www.cbssports.com/fantasy/baseball/ To hear more from the CBS Sports Podcast Network, visit https://www.cbssports.com/podcasts/ You can listen to Fantasy Baseball Today on your smart speakers! Simply say "Alexa, play the latest episode of the Fantasy Baseball Today podcast" or "Hey Google, play the latest episode of the Fantasy Baseball Today podcast." 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
CrossFit Semifinalist Heals L5-S1 Disc Herniation Without Surgery | MRI Reveals 14mm Herniation GoneLindsey, a competitive CrossFit Semifinalist and gym owner, was diagnosed with a massive 14mm L5-S1 disc herniation that caused debilitating back pain and sciatica. After 18 months of pain and trying everything — including chiropractic care, spinal decompression, massage therapy, injections, and being scheduled for a microdiscectomy — she made a life-altering decision: she canceled surgery 12 hours before it was set to happen.Instead, she committed to the Whealth Limitless program, a movement-based recovery approach designed to help people with herniated discs avoid surgery. Five months later, a follow-up MRI showed her herniation was completely gone — from 14mm to 0mm. In this episode, Lindsey shares exactly what she did, what her neurosurgeon said after the MRI, and how she's rebuilding trust in her body.If you're searching for:How to heal an L5-S1 disc herniation naturallyCrossFit with a herniated discSciatica relief without surgeryMRI proof of disc herniation reabsorption…this is your episodeChapters00:00 Lindsey's MRI Results: A Surprising Turnaround03:37 The Emotional Journey of Recovery06:32 Navigating Medical Opinions and Personal Choices09:36 Future Goals and Overcoming Fear12:21 The Importance of Movement in RecoveryLearn more about the Limitless program Lindsey used to help herself heal: https://spreadwhealth.com/limitless-program
Ezra CEO Emi Gal breaks down how AI is revolutionizing full-body MRI cancer screening. Learn how FDA-cleared tools accelerate scan time, assist radiologists, and empower patients with easy-to-understand reports—all for just $499. Discover why early detection matters, especially for younger adults, and how Ezra is scaling access to lifesaving diagnostics.
Greg Brady spoke to Aaron Waxman, Partner and Director of Business Development at Canmax Medical Imaging Inc. about Canadian owned MRI clinic in Buffalo says business is booming Learn more about your ad choices. Visit megaphone.fm/adchoices
Greg Brady and the panel of: Sharan Kaur, political strategist Laryssa Waler, Founder of Henley Strategies Discuss: 1.Toronto City Council votes to permit sixplexes in nine wards: The Mayor says sixplexes would make average rents about $830/month cheaper than condos, why are some councillors still clutching their pearls? Are some councillors really just guarding home prices instead of helping renters? What does this mean for parking? 2.This Canadian-owned MRI clinic in Buffalo says business is booming: Should OHIP cover a U.S. scan once the wait times reach a certain limit? Does cross-border medical care ease the pressure on Ontario wait-lists, or does it let politicians dodge fixing the backlog? 3.Some Toronto students offered Free Palestine and Free Tibet as yearbook quotes. The school removed quotes from the entire Grade 12: Should political quotes/opinions be permitted in yearbooks here? Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode, Mark gets his air conditioning back and lets his father-in-law use his shop. Bruce harvests rocks. Drew gets denied an MRI. Plus, a ton more! T-shirts: https://fishersshoponline.com/merch & https://www.bruceaulrich.com/shop/clothing SUBSCRIBE TO DIRTtoDONE on YouTube: http://tinyurl.com/DIRTtoDON -This episode is sponsored by OneFinity CNC! We have partnered with them and would love it if you would go to their website and check them out: https://www.onefinitycnc.com/ Become a patron of the show! http://patreon.com/webuiltathing OUR TOP PATREON SUPPORTERS -Tim Morrill -Scott @ Dad It Yourself DIY http://bit.ly/3vcuqmv -Ray Jolliff -Deo Gloria Woodworks (Matthew Allen) https://www.instagram.com/deogloriawoodworks/ -Henry Lootens (@Manfaritawood) -Chris Simonton -Maddux Woodworks http://bit.ly/3chHe2p -Bruce Clark -Will White -Cody Elkins (creator of the Jenny Bit) -Andy @ Mud Turtle Woodworks -Damon Moran -Monkey Business Woodworks -Rich from Woodnote Studio -AC Nailed It -Joe Santos from Designer's Touch Kitchen & Bath Studio -Chad Green -Trevor -Mark Herrick @ Empty Nest Woodworks -Not That Aaron, the other one Support our sponsors: TOOL CODES: -MagSwitch: “WBAT” -SurfPrep: “FISHER10” -Bumblechutes: “FISHER10” -Starbond: “BRUCEAULRICH” -Brunt Workgear: “GUNFLINT10” -Rotoboss: “GUNFLINT” -Merlin Moisture Meters: “FISHER10” -Montana Brand Tools: “GUNFLINT10” -Monport: “GUNFLINT6” -Stone Coat Epoxy: Gunflint -MAS Epoxy: FLINT -YesWelder: GUNFLINT10 -Millner-Haufen Tool Co: “ULRICH20” for 20% off -SmartSquareTools.com: “FISHER10” -Camel City Mill: GUNFLINT10 -Arbortech Tools: “BRUCEAULRICH” for 10% off -HighCountryTool.com: “FISHER10” for 10% off -Wagner Meters: https://www.wagnermeters.com/shop/orion-950-smart/?ref=210 We Built A Thing T-shirts! We have two designs to choose from! (You can get one of these as a reward at certain levels of support) https://amzn.to/2GP04jf https://amzn.to/2TUrCr2 ETSY SHOPS: Bruce: https://www.etsy.com/shop/BruceAUlrich?ref=simple-shop-header-name&listing_id=942512486 Drew: https://www.etsy.com/shop/FishersShopOnline?ref=simple-shop-header-name&listing_id=893150766 Mark: https://www.etsy.com/shop/GunflintDesigns?ref=search_shop_redirect Bruce's most recent video: https://youtu.be/xRFe5bELcyE?si=rXBq3csbaaBq7quz Drew's most recent video: https://youtu.be/uVlsKXiIoXo?si=7C3E3sYKkZz6uPIV Mark's most recent video: https://youtu.be/a701NsPo4ss?si=96H_AiQVVNV1YvbL We are all makers, full-time dads and all have YouTube channels we are trying to grow and share information with others. Throughout this podcast, we talk about making things, making videos to share on YouTube, Instagram, Facebook, etc...and all of the life that happens in between. CONNECT WITH US: WE BUILT A THING: www.instagram.com/webuiltathingWE BUILT A THING EMAIL: webuiltathing@gmail.com FISHER'S SHOP: www.instagram.com/fishersshop/ BRUDADDY: www.instagram.com/brudaddy/ GUNFLINT DESIGNS: https://www.instagram.com/gunflintdesigns Music by: Jay Fisher (Thanks, Jay!)
TISS is a weekly podcast where Varun, Kautuk, Neville & Aadar discuss crazy "facts" they find on the internet. Come learn with them... or something like that.This week, the boys are diving into yet another eerie episode of Ghost Stories — brought to you by Amazon Music India. ️ Listen to the episode first on Amazon Music, before any other audio streaming platform - included with your Prime Video Membership — https://shorturl.at/hfQZX To support TISS, check out our Instamojo: www.instamojo.com/@TISSOPFollow #TISS Shorts where we put out videos: https://bit.ly/3tUdLTCYou can also check out the podcast on Apple podcast, Spotify and Google podcast!https://shorturl.at/hfQZXhttp://apple.co/3neTO62http://spoti.fi/3blYG79http://bit.ly/3oh0BxkCheck out the TISS Sub-Reddit: https://bit.ly/2IEi0QsCheck out the TISS Discord: / discord Buy Varun Thakur's 420 Merch - http://bit.ly/2oDkhRVSubscribe To Our YT Channels:Varun - https://bit.ly/2HgGwqcAadar - https://bit.ly/37m49J2Kautuk - https://bit.ly/3jcpKGaNeville - https://bit.ly/2HfYlWyFollow Us on Instagram:Varun - / varunthakur Aadar - / theaadarguy Kautak - / cowtuk Neville - / nevilleshah. Chapters:0:00 - Cold Open2:25 - Love for Amazon Music3:14 - Welcome to The Internet Said So 3:20 - Lights Off For Mood Setting5:55 - Kautuk's story about a cursed waterfall21:14 - Kautuk's story discussion22:30 - Varun talks about a similar actual case he has heard of24:10 - Getting lost in the wild25:25 - The fears of exploring nature26:06 - Varun's recent experience with MRI scan28:32 - 'The Descent' movie28:51 - 'Cursed' the documentary31:06 - Stories of cursed objects are insane!35:57 - Varun's neighbour did black magic?!38:01 - Witch-Hacks!41:12 - Aadar's story from Sapporo, Japan49:20 - Aadar's story discussion49:24 - Kautuk's experiences with creepy dolls50:30 - Varun shares a story from '?: A Question Mark'51:27 - Reddit story of the father and child with doll53:42 - Varun's story about cab driver from Dhanbad, Jharkhand1:04:42 - Varun's story discussion1:07:02 - One of the scariest things Kautuk has ever seen (new fear unlocked)1:10:45 - Varun shares story about security guard in Nandambakkam, Chennai1:16:28 - Aadar's Wonderland Toys story1:23:15 - Aadar's story discussion1:24:14 - Kautuk talks about the 'Phantom Mahjong Players' from Hong Kong1:32:00 - Kautuk's story discussion 1:33:20 - Thanks for tuning in, folks!1:33:52 - Post credits sceneCreative Producer- Antariksh TakkarChannel Artwork by OMLThumbnail - OML
Text Dr. Lenz any feedback or questions This detailed podcast episode delves into the findings of a study on Chronic Fatigue Syndrome (CFS) using functional MRI and immune system analysis. The speaker explains the technology behind functional MRI and what it revealed about brain activity, specifically in the parietal temporal junction, which showed hypoactivity in CFS patients. The discussion extends to immune abnormalities, highlighting immune cell exhaustion, and hypothesizing links to persistent infections. The episode emphasizes the need for interdisciplinary, evidence-based approaches to treating these 'invisible' illnesses and calls for more integrated, patient-centric research. Other discussed topics include the limitations of current medical specialization and the need for generalist knowledge, the role of gut microbiome, and potential lessons from oncology on immune checkpoints.00:00 Introduction to Functional MRI01:48 Understanding Functional MRI Findings04:08 Immune System Insights04:54 Cancer Research and Immune Exhaustion09:01 Genetic Susceptibility and Long COVID10:33 Holistic Approach to Medicine13:34 Challenges in Treating CFS and Fibromyalgia15:38 Future Directions in Research22:40 Gut Microbiome and Immune Response25:41 Neurodivergence and Immune System29:25 Conclusion and Final Thoughts International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers. Support the showWhen I started this podcast—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That's why I created this space: to offer education, validation, and hope. If you've been told fibromyalgia “isn't real” or that it's “all in your head,” know this—I see you. I believe you. You're not alone. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you'll find trusted, evidence-based insights here, drawn from my 28+ years as an MD. Please remember to talk with your doctor about your symptoms and care. This content doesn't replace personal medical advice.* ...
Join us for an extraordinary conversation with Jill Cole, whose near-death experience during a ski accident and subsequent MRI catapulted her into a profound spiritual awakening. From divine downloads about the human energy system at Stonehenge to miraculous physical healing and unexpected activations, Jill shares her incredible journey of remembering her true purpose. Discover how this life-altering event ignited her path as a spiritual guide, unlocking ancient wisdom and new abilities, and forever changing her understanding of reality. Find Jill Cole at https://www.jillcole.org/ You can also watch this on YouTube at https://youtu.be/Wu0M57rxahY #NDE #NearDeathExperience #SpiritualAwakening #JillCole #EnergyHealing #Consciousness #DivineGuidance #SpiritualJourney #BeyondTheVeil #MindBodySpirit
Facing MS: From First Symptoms to First Steps- Episode 186 - Transcript In this episode, we explore how the landscape of being newly diagnosed with multiple sclerosis (MS) has transformed over the last decade. Thanks to advances in MRI technology, biomarkers, and updated diagnostic criteria, more people are being diagnosed earlier. We break down how diagnosis and treatment options have improved across the board. We also dive into why getting a diagnosis can still take time, and why accuracy is so crucial, even when emotions are high. You'll hear practical tips on building a strong relationship with your MS care team, how to know when it might be time for a second opinion, and how to navigate that often overwhelming first treatment decision Disclaimer: This podcast provides general educational information. Can Do MS does not endorse, promote, or recommend any product, service, or diet associated with the content of this program.
Idiopathic intracranial hypertension (IIH), a condition of increased intracranial pressure (ICP), causes debilitating headaches and, in some, visual loss. The visual defects are often in the periphery and not appreciated by the patient until advanced; therefore, monitoring visual function with serial examinations and visual fields is essential. In this episode, Kait Nevel, MD speaks with John J. Chen, MD, PhD, and Susan P. Mollan, MBChB, PhD, FRCOphth, authors of the article “Treatment and Monitoring of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Chen is a professor of ophthalmology and neurology at the Mayo Clinic in Rochester, Minnesota. Dr. Mollan is an honorary professor of metabolism and systems science in the department of neuro-ophthalmology at University Hospitals Birmingham in Birmingham, United Kingdom. Additional Resources Read the article: Treatment and Monitoring of Idiopathic Intracranial Hypertension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Guests: @chenmayo, @DrMollan Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kate Nevel. Today, I'm interviewing Drs John Chen and Susan Mollan about their article on treatment and monitoring of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics. Drs Chen and Mollan, welcome to the podcast. And please, could you introduce yourselves to the audience? Dr Chen: Hello, everyone. I'm John Chen, one of the neuro-ophthalmologists at the Mayo Clinic. Thanks for having us here. Dr Mollan: Yeah, it's great to be with you here. I'm Susan Mollan. I'm a consultant neuro-ophthalmologist in Birmingham, England. Dr Nevel: Wonderful. So great to have you both here today, and our listeners. To start us off, talking about your article, can you share with us what you think is the most important takeaway from your article for the practicing neurologist out there? Dr Chen: Yeah, so our article talked about the treatment and monitoring of IIH. And I think one takeaway point is, IIH is becoming much more prevalent now that there's this worldwide obesity epidemic with obesity having- essentially being the largest risk factor for IIH other than female. It's really important to monitor vision because vision loss is often peripheral vision loss at first, which the patient may be completely unaware of. And so, it's important to pair up with an ophthalmologist so you can monitor the papilledema of the visual fields and make sure they don't get permanent vision loss. And in the article, we also talk about- there's been changes in the treatment of severe IIH, where traditionally, we used VP shunts; but there's been a trend toward using more venous sinus stenting in addition to the traditional surgeries. Dr Nevel: Great, thank you. I think probably most of our listeners or a lot of neurologists out there have a pretty good understanding of kind of the basics of the IIH. But can you kind of just go over a few key characteristics of IIH, and maybe some things that are less commonly known or things that are maybe just been kind of better understood over the past decade, perhaps? Dr Mollan: Yes, certainly. I think, as Dr Chen said, it's because this condition is becoming more prevalent, people recognize it. I think it's- we like to go back to the diagnostic criteria so that we're making a very accurate diagnosis. So, the patients may come in to the emergency room with, say, papilledema that's been identified elsewhere or crashing headaches. And it's important to go through that sort of diagnostic pathway, taking a blood pressure, taking a full blood count to make sure the patient is anemic, and then moving forward with that confirmation of papilledema into urgent neuroimaging, whether it's CT or MRI, but including venography to exclude a venous sinus thrombosis. And then if you have no structural lesion that's causing the raised ICP, it's moving forward with your lumbar puncture and carefully checking those pressures. But the patients may not only have crashing headache, they often have pulsatile tinnitus and neck pain. I think some of the features that we're now recognizing is the systemic metabolic effects that are unique to IIH. And so, there's an increased risk of cardiometabolic disease that's over and above what is conferred by obesity. Also, our patients have a sort of maternal health burden where they get impaired fertility, gestational diabetes and preeclampsia. And there's also an associated mental health burden, amongst other things. So we're really starting to understand the spectrum of the disease a bit more. Dr Nevel: Yeah, thank you for that. And that really struck me in your article, how important it is to be aware of those things so that we're making sure that we're managing our whole patient and connecting them with the appropriate providers for some of those other issues that may be associated. For the practicing neurologist out there without all the neuro-ophthalmology equipment, if you will, what should our bedside exam focus on to help us get maybe an early but accurate picture of the patient's visual function when we suspect IIH to be at play, perhaps before they can get in with the neuro-ophthalmologist? Dr Chen: Yeah, I think at the bedside you can still check visual acuity and confrontational visual fields, you know, with finger counting. Of course, you have to know that those are, kind of, crude kind of ways of screening. With papilledema, oftentimes the visual acuity is intact. And the confrontational visual fields aren't as sensitive as automated perimetry. Another important thing will be to do your direct ophthalmoscope and look at the amount of papilledema. If it's grade one or two papilledema on the more mild side, it's actually not vision threatening. It's the higher degrees of papilledema that can cause rapid vision loss. And so, if you look in and you see grade one papilledema, obviously you need to do the full workup, the MRI, MRV, lumbar puncture. But in terms of rapidly getting to an ophthalmologist to screen for vision loss, it's not going to be as important because you're not going to have vision loss at that low grade. If you look in and you see this rip-roaring papilledema, grade five papilledema, that patient is going to be at very severe risk of vision loss. So, I think that exam, looking at the optic nerve can be very helpful. And of course, talking to the patient about symptoms; is there decreased vision Is there double vision from a sixth nerve palsy? Are there transient visual obscurations which would indicate at least a higher degree of papilledema? That'd be helpful as well. Dr Nevel: Great, thank you. And when the patient does get in with a neuro-ophthalmologist, you talk in your article and, of course, in clinical practice, how OCT testing is important to monitor in this condition. Can you provide for the listeners the definition of OCT and how it plays a role in monitoring patients with IIH? Dr Mollan: Sure. So, OCT is short for optical coherence tomography imaging, and really the eye has been at the forefront of OCT alone. Our sort of cardiology colleagues are catching up on the imaging of blood vessels. But what it allows us to do is give us really good cross-sectional, anatomical-level changes that we can see both in the retina and also at the optic nerve head. And it gives us some really good measurements. It's not so good at sort of saying, is this definitely papilledema or not? That sort of lower end of disc elevation. But it is very good at ruling out what we call the pseudopapilledema. So, things like drusens or these other little masses we find underneath the optic nerve head. But in terms of monitoring, because we can longitudinally take these images and the reproducibility is pretty good at the optic nerve head, it allows us to see whether there's direct changes: either the papilledema getting worse or the papilledema getting better at the optic nerve head. It also gives us some indication of what's going on in the ganglion cell layer complex. And that can be helpful when we're thinking about sort of looking at structure versus function. So, ophthalmologists in general, we love OCT; and we spend much more time nowadays looking at the OCT than we really do the back of the eye. And it's just become critical for patients with papilledema to be able to be very accurate from visit to visit to see what's changing. Dr Nevel: How do you determine how frequently somebody needs to see the neuro-ophthalmologist with IIH and how often they need that OCT evaluation? Dr Chen: Once the diagnosis of IIH is made, how often they need to be seen and how frequent they need to be seen depends on the degree of papilledema. And again, OCT is really nice. You can quantify it and then different providers can actually use the same OCT numbers, which is super helpful. But again, if it's grade three papilledema or higher, or article thickness of 200 or higher, I tend to follow them a little bit more closely, trying to treat them more aggressively. Try to get the papilledema down into a safer zone. If it's grade one or two papilledema, we see them less frequently. So, my first visit might be three months out. They come with grade five papilledema, I'm seeing them within a few days to make sure that's papilledema's come down quickly because we're trying to decide, are they going to need surgery or not? Dr Nevel: Yeah, great. And that's a nice segue into talking a little bit about how we treat patients with IIH after the diagnosis is confirmed. And I'd like to just point out you have a very lovely figure in your article---Figure 5-6,---that I'd like to direct our listeners to read your article and check out that figure, which is kind of an algorithm on how we think about the various treatment options for patients who have IIH, which seems to rely a lot on the degree of presence of papilledema and the presence of vision disturbance. Could you maybe walk us through a little bit about how you think about the different treatment options for patients with IIH and when more urgent surgical intervention might be indicated? Dr Mollan: Yeah, sure. We always find it quite hard in any medical specialty to write these kind of flow diagrams because it's really an individual we're looking at. But these are kind of what we'd say is “broad brushstrokes” into those patients that we worry about, sort of, red disease in those patients, more amber disease. Now obviously, even those patients that may not have severe papilledema, they may have crashing headaches. So, they may be an urgent referral themselves because of that. And so, it's nice to try and work out which end of the spectrum you're working with. If we think of the papilledema, Dr Chen's already laid out the sort of lower end of the prison's scale---our grades one, our grades two---that we're less anxious about. And those patients, we would definitely be having discussions about medical management, which includes acetazolamide therapy; but also thinking about weight management. And it may well be that we talk a little bit further about weight management, but I think it's helpful to sort of coach those conversations after you've made a definite diagnosis. And then laying out the risk that's caused, potentially, the IIH in an individual. And then having a sort of open conversation with them about what changes they can have in their lifestyle alongside thinking about medical therapy. There's some patients with very low levels of papilledema that we decide not to put on medicines initially. As patients progress up that papilledema grade, we're definitely thinking about medical therapy. And our first line from the IIH treatment trial would be using acetazolamide, but we need to be thinking about using appropriate dosing. So, a lot of the patients that I see can be sent to me with very low doses that may be inappropriate for that person. In the IIHTT they used up to four grams daily in a divided dose. And you do need to counsel your patients when you're putting them on acetazolamide because of the side effects. You've got quite a nice table in this article about the side effects. I think if you get the patient on board, that they understand that they will experience side effects, that is helpful because they will expect it, and then possibly tolerate it a bit better. Moving through to that area where we're more anxious, that visual-threatening papilledema. As Dr Chen said, it's sort of like you look in and it's sort of “blood and thunder” in there. And you need to be getting on and encouraging the ophthalmologist to get a formal assessment of the visual field. It's very difficult to determine exactly the level at which- and we talk about the mean deviation in a lot of our research studies. But in general, it's a combination of things: the patient's journey to get to you, their symptoms, what's going on with the visual field, but what's also happening at the OCT. So, we look in and we see that fluid is seeping towards the fovea. We get very anxious, and those patients may not even have enough time for a rapid escalation of acetazolamide. It may well be at the first presentation, which we would term, like, fulminant; that we'd be thinking about surgical intervention. And I think before I stop, the other thing to say is, the surgical landscape is really changing. So, we're having some good studies coming out in terms of stenting. And so, there is a sort of bracket where it may well be that we are thinking about neuroradiological intervention in an earlier case. They may not quite be at that visual-threatening stage, but they may be resistant to medical treatments. Dr Nevel: Thank you for that. What do you think is a potential pitfall or a mistake to avoid, if you will, in the management of patients with IIH? Dr Chen: I think it's- in terms of pitfalls, I think the potential pitfalls I've seen are essentially patients where we don't necessarily create a good patient physician relationship. Where they don't have buy-ins on the treatment, they don't have buy-ins to come back, and they're lost to follow-up. And these patients can be dangerous, because they could have vision threatening papilledema and if not getting the appropriate treatment---and if they're not monitoring the vision---this can lead to poor outcomes. So, I've definitely seen that happen. As Dr Mollan said, you really have to tell them about the side effects from the medications. If you just take acetazolamide, letting them know the paresthesias and the changes in taste and some of these other side effects, they're going to immediately stop the medication. Again, and these medications do work, proven in the IIH treatment trial. So again, I think that patient-physician relationship is very important to make sure they have appropriate follow up. Dr Nevel: The topic of weight loss in this patient population can be tricky, and I know I talked with Susie in a prior interview about how to approach this topic with our patients in a sensitive and compassionate manner. Once this topic is broached, I find many patients are looking for advice on strategies for weight loss, or potentially medications or other interventions. How do you prioritize or think about the different weight loss strategies or treatments with your patients, and how do you think about the way that you recommend these different treatments or not? Dr Mollan: Yeah. I think that's a really great question because we sort of stray here into a specialty that we have not been trained in. One thing I definitely ask my patients: if they've been on a weight loss journey before, and what's worked for them and what's not worked for them. And within our different healthcare systems, we have access to different tiers of weight management approaches. But for the person sitting in front of me, that possibly there may be a long journey to access more professional care, it's about understanding. iIs there things that are free, such as, we have some apps in the National Health Service which are weight management applications where they can actually just start putting in their calories, their daily calorie intake. And those apps can be quite helpful and guiding in terms of targeting areas, but also informing the patient of what types of foods to avoid in their diet and what types of foods to include in their diet. And with some of the programs that are completely complementary, they also sometimes add on things about exercise. But I think it is a really difficult thing to manage as, say, an ophthalmologist or a neurologist, mainly because it's not our area of expertise. And I think we've all got to find, in our local hospitals and healthcare systems, those pathways where the patients may be able to access nutritional support, and sort of behavioral lifestyle therapy support, all the way through to the new medications for weight loss; and also for some people, bariatric surgery pathways. It's a tricky topic. Dr Nevel: So how should we counsel our patients about what to expect in the future in terms of visual outcomes? Dr Chen: I think a lot of that depends on the degree of papilledema when they present. If a patient comes in with grade five papilledema, that fulminant IIH that Dr Mollan had mentioned, these patients can have very severe vision loss. And even if we treat them very aggressively with high-dose medications and urgent surgical interventions, sometimes they can have permanent vision loss. And so, we counsel them that, you know, there's a strong chance that they're going to have a good amount of vision loss. But some patients, we're very surprised and we get a lot of vision back. So, we kind of set expectations, but we're cautiously optimistic that we can get vision back. If a patient presents with more mild papilledema like grade one or two papilledema, they're most likely not going to have any permanent vision loss as long as we're treating them, we're monitoring their vision, they're coming to their follow-ups. They tend to do very well from a vision perspective. Dr Nevel: That's great, thank you. And you know, ties into what you said earlier about really making sure that, you know, we create good- as with any patient, but good physician-patient relationships so that they, you know, trust us and they come to follow up so we can really monitor their vision appropriately. What do you think is going on in research in this area that's exciting? What do you think one of the next breakthroughs or thing that we need to understand the most about treatment and monitoring of IIH? Dr Chen: I think surgically, venous sinus stenting is going to probably take over the bulk of surgeries. We still need that randomized clinical trial, but we have some amazing outcomes with venous sinus stenting. And there's many efforts on randomized clinical trials for venous sinus stenting. So we'll have those results soon. From a medical standpoint, Dr Mollan can actually say, actually, more about this. Dr Mollan: I completely agree. The GLP-1 receptor agonists, the twofold prong approach: one is the weight loss where these patients, you know, have significant weight loss to put their disease into remission; and the other side of it is whether certain GLP-1s have the ability to reduce intracranial pressure. So, a phase 2 study that we undertook here in Birmingham did show that we were able to reduce intracranial pressure, but we don't think it's a class effect. So, I think the sort of big breakthrough will be looking at novel therapies like xenotide and other drugs that, say, work on the proximal kidney tubule. Are they able to reduce intracranial pressure directly? And I think we are on the cusp of a real breakthrough for this disease. Dr Nevel: Great. Thank you so much for chatting with me today. And I really learned a lot, appreciated the opportunity. I hope our listeners learned something today, too. So again, today I've been interviewing Drs John Chen and Susan Mollan about their article on treatment and monitoring of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
In this episode we welcome Dr. Missy Carpentier, a veterinary neurologist from Minnesota, to discuss the fascinating and often complex world of veterinary neurology. Dr. Carpentier shares her journey from veterinary school to opening her own specialty clinic, Minnesota Veterinary Neurology, dedicated to treating neurological conditions in pets.The trio delves into a variety of topics, including the increasing prevalence of neurological issues in popular dog breeds like the French Bulldog, the challenges of diagnosing conditions such as seizures and disc disease, and the importance of owner awareness in recognizing subtle signs of distress in their pets. With her expertise, Dr. Carpentier explains the different types of neurological disorders, the significance of proper imaging techniques like MRI, and the impact of conditions such as paroxysmal dyskinesia and cervical spondylomyelopathy on pets.Listeners will gain valuable insights into what to do in case of a pet emergency, the innovative treatments available, and how pet owners can advocate for their furry friends. Tune in for an enlightening conversation that underscores the importance of understanding veterinary neurology and the passion behind helping animals lead healthier lives.Whether you're a pet owner, a veterinary professional, or just curious about animal health, this episode is packed with information you won't want to miss! --What started during the COVID-19 lockdown with one baby gorilla at the Cleveland Zoo has grown into a channel loved by animal fans around the world. I'm a one-person operation—filming, editing, narrating, and sharing the most heartfelt moments of baby gorillas, orangutans, elephants, and other zoo animals. Whether it's Jameela's emotional journey or Clementine's first steps, each video brings you closer to the animals and their stories. If you love watching real animal behavior, learning fun facts, and supporting conservation through storytelling—this is your place! Subscribe to Larry's Animal Safari on YouTube @larrysanimalsafari ---Support our sponsor for this episode Blue Buffalo by visiting bluebuffalo.com. BLUE Natural Veterinary Diet formulas offer the natural alternative in nutritional therapy. At Blue Buffalo, we have an in-house Research & Development (R&D) team with over 300 years' experience in well-pet and veterinary therapeutic diets, over 600 scientific publications, and over 50 U.S. patents. At Blue Buffalo, we have an in-house Research & Development (R&D) team with over 300 years' experience in well-pet and veterinary therapeutic diets, over 600 scientific publications, and over 50 U.S. patents.---All footage is owned by SLA Video Productions.
Computertomographie und Magnetresonanztomographie sind in der Humanmedizin häufig eingesetzte Verfahren. Auch in der Tiermedizin werden diese beiden Verfahren häufig eingesetzt. Auch in der Tiermedizin gewinnen diese Verfahren zunehmend an Bedeutung. Die Computertomographie ist besonders gut für die feinauflösende Darstellung von Hochkontraststrukturen wie Knochen. Bei der Magnetresonanztomographie wird nicht mit Röntgenstrahlen gearbeitet, sondern mit einem starken Magnetfeld. Dadurch können Bereiche im Körper dargestellt werden, die sonst durch einen Knochen abgeschirmt sind. Abgeklärt werden vor allem zentrale Störungen, Prozesse im Gehirn, Entzündungen, Blutungen oder Verletzungen im Rückenmark, wie Bandscheibenvorfälle, Embolien und Infarkte. In der Human und Tiermedizin. Für Untersuchungen im CT und dem MRI werden die Tiere sediert.
Is death the end, or the beginning of something even more magical?In this enlightening episode of Uncover Your Magic, Ashley sits down with Julie Ryan, a psychic, medical intuitive, and bestselling author of "Angelic Attendance," to explore what actually happens when we transition from this life to the next. Julie brings decades of experience scanning bodies, connecting with spirits, and teaching others how to unlock their own "buffet of psychicness."Julie shares her incredible story of how she went from surgical device entrepreneur to energy healer and spiritual communicator. She explains the 12 Phases of Transition, how to communicate with dying loved ones (and even pets), and how spirit works through us to support healing, bring peace, and in some cases reverse disease. You'll also learn the surprising role our maternal ancestors play at the time of death, along with why "hopium" might be the most powerful medicine of all.Whether you're grieving, exploring, or stepping into your own intuitive gifts, Julie's grounded wisdom and extraordinary experiences will expand your understanding of life, death, and the unseen connections in between.This episode offers clarity, comfort, and a new way of looking at what comes next. A must-listen for anyone who longs for peace, guidance, and proof that love never dies.Episode Takeaways:08:30 How she went from inventor and businesswoman to intuitive healer (by following the breadcrumbs of curiosity)12:10 Julie explains how she “scans” people like a human MRI to identify imbalances and help the body heal.18:27 Julie shares how maintaining a high-frequency lifestyle influences healing, joy, and intuition.21:40 Healing Dogs, Discs & Bone Spurs. A behind-the-scenes at Julie's energetic work on Ashley's dog Harley31:25 How Julie Sees Past Lives34:44 The 12 Phases of Transition Explained41:14 Do We Live Many Lives At Once?53:05 Your Guardian Angel Has a Name. Julie reveals how we can connect with themConnect with Julie Ryan:WebsiteInstagramYouTubeListen to her podcast: Ask Julie RyanClaim your FREE copy of Angelic Attendants!Let's Connect!WebsiteFacebookInstagram Hosted on Acast. See acast.com/privacy for more information.
Eno and DVR discuss a busy weekend around the league including the announcement that Chase Burns will make his Reds debut Tuesday night against the Yankees. Plus, key injuries to Chris Sale and Adley Rutschman, awaiting MRI results on Corbin Carroll, Francisco Alvarez's demotion to Triple-A, and where the money went with pickups in fantasy baseball leagues over the weekend.Rundown2:18 Chase Burns to Debut on Tuesday v. Yankees6:59 Corbin Carroll's Thumb Injury; D-backs' Offense Continues to Roll12:16 Chris Sale's Fractured Rib Cage; Opportunity for Didier Fuentes18:29 Adley Rutschman's Absence Through the All-Star Break20:15 Francisco Alvarez Optioned to Triple-A27:30 Injury Follow-Ups and Other News32:08 Moving Quickly Ranking Rookie Pitchers40:00 Where the Money Went, Brady House's Interesting Approach53:49 Lingering Concern About Max Scherzer's Thumb?Follow Eno on Bluesky: @enosarris.bsky.socialFollow DVR on Bluesky: @dvr.bsky.sociale-mail: ratesandbarrels@gmail.comJoin our Discord: https://discord.gg/FyBa9f3wFeSubscribe to The Athletic: theathletic.com/ratesandbarrelsHosts: Derek VanRiper & Eno SarrisProducer: Brian SmithExecutive Producer: Derek VanRiper Hosted on Acast. See acast.com/privacy for more information.
Abbie Hills is a UK-based talent agent, producer, writer, and passionate disability advocate with cerebral palsy. Abbie founded The Dazey Hills Company in 2019 to promote diversity and inclusion in the entertainment industry, representing talent across the UK and Europe. Her writing has gained recognition with recent placements in film festivals, including the British Independent Film Festival, Lit Laughs, and the Palm Springs Diversity Screenplay Contest. In addition to her writing, Abbie works as an Access Coordinator, supporting D/deaf, disabled, and neurodivergent talent in film and television productions. She also mentors aspiring talent, advocating for greater accessibility and representation in the entertainment industry. During this episode, you will hear Abbie talk about: Her experience growing up with cerebral palsy, which for her is an “invisible" disability How an MRI scan of her brain changed the way she viewed her disability How people have judged her because of her disability How cerebral palsy affects her day-to-day life What inspired her to become an actress, and how her disability affected her experience in the entertainment industry The need for community among adults with disabilities Her journey from being an actor who hid her disability to founding her own talent agency and working as an Access Coordinator To find out more about Abbie and her work, visit her personal website AbbieHills.uk and production company website TheDazeyHillsCompany.co.uk and follow her on Instagram @itsabbiehills. Watch the video of this interview on YouTube. Read the episode transcript. Follow the Beyond 6 Seconds podcast in your favorite podcast player. Subscribe to the FREE Beyond 6 Seconds newsletter for early access to new episodes. Support or sponsor this podcast at BuyMeACoffee.com/Beyond6Seconds! *Disclaimer: The views, guidance, opinions, and thoughts expressed in Beyond 6 Seconds episodes are solely mine and/or those of my guests, and do not necessarily represent those of my employer or other organizations. These episodes are for informational purposes only and do not substitute for professional medical advice. Consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment.*
What if your service lane could scan a car like an airport security system—except instead of searching for bombs, it's finding oil leaks, tire damage, and alignment issues? In this episode of Dealer Talk with Jen Suzuki, I sit down with Yaron from UVeye, the company turning heads (and lifting RO numbers) with their instant vehicle imaging tech—also known as the MRI for cars. We talk about how UVeye's AI-powered tunnel gives advisors and customers crystal-clear visuals on a vehicle's condition in seconds. This transparency builds trust, boosts upsells, and drives higher labor hours—all while improving CSI scores. Yaron shares the wild origin story of UVeye (hint: it started with bomb detection!), how OEMs like Toyota and GM helped shape its evolution, and why seeing is believing in today's service experience. If you're in fixed ops, recon, or even sales—you need to hear how this tech is transforming how we inspect, present, and sell needed service work. Dealer Talk with Jen Suzuki Podcast |
In this episode, Chris and Nancy welcome Dr. Ameer Shah to discuss Inspire, a revolutionary treatment for obstructive sleep apnea. Dr. Shah breaks down the science behind the device, how it compares to CPAP, and what patients can expect before, during, and after implantation. This episode offers valuable insights into the importance of treating sleep apnea, lifestyle modifications versus advanced treatments, insurance coverage, MRI compatibility, visibility concerns, how Inspire works, and why it might become a first-line option. Stay tuned to Twenty Seven Degrees for more insightful discussions on healthcare innovations. Subscribe and follow us on social media to support our podcast and ensure you never miss an episode! Special Thanks: BayCoast Bank and Duncan Hearing Healthcare for their sponsorship. Ron Gamache for our intro music. PrimaCARE and Bioskills of the Northeast for their continued support. Stay tuned to "Twenty Seven Degrees" for more insightful discussions on healthcare innovations. Subscribe and follow us on social media to support our podcast and ensure you never miss an episode!
In this episode, CardioNerds Dr. Gurleen Kaur, Dr. Richard Ferraro, and Dr. Jake Roberts are joined by Cardio-Rheumatology expert, Dr. Monica Mukherjee, to discuss the role of utilizing multimodal imaging for cardiovascular disease risk stratification, monitoring, and management in patients with chronic systemic inflammation. The team delves into the contexts for utilizing advanced imaging to assess systemic inflammation with cardiac involvement, as well as the role of imaging in monitoring various specific cardiovascular complications that may develop due to inflammatory diseases. Audio editing by CardioNerds academy intern, Christiana Dangas. 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 - Cardiovascular Multimodality Imaging & Systemic Inflammation Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk stratification, and implementation of therapeutic strategies to address these risks and disease-specific complications. As an example, patients with SLE have a 48-fold increased risk for developing ASCVD compared to the general population. They may also develop disease-specific complications, such as pericarditis, that require focused imaging approaches to detect. In addition to increasing the risk for CAD, systemic inflammatory diseases can also result in cardiac complications, including myocardial, pericardial, and valvular involvement. Assessment of these complications requires the use of different imaging techniques, with the modality and serial studies selected based on the suspected disease process involved. In most contexts, echocardiography remains the starting point for evaluating cardiac involvement in systemic inflammatory diseases and can inform the next steps in terms of diagnostic study selection for the assessment of specific cardiac processes. For example, if echocardiography is completed in an SLE patient and demonstrates potential myocardial or pericardial inflammation, the next steps in evaluation may include completing a cardiac MRI for better characterization. While no current guidelines or standards of care directly guide our selection of advanced imaging studies for screening and management of CVD in patients with systemic inflammatory diseases, our understanding of cardiac involvement in these patients continues to improve and will likely lead to future guideline development. Due to the vast heterogeneity of cardiac involvement both across and within different systemic inflammatory diseases, a personalized approach to caring for each individual patient remains central to CVD evaluation and management in these patients. For example, patients with systemic sclerosis and symptoms of shortness of breath may experience these symptoms due to a range of causes. Echocardiography can be a central guiding tool in assessing these patients for potential concerns related to pulmonary hypertension or diastolic dysfunction. Based on the initial echocardiogram, the next steps in evaluation may involve further ischemic evaluation or right heart catheterization, depending on the pathology of concern. Show notes - Cardiovascular Multimodality Imaging & Systemic Inflammation Episode notes drafted by Dr. Jake Roberts. What are the contexts in which we should consider pursuing multimodal cardiac imaging, and are there certain inflammatory disorders associated with systemic inflammation and higher associated CVD risk for which advanced imaging can help guide early intervention? Systemic inflammatory diseases are associated with elevated CVD risk, which has significant implications for early detection, risk stratification, prognostication, and implementation of therapeutic strategies to address CVD risk and complicat...
Episode 194: Acute low back pain. Future Dr. Ibrahim presents a clinical case to explain the essential points in the evaluation of back pain. Future Dr. Redden adds information about differentiating between a back strain and more serious diseases such as cancer, and Dr. Arreaza shares information about returning to work after back strain.Written by Michael Ibrahim, MSIV. Editing and comments by Jordan Redden, MSIV, and Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Dr. Arreaza:Welcome back, everyone. Today's topic is one that every primary care provider, emergency doctor, and even specialist sees routinely: low back pain. It's so common that studies estimate up to 80% of adults will experience it at some point in their lives. But despite how frequent it is, the challenge is to identify which cases are benign and which demand urgent attention.Jordan:Exactly. Low back pain is usually self-limiting and mechanical in nature, but we always need to keep an eye out for the rare but serious causes: things like infection, malignancy, or neurological compromise. That's why a good history and physical exam are our best tools right out of the gate.Michael:And to ground this in a real example, let me introduce a patient we saw recently. John is a 45-year-old warehouse worker who came in with two weeks of lower back pain that started after lifting a 50-lb box. He describes it as a dull, aching pain that radiates from his lower back down the posterior left thigh into the calf. He says it gets worse with bending or coughing, but he feels better when lying flat. He also mentioned some numbness in his left foot, but he denies any bowel or bladder issues. His vitals are completely normal. On exam, he had lumbar paraspinal tenderness, a positive straight leg-raise at 40 degrees on the left and decreased sensation in the L5 dermatome, though reflexes were still intact.Dr. Arreaza:That's a great case. Let's take a minute and talk about the straight leg raise test. This is a bedside tool we use to assess for lumbar nerve root irritation often caused by a herniated disc. ***Here's how it works: the patient lies supine, and you slowly raise their straight leg. If pain radiates below the knee between 30° and 70°, that suggests radiculopathy, especially involving the L5 or S1 nerve roots. Pain at higher angles is more likely due to hamstring tightness or mechanical strain.Michael:Right. So, stepping back: what do we mean by "low back pain"? Broadly, it's any pain localized to the lumbar spine, but it's often classified by type or cause:Mechanical (like muscle strain or degenerative disc disease), Radicular (nerve root involvement), Referred pain (like from pelvic or abdominal organs), Inflammatory (AS), and Systemic or serious causes like infection or malignancy. Jordan:In John's case, we're thinking radicular pain, most likely from a herniated disc compressing the L5 nerve root. That's supported by the dermatomal numbness, the leg pain, and that positive straight leg test.Dr. Arreaza:Good reasoning. Now, anytime we see back pain, our brains should run a checklist for red flags. These help us pick up more serious causes that require urgent attention. Let's run through the red flags.Michael:Sure. For fracture, we think about major trauma or even minor trauma in the elderly, especially those with osteoporosis or on chronic steroids. Also, anyone over 70 years old.Jordan:Then we have infections, which could include things like discitis, vertebral osteomyelitis, or epidural abscess. Red flags include fever, IV drug use, recent surgery, or immunosuppression.Michael:Malignancy is another critical one, especially if there's a history of breast, prostate, lung, kidney, or thyroid cancer. Clues include unexplained weight loss, night pain, or constant pain not relieved by rest.Jordan:And don't forget about inflammatory back pain, like ankylosing spondylitis, which is often seen in younger patients with morning stiffness that lasts more than 30 minutes and improves with activity.Dr. Arreaza:And of course, we always rule out cauda equina syndrome: a surgical emergency. That's urinary retention or incontinence, saddle anesthesia, bilateral leg weakness, or fecal incontinence. Missing this diagnosis can be catastrophic.Michael:Thankfully, in John's case, we don't see any red flags. His presentation is classic for uncomplicated lumbar radiculopathy. But we must stay vigilant, because sometimes patients don't offer up key symptoms unless we ask directly.Jordan:And that's where associated symptoms help guide us. For example:Radicular symptoms like numbness or weakness follow dermatomal patterns. Constitutional symptoms like fever or weight loss raise red flags. Bladder/bowel changes or saddle anesthesia raise alarms for cauda equina. Pain that wakes patients up at night might point to malignancy. Dr. Arreaza:So when do we order labs or imaging?Michael:Not right away. For most patients with acute low back pain, imaging is not needed unless they have red flags. If infection is suspected, we'd get CBC, ESR, and CRP. For cancer, maybe PSA or serum protein electrophoresis. And if inflammatory back disease is suspected, HLA-B27 can be helpful.Jordan:Yes, imaging should be delayed for at least six weeks unless red flags or significant neurologic deficits are present. When we do image, MRI is our go-to especially for suspected radiculopathy or cauda equina. X-rays can help if we're thinking about fractures, but they won't show soft tissue or nerve root issues.Michael:In the example from our case, since the patient doesn't have red flags, we'd go with conservative management: start NSAIDs and recommend activity modification. As this is the acute setting, physical therapy would not be recommended.Jordan:For the acute phase, research shows no serious difference between those with PT and those without in the long term. However, physical therapy is really the cornerstone of management for chronic back pain. It's not just movement: it's education, body mechanics, and teaching patients how to move safely. And PT can actually reduce opioid use, imaging, and injections down the line for patient struggling with long term back pain.Dr. Arreaza:Yes, and PT is not one-size-fits-all. PT might include McKenzie exercises, manual therapy, postural retraining, or even neuromuscular re-education. The goal is always to build core stability, promote healthy movement patterns, and reduce fear of motion.Jordan:Let's take a minute to talk about the McKenzie Method, a physical therapy approach used to treat lumbar disc herniation by identifying a specific movement, (often spinal extension) that reduces or centralizes pain. A common exercise is the prone press-up, (cobra pose for yoga fans) where the patient lies face down and pushes the upper body upward while keeping the hips on the floor to relieve pressure on the disc. These exercises should be done carefully, ideally under professional guidance, and discontinued if symptoms worsen.Michael:For our case patient, our working diagnosis is mechanical low back pain with L5 radiculopathy. No imaging needed now, no red flags. We'll treat conservatively and educate him about proper lifting, staying active, and recovery expectations.Jordan:We also emphasized to him that bed rest isn't helpful. In fact, bed rest can make things worse. Keeping active while avoiding heavy lifting for now is key.Dr. Arreaza:Return-to-work recommendations should be individualized. For example, an office worker, positioning while working, or work hours may be able to return to work promptly. However, those with physically demanding jobs may need light duty or be off work.Ice: no evidence of benefit. Heat: may reduce pain and disability in pain of less than 3 months, although the benefit was small and short.And we should always teach safe lifting techniques: bend at the knees, keep the load close, avoid twisting. It's basic knowledge, but it is very effective in preventing recurrence.Jordan:Now, if a patient fails to improve after 6 weeks of conservative therapy, or if they develop new neurologic deficits, that's when we think about referral to spine specialists or surgical consultation.Michael:And as previously mentioned: in cases where back pain becomes chronic (lasting more than 12 weeks) a multidisciplinary approach works best. That can include:Physical therapy, Cognitive behavioral therapy (CBT) And sometimes pain management interventions. Jordan:We can't forget the psychological toll either. Chronic back pain is associated with depression, anxiety, and opioid dependence. Increased risk factors include obesity, smoking, sedentary lifestyle, and previous back injuries.Dr. Arreaza:Well said. So, let's summarize. Michael?Michael:Sure! Low back pain is common, and most cases are benign. But we have to know the red flags that point to serious pathology. A focused history and physical exam are more powerful than many people realize. And the first step in treatment is almost always conservative, with a strong emphasis on maintaining physical activity.Jordan:And don't underestimate the value of patient education. Helping patients understand their pain, set realistic expectations, and stay active is often just as important as the medications or therapies we offer.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491. https://doi.org/10.7326/0003-4819-147-7-200710020-00006Deyo, R. A., Mirza, S. K., Turner, J. A., & Martin, B. I. (2009). Overtreating chronic back pain: Time to back off? Journal of the American Board of Family Medicine, 22(1), 62–68. https://doi.org/10.3122/jabfm.2009.01.080102National Institute for Health and Care Excellence. (2020). Low back pain and sciatica in over 16s: Assessment and management (NICE Guideline No. NG59). https://www.nice.org.uk/guidance/ng59Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530. https://doi.org/10.7326/M16-2367UpToDate. (n.d.). Evaluation and treatment of low back pain in adults. Wolters Kluwer. https://www.uptodate.com (Access requires subscription)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
Interview with Bo Sears, CEO of Helix ExplorationOur previous interview: https://www.cruxinvestor.com/posts/helix-exploration-lsehex-strategic-producer-targets-us-helium-supply-gap-6513Recording date: 18th June, 2025Helix Exploration presents a compelling investment opportunity as a self-funded helium producer positioned to begin commercial production by end of summer 2025. CEO Bo Sears leads a company with 355 million cubic feet of recoverable helium reserves in Montana's Rudyard Field, demonstrating a perfect drilling success rate with three productive wells from three attempts. The company's processing plant is two-thirds complete with critical membrane units arriving from Europe, positioning Helix to capitalize on helium's unique market characteristics where "there is no substitute for most of helium's applications by virtue of its atomic properties," as Sears explains.Unlike typical resource companies requiring continuous equity raises, Helix maintains a self-funding growth model that eliminates dilution risk while providing operational flexibility. The company projects $4 million gross annual revenue per well at $500 per thousand cubic feet helium pricing, with substantial margins driven by efficient drilling operations and low variable costs primarily related to compression power. This economic model supports organic expansion through cash flow generation rather than dilutive financing, a significant advantage in today's challenging capital markets.The strategic value of North American helium production has increased due to geopolitical tensions affecting major supply sources. With ongoing conflicts near Qatar's North Pars Field, US-based production offers supply security that supports long-term pricing stability. Helium's applications span from MRI machines to semiconductor manufacturing, creating inelastic demand that provides pricing power unavailable in substitutable commodities. As Sears notes, "you can't replace helium with hydrogen for obvious purposes. Think Hindenburg, right? On up the food chain to the MRI machines and the semiconductor manufacturing, there is no other element that can do what Helium does."Helix demonstrates operational excellence through strategic well spacing that allows one well to drain an entire square mile section, minimizing development costs while maximizing recovery. The company's partnerships with established operators Wacoda and Treasure State Drilling provide operational expertise while maintaining cost control. Infrastructure advantages include reliable power access, excellent road networks, and proximity to end markets, with a gathering system design that allows efficient integration of additional wells as production scales.Traditional exploration risks have been substantially reduced through proven reserves, successful drilling results, and an immediate production timeline. Management's 25+ years of industry experience and focus on operational benchmarks differentiate Helix from competitors facing execution challenges. The combination of immediate production timeline, self-funded growth capability, proven reserves, and exposure to a strategic commodity with inelastic demand creates a unique value proposition for investors seeking commodity exposure with limited downside and substantial upside potential in an essential but underappreciated sector.—Learn more: www.cruxinvestor.com/companies/helix-explorationSign up for Crux Investor: https://cruxinvestor.com
Dr. Peter Diamandis first joined me, along with guest Tony Robbins, for the show: “Tony Robbins, Peter Diamandis & Ben Greenfield Reveal New Anti-Aging Biohacks & Breakthroughs in Precision Medicine You’ve Never Heard Of Before.” Today, the physician, investor, entrepreneur, and longevity enthusiast is back to reveal the secrets from his brand new book, Longevity Guidebook: How to Slow, Stop, and Reverse Aging—and NOT Die from Something Stupid, which includes tactics such as: Implementing proven lifestyle practices to optimize your diet, sleep, exercise, and mindset, all enabling extended healthspan. Understanding advancements in diagnostic and therapeutic technologies to find and reverse disease at the earliest time possible. Receiving insights on how to “NOT die from something stupid” and the breakthroughs that can save your life and the lives of those you love. Maximizing female healthspan through every stage of life. Building and maintaining a “longevity mindset” (coupled with the routines that will transform your health). You'll also get to explore what truly correlates with heart disease (the answer may surprise you), why your genes might matter less than you think, and the practical steps Dr. Diamandis personally takes to optimize muscle, metabolism, and sleep well into his 60s. From the impact of GLP-1s and the real story on alcohol's effect on longevity, to biohacks for sleep and the promise (and practical realities) of advanced diagnostics like full-body MRI and AI-powered heart scans—nothing is off the table. Whether you’re a health tech enthusiast, longevity nerd, or just curious about actionable strategies to dramatically extend your healthspan, this episode is packed with groundbreaking science, inspiring personal stories, and a glimpse into the future of human potential. Full show notes: https://bengreenfieldlife.com/longevityguide Episode Sponsors: CAROL Bike: The science is clear—CAROL Bike is your ticket to a healthier, more vibrant life. And for a limited time, you can get $100 off yours with the code BEN. Don't wait any longer, join over 25,000 riders and visit carolbike.com/ben today. Organifi Shilajit Gummies: Harness the ancient power of pure Himalayan shilajit anytime you want with these convenient and tasty gummies. Get them now for 20% off at organifi.com/Ben. LVLUP Health: Head over to lvluphealth.com/BGL and use code BEN15 for a special discount on their game-changing range of products. MOSH: MOSH's signature blend offers a plant-based high-protein bar. They are a great source of vitamin D and an excellent source of vitamin B12. Head to moshlife.com/BEN to save 20% off, plus FREE shipping on either the Best Sellers Trial Pack or the new Plant-Based Trial Pack. Pique: Go to Piquelife.com/Ben to get 20% off for life, plus a free starter kit with a rechargeable frother and glass beaker to elevate your ritual.See omnystudio.com/listener for privacy information.
What happens when a superintendent builds the hospital… and years later, his own daughter becomes a patient there? In this unforgettable episode, Jason sits down with one of his all-time favorite humans: Jake Smaellie, a master builder with a story that will hit you right in the gut. From healthcare construction to personal healing, Jake opens up about: The emotional moment he walked his daughter into an MRI room he built. Why cleaning jobsite bathrooms (yes, really) sets the tone for leadership. The power of saying “good morning” and how it's a secret weapon for team culture. His incredible 180-pound weight loss and training for a 200-mile bike ride. How to lead by example, not by title. Funny. Raw. Inspiring. This is more than construction, it's a masterclass in humility, grit, and taking care of people.
MOVE NOW to Fight Cancer Podcast / DARE TO BE VITAL BOOKFIVE PRIMARY POINTS of this Week's Podcast* Stop injecting cortisone for knee or elbow pain.A newly published MRI study of 210 patients showed that even one cortisone shot accelerated knee-osteoarthritis progression and carried risks such as bone-marrow lesions and rapid joint destruction. Dr. Mishra argues that “doing nothing” is safer than cortisone and recommends a “better biologics flywheel” of weight control, muscle building, and vitamin D optimization instead.* Whole-body vibration (WBV) is a promising muscle- and bone-builder.A meta-analysis of 21 randomized trials (~750 healthy women) found WBV platforms significantly improved lower-body strength and femoral bone density; benefits were greatest with >12 weeks of training at frequencies above 30 Hz, and in post-menopausal women.* Musculoskeletal health underpins long-term vitality.Losing mobility cascades into weight gain, cardiovascular decline, and even cognitive slowdown. Dr. Mishra positions whole-body vibration, strength training, and biologic approaches (muscle, bone, vitamin D) as an “all-in strategy” to safeguard movement capacity and overall life performance.* Interacting with dogs measurably boosts brain health and mood.An EEG study of 30 adults showed activities like playing, grooming, and walking a dog lowered stress markers and heightened relaxation, attention, and creativity, branding dogs as “verified vitality enhancers.”* Weekly action plan—do the right thing because it is right.Inspired by Kant's dictum, the episode's practical call-outs are: skip cortisone, build muscle via whole body vibration and spend time with a dog to spark calm and creativity. Implementing even one of these evidence-based steps moves you toward Dr. Mishra's goal of optimizing vitality and performance “one person at a time.” This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit vitalityexplorers.substack.com/subscribe
Shannon Sharpe & special guest Bun B talk about Bun B restaurant Trill Burger and getting the Key to the City of Port Arthur, Texas, Tyrese Halliburton suffers a calf strain, MRI to determine severity, Lebron pushes back on ring culture and much more!03:13 - Trill Burger17:12 - Bun B got key to city of Port Arthur, TX22:53 - Shams reports Hali calf strain concern32:11 - Bron pushes back on Ring Culture51:38 - Doc Rivers pushing back on Giannis trade rumors58:20 - Univ of SC’s Sellers turns down 8m NIL(Timestamps may vary based on advertisements.)#Volume #ClubSee omnystudio.com/listener for privacy information.
Send us a textIn this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols breaks down one of the most commonly overlooked causes of infertility: elevated prolactin levels, also known as hyperprolactinemia.If you've ever been asked about nipple discharge at a fertility consult and thought, “What does that have to do with getting pregnant?”—this episode is for you.Dr. Amols dives into:What prolactin is and why your body produces itHow elevated prolactin shuts down ovulation by disrupting GnRH, FSH, and LHThe connection between dopamine and prolactin controlCauses of high prolactin—including prolactinomas, medications, thyroid issues, and even stress or exerciseDiagnostic steps: when to repeat the test, when to order an MRI, and how to rule out macroprolactinFirst-line treatments (cabergoline, bromocriptine) and what to expect during recoveryHow untreated hyperprolactinemia affects IUI, Clomid, Letrozole, and IVF outcomesLearn how to identify this hormone imbalance, when to treat it, and how correcting it can restore ovulation and dramatically improve your chances of pregnancy.Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform. Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com. Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com. Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.
LIVE footage from the Elbo Room shows Nate Schmidt shotgunning beer with fans. The chat goes in on Leroy for his confusion on the location of the Cats and fat shaming a fruit. Road to Repeat Complete! The NBA Finals resume tomorrow night with Game 6 between the Pacers and Thunder. OKC leads the series 3-2 Tyrese Haliburton has a calf strain and is getting a MRI to determine the severity.
ANOTHER ONE! The Florida Panthers are back to back Stanley Cup Champions beating the Edmonton Oilers down 5-1 in Game 6. We start the celebration by going over Sam Reinhart and Matthew Tkachuk goals and this ranging case of CAT FEVERRRRR! Our favorite Goaltender Sergei Bobrovsky finishes with 28 saves in the win. Public enemy number one Sam Bennett gets named the Conn Smythe Trophy winner! The celebration continues with open phone lines! Cat Nation calls in to celebrate this monumental day alongside us and JFig!!! While Leroy tries to alter her perception, JFig claims hockey is the toughest sport after Matthew Tkachuk revealed he had a torn abductor off the bone. Cats Head Coach Paul Maurice reveals Sam Reinhart played with a torn MCL and Barkov played with a bad cut on his hand that had to get glued shut after it kept opening. As live footage continues to roll in from Fort Lauderdale Beach, JFig bottles up the true scent of the Elbo Room to give listeners an idea of what Cat Nation is experiencing this morning. Cats in 6, JFig was right! Tobin continues to insist that it should've been Cats in 5. Edmonton Oilers head coach Kris Knoblauch Connor McDavid Marcos Mixed Bag! Tobin gets exotic... LIVE footage from the Elbo Room shows Nate Schmidt shotgunning beer with fans. The chat goes in on Leroy for his confusion on the location of the Cats... He then follows up by fat shaming a fruit. Road to a (complete) Repeat! Marcos does his research and only to find that we have "Baby Good Luck Charms" for the Florida Panthers! Where will things stand between the Panthers and Brad Marchand, Sam Bennett, and Aaron Ekblad after this outstanding season where contracts expire... Who's to stay, who's to go? The NBA Finals resume tomorrow night with Game 6 between the Pacers and Thunder. OKC leads the series 3-2. Tyrese Haliburton has a calf strain and is getting a MRI to determine the severity. We take a break from Praising the Panthers to give you some NFL Breaking News The Baltimore Ravens sign Jaire Alexander. Tyreek Hill mocks Noah Lyles after Lyles pulls out race this weekend citing personal reasons. Conor McGregor knocks out a man in a club in Ibiza... on brand? The Miami Marlins handle the Philadelphia Phillies 8 to 3. We review some of Frogboy's footage from this morning's festivities at Elbo Room Leroy asks Dolphin Fans to make up their damn mind The Stanley Cup takes damage after spending a 2nd straight season in South Florida Tobin demands the Cup be Soaked in Ocean Water Frog Boy disrespects a Key member of the 2003 Marlins team The guys take time praising Sergei Bobrovsky
Caitlin Clark abused by idiots - refs no help in protecting her, so Sophie Cunningham brought some street justice to the WNBA! Tyrese Haliburton getting an MRI on his calf. The result will determine whether he will play in tomorrow night's Game Four! Colts are a potential playoff team because they are going to be better - AND they play in the AFC South! Here is the link for the only autobiography ever published without praise for its author: https://www.amazon.com/Oops-Art-Learning-Mistakes-Adventures/dp/173420740X
Dr. Linda Chu speaks with Dr. Rajiv Gupta and Dr. Andrea Diociasi about new findings linking repetitive blast exposure in Special Operations Forces (SOF) members to distinct changes in brain connectivity and cortical volume. They discuss how advanced MRI techniques and predictive models are uncovering correlations between neuroimaging markers and long-term neurobehavioral symptoms. Distinct Functional MRI Connectivity Patterns and CorticalVolume Variations Associated with Repetitive BlastExposure in Special Operations Forces Members. Diociasi et al. Radiology 2025; 315(1):e233264.
How do the experts balance organ preservation, oncologic control, and emerging therapies in both localized and metastatic cases of penile cancer? This episode of BackTable Tumor Board focuses on penile cancer diagnosis and treatment, featuring urologic oncologist Dr. Charles Peyton (UAB), radiation oncologist Dr. Juanita Crook (UBC), and medical oncologist Dr. Andrea Apolo (NCI). --- This podcast is supported by:Ferring Pharmaceuticals --- SYNPOSIS This session covers case studies ranging from localized to advanced penile cancer, diagnostic practices, imaging preferences (MRI vs. CT), and treatment options, including surgery, brachytherapy, chemoradiation, and neoadjuvant chemotherapy. The multidisciplinary team highlights the complexities of treating this rare cancer, underscores the importance of physical exams, and stresses the necessity of personalized treatment plans. They also delve into the challenges of managing metastatic stages, potential salvage therapies, and the importance of clinical trials in enhancing treatment efficacy. The doctors also emphasize the potential of immunotherapy and chemotherapy combinations for metastatic disease. --- TIMESTAMPS 00:00 - Introduction02:23 - Imaging Preferences03:29 - Biopsy vs Immediate Surgery06:04 - Lymph Node Dissection vs Radiation13:48 - Brachytherapy Techniques and Case Study23:21 - Challenges in Advanced Penile Cancer27:03 - Chemotherapy and Chemoradiation30:15 - InPACT Trial37:12 - Salvage Therapies and Exploring New Treatment Frontiers44:25 - Support and Awareness for Penile Cancer51:29 - Final Thoughts --- RESOURCES Society of Urologic Oncologyhttps://suonet.org/home.aspx
What if prostate cancer could be treated without surgery or full-gland radiation?In this episode of the Dr. Geo Prostate Podcast, Dr. Geo is joined by Dr. Aaron Katz, Chairman of Urology at NYU Long Island, a pioneer in prostate cryotherapy and integrative urology.With over 130 peer-reviewed publications and two books on prostate health, Dr. Katz has helped redefine prostate cancer treatment through focal cryotherapy—a minimally invasive technique that targets only the tumor, preserving sexual and urinary function.Together, they explore:The difference between whole-gland and focal cryotherapyHow imaging (like MRI and fusion biopsy) guides precision treatmentWho is an ideal candidate—and who is notWhy cryotherapy is gaining attention as a frontline optionWhat men should know after President Biden's prostate cancer diagnosisA holistic, patient-centered view of long-term prostate healthWhether you're newly diagnosed or exploring treatment alternatives, this episode will give you clarity, confidence, and options._________________________ Thank you to our June 2025 Sponsor LynxDx.Discover MyProstateScore 2.0 (MPS2), the next-generation urine test that helps you understand your prostate cancer risk. MPS2 analyzes a powerful panel of 18 biomarkers to deliver a personalized risk score, helping you and your doctor decide if further testing or a biopsy is right for you. MPS2 brings clarity and convenience to your prostate cancer screening journey with easy at-home or in-office collection. Visit lynxdx.com to learn more
Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks… Lina: Hi Dr. Cabral, My neck has been feeling very fatigue for the past months. My spinal X-ray revealed a mild C5-6 disc space narrowing with endplate osteophyte formation. I am applying castor oil onto this area daily as I believe it help disintegrate bone spurs. Can you please provide guidance on what more I can do to break up these bone spurs and strengthen that area of my neck? Besides neck exercises which I am doing, are there any dietary suggestions or supplementation that would help. I am very grateful for all you do for us in this community. With much thanks, Lina Heather: Hello Dr. Cabral! I am a 47-year-old woman who has been experiencing double vision upon waking that usually lasts until around 11 AM, It does not happen every day but has been happening for a year and a half. It also happens when I have alcohol. I went to my optometrist and he said everything looked good, I went to my PCP and he wanted to run labs. No red flags, so he wanted to do an MRI on my brain. I decided to run the big five labs instead and found out I was low on all the B vitamins, had SIBO & Candida. I did The 21 day detox, completed the CBO protocol and will be starting a heavy metal detox next week. As of writing this I still am experiencing the double vision intermittently. Thank you! Thomas: Thanks for all your work. It has been a very helpful resource for my family and I as we continue to improve our health. My question is about SPMs (specialized pro-resolving mediators). Can you speak about their efficacy or the lack thereof and whether you've personally used them or use them in your practice? Michelle: Hi! Thank you for your show, I've learned so much from listening to your podcast! I'm just wondering your thoughts on a dental procedure. After my last dentist appointment I was told I needed two root canals or if I wanted to spend a little more I could have two implants. My question is, which one is safer? I've heard root canals can cause problems like low grade infections lasting a long time but I haven't heard anyone talk about any bad side affects from implants. Thank you for all you do. Michelle Savannah: Hypothyroidism runs in my family both my mom and dad have it and both my grandmothers had it. I was diagnosed in my early 20's but I haven't been on medicine since having my son in 2023 and was wondering what's the best protocol of supplements and foods to help keep the thyroid healthy or heal it if possible. Thanks! Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3418 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!