Podcasts about mri

Full episodes notes are on Dr. Aimee's website. In this episode, I'm shining a spotlight on adenomyosis: a condition that's often misunderstood and overlooked, yet can have a profound impact on fertility and overall uterine health. I'm joined by Dr. Armando Hernandez-Rey, a board-certified reproductive endocrinologist and founder of Conceptions Florida, who is at the forefront of treating complex reproductive health issues, including adenomyosis, endometriosis, and recurrent pregnancy loss. Together, we dive deep into what adenomyosis is, how it differs from endometriosis, why it's so frequently undiagnosed, and what it means for those struggling with infertility or recurrent pregnancy loss. Dr. Hernandez-Rey shares his expertise on diagnosis, treatment options (including the latest in minimally invasive therapies) and how patients can best advocate for themselves. Whether you're newly diagnosed or searching for answers, this conversation is packed with insights to empower you on your fertility journey. In this episode we cover: The difference between adenomyosis and endometriosis, and why that distinction matters Why adenomyosis is often missed or misdiagnosed in fertility workups The impact of adenomyosis on implantation, pregnancy outcomes, and miscarriage risk Diagnostic tools: ultrasound vs. MRI and what to ask your doctor Treatment options, including hormonal therapies and emerging minimally invasive procedures like radiofrequency ablation How to advocate for yourself and what questions to ask your fertility specialist Real-world outcomes and statistics from Dr. Hernandez-Rey's clinical experience Resources: Dr. Armando Hernandez-Rey's practice: Conceptions Florida Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, October 20, 2025 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. Other ways to connect with Dr. Aimee and The Egg Whisperer Show: Subscribe to my YouTube channel for more fertility tips!Subscribe to the newsletter to get updates

When radiology meets surgery, endometriosis care becomes more precise, personalized, and proactive. In this BackTable OBGYN Brief, host Dr. Mark Hoffman is joined by Dr. Wendaline VanBuren, an associate professor of radiology at Mayo Clinic, and Dr. Tatnai Burnett, a minimally invasive GYN surgeon at Mayo Clinic, to discuss the complexities of diagnosing and managing endometriosis. The discussion covers the roles of advanced imaging techniques like MRI and ultrasound, the importance of pre-surgical planning, and the need for multidisciplinary collaboration. They share their approach to managing symptomatic and asymptomatic patients, the use of hormonal treatments, and the significance of monitoring potential malignant transformations in endometrioma cases. The episode underscores the critical role of imaging in planning effective surgical interventions for patients while highlighting the progression of endometriosis management protocols. TIMESTAMPS 00:00 - Introduction  01:07 - Discussing Endometriosis Management 02:18 - Imaging Techniques and Their Importance 04:24 - Interdisciplinary Collaboration 05:40 - Advanced Imaging Protocols 08:12 - Monitoring and Follow-Up Strategies 08:50 - Concerns About Malignancy 11:04 - Future Directions CHECK OUT THE FULL EPISODE OBGYN Ep. 69 https://www.backtable.com/shows/obgyn/podcasts/69/imaging-protocols-to-guide-endometriosis-treatment

In this episode, Ajay Mody and Asher Perzigian sit down with Sangeeta Bardhan Cook, Chief Innovation Officer at Fox Chase Cancer Center and SVP of Commercialization Strategy and Business Development at Temple Health. Together, they explore how to close the gap between cutting-edge research and real-world patient care, using scientific expertise and strategic leadership to drive innovation in oncology and diagnostics. The conversation dives into how hospitals and research institutions are collaborating with startups and pharmaceutical companies to accelerate new ideas. Topics include scalable therapies, precision diagnostics, and the thoughtful application of AI—from early-stage research to clinical use cases like MRI interpretation and protein folding. Listeners will also gain insight into the collaborative spirit of academic medicine, the complexities of commercialization, and the importance of nurturing early-stage innovation despite market pressures. This episode offers a compelling look at how curiosity, collaboration, and strategic thinking are reshaping the future of healthcare.

Send us a textOn this episode we get to hear from a man who reluctantly became a chiropractor.  He was working with the 1996 Olympic team as a medical doctor, part of his job was  supervising the treatment of the world class athletes. While he didn't really understand exactly what the chiropractors were doing , he saw it worked. He went on to work at and attend Chiropractic School in Georgia. He founded and currently owns a “mini hospital” complete with standing MRI , and a complete integrated healthcare team. He believes chiropractors and physical therapists should work closely together. He. Also has said medical doctors should love sending patients for chiropractic care with minimal drug intervention when possible. I hope you enjoy this interview with Dr. Scott Wagner.

Rethinking prostate care begins with one powerful question: are biopsies always necessary or is there a better way to protect both life and vitality?In this episode, Dr. Stephen Petteruti speaks directly to those who value longevity and proactive health. He walks through compelling data from studies like TOAD, CHAARTED, STAMPEDE, and PEACE-1, showing that aggressive prostate cancer treatments often offer little survival benefit.Dr. Stephen doesn't advocate ignoring abnormal PSA or MRI results. Instead, he encourages you to ask smarter questions about your care. He outlines practical steps for non-invasive monitoring and decision-making that prioritizes long-term health.If you or someone you care about is navigating prostate care, tune into the full episode of Metastatic Disease: Why Prostate Biopsies Can Do More Harm Than Good.Enjoy the podcast? Subscribe and leave a 5-star review on your favorite platforms.Dr. Stephen Petteruti is a leading Functional Medicine Physician dedicated to enhancing vitality by addressing health at a cellular level. Combining the best of conventional medicine with advancements in cellular biology, he offers a patient-centered approach through his practice, Intellectual Medicine 120. A seasoned speaker and educator, he has lectured at prestigious conferences like A4M and ACAM, sharing his expertise on anti-aging. His innovative methods include concierge medicine and non-invasive anti-aging treatments, empowering patients to live longer, healthier lives.Website: www.intellectualmedicine.com Website: https://www.theprostateprotocol.com/ YouTube: https://www.youtube.com/@intellectualmedicine LinkedIn: https://www.linkedin.com/in/drstephenpetteruti/ Instagram: instagram.com/intellectualmedine Consultation: https://www.theprostateprotocol.com/book-a-consultation Store: https://www.theprostateprotocol.com/store Community: https://www.theprostateprotocol.com/products/communities/v2/fightcancerlikeaman/home    Disclaimer:  The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.Produced by https://www.BroadcastYourAuthority.com 

A new study shows that more degenerative changes on cervical MRIs actually mean less severe headaches in patients with neck pain. So, if you or your patients are stressing over how bad their imaging looks, it's time to rethink that. The big takeaway? Imaging findings don't dictate the future—holistic care, communication, and proactive strategies make the real difference.Episode Notes: Association between cervical MRI findings and patient-reported severity of headache in patients with persistent neck painLeander Tables- Save $1,000 on the Series 950 Table using the code EBC2025 — their most advanced flexion-distraction tablePatient Pilot by The Smart Chiropractor is the fastest, easiest to generate weekly patient reactivations on autopilot…without spending any money on advertising. Click here to schedule a call with our team.Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

Alliance for Natural Health sues FDA to allow truthful, science-based health claims for 118 vitamins, minerals and nutraceuticals in 1st Amendment test; What to do for H. pylori—or should it even be treated? Whole body MRI for cancer screening—is it worth undertaking? A remarkable new functional food supplement and beverage, harnessing the unique benefits of the muscadine grape. 

With no Commanders game to review, Andy takes a look around the action from over the weekend, both in the NFL and in CFB. Also, the report that Jayden Daniels had an MRI on his knee following Thursday's loss in Green Bay. To hear the whole show, tune in live from 9:00 AM - 11:00 AM Monday-Friday. For more sports coverage, download the ESPN630 AM app, visit https://www.sportscapitoldc.com. To join the conversation, check us out on twitter @ESPN630DC and @andypollin1See omnystudio.com/listener for privacy information.

On Off The Bench and The Stone Shields Show today we discuss the Bengals improving to 2-0 but losing star QB Joe Burrow to a toe injury in the process. Off The Bench is back weekdays from 10a to 11a followed by The Stone Shields Show from 11a to noon! In the electrifying chaos of Week 2's NFL showdown on September 14, 2025, at Paycor Stadium, the Cincinnati Bengals clawed to a thrilling 31-27 victory over the Jacksonville Jaguars, marking their first 2-0 start under head coach Zac Taylor since 2018. But the triumph was bittersweet, overshadowed by a devastating injury to star quarterback Joe Burrow. Burrow, the Bengals' franchise cornerstone and reigning Comeback Player of the Year after a stellar 2024 rebound from wrist surgery, dazzled early. He completed 7 of 13 passes for 76 yards and a touchdown, including a sharp 4-yard slant to Ja'Marr Chase in the first quarter. The offense hummed, with Chase erupting for 14 receptions and 165 yards—his best outing since the prior season. Yet, midway through the second quarter, disaster struck. On a second-down sack by Jaguars defensive tackle Arik Armstead, Burrow's left cleat caught the turf awkwardly, hyperextending his big toe. He crumpled, clutching his ankle initially, before trainers zeroed in on the foot. Helped off the field and into the medical tent, Burrow underwent an immediate MRI, emerging on a one-legged scooter, unable to bear weight. Diagnosed with turf toe—potentially a severe Grade 3 tear involving ligaments—the injury could sideline him for multiple weeks, or worse, up to three months if surgery is required. Images were rushed to renowned foot specialist Dr. Robert Anderson, with reports indicating non-surgical options are fading. Burrow was spotted postgame in a walking boot and on crutches, a gut punch for a QB whose career has been plagued by setbacks: a rookie-year ACL rupture in 2020, a 2023 wrist fracture, and nagging knee strains. Enter backup Jake Browning, the steady veteran who went 4-3 in Burrow's 2023 absence. Thrust into the fray with Cincinnati trailing 17-10 at halftime, Browning shook off early jitters—throwing three interceptions, including two picks forced by Bengals defenders Jordan Battle and Dax Hill on Trevor Lawrence. Yet, he steadied, finishing 21-of-32 for 241 yards and two scores. The game-winner? A masterful 93-yard, 15-play drive capped by Browning's 1-yard sneak with 18 seconds left, aided by a pass-interference call on Jaguars rookie Travis Hunter. Lawrence, meanwhile, torched the secondary for 294 yards and three TDs but faltered with two costly picks, dropping Jacksonville to 1-1. Music from #InAudio: https://inaudio.org/ Track Name Holy (Trap). Music from #InAudio: https://inaudio.org/ Track Name Exercise (Rock). #NFL #Bengals #OffTheBench

In this raw and deeply personal episode of Everyday Epigenetics: Raw. Real. Relatable., Susan opens up about her terrifying journey with Gadolinium Deposition Disease (GDD), a condition triggered by contrast injections commonly used in MRIs. What started as a routine scan for hip pain spiraled into months of excruciating suffering, disbelief from doctors, and a desperate search for answers.Susan is joined by Dr. Richard Semelka, one of the world's leading experts on MRI safety and the physician who has dedicated his career to researching, identifying, and treating GDD. Together, they shine light on a condition too often dismissed, ignored, or misdiagnosed, and discuss why awareness could be life-saving for countless people undergoing MRIs with contrast.This conversation is equal parts personal testimony, medical expertise, and call to advocacy. If you or someone you love has ever had, or may need, a contrast MRI, this is an episode you cannot afford to miss.In this episode:Susan's unfiltered story of surviving GDD and finding validation after years of pain and dismissalWhat Gadolinium Deposition Disease actually is, its symptoms, and why it's often overlookedWho is most at risk, and why some people may react while others don'tThe latest research on heavy metal toxicities and how GDD is treatedThe critical role lifestyle and immune system regulation play in recoveryWhy informed choice matters when doctors recommend contrast MRIsThis episode is not only about awareness, it's about reclaiming your voice, listening to your body, and refusing to be silenced when you know something is wrong.Learn more about our guest Dr. Richard SemelkaDr Semelka's career is shown to be the #10 in MRI, # 12 in Medical Imaging worldwide by Scholar GPS. He has written 6 editions of textbooks on MRI of the abdomen and pelvis, 5 editions of a textbook on MR physics,  a textbook on quality improvement in Radiology and over 380 peer-reviewed articles, including the broadest range of subjects on safety issues in Radiology. Most recently he has described the entity Gadolinium Deposition Disease, on which he has written more than 16 articles. He has lectured around the world on topics in Radiology over a 35 year career. Presently he devotes his medical career to treating individuals with Gadolinium Deposition Disease and other metal toxicities. He is the president of the nonprofit GadTTRAC, an organization devoted to helping sufferers with Gadolinium and other heavy metal toxicity.RESOURCES:Connect with Dr Richard Semelka:Website: gadttrac.orgWebsite: www.richardsemelka.comFind all of Kate and Susan's Resources and links in the show notes: https://healthyawakening.co/2025/0915/episode74Connect with Susan: https://healthyawakening.co/Connect with Kate: https://theradiantlifeproject.com/Visit the website: healthyawakening.co/podcastFind listening links here: https://healthyawakening.co/linksP.S. Want reminders about episodes? Sign up for our newsletter, you can find the link on our podcast page! https://healthyawakening.co/podcast

In this episode, Dr. Erica Lacher and show host Justin Long take a closer look at all the different imaging modalities available to veterinarians, and how they are used. Topics include digital radiograh (x-ray), ultrasound, CT scan, MRI, and PET scan. 

How much would you pay for brewery swag???Brian and I checked out Atlanta's new soju distillery this week and learned a lot—everything from smooth 17% pours to a fiery 40% bottle, plus makgeolli, the cloudy, tangy rice wine that surprised us in the best way. Back at Halfway Crooks, I nearly bought a tote bag until I saw the $20 price tag, which sparked a whole chat about brewery swag sticker shock.We also dug into the sad news that 21st Amendment is closing after 25 years, shared our beers of the week (including Focal Banger, Cold-Hearted IPA, and a big port-and-bourbon-barrel stout), and laughed about Gen Z putting ice in beer. Add in some global stories—Africa's beer boom, mosquitoes loving beer drinkers, and even trace MRI chemicals in European lagers—and it was a packed episode.Next week's our Oktoberfest tasting show, so no livestream, but plenty of Märzens on deck!Cheers!TimThanks for listening to Beer Guys Radio! Your hosts are Tim Dennis and Brian Hewitt with producer Nate "Mo' Mic Nate" Ellingson and occasional appearances from Becky Smalls.Subscribe to Beer Guys Radio on your favorite app: Apple Podcasts | Google Podcasts | Spotify | Stitcher | RSSFollow Beer Guys Radio: Facebook | Instagram | Twitter | YouTube If you enjoy the show we'd appreciate your support on Patreon. Patrons get cool perks like early, commercial-free episodes, swag, access to our exclusive Discord server, and more!

JD5 got an MRI and we are waiting for the news fans on edge after taking the first L Give Bill the ball!

FOLLOW RICHARD Website: https://www.strangeplanet.ca YouTube: @strangeplanetradio Instagram: @richardsyrettstrangeplanet TikTok: @therealstrangeplanet EP. #1253 The Human MRI: Medical Intuitive Julie Ryan's Extraordinary Psychic Perception On this episode of Strange Planet, Richard dives into the extraordinary world of medical intuitive Julie Ryan—a psychic powerhouse who scans bodies like a living MRI, detects illnesses remotely, and bridges science with the supernatural. From inventing global surgical devices to hosting a top-ranked podcast where she reads callers live, Julie reveals how she tunes into energy imbalances, communicates with spirits, and navigates the 12 Phases of Transition at life's end. Skeptics, prepare to question everything—could intuition revolutionize medicine? GUEST: Julie Ryan is a trailblazing medical intuitive, psychic medium, and serial entrepreneur dubbed a "buffet of psychicness™." With over 25 years scanning bodies for illnesses, detecting imbalances, and facilitating distant healings—always with permission—she blends scientific rigor from her 35-year career founding nine companies and inventing globally distributed surgical devices. Her unique fusion of ingenuity and intuition allows her to read the body like a map, access past lives, commune with spirits, and gauge proximity to death. Host of the globally top-ranked podcast Ask Julie Ryan, she bridges medicine, energy, and the afterlife, proving intuitive skills are learnable and transformative. WEBSITE: https://askjulieryan.com BOOK: Angelic Attendants: What Really Happens as we Transition from this Life into the Next SUPPORT OUR SPONSORS!!! FABRIC BY GERBER LIFE Life insurance that's designed to be fast and affordable. You could get instant coverage with no medical exam for qualified applicants. Join the thousands of parents who trust Fabric to help protect their family. Apply today in just minutes at meet fabric dot com slash STRANGE TESBROS We're a small business built by Tesla owners, for Tesla owners. Everything we do is about helping our customers customize, protect, and maintain their ride — whether it's through our products or YouTube how-tos and reviews. Go to tesbros.com and use code POD15 for 15% off your first order. That's T-E-S-B-R-O-S dot com and use code P-O-D-1-5 at checkout. ⁠BUTCHERBOX⁠ ButcherBox delivers better meat and seafood straight to your door – including 100% grass-fed beef,free-range organic chicken, pork raised crate-free, and wild-caught seafood. Right now, ButcherBox is offering our listeners $20 off their first box and free protein for a year. Go to ⁠ButcherBox.com/strange⁠ to get this limited time offer and free shipping always. Don't forget to use our link so they know we sent you. HIMS - Making Healthy and Happy Easy to Achieve Sexual Health, Hair Loss, Mental Health, Weight Management START YOUR FREE ONLINE VISIT TODAY - HIMS dot com slash STRANGE https://www.HIMS.com/strange QUINCE BEDDING Cool, Relaxed Bedding. Woven from 100% European flax linen. Visit QUINCE BEDDING to get free shipping on your order and 365-day returns. BECOME A PREMIUM SUBSCRIBER!!! https://strangeplanet.supportingcast.fm Three monthly subscriptions to choose from. Commercial Free Listening, Bonus Episodes and a Subscription to my monthly newsletter, InnerSanctum. Visit https://strangeplanet.supportingcast.fm Use the discount code "Planet" to receive $5 OFF off any subscription. We and our partners use cookies to personalize your experience, to show you ads based on your interests, and for measurement and analytics purposes. By using our website and services, you agree to our use of cookies as described in our Cookie Policy. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://strangeplanet.supportingcast.fm/

We are ready to go for the Canelo Alvarez-Terence Crawford mega showdown in Vegas Satuday night on the newest edition of our "Big Fight Weekend Preview" show and podcast.Host T.J. Rives and insider Dan Rafael, who is in Vegas, did this show as a live broadcast on our Youtube channel. And, now you are hearing it on podcast!They Preview Saturday's Zuffa Boxing card at Allegiant Stadium in Las Vegas on Netflixwith Canelo Alvarez vs. Terence Crawford, for Alvarez's undisputed super middleweight title. The guys discuss. Also, Callum Walsh vs. Fernando Vargas Jr., 10 rounds, junior middleweights Christian Mbilli vs. Lester Martinez, 10 rounds, for Mbilli's WBC interim super middleweight title and Mohammed Alakel vs. Travis Kent Crawford, 10 rounds, junior lightweightsSerhii Bohachuk vs. Brandon Adams, rematch, 10 rounds, middleweights  Then, hear Dan one on one in conversation with Canelo from earlier this week in advance of the showdown with Crawford.Next, they also preview Saturday's Matchroom Boxing DAZN at Windsor Park, Belfast, Northern IrelandLewis Crocker vs. Paddy Donovan, rematch, for vacant IBF welterweight title. Donovan was dominating last time before he got DQ'ed knocking down Crocker just after the bell. What happens in the second fight?And, a preview of Sunday's Ohashi Promotions card in Nagoya, JapanNaoya Inoue vs. Murodjon Akhmadaliev, for Inoue's undisputed junior featherweight title. The "Monster" is back, but will he get a test in the defense? We finish with fight newsRising British junior welterweifght star Adam Azim has has re-signed with Boxxer after rampant speculation about where he might go following the end of Boxxer's deal with broadcaster Sky Sports and new deal with BBC, the company announced on Thursday.  Former featherweight and junior lightweight titlist Oscar Valdez, coming off his lackluster decision over   Ricky Medina in their 130-pound bout this past Saturday in a Nogales, Mexico, homecoming fight but, had an MRI on his injured shoulder and was diagnosed two partial ruptures  Undisputed women's flyweight champion Gabriela Fundora will face late-replacement Alexas Kubicki, who has stepped in for Ayelen Granadino, on Sept. 20. Granadino is out because she could not secure a visa to come to the United States from Argentina.   Hear it all on the "Big Fight Weekend Preview" Show/Podcast here on Apple/Spreaker/Spotify, etc.

Send us a textThe boys are back and riding high after the Steelers edged out the Jets 34–32 on a 60-yard Boswell kick. Rodgers had some spicy words for his old team, we're talking predictions for the Seahawks matchup, and Pittsburgh got a little less golden with the WDVE sign coming down. Over on the scanner, raccoons are risking it all on the power lines, a Home Depot bathroom beatdown broke out, and two guys in East Liberty almost stripped down mid-argument.Then it's time for Corn Dick of the Week—featuring an “anal rail gun” MRI mishap, a drunk Canadian joyriding in a Barbie Jeep, Tuco from Breaking Bad getting arrested, and a college football player who thought mom and dad's checkbook would cover a $270K boat robbery. Plus, we break down the survey that says Rogan listeners are officially a dating red flag. Brother in Arms brings Druski in white face at NASCAR, a breakdancing tax protestor, Japan's robo-suits for the elderly, and one wholesome tennis ball handoff. We wrap it up with Gear Grinders and “What Would Greenfield Do?”—mascot suits, mystery drinks, and the eternal Pittsburgh battle: potholes or snow shoveling.All that and more on this week's episode of Greenfield's Finest Podcast!Check out our upcoming events, social media, and merch sale at the link below ⁠⁠https://linktr.ee/GFP Spotify:https://open.spotify.com/show/7viuBywVXF4e52CHUgk1i5 Produced by Lane Media ⁠https://www.lanemediapgh.com/

There is a new treatment option available now that can precisely target prostate lesions with electrical pulses, while helping preserve sexual function and urinary control. Whether you or a loved one has prostate disease, or you are a urologist considering this technology for your practice, you will not want to miss today's discussion on this innovative new option. September is Prostate Cancer Awareness Month, so we have a special episode today to kick it off. We are excited to welcome the distinguished urologist, Dr. Spencer Krane, to the Prostate Health Podcast. Dr. Krane is the Chief of Urology at the US Department of Veterans Affairs in New Orleans, Louisiana. He specializes in personalized medicine for patients with urologic malignancies, aiming to use new biomarkers, genomic classifications, epigenetic signatures, and advanced imaging modalities, including MRI-guided prostate biopsies, to offer his patients individualized care that improves cancer outcomes while minimizing therapy side effects. Dr. Krane has published extensively in urologic journals, and his work was selected to provide guidelines for urologic care. He has 50 peer-reviewed articles in national and international journals and has presented his work internationally, from Chile and Rome to Taiwan, as well as across the United States. We are excited to welcome him today to share his experience with the innovative new NanoKnife system as a treatment option for men with prostate tumors.  It is exciting to see ongoing innovation in the technology we have available for men with prostate tumors. For the appropriate candidates, this minimally invasive option offers precise targeting of the lesion while helping preserve both sexual function and urinary control.  Pertinent disclosure for today's episode – Dr. Krane is a paid consultant for AngioDynamics, Inc., which manufactures and sells the NanoKnife System. The views, information, and opinions expressed in this podcast are solely those of Dr. Krane, and does not necessarily represent those of AngioDynamics, Inc., its affiliates, or subsidiaries.  Show Highlights: Dr. Krane reviews the concept of targeted focal therapy and explains what  the NanoKnife system is Who is an ideal candidate for irreversible electroporation with the NanoKnife system? The advantages and features of the NanoKnife system   Does prostate size or shape limit the candidacy for IRE with the NanoKnife system? Would prostate anatomies on the MRI or biopsy exclude a patient from NanoKnife therapy? Dr. Krane explains how long it takes to resolve the initial decrease in sexual ability after NanoKnife therapy.   Why many patients experience improved urinary function in the long term after having NanoKnife therapy Dr. Krane clarifies the time it takes to resolve the initial decrease in sexual ability after being treated with NanoKnife therapy.   Links:  Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd.  Get your free What To Expect Guide (or find the link on our podcast website)   Join our Facebook group  Follow Dr. Pohlman on X and Instagram  Sign up for the Prostate Health Academy   You can access Dr. Pohlman's free mini-webinar, where he discusses his top three tips to promote men's prostate health, longevity, and quality of life here.  

What if prostate cancer treatment weren't months of daily radiation—but five ultra-precise sessions guided in real time by MRI? Today, Dr. Michael J. Zelefsky (Professor of Radiation Oncology, NYU Grossman School of Medicine) explains how MRI-LINAC and adaptive planning are redefining accuracy, reducing side effects, and personalizing care. A pioneer behind IMRT and image-guided radiotherapy, Dr. Zelefsky breaks down SBRT vs. IMRT, protons vs. photons, HDR brachytherapy, when to add hormone therapy, and how genomics + AI are shaping what's next.In this conversation, Dr. Zelefsky charts the evolution from long-course radiation to short-course SBRT with outcomes comparable to 7–9 week regimens—thanks to precision imaging and planning. He clarifies where IMRT ends and SBRT begins, why protons haven't shown superiority over photons in prostate cancer, and where HDR brachytherapy (Ir-192) shines—especially as a boost in higher-risk disease. We dig into dose equivalence (why 5×8 Gy can match ~80–90 Gy long-course), risk-based treatment + ADT duration, and how Decipher/Artera scores can refine decisions. Most exciting: MRI-LINAC with continuous motion monitoring keeps the prostate in a virtual “bullseye,” enabling whole-gland treatment with focal boosts today—and potentially true focal therapy tomorrow as biologic imaging and AI mature.Time-Stamped Highlights00:00 – Welcome 02:00 – Why Dr. Zelefsky's work is so respected; career arc and impact04:00 – What changed: CT/MRI planning → 3D-CRT → IMRT → SBRT12:45 – IMRT vs. SBRT: definitions, session counts, who gets what19:10 – Energy sources overview: photons, protons, brachytherapy20:30 – Protons vs. photons: evidence, indications, cost, access24:00 – HDR brachytherapy (Ir-192) as a temporary “in-and-out” boost28:00 – Dose logic: why 5×8 Gy (~40 Gy) ≈ long-course 80–90 Gy29:30 – Risk groups (low/intermediate/high) and when ADT is crucial33:00 – ADT durations (6–36 months): what trials actually showed37:00 – Genomics (Decipher/Artera): resolving risk discrepancies39:00 – What MRI-LINAC adds: real-time adaptive planning43:00 – Continuous Motion Monitoring (CMM): beam stops if target moves47:00 – Treat whole gland + boost the DIL (FLAME study approach)49:00 – Toward focal therapy with better biologic imaging + AI54:00 – How to choose: values, side-effects, lifestyle, comorbidities01:01:00 – Final guidance: don't be overwhelmed—multiple good option

Ataxia is a neurologic symptom that refers to incoordination of voluntary movement, typically causing gait dysfunction and imbalance. Genetic testing and counseling can be used to identify the type of ataxia and to assess the risk for unaffected family members. In this episode, Katie Grouse, MD, FAAN, speaks with Theresa A. Zesiewicz, MD, FAAN, author of the article “Ataxia” in the Continuum® August 2025 Movement Disorders 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. Zesiewicz is a professor of neurology and director at the University of South Florida Ataxia Research Center, and the medical director at the University of South Florida Movement Disorders Neuromodulation Center at the University of South Florida and at the James A. Haley Veteran's Hospital in Tampa, Florida. Additional Resources Read the article: Ataxia 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 Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, and please introduce yourself to our audience.  Dr Zesiewicz: Well, thank you, Dr Grouse. I'm Dr Theresa Zesiewicz, otherwise known as Dr Z, and I'm happy to be here. Dr Grouse: I have to say, I really enjoyed reading your article. It was a really great refresher for myself as a general neurologist on the topic of ataxia and a really great reminder on a great framework to approach diagnosis and management. But I wanted to start off by asking what you feel is the key message that you hope our listeners will take away from reading your article. Dr Zesiewicz: Yes, so, thanks. I think one of the key messages is that there has been an explosion and renaissance of genetic testing in the past 10 years that has really revolutionized the field of ataxia and has made diagnosis easier for us, more manageable, and hopefully will lead to treatments in the future. So, I think that's a major step forward for our field in terms of genetic techniques over the last 10 years, and even over the last 30 years. There's just been so many diseases that have been identified genetically. So, I think that's a really important take-home message. The other take-home message is that the first drug to treat Friedreich's ataxia, called omaveloxolone, came about about two years ago. This was also a really landmark discovery. As you know, a lot of these ataxias are very difficult to treat. Dr Grouse: Now pivoting back to thinking about the approach to diagnosis of ataxia, how does the timeline of the onset of ataxia symptoms inform your approach? Dr Zesiewicz: The timeline is important because ataxia can be acute, subacute or chronic in nature. And the timeline is important because, if it's acute, it may mean that the ataxia took place over seconds to hours. This may mean a toxic problem or a hypoxic problem. Whereas a chronic ataxia can occur over many years, and that can inform more of a neurodegenerative or more of a genetic etiology. So, taking a very detailed history on the patient is very important. Sometimes I ask them, what is the last time you remember that you walked normal? And that can be a wedding, that can be a graduation. Just some timeline, some point, that the patient actually walked correctly before they remember having to hold onto a railing or taking extra steps to make sure that they didn't fall down, that they didn't have imbalance. That sometimes that's a good way to ask the patient when is the last time they had a problem. And they can help you to try to figure out how long these symptoms have been going on. Dr Grouse: I really appreciate that advice. I will say that I agree, it can sometimes be really hard to get patients to really think back to when they really started to notice something was different. So, I like the idea of referencing back to a big event that may be more memorable to them. Now, given that framework of, you know, thinking through the timeline, could you walk us through your approach to the evaluation of a patient who presents to your clinic with that balance difficulties once you've established that? Dr Zesiewicz: Sure. So, the first thing is to determine whether the patient truly has ataxia. So, do they have imbalance? Do they have a wide base gait? That's very important because patients come in frequently to your clinic and they'll have balance problems, but they can have knee issues or hip issues, neuropathy, something like that. And sometimes what we say to the residents and the students is, usually ataxia or cerebellar symptoms go together with other problems, like ocular problems are really common in cerebellar syndromes. Or dysmetria, pass pointing, speech disorder like dysarthria. So, not only do you need to look at the gait, but you should look at the other symptoms surrounding the gait to see if you think that the patient actually has a cerebellar syndrome. Or do they have something like a vestibular ataxia which would have more vertigo? Or do they have a sensory ataxia, which would occur if a person closes his eyes or has more ataxia when he or she is in the dark? So, you have to think about what you're looking at is the cerebellar syndrome. And then once we look to see if the patient truly has a cerebellar syndrome, then we look at the age, we look at---as you said before, the timeline. Is this acute, subacute, or chronic? And usually I think of ataxia as falling into three categories. It's either acquired, it's either hereditary, or it's neurodegenerative. It can be hereditary. And if it's not hereditary, is it acquired, or is it something like a multiple system atrophy or a parkinsonism or something like that? So, we try to put that together and start to narrow down on the diagnosis, thinking about those parameters. Dr Grouse: That's really a helpful way to think through it. And it is true, it can get very complex when patients come in with balance difficulties. There's so many things you need to think about, but that is a great way to think about it. Of course, we know that most people who come in to the Movements Disorders clinic are getting MRI scans of their brains. But I'm curious, in which cases of patients with cerebellar ataxia do you find the MRI to be particularly helpful in the diagnosis? Dr Zesiewicz: So, an MRI can be very important. Not always, but- so, something like multiple system atrophy type C where you may see a hot cross bun sign or a pontine hyperintensity on the T2-weighted image, that would be helpful. But of course, that doesn't make the diagnosis. It's something that may help you with the diagnosis. In FXTAS, which is fragile X tremor/ataxia syndrome, the patient may have the middle cerebellar peduncle sign or the symmetric hyperintensity in the middle cerebellar peduncles, which is often visible but not always. Something like Wernicke's, where you see an abnormality of the mammillary bodies. Wilson's disease, which is quite rare, T2-weighted image may show hyperintensities in the putamen in something like Wilson's disease. Those are the main MRI abnormalities, I think, with ataxia. And then we look at the cerebellum itself. I mean, that seems self-evident, but if you look at a sagittal section of the MRI and you see just a really significant atrophy of the cerebellum, that's going to help you determine whether you really have a cerebellar syndrome. Dr Grouse: That's really encouraging to hear a good message for all of us who sometimes feel like maybe we're missing something. It's good to know that information can always come up down the line to make things more clear. Your article does a great review of spinal cerebellar ataxia, but I found it interesting learning about the more recently described syndrome of SCA 27B. Would you mind telling us more about that and other really common forms of SCA that's good to keep in mind? Dr Zesiewicz: Sure. So, there are now 49 types of spinal cerebellar ataxia that have been identified. The most common are the polyglutamine repeat diseases: so, spinocerebellar ataxia type 3 or type 2, type 6, are probably the most common. One of the most recent spinocerebellar ataxias to be genetically identified and clinically identified is spinocerebellar ataxia 27B. This is caused by a GAA expansion repeat in the first intron of the fibroblast growth factor on chromosome 13. And the symptoms do include ataxia, eye problems, downbeat nystagmus, other nystagmus, vertical, and diplopia. It appears to be a more common form of adult-onset ataxia, and probably more common than was originally thought. It may account for a substantial number of ataxias, like, a substantial percentage of ataxias that we didn't know about. So, this was really a amazing discovery on SCA 27B. Dr Grouse: Now a lot of us I think feel a little anxious when we think about genetic testing for ataxia simply because there's so many forms, things are changing quickly. Do you have a rule of thumb or a kind of a framework that we can think of as we approach how we should be thinking about getting genetic testing for the subset of patients? Dr Zesiewicz: Sure. And I think that this is where age comes into play a lot. So, if you have a child who's 10, 11, or 12 who's having balance problems in the schoolyard, does not have a history of ataxia in the family, the teachers are telling you that the child is not running correctly, they're having problems with physical education, that is someone who you would think about testing for Friedreich's ataxia. A preteen or a child, that would be one thing that would be important to test. When you talk to your patient, it's important to really take a detailed family history. Not just mom or dad, but ethnicity, grandparents, etc. And sometimes, once in a while, you come up with a known spinal cerebellar ataxia. Then you can just test for that. So, if a person is from Portugal or has Portugal background and they have ataxia and the parents had ataxia, you would think of spinal cerebellar ataxia type 3. Or if they're Brazilian, or if the person is from a certain area of Cuba and mom and dad had ataxia and that person has ataxia, you would think of spinal cerebellar ataxia type 2. Or if a person has ataxia and their parent had blindness or visual problems, you may be more likely to think of spinal cerebellar ataxia type 7, for example. If they have that---either they have a known genetic cause in in the family, first degree family, or they come from an area of the world in which we can pinpoint what type we think it is---you can go ahead and get those tests. If not, you can take an ataxia comprehensive panel. Many times now, if you take the panel and the panel is negative, it will reflex to the whole exome gene sequencing, where we're finding really unusual and more rare types of ataxia, which are very interesting. Spinal cerebellar ataxia type 32, spinal cerebellar ataxia type 36, I had a spinal cerebellar ataxia type 15. So, I think you should start with the age, then the family history, then where the person is from. And then, if none of those work out, you can get a comprehensive panel, and then go on to whole exome gene sequencing. Dr Grouse: That's really, really useful. Thank you so much for breaking that down in a really simple way that a lot of us can take with us. Pivoting a little bit now back towards different types of acquired ataxias, what are some typical lab tests that you recommend for that type of workup? Dr Zesiewicz: Again, if there's no genetic history and the person does not appear to have a neurodegenerative disease, we do test for acquired ataxias. Acquired ataxias can be complex. Many times, they are in the autoimmune family. So, what we start with are just basic labs like a CBC or a CMP, but then we tried to look at some of the other abnormalities that could cause ataxia. So, celiac disease, stiff person syndrome. So, you would look at anti-glutamic acid decarboxylase antibodies, Hashimoto's---so, antithyroglobulin antibodies or antithyroperoxidase antibodies would be helpful. You know, in a case of where the patients may have an underlying neoplasm, maybe even a paraneoplastic workup, such as an anti-Hu, anti-Yo, anti-Ri. A person has breast cancer, for example, you may want to take a paraneoplastic panel. I've been getting more of the anti-autoimmune encephalitis panels in some cases, that were- that are very interesting. And then, you know, things that sometimes we forget now like the syphilis test, thyroid-stimulating test, take a B12 and folate, for example. That would be important. Those are some of the labs. We just have on our electronic chart a group of acquired labs for ataxia. If we can't find any other reason, we just go ahead and try to get those. Dr Grouse: Now, I'm curious what you think is the most challenging aspect of diagnosing a patient with cerebellar ataxia? Dr Zesiewicz: So, for those of us who see many of these patients a day, some of the hardest patients are the ones that---regardless of the workup that we do, we've narrowed it down, it's not hereditary. You know, they've been through the whole exome gene sequencing and we've done the acquired ataxia workup. It doesn't appear to be that. And then we've looked for parkinsonism and neurodegenerative diseases, and it doesn't appear to be that either; like, the alpha-synuclein will be negative. Those are the toughest patients, where we think we've done everything and we still don't have the answer. So, I've had patients in whom I've taken care of family members years and years ago, they had a presumed diagnosis, and later on I've seen their children or other family members. And with the advent of the genetic tests that we have, like whole exome gene sequencing, we have now been able to give the patient and the family a definitive diagnosis that they didn't have 25 years ago. So, I would say don't give up hope. Retesting is important, and as science continues and we get more information and we make more landmark discoveries in genetics, you may be better able to diagnose the patient. Dr Grouse: I was wondering if you had any recommendations regarding either some tips and tricks, some pearls of wisdom you can impart to us regarding the work of ataxia, or conversely, any big pitfalls that you can help us avoid? I would love to hear about it. Dr Zesiewicz: Yeah, there's no easy way to treat or diagnose ataxia patients. I've always felt that the more patients you see- and sounds easy, but the more patients you see, the better you're going to become at it, and eventually things are going to fall into place. You'll begin to see similarities in patients, etc. I think it's important not only to make sure that a person has ataxia, but again, look at the other signs and symptoms that may point to ataxia that you'll see in a cerebellar syndrome. I think it's important to do a full neuroexam. If a person has spasticity, that may point you more towards a certain type of ataxia than if a person has no reflexes, for example, that we see in Friedreich's ataxia. Some of the ocular findings are very interesting as well. It's important to know if a person has a tremor. I've seen several Wilson's disease cases in my life with ataxia. They're very important. I think a full neuroexam and also a very detailed history would be very helpful. Dr Grouse: Tell us about some promising developments in the diagnosis and management of ataxia that we should be on the lookout for. Dr Zesiewicz: The first drug for Friedreich's ataxia was FDA-approved two years ago, which was an NRF2 activator, which was extremely exciting and promising. There are also several medications that are now in front of the FDA that may also be very promising and have gone through long clinical trials. There's a medication that's related to riluzole, which is a medication used for amyotrophic lateral sclerosis, that has been through about seven years of testing. That is before the FDA as well for spinal cerebellar ataxia. Friedreich's ataxia has now completed the first cardiac gene therapy program with AAV vectors, which- we're waiting for full results, but that's a cardiac test. But I would assume that in the future, neurological gene therapy is not far behind if we've already done cardiac gene therapy and Friedreich's ataxia. So, you know, some of these AAV vector-based genetic therapies may be very helpful, as well as ASO, antisense oligonucleotides, for example. And I think in the future, other things to think about are the CRISPR/Cas9 technology for potential treatment of ataxia. It is a very exciting time, and some major promising therapies have been realized in the past 2 to 3 years. Dr Grouse: Well, that's really exciting, and we'll all look forward to seeing these becoming more clinically applicable in the future. So, thank you so much for coming to talk with us today. Dr Zesiewicz: Thank you. Dr Grouse: Again, today I've been interviewing Dr Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. 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.

Meredith Hilliard, armed with the knowledge of her BRCA gene and her family's history, decided to have a robotic prophylactic mastectomy to avert the disease that haunted her relatives. Supported by her community and inspired by her mother’s experience, she became one of the first in Texas to try this innovative procedure. Her story is one of preparation, courage, and hope for a cancer-free future. Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts. Key Questions Answered 1. Who is Meredith Hilliard, and what makes her story unique? 2. How did Meredith learn about breast cancer at a young age? 3. What is the BRCA gene, and how did Meredith’s family discover they were carriers? 4. How did having a family history and the BRCA gene influence Meredith’s decisions about her health? 5. What is a prophylactic mastectomy and why did Meredith choose to have one? 6. How did Meredith feel during the regular surveillance (MRI and mammograms) before surgery? 7. What support did Meredith have during her decision and surgery? 8. What is a robotic mastectomy, and how did Meredith become a candidate for this procedure? 9. What was Meredith’s experience with reconstruction following her mastectomy? 10. How does Meredith feel about her decision in hindsight? Timestamped Overview 00:00 Secret Struggles with Cancer 04:23 Early Diagnosis Key to Discovery 08:03 BRCA Gene and Cancer Anxiety 11:23 Robotic Mastectomy Experience 15:02 Family Health and Surgery Discussion 18:26 Referral to MD AndersonSee omnystudio.com/listener for privacy information.

Listen or watch along as we dive into the changing landscape of axial spondyloarthritis (axSpA) diagnosis.In this episode, podcast host Mel Brooke, BIRDs Patient and Public Engagement Programme talks with Dr Tom Williams, Consultant rheumatologist and Education Lead at the RNHRD, RUH Bath about changes to the axSpA diagnosis process since our first series in 2020. From persistent delays and the different experiences of women, to new tools like the NASS Playbook, PRIMIS pop-up, and Symptom Checker, we look at what's helping clinicians and patients. We also touch on non-radiographic axSpA, the growing role of MRI, blood markers, and how to approach cases that aren't clear-cut — before rounding off with some patient questions. Useful Links:National Axial Spondyloarthritis SocietyRoyal National Hospital for Rheumatic Diseases, RUH BathConnect further with us:Have questions or thoughts about our information Podcast library?  Interested in joining BIRDs patient research panel? Email Mel at  ppe@birdbath.org.ukBe sure to subscribe, rate, and review the podcast to help us continue sharing information that matters!Thank you to all our sponsors for helping us to bring you information that supports you and helps to increase your knowledge of rheumatic diseases.Please visit the⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠BIRD website ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to sign up for news.

Two Onc Docs, hosted by Samantha A. Armstrong, MD, and Karine Tawagi, MD, is a podcast dedicated to providing current and future oncologists and hematologists with the knowledge they need to ace their boards and deliver quality patient care. Dr Armstrong is a hematologist/oncologist and assistant professor of clinical medicine at Indiana University Health in Indianapolis. Dr Tawagi is a hematologist/oncologist and assistant professor of clinical medicine at the University of Illinois in Chicago. In this episode, OncLive On Air® partnered with Two Onc Docs to feature a conversation about soft tissue sarcoma management. Drs Armstrong and Tawagi discussed that soft tissue sarcomas represent a rare and heterogeneous group of malignancies that arise from mesenchymal cells rather than epithelial cells and encompass several distinct histologic subtypes. They explained that although uncommon, these sarcomas are frequently emphasized in board examinations, partly because their management has historically been stable, though recent FDA approvals and ongoing research have expanded therapeutic options. They noted that risk factors may include prior radiation exposure, environmental agents, and viral infections. Additionally, they shared that chronic lymphedema is associated with angiosarcoma, whereas rare hereditary syndromes may predispose individuals to specific sarcoma subtypes.  Clinically, they explained that sarcomas may arise anywhere in the body, though many occur in the thigh, buttocks, or groin, typically presenting as painless, enlarging masses often mistaken for benign lesions. They emphasized that diagnosis requires core needle biopsy to preserve tissue architecture and that staging relies on MRI of the primary site and CT of the chest, given the strong predilection for pulmonary metastases. They also summarized the five subtypes of soft tissue sarcoma—synovial, clear cell, angiosarcoma, rhabdomyosarcoma, and epithelioid. They reported that the cornerstone of localized disease management is surgical resection, preferably limb-sparing when feasible, combined with radiation for larger or high-risk tumors. They also highlighted novel strategies like immunotherapy. For metastatic disease, they stated that surgical resection of pulmonary metastases can achieve durable remissions in select patients. 

Shownotes How purity culture manifests in women's bodies and sexual experiences Why a woman's pleasure is a gift to everyone around her How ecstatic states purify and cleanse the soul  Why shame is actually the gateway to pleasure A powerful practice that saved Dr. Kim's life Why Jesus' ministry would not exist without the women who supported it   Bio Dr. Kimberly Rose Pendleton is a speaker, writer, teacher and the founder of UNCOVER, a 7-figure global lifestyle brand focused on intimacy, pleasure and women's empowerment.   With a M.A. from Yale, a PhD, in-depth coaching training and many years of experience, Dr. Kim considers it a deep honor and pleasure to weave the intellectual side of empowerment, healing and intimacy work into embodied, playful pleasure practices.   Learn more about Dr. Kimberly and her work on her website and find her on all social media platforms @drkimberlyrosependleton.   Timestamps 00:00:48 - Guest introduction 00:02:49 - Layla shares her religious history 00:05:57 - Why Jesus' ministry would not exist without the women who supported it 00:09:32 - Religious conditioning is baked into our society 00:09:56 - Sign up for Layla's newsletter at LaylaMartin.com 00:12:55 - How purity culture manifests in women's bodies and sexual experiences 00:14:58 - The reality of women who follow the rules of purity culture 00:19:06 - An MRI study from Daniel Bergner's book What Do Women Want? proves that women silence their pleasure  00:26:29 - Discover the VITA™ Sex, Love and Relationship Coaching Certification  00:30:40 - Pleasure is something all of us can access 00:37:51 - Dr. Kim shares a powerful practice that saved her life 00:40:30 - Why shame is the gateway to pleasure 00:42:30 - Explore the magic of  MOOD SEX MAGIC™ Elixir 00:44:09 - Why a woman's pleasure is a gift to everyone around her 00:44:51 - How ecstatic states purify the soul from Ritual Texts for the Afterlife: Orpheus and the Bacchic Gold Tablets by Fritz Graf and Sarah Iles Johnston 00:49:11 - A woman connected to her pleasure can do anything 00:52:25 - Dr. Kim shares why her good girl part had to experience a death to liberate her 00:57:29 - Why every woman needs to learn how to activate pleasure 00:57:35 - Enhance your sensitivity and pleasure inside Crystal Pleasure 01:01:27 - Humans were designed to play multiple notes in life 01:02:24 - Discover Dr. Kim's free course Harlots and Heretics 01:02:40 - Dr. Kim shares about her experience inside VITA Coaching 01:08:05 - Conclusion  

In this powerhouse episode, Dr. Robert Kiltz sits down with Dr. Shawn O'Mara—former prosecutor turned physician-scientist—to expose the hidden epidemic of visceral fat and the radical healing power of a meat-centric lifestyle. From erectile dysfunction and eczema to reversing chronic disease and sprinting at 69, Dr. O'Mara shares how carnivore nutrition transformed his life and thousands of others.Together, they unpack:

Drive with Dr. Peter Attia: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Stuart McGill is a distinguished professor emeritus at the University of Waterloo and the chief scientific officer at Backfitpro where he specializes in evaluating complex cases of lower back pain from across the globe. In this episode, Stuart engages in a deep exploration of lower back pain, starting with the anatomy of the lower back, the workings of the spine, the pathophysiology of back pain, and areas of vulnerability. He challenges the concept of nonspecific back pain, emphasizing the importance of finding a causal relationship between injury and pain. Stuart highlights compelling case studies of the successful treatment of complex cases of lower back pain, reinforcing his conviction that nobody needs to suffer endlessly. He also covers the importance of strength and stability, shares his favorite exercises to prescribe to patients, and provides invaluable advice for maintaining a healthy spine. We discuss: Peter's experience with debilitating back pain [3:00]; Anatomy of the back: spine, discs, facet joints, and common pain points [14:15]; Lower back injuries and pain: acute vs. chronic, impact of disc damage, microfractures, and more [24:30]; Why the majority of back injuries happen around the L4, L5, and S1 joints [30:45]; How the spine responds to forces like bending and loading, and how it adapts to different athletic activities [36:00]; The pathology of bulging discs [43:00]; The pathophysiology of Peter's back pain, injuries from excessive loading, immune response to back injuries, muscle relaxers, and more [45:45]; The three most important exercises Stuart prescribes, how he assesses patients, and the importance of tailored exercises based on individual needs and body types [56:00]; The significance of strength and stability in preventing injuries and preserving longevity [1:08:00]; Stuart's take on squats and deadlifting: potential risks, alternatives, and importance of correct movement patterns [1:19:15]; Helping patients with psychological trauma from lower back pain by empowering them with the understanding of the mechanical aspects of their pain [1:29:45]; Empowering patients through education and understanding of their pain through Stuart's clinic and work through BackFitPro [1:38:30]; When surgical interventions may be appropriate, and “virtual surgery” as an alternative [1:46:30]; Weakness, nerve pain, and stenosis: treatments, surgical considerations, and more [1:55:15]; Tarlov cysts: treatment and surgical considerations [2:00:00]; The evolution of patient assessments and the limitations of MRI [2:02:00]; Pain relief related to stiffness and muscle bulk through training [2:06:45]; Advice for the young person on how to keep a healthy spine [2:14:00]; Resources for individuals dealing with lower back pain [2:25:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Tom Cross, MBBS, DCH, to discuss the Cross Bracing Protocol. In this conversation, Dr. Cross discusses the following: Background on the Cross Bracing Protocol (CBP) and its origins The selection criteria and the grading system for the CBP The rehabilitation considerations for the CBP and potential complications Future directions of research for the CBP Dr. Tom Cross has practiced sports medicine for the past 28 years and during that time successfully completed 5 years of specialist post-graduate training in sport & exercise medicine. He has broad sports medicine experience caring for recreational athletes (adults and children), musculoskeletal injuries that occur at work or home, elite/professional athletes and also military personnel. Resources: Healing of Acute Anterior Cruciate Ligament Rupture on MRI and Outcomes Following Non-Surgical Management with the Cross Bracing Protocol https://bjsm.bmj.com/content/57/23/1490 Cross's Website, including additional resources and information about the CBP: https://www.stadiumclinic.com.au/dr-tom-cross-sports-doctor-sydney.html

Tense morning as we await the results from Roman Anthony's MRI

Have a message for Karena? She'd love to hear from you and share your comment or question on air!Leave Karena a voicemail: https://www.speakpipe.com/KarenaDawnCould the secret to mental health be linked to brain health rather than what's inside a pill bottle?In this illuminating episode of The Big Silence, Karena sits down with world-renowned psychiatrist, brain health expert, and bestselling author Dr. Daniel Amen. With over 200,000 brain scans and decades of research, Dr. Amen is on a mission to end the stigma around mental illness by reframing it as brain health. Together, they dive into the real causes of depression, the daily habits that heal your brain, and the tiny shifts that can transform your life. If you've ever struggled with anxiety, negative thoughts, or burnout, this conversation will change how you see yourself—and your future.Is Mental Illness Really a Brain Health Issue?Dr. Amen challenges the outdated way psychiatry diagnoses mental illness and shows us how brain scans, nutrition, movement, and mindset can unlock the healing we've been searching for.(00:00) Rethinking Mental Illness: It Starts with the BrainWhy psychiatric diagnoses haven't evolved since the 1800s and what needs to changeDepression is like “chest pain”: why we must ask why before we treatHow Dr. Amen divides depression and anxiety into seven different typesThe four “circles” of health: biological, psychological, social, and spiritual(05:28) What Brain Scans Reveal That Doctors MissThe difference between brain structure scans (MRI, CT) and SPECT scansWhy PTSD and traumatic brain injury need different treatments, and how scans show the differenceThe danger of misdiagnosing a “busy brain” vs. a “sleepy brain”Why more information is always better when it comes to treatment(08:22) Brain Health Habits Anyone Can Start TodayDr. Amen's three essentials: brain envy, avoiding what hurts, and doing what helpsWhy alcohol and marijuana are not brain-friendly, despite cultural messagingThe shocking truth about body weight and brain size/functionHow media and marketing feed mental illness(13:37) Social Media, Sleep & The Digital Brain DrainHow social media thins your brain's cortex and lowers self-esteemWhy more online “connection” often leads to greater lonelinessSleep as one of the most underrated brain health toolsHow Dr. Amen balances his social media presence with mental wellness(15:59) Tiny Habits, Big Shifts: Healing Your Brain DailyThe simple nightly practice that rewires your brain for positivityWhy accurate self-talk beats blind positivityThe “ANTs”: automatic negative thoughts and how to kill themMeditation and chanting as proven brain boosters(24:56) Hydration, Food & Loving What Loves You BackWhy just 2% dehydration can wreck your focus and coordinationThe story of Nancy, who transformed her life by starting with hydrationNo more fruit juice, and what to do insteadSecret #4 from You, Happier: Love food that loves you back(30:11) A Mission Too Big for One PersonDr. Amen on founding the Change Your Brain FoundationWhy infectious diseases like Lyme may play a role in schizophreniaKarena shares how changing her mother's diet extended her life by five yearsWhy the fight for brain health is a mission for all of usGuest...

Dizziness in the emergency department is common—and complicated. Today, hosts Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT talk with Dr. Peter Johns (MD) and Dr. Rebekah Griffith, PT about what actually works in the ED: using the HINTS exam correctly, avoiding unnecessary imaging and meclizine-only discharges, knowing when to call stroke, and why physical therapists in the ED can transform safety, outcomes, and costs.You'll hear about how to triage dizzy patients, spot posterior circulation stroke red flags, treat BPPV efficiently, and keep patients safe when answers aren't immediate. We also cover topics such as orthostatic hypotension, POTS, rapid-access dizzy clinics, and practical discharge planning.About the GuestsPeter Johns, MD — Emergency physician and vertigo educator (creator of “Spin Class” vertigo course and a popular YouTube channel).Dr. John's "Spine Class" Course: https://emneuro.com/spinclass/Dr. John's YouTube Channel: https://www.youtube.com/@PeterJohnsRebekah Griffith, PT, DPT — Emergency Department physical therapist and educator advocating for PT/OT presence in EDs nationwide.Dr. Griffith's Website: https://theeddpt.com/Instagram: https://www.instagram.com/theeddpt/https://www.instagram.com/theeddpt/Key TakeawaysUse HINTS to rule in peripheral vestibular dysfunctionBPPV is common and under-treated—confirm with positional nystagmus and treat with the correct maneuvers.Assess gait and orthostatics upright, not just vitals in bed; orthostatic hypotension is frequently missed.Embedding PTs in EDs improves safety, reduces unnecessary imaging and admissions, and boosts patient/provider satisfaction.Upstream PT access (outpatient/telehealth) prevents many ED visits and fear-avoidant patterns (e.g., PPPD risk).If this episode helped you, subscribe, like, and share. Comment with your biggest ED dizziness challenge—and we may just cover it in a future episode!#Dizziness #Vertigo #BPPV #HINTSExam #Stroke #EmergencyMedicine #VestibularRehab #PhysicalTherapy #POTS #OrthostaticHypotension #NeuroPT #TalkDizzyToMeHosted by:

Chorea describes involuntary movements that are random, abrupt, and unpredictable, flowing from one body part to another. The most common cause of genetic chorea in adults is Huntington disease, which requires comprehensive, multidisciplinary care as well as support for care partners, who may themselves be diagnosed with the disease. In this episode, Aaron Berkowitz, MD, PhD FAAN speaks with Kathryn P. L. Moore, MD, MSc, author of the article “Huntington Disease and Chorea” in the Continuum® August 2025 Movement Disorders issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology at the University of California San Francisco in the Department of Neurology in San Francisco, California. Dr. Moore is an assistant professor and director of the Parkinson's Disease and Movement Disorders Fellowship in the department of neurology at Duke University in Durham, North Carolina. Additional Resources Read the article: Huntington Disease and Chorea 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: @AaronLBerkowitz Guest: @KatiePMooreMD 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 Berkowitz: This is Dr Aaron Berkowitz with Continuum Audio, and today I'm interviewing Dr Kathryn Moore about her article on diagnosis and management of Huntington disease and chorea, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, Dr Moore. Could you please introduce yourself to our audience? Dr Moore: Yeah, thank you so much. I'm so excited to be here. I'm Dr Moore. I'm an assistant professor of neurology at Duke University, where I work as a movement disorder specialist. I run our fellowship there and help with our residency program as well. So, I'm excited to speak with our listeners about chorea today. Dr Berkowitz: Fantastic. And we're excited to talk to you about chorea. So, as a general neurologist myself, I only see chorea pretty rarely compared to other movement disorders like tremor, myoclonus, maybe the occasional tic disorder. And like anything I don't see very often, I always have to look up the differential diagnosis and how to evaluate a patient with chorea. So, I was so glad to read your article. And next time I see a patient with chorea, I know I'll be referring to your article as a great reference to have a framework for how to approach it. I hope our readers will look at all these helpful tables on differential diagnosis based on distribution of chorea in the body, potential etiologies, time course of onset and evolution, associated drug-induced causes, what tests to send. So, I highly recommend our listeners read the article. Keep those tables handy for when a patient comes in with chorea. I'm excited to pick your brain about some of these topics today. First, how do you go about distinguishing chorea from other hyperkinetic movement disorders when you see a patient that you think might have chorea? Dr Moore: One of the wonderful things about being a movement disorder specialist is we spend a lot of time looking at movements and training our brain to make these distinctions. The things that I would be looking out for chorea is involuntary, uncontrolled movements that appear to be brief and flowing from one part of the body to another. So, if you can watch a patient and predict what movements they're going to do, this probably isn't chorea. And it should be flowing from one part of the body to another. So, not staying just in one part of the body or having sustained movements. It can be difficult to distinguish between a tic or dystonia or myoclonus. Those things tend to be more predictable and repetitive than the chorea, which tends to be really random and can look like dancing. Dr Berkowitz: That's very helpful. So, once you've decided the patient has chorea, what's your framework for thinking about the differential diagnosis of the cause of the patient's chorea? Dr Moore: Well, that could be really challenging. The differential for chorea is very broad, and so the two things that I tend to use are age of the patient and acuity of onset. And so, if you're thinking about acute onset of chorea, you're really looking at a structural lesion like a stroke or a systemic issue like infection, hyperglycemia, etc. Where a gradually progressive chorea tends to be genetic in nature. When you're thinking about the difference between a child and an adult, the most common cause of chorea in a child is Sydenham's chorea. And actually, the most common cause of chorea that I tend to see is Parkinson's disease medication. So, if anybody's seen dyskinesia in Parkinson's disease, you've seen chorea. But it's those two things that I'm using, the age of the patient and the acuity. Somewhere in the middle, though---so, if you have subacute onset of chorea---it's important to remember to think about autoimmune conditions or paraneoplastic conditions because these are treatable. Dr Berkowitz: That's very helpful. So, like in any chief concern in neurology, we're using the context like the age and then the time course. And then a number of other helpful points in your article about the distribution of chorea in the body. Any comments you'd like to make about- we have this very helpful table that I thought was very interesting. So, you really get deep into the nuances of chorea and the movement disorder specialist expert level. Are there any aspects of parts of the body affected by chorea or distribution of chorea across the body that help you hone your differential diagnosis? Dr Moore: Certainly. I think where the chorea is located in the body can be helpful, but not as helpful as other conditions where you're localizing a lesion or that sort of thing. Because you can have a systemic cause of chorea that causes a hemichorea; that you can have hyperglycemia causing a hemichorea, or even Sydenham's chorea being a hemichorea. But things that we think about, if the forehead is involved, I would think about Huntington's disease, although this is not pathognomonic. And if it's involving the face or the mouth, you can think about neuroacanthocytosis or, more commonly, tardive dyskinesia. Hemichorea would make me think about some of those systemic issues like hyperglycemia, Sydenham's chorea, those sorts of things, but I would rely more on the historical context and the acuity of presentation than the distribution itself. Dr Berkowitz: Got it. That's very helpful. So those can be helpful features, but not sort of specific for any particular condition. Dr Moore: Exactly. Dr Berkowitz: Yeah, I often see forehead chorea mentioned as sort of specific to Huntington's disease. Since I don't see much Huntington's disease myself, what does forehead chorea look like? What is the forehead doing? How do you recognize that there is chorea of the forehead? It's just sort of hard for me to imagine what it would look like. Dr Moore: It's really tricky. I think seeing the eyebrows go up and down or the brows furrow in an unpredictable way is really what we're looking for. And that can be hard if you're having a conversation. My forehead is certainly animated as we're talking about one of my favorite topics here. One of the tricks that I use with the fellows is to observe the forehead from the side, and there you can see the undulation of the forehead muscles. And that can be helpful as you're looking for these things. I think where it's most helpful to use the forehead is if you're trying to determine if someone with a psychiatric history has tardive dyskinesia or Huntington's disease, because there can be quite a lot of overlap there. And unfortunately, patients can have both conditions. And so, using the forehead movement can be helpful to maybe direct further testing for Huntington's disease. Dr Berkowitz: Oh, wow, that's a very helpful pearl. So, if you see, sort of, diffuse chorea throughout the body and the forehead is involved, to my understanding it may be less specific. But in the context of wondering, is the neuropsychiatric condition and movement disorder related by an underlying cause in the case of seeing orofacial dyskinesias, is the relationship a drug having caused a tardive dyskinesia or is the whole underlying process Huntington's, the absence of forehead might push you a little more towards tardive dyskinesia, presuming there is an appropriate implicated drug and the presence of forehead chorea would really clue you in more to Huntington's. Did I understand that pearl? Dr Moore: That's exactly right, and I'm glad you brought up the point about making sure, if you're considering tardive dyskinesia, that there has been an appropriate drug exposure. Because without that you can't make that diagnosis. Dr Berkowitz: That's a very helpful and interesting pearl, looking at the forehead from the side. That is a movement disorders pearl for sure. Sort of not just looking at the forehead from one angle and trying to figure out what it's doing, but going to look at the patient in profile and trying to sort it out. I love that. Okay. So, based on the differential diagnosis you would have crafted based on whether this is sort of acute, subacute, chronic, the age of the patient, whether it's unilateral, bilateral, which parts of the body. How do you go about the initial evaluation in terms of laboratory testing, imaging, etc.? Dr Moore: Well, certainly in an acute-onset patient, you're going to get a number of labs---and that's listed out for you in the paper---and consider imaging as well, looking for an infarct. One thing our learners will know is that sort of the typical answer to what's the infarct causing hemichorea would be the subthalamic nucleus. But really, those infarcts can be almost anywhere. There are case reports for infarcts in a wide variety of places in the brain leading to hemichorea. So, I think some general blood work and an MRI of the brain is a good place to start. For someone who has a more chronic course of the development of chorea, there are certain labs that I would get---and an MRI, because if you get an MRI and there's heavy metal deposition or other disease, structurally, that indicates a certain condition, that can help you pretty considerably. But otherwise, I'm looking for inflammatory markers, heavy metals, HIV, some general other things that are outlined, to help make sure that I'm not missing something that's treatable before I go down the route of genetic testing. And we may talk about this in a little bit, but if you start out with genetic testing and then you sort of have to back up and do more systemic testing, that can be very disjointed when it comes to good patient care. Dr Berkowitz: That's very helpful. So yeah, if it's acute, obviously this is the most straightforward scenario, acute and unilateral. We're imagining something lesional, as you said, either a stroke or---not sort of sudden, but fast, but not sudden---you might think of another structural lesion. Toxoplasmosis, right, has an affinity for the basal ganglia if you were seeing this in a patient who is immunocompromised. But in a case that, probably as you alluded to, sort of what we would see most commonly in practice, those still relatively rare, sort of subacute to chronic symmetric chorea. There's a long list of tests that are recommended. In your article and in other texts, I've read lupus testing, anti-phospholipid antibodies… but the list is long. I'll refer readers to your article. Out of curiosity as a specialist, how often do you see any of these labs come back revealing any underlying diagnosis in a patient who's otherwise healthy and just has developed chorea and comes to you with that chief concern? I feel like I've sent that mega-workup a few times; I'm obviously a general neurologist, but not nearly as many times as you have been. It's- I can't remember a time where something has come up, maybe an ANA one to forty or something like this that we don't think is relevant. But in your practice, how often do you end up finding a reversible cause in the laboratory testing versus ending up starting to go down the genetic testing route, which we'll talk about in a moment? Dr Moore: It's not common, but it is important that we capture these things. Because for a lot of those laboratory tests, there are treatments that are available, or other health implications if those come back positive. So, the case I think of is a polycythemia vera patient who had diffused subacute onset chorea and was able to be treated, was temporarily managed with medication for her chorea, and as her PV improved, she was able to come off those medications. As I was alluding to before---and I'm sure we'll talk about genetic testing---if you test for HD and it's negative, do you go down the route of additional expensive genetic testing, or do you then circle back and go, oops, I missed this treatable condition? As we talk about genetic testing as well, getting HD testing is a pretty involved process. And so, we want to make sure we are checking all those boxes before we move forward. So, it's not common, but we do catch some treatable conditions, and that's really important not to miss. Dr Berkowitz: That's very interesting. So, you diagnosed that polycythemia vera by blood smear, is that how you make the diagnosis? Dr Moore: Yes. Dr Berkowitz: And is that a once-in-a-career-so-far type of thing, or does that happen time to time? Dr Moore: For me, that's a once-so-far, but I don't doubt that I'll see it again. Dr Berkowitz: Great. And how about lupus and some of these other things we look for in the absence of other systemic features? Have you picked up any of these or heard of colleagues picking up something on laboratory testing? They said, oh, this patient came in for a referral for genetic testing, negative Huntington's disease. And good news, we found polycythemia vera; good news, we found undiagnosed lupus and we reversed it. I'm just curious, epidemiologically, seeing these long lists and not having the subspecialty practice that you do, how often you find a reversible cause like we do for neuropathy all the time, right? Oh, it's diabetes, it's B12---maybe not reversible, but preventing progression---or reversible dementia work up. You get so excited when you find low B12 and you replete the patient's B12, and they get better when they had been concerned they were developing an irreversible condition. How often does one in your subspecialty find a reversible cause on that initial mega-lab screen? Dr Moore: I think it's really uncommon, and maybe the folks that do are caught by someone else that never make it to Huntington's clinic, but I don't tend to see those cases. There are, of course, case reports and well-described in the literature about lupus and movement disorders and things of that nature, but that doesn't come to our clinic on a regular basis for sure. Dr Berkowitz: Got it. That's helpful to hear. Well, we've alluded to genetic testing a number of times now, so let's go ahead and talk about it. A lot of your article focuses on Huntington disease, and I was thinking about---in the course of our medical training in medical school, and then neurology residency, for those of us who don't become movement disorder experts like yourself---we learn a lot about Huntington disease. That's sort of the disease that causes chorea, until we later learned there are a whole number of diseases, not just the reversible causes we've been talking about, but a number of genetic diseases which you expertly reviewing your article. So, what are some of the red flags that suggest to you that a patient with chronically progressive chorea---and whom you're concerned for Huntington's or another genetic cause---what are some things you notice about the history, about the exam, the symptoms, the signs, the syndrome, that suggest to you that, actually, this one looks like it might not turn out to be HD. I think this patient might have something else. And as you have alluded to, how do you approach this? Do you send HD testing, wait for it to come back, and then go forward? Are there genetic panels for certain genetic causes of chorea? Do you skip just a whole exome sequencing, or will you miss some of the trinucleotide repeat conditions? How do you approach this in practice? Dr Moore: I'll try to tackle all that. One thing I will say is that a lot of patients with chorea, regardless of the cause, can look very similar to one another. So, if you're looking at chronic onset chorea, perhaps with some neuropsychiatric features, I'm going to most often think about HD because that's the most common cause. Certainly, as we mentioned before, if there's a lot of tongue protrusion, I would think about the acanthocytic conditions, neurocanthocytosis and McCloud syndrome. But generally in those conditions, we're looking at HD as the most likely cause. Certainly, if there is epilepsy or some other syndromic types of things going on, I may think more broadly. But it's important to know that while HD, as you mentioned, is the cause of chorea, many of our patients will have parkinsonism, tics, dystonia, a whole host of other movement phenomenologies. So, that wouldn't dissuade me from thinking about HD. When we think about the kind of patients that you're describing, upwards of 95% of those people will have Huntington's disease. And the process for genetic testing is fairly involved. The Huntington's Disease Society of America has organized a set of recommendations for providers to go about the process of genetic testing in a safe and supportive way for patients and their families. And so that's referred to in the article because it really is important and was devised by patients and families that are affected by this disease. And so, when we're thinking about genetic testing for HD, if I reveal that you have HD, this potentially affects your children and your parents and your siblings. You can have a lot of implications for the lives and health and finances of your family members. We also know that there is high suicidality in patients with HD, in patients who are at risk for HD; and there's even a higher risk of suicidality in patients who are at risk but test negative for HD. So, we do recommend a supportive environment for these patients and their families. And so, for presymptomatic patients or patients who are at risk and don't have chorea, this involves making sure we have, sort of, our ducks in a row, as it were, when we think about life insurance, and, do you have somebody supportive to be with you through this journey of genetic testing, no matter what the results are? So, oftentimes I'll say to folks, you know, there's this 20-page policy that I encourage you to look at, but there are Huntington's Disease Centers of Excellence across the country that are happy to help you with that process, to make sure that the patients are well supported. This is an individual genetic test because, as you mentioned, it is a CAG repeat disorder. And unfortunately, there is no chorea panel. So, if an HD test comes back negative, what we'll do then is think about what's called the HD phenocopies. As I mentioned before, some of these patients who look like they have HD will have a negative HD test. And so, what do you do then? Well, there's a handful of phenocopies---so, other genetic mutations that cause a very similar presentation. And so, we try to be smart, since there's not a panel, we try to be smart about how we choose which test to do next. So, for instance, there's a condition called DRPLA that is present in an African-American family here in my area, in North Carolina, as well as in Japan. And so, if someone comes from those backgrounds, we may decide that that's the next test that we're going to do. If they are white European descent, we may consider a different genetic test; or if they're sub-Saharan African, we may choose a different one from that. However, even if you do a really thorough job, all those blood tests, all those genetic tests, you will occasionally get patients that you can't find a diagnosis for. And so, it's important to know even when you do a good job, you may still not find the answer. And so, I think trying to do things with this complex of the presentation in a systematic way for yourself so you're not missing something. So, going back to our answer about, how do I look at lupus and polycythemia vera and all of that, to think about it in a systematic way. That when you get to the end and you say, well, I don't have an answer, you know you've tried. Dr Berkowitz: That's very helpful to hear your approach to these challenging scenarios, and also how to approach the potential challenging diagnosis for patients and their families getting this diagnosis, particularly in the presymptomatic phase. And your article touches on this with a lot of nuance and thoughtfulness. So, I encourage our listeners to have a read of that section as well. So, last here, just briefly in our final moments, you discuss in your article the various symptomatic treatments for chorea. We won't have time to go into all the details of all the many treatments you discussed, but just briefly, how do you decide which medication to start in an individual patient with chorea for symptomatic management? What are some of the considerations related to the underlying condition, potential side effect profiles of the particular medications, or any other considerations just broadly, generally, as you think about choosing one of the many medications that can be used to treat chorea? Dr Moore: Certainly. So, there is a group of FDA-approved medications, VMAT2 inhibitors, that we can choose from, or the off-label use of neuroleptics. And so, there's a lot of things that go into that. Some of that is insurance and cost and that sort of thing, and that can play a role. Others are side effects. So, for the VMAT2 inhibitors, they all do have a black box warning from the FDA about suicidality. And so, if a patient does struggle with mental health, has a history of suicidality, psychiatric admissions for that sort of thing, then I would be more cautious about using that medication. All patients are counseled about that, as are their families, to help us give them good support. So, the neuroleptics do not tend to have that side effect and can help with mood as well as the chorea and can be helpful in that way. And some of them, of course, will have beneficial side effects. So, olanzapine may help with appetite, which can be important in this disease. So, the big considerations would be the black box warning and suicidality, as well as, are we trying to just treat chorea or are we treating chorea and neuropsychiatric issues? Dr Berkowitz: Fantastic. Thank you for that overview. And again, for our listeners, there's a lot more detail about all of these medications, how they work, how they're used in different patient populations, their side effects, etc, to be reviewed in your excellent article. Again, today, I've been interviewing Dr Kathryn Moore about her article on diagnosis and management of Huntington's disease in chorea, which appears in the August 2025 Continuum issue on movement disorders. Be sure to check out Continuum Audio episodes from this and other issues. And thank you so much to our listeners for joining today. And thank you again, Dr Moore. Dr Moore: Thanks for having me. 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.

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HIFU (high-intensity focused ultrasound) is one of the most talked-about focal therapies in prostate cancer—but who is it really right for? In this conversation, Dr. Matthew Cooperberg (UCSF)—a leading voice in urology, epidemiology, and integrative prostate cancer care—breaks down patient selection vs. energy modality, how modern imaging (MRI, fusion, RSI) drives precision, what genomics (e.g., Decipher) can and can't tell us, and how salvage options compare after focal therapy vs. radiation. We also tackle lifestyle factors, trial design, and why midlife PSA screening (ideally

In this episode of Keeping Abreast, Dr. Jenn Simmons welcomes Dr. Hania Bednarski, a breast surgeon pioneering cryoablation as an alternative to conventional breast cancer surgery.For decades, breast cancer treatment has changed little—yet Dr. Bednarski is forging a new path, reducing trauma while preserving women's wholeness. She shares her journey from trauma and hand surgery into breast care, and ultimately into cryoablation. Together, she and Dr. Jenn explore why this approach matters, how it's performed, and what it means for the future of breast cancer care.The conversation challenges assumptions about mammograms, chemotherapy, lymph node surgery, and hormones. Both physicians stress the importance of autonomy, personalized treatment, and a future where patient choice—not rigid protocols—guides care.This episode is essential for women navigating breast health, practitioners curious about new frontiers, and anyone passionate about transforming medicine from invasive to empowering.In This Episode, You Will Learn:How Dr. Bednarski's career led her to cryoablationWhy conventional surgery can cause lasting traumaWhat cryoablation is, how it works, and who it helpsWhy informed consent and patient choice matterThe pitfalls of mammograms and over-diagnosisHow cryoablation may engage the immune systemWhy lymph node surgery is diagnostic—not curativeThe truth about estrogen and breast cancer riskHow financial incentives block innovation

Get the book!The greatest innovations often begin with a simple question: "What if we tried this differently?" In this fascinating exploration of innovation mindsets, we unpack the two complementary approaches that fuel breakthroughs—design thinking and first principles thinking.hese very approaches are at the heart of my book Protection for the Inventive Mind, a practical fieldbook that helps inventors and creatives turn frustrations into prototypes and big ideas into protected strategies.From the Wright brothers' wind tunnel experiments at Kitty Hawk to SpaceX landing rockets upright, we trace how returning to fundamental truths allows inventors to rebuild solutions from scratch. These stories show first principles thinking as the "logic scalpel" that cuts through assumptions and tradition to reveal new possibilities.Alongside this analytical approach, we discover design thinking—the "empathy engine" that powers human-centered innovation. We see how watching an arthritic woman struggle with kitchen tools birthed OXO Good Grips, how children's tears transformed hospital MRI machines into pirate ships, and how PillPack revolutionized medication management by truly understanding patient frustrations.The episode reveals surprising connections between seemingly unrelated innovations. The kingfisher bird's perfect dive inspired Japan's bullet train nose design. Velcro emerged when a Swiss engineer examined burrs stuck to his dog under a microscope. These moments of biomimicry demonstrate how nature offers solutions to our most persistent challenges.What's particularly inspiring is how often world-changing ideas emerge from everyday annoyances—James Dyson's 5,000 vacuum prototypes, IKEA's flat-pack revelation from a stubborn table that wouldn't fit in a car, and Airbnb's humble beginnings with air mattresses on an apartment floor. These stories prove that frustration can be billion-dollar inspiration when viewed through the right lens.Ready to apply these mindsets to your own challenges? Listen for five actionable innovation principles distilled from these remarkable stories, and discover how combining empathy with fundamental thinking can transform not just products, but experiences, systems, and culture itself. Whether you're sketching on a napkin or aiming for the stars, the way you think might be your greatest invention yet.Send us a textSupport the show

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…   Suzanne: Thank you for your time in advance. In late 2021, my husband was diagnosed with Stage IV prostate cancer. He underwent six rounds of chemo along with Eligard injections. After his last scans, whole body and bone, we were told the cancer is "stabilized". He is currently on 300 mg of Nubeqa 2x a day (down from 4 x because I asked about it) and Lupron injections every 3 months. We have consciously changed our diet (no added sugar, no alcohol, no processed foods) and he is doing pretty well, although, he does fatigue and sweat easily. My question is whether you believe that taking a couple of your home tests would be beneficial for him? I worry about these powerful drugs he is being given and have noticed a reluctance from the doctor about reducing his drugs any further. Thank you again!                                                Sheena: Hi Dr C! Hope you and your team are well. I recently went for blood work. I fasted for 14 hours and was wondering what your thoughts are specifically regarding my Lipid Panel and Iron Panel. My triglycerides is 1.83, Total 4.05, HDL 1.72 and LDL 1.63 (all mmol/L). For iron my levels are 37 umol/L, iron binding 0.70 umol/L, and ferritin 44 ugL. My Dr says she's concerned with my triglycerides. How can I lower it? And shes concerned with my ferritin and iron levels so shes sending me for a Hemochromatosis blood test to see why the levels are off. (My fasting glucose is 4.9, hbA1c is 5.2, TSH is 1.04 and Auto CBC is 3.8). Would love your thoughts and any food and supplementation recommendations would be appreciated! Love you and all the best to everyone on their health journey!                                                            Madhia: Hello My Dr is giving me a hard time to prescribe MRI for my breast exam. Do you have any Dr you can recommend that would help me in greater Los Angeles area?                                                                                                 Margie: My son, who is 46 years old has had Alpha-Gal for approximately 10 years. Now his wife has also been diagnosed with it. I am aware it is caused by a tick bite. He constantly has mass cell inflammation including breathing and allergy issues. Could you please explain specifically how this disease affects the body's immune system and which of your protocols should be used to bring the body back into balance. Will that particular protocol bring the body back into balance enough so that it will relieve the mass cell inflammation and they can return to eating mammal meat?                                                     Jackie: Hi Dr. Cabral thank you for all that you do. You have made a tremendous impact in my and my clients lives. My husband has just finally been diagnosed after 10 years of misdiagnosis with neurogenic TOS. We have a great rehab team working on the biomechanics and we are exploring Big 5 root causes. I was wondering what natural pain management methods you would recommend during the process pain is 10/10 and conventional medicines wants to basically kill the nerve or put him on Lyrica which neither are an option for us. We are exploring accupuncture, grounding and adrenal sooth/inflammasoothe/cbd protocol. Any other alternative inflammation reduction techniques or devices you would recommend? Could you do a podcast on natural pain management strategies for people with chronic pain?          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/3495 - - - 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!  

Delaying diagnosis of parkinsonism can mean delaying care. In a study recently published in JAMA Neurology, David Vaillancourt, PhD, and colleagues tested the ability of an AI model to differentiate between Parkinson disease and other neurodegenerative disorders when paired with MRI. He joins JAMA and JAMA+ AI Associate Editor Yulin Hswen, ScD, MPH to discuss. Related Content: A Large Proportion of Parkinson Disease Diagnoses Are Wrong—Here's How AI Could Help Automated Imaging Differentiation for Parkinsonism

국민의힘 신종 입틀막… 살벌한 공포 정치민주당으론 땡큐지만, 정치 전체로는 안타까워정치인 변신은 무죄.. 장동혁, 중도 확장할 수도김민수 '무지성 발언'… 민주주의 이해 못한 것입틀막 정치? 진짜 해당 행위는 윤석열 비상계엄극우·극좌 뇌 MRI 찍어보니 같아, 양당의 비극 ■ 방송 : CBS 라디오 FM 98.1 (07:10~09:00)■ 진행 : 김현정 앵커■ 대담 : 박용진(더불어민주당 前 의원), 김종혁(국민의힘 前 최고위원)See omnystudio.com/listener for privacy information.

Charlie was stopped by a man in the garage. Rover has been having problems scheduling his MRI. Tomas is out on the town. Revisiting Jeffrey at the Cracker Barrel. How do TikTok creators make so much money? Rover spots former RMG calendar girl, Cali Miles, in an article. See omnystudio.com/listener for privacy information.

Charlie was stopped by a man in the garage. Rover has been having problems scheduling his MRI. Tomas is out on the town. Revisiting Jeffrey at the Cracker Barrel. How do TikTok creators make so much money? Rover spots former RMG calendar girl, Cali Miles, in an article. 

Charlie was stopped by a man in the garage. Rover has been having problems scheduling his MRI. Tomas is out on the town. Revisiting Jeffrey at the Cracker Barrel. How do TikTok creators make so much money? Rover spots former RMG calendar girl, Cali Miles, in an article. AI Company, Anthropic, claims someone attempted to hack their chatbot Claude AI. Two children have died after a mass shooting at a Catholic school church in Minneapolis. Mental health needs to be addressed in this country. Man has his balls cut off to become the leader of the eunuchs. BME videos. The man who bought JLR's Cracker Barrel calls into the show. Home theater rooms. Rover has airport anxiety but wants to go to Seattle for the soccer game. Staff outing. Cruise ships

Charlie was stopped by a man in the garage. Rover has been having problems scheduling his MRI. Tomas is out on the town. Revisiting Jeffrey at the Cracker Barrel. How do TikTok creators make so much money? Rover spots former RMG calendar girl, Cali Miles, in an article. AI Company, Anthropic, claims someone attempted to hack their chatbot Claude AI. Two children have died after a mass shooting at a Catholic school church in Minneapolis. Mental health needs to be addressed in this country. Man has his balls cut off to become the leader of the eunuchs. BME videos. The man who bought JLR's Cracker Barrel calls into the show. Home theater rooms. Rover has airport anxiety but wants to go to Seattle for the soccer game. Staff outing. Cruise ships See omnystudio.com/listener for privacy information.

Today, we talk through a 4-part system to generate ideas - one that'll tap into your brain's natural ability to develop novel solutions rather than just waiting (hoping) inspiration will strike. We'll do it with a little help from a baseball training facility, a corked wine bottle, and an MRI startup. The Tacklebox Customer Interviews Workshop - Sept. Session is OPENIdea to Startup NewsletterFermenting IdeasPod: Customers speak ProblemPod: How to Create a Strategy for your StartupReadwiseIdea to Startup Bot00:26 Idea People02:47 A Baseball Training Facility04:45 Inversion07:46 Smooth Jazz9:24 Part 1: Identifying the Problem12:34 Part 2: Collecting17:22 Part 3: Chewing20:14 Part 4: Testing21:37 The End + How to Start

• Sponsor plugs for Bart Merrick realtors and Just Call Mo • Wordplay with Hot Crystal Van/Rainy Bart Merrick • Housing market slow, Fed rates, experience matters, houses sitting, real estate biggest decision • Friday free show announced • Seth Petruzzelli guest, first appearance in years, brings daughter Vera • Jokes about health, colonoscopy, IAS syndrome • Baby sounds on mic, Dan's CTE/death song • Parenting sacrifices, kids growing fast, dance studio life • Seth juggling dojo, house sale stress, slanted room, inspectors nitpicking • House dropped from $1.799M to $1.299M • Million-dollar homes common now, Trump house in Winter Park lowers appeal • Seth reads Brown Bear to Vera, dad life fulfilling • Dojo students still testing, but marketing neglected • Friends like Jackal help, his daughter earns black belt • Vera choking scares, anti-choking device, treadmill running gag • Butt cancer jogging jokes • Seth bullied as “mop head,” dad threatened principal with karate death blow • Tommy adjusting to sixth grade, awkward transitions, name-using debate • Seth recalls Christian school and Bishop Varel drug issues • Seth's boat broke after sitting too long • Looking for female roommate to help babysit Vera, prefers no dogs, okay with reptiles • Parenting challenges with Vera's SpaghettiOs diet • Ongoing B6 toxicity muscle twitching • Vera learning karate punches in Japanese • Music break: Teen Mortgage “Box” • Hollerbach's German Restaurant wins Best Restaurant 2025 • Praised for schnitzel, sausage platter, pork shank, spätzle, kids menu • New T&D pins available, Knight's Table events • Straw hats by Hittin Skins/Danger Brain • Fantasy Football draft on Twitch with catering from The Joint • Pinball Dudes tournament with Ross and EJ, better camera setup • Draft frustrations • Max learning breakdancing, hitting windmills, hopes to impress peers • Dan recalls drumming at black church, excitement for son's moments • Listener Jeff “Nutman” visits, therapist, offers Tom scraping therapy for “limp cock foot” • MRI inconclusive, willing to try gua sha • Miami Heat guard Marcos Perez stole 400+ jerseys/memorabilia, sold $1.9M • LeBron Finals jersey resold $3.7M • Items from Wade, Butler, Bosh, Mourning, Shaq • Lack of cameras allowed theft, facing 10 years • Dolphins security family tie mentioned • Tyreek Hill cleats worth ~$10K • Caller Rob's recurring butt abscess, hospital lancing, embarrassing but funny • Fiber supplements and clean bowel jokes • Caller recalls Sarasota Pee-wee Herman theater, Guthrie's gut box • Make-A-Wish survivor “owe back” jokes • Peanut roadside stories • Local rapper MC Search, Pete Nice memorabilia scam • Music by White Reaper, Bowling Shoes • Sponsor Modern Plumbing Industries offering discounts and installs • Jen joins, surname debates, euphonium joke, Becca in jazz band • Hogan death rumor • Jen fixes engines, bad financial decisions, Gateway PC, Mars Music credit spree, Technics 1200s • Pregnant in court with detoxing lawyer • Blockbuster decline stories, stealing media, renting consoles, like Home Depot waste • Insurance jobs pay well but hated • Jen considering insurance, influencer idea dismissed, maybe producer • Crystal stops in for peanuts • Food service memories • Blockbuster porn rental awkwardness • Norm and Crystal contributions • 3D printing toys, micropenises, valve caps • Scandinavian kaffeost voicemail, Viking toughness • Voicemail about orgasms • Heat warning • Viral Bijan Robinson drill • Dan scooter photoshoot, motorcycle safety, Brad Hines death, SeaWorld ride memory • Bike discomfort, anatomy jokes, DCF concerns • Jen birthday wishes, insurance job search, old silly emails • Show wrap-up and comedic disclaimer ### **Social Media:**   [Website](https://tomanddan.com/) | [Twitter](https://twitter.com/tomanddanlive) | [Facebook](https://facebook.com/amediocretime) | [Instagram](https://instagram.com/tomanddanlive) **Where to Find the Show:**   [Apple Podcasts](https://podcasts.apple.com/us/podcast/a-mediocre-time/id334142682) | [Google Podcasts](https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2FtZWRpb2NyZXRpbWUvcG9kY2FzdC54bWw) | [TuneIn](https://tunein.com/podcasts/Comedy/A-Mediocre-Time-p364156/) **The Tom & Dan Radio Show on Real Radio 104.1:**   [Apple Podcasts](https://podcasts.apple.com/us/podcast/a-corporate-time/id975258990) | [Google Podcasts](https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2Fjb3Jwb3JhdGV0aW1lL3BvZGNhc3QueG1s) | [TuneIn](https://tunein.com/podcasts/Comedy/A-Corporate-Time-p1038501/) **Exclusive Content:** [Join BDM](https://tomanddan.com/registration) **Merch:** [Shop Tom & Dan](https://tomanddan.myshopify.com/)

Today's word of the day is ‘rebound' as in the Brewers as in the Cubs as in new streak as in NL Central as in Kyle Tucker. Milwaukee won Game 1 of the series 7-0. Kyle Tucker struggled again. And the Cubs have decided to give him a few days off. Wow. (15:30) The AL West has a small problem right now. Every one of the teams is struggling at the same time. The Astros have been getting shut out. The Mariners are losing. And the Rangers fell off a cliff. (25:00) The St. Louis Cardinals have some problems. Attendance. For the first time in 21 years the Cardinals attendance will finish outside the top 7 in MLB. (33:27) Review: Just A Bit Outside. (39:45) Vlad Guerrero Jr got hurt yesterday doing a split. Now he needs an MRI. Oh boy. This is the last thing the Blue Jays needed. (45:00) NPPOD. Let's talk about Tommy Pham. Learn more about your ad choices. Visit podcastchoices.com/adchoices