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This episode is presented by Create A Video – A court in California rules President Trump can take control of the National Guard to provide security during the recent riots. A North Carolina court heard arguments about whether the state messed up in granting a company a monopoly on MRIs in northeastern NC. Plus, four plead guilty in USAID fraud scheme going back years. Subscribe to the podcast at: https://ThePetePod.com/ All the links to Pete's Prep are free: https://patreon.com/petekalinershow Media Bias Check: If you choose to subscribe, get 15% off here! Advertising and Booking inquiries: Pete@ThePeteKalinerShow.com Get exclusive content here!: https://thepetekalinershow.com/See omnystudio.com/listener for privacy information.
Text Dr. Lenz any feedback or questions In this episode, we delve into the ongoing research and new findings related to Chronic Fatigue Syndrome (CFS). The discussion covers the development of standardized diagnostic criteria known as the Hingston Criteria, as well as the discovery of biological abnormalities in CFS patients. Key areas of focus include the autonomic nervous system, heart rate variability, and muscle strength. The episode also touches on the concept of 'effort preference' and the complex interplay between sympathetic and parasympathetic nervous system activity in chronic conditions like CFS and fibromyalgia. Additionally, the episode previews upcoming discussions on findings from functional MRIs of the brain in CFS patients.00:00 Introduction and Importance of Defining the Disease00:15 The Hingston Criteria: A New Standard for Clinical Trials00:59 Biological Evidence and Clinical Trials02:13 Autonomic Dysfunction in Chronic Fatigue Syndrome04:14 Sympathetic and Parasympathetic Systems Explained08:24 Chronic Stress and Its Impact on Health10:21 Comparing Functional Somatic Syndromes and Stress-Related Syndromes20:59 Muscle Strength and Cognitive Effort in CFS22:28 Understanding EMG and Its Diagnostic Value26:57 Effort Preference and Its Clinical Implications28:42 Conclusion and Next Week's Preview Joy LenzFibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start. Support the showWhen I started this podcast—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That's why I created this space: to offer education, validation, and hope. If you've been told fibromyalgia “isn't real” or that it's “all in your head,” know this—I see you. I believe you. You're not alone. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you'll find trusted, evidence-based insights here, drawn from my 28+ years as an MD. Please remember to talk with your doctor about your symptoms and care. This content doesn't replace personal medical advice.* ...
In this part two episode, Andrea and Dr. Susie Spirlock (aka Dr. Susie Squats) tackle what to do when you actually are injured. Building on last week's discussion about pain during strength training, this conversation dives into how to approach recovery with confidence. Andrea and Dr. Susie break down the "peace and love" method for healing, why MRIs are not always the gold standard, and how to choose the right physical therapy program. You will walk away with practical tips to manage injury, stay optimistic during rehab, and ease back into your favorite workouts. If you want to stay strong at any age and keep lifting for life, this is a must-listen follow up.Follow Dr. Susie Spirlock on all socials: @dr.susie.squatsHer Website HEREThe PEACE & LOVE acronym HEREFree Downloads HERE Follow the Make Fit Simple Podcast@MakeFitSimplePodcastHave a suggestion for a topic click HEREHave a suggestion for a guest click HERENEW! Leave a question for Andrea HERE on SpeakPipe! Follow Andrea on Instagram@deliciouslyfitnhealthy@dfh.training.picsTraining & Coachinghttps://www.deliciouslyfitnhealthy.com/linksVisit Andrea's Websitewww.deliciouslyfitnhealthy.comProduced by Light On Creative Productions
Dr. Adam Silberman is a naturopathic doctor and expert in anti-aging and regenerative medicine. Dr. Silberman brings over a decade of training and clinical experience to his patients and their families, specializing in the use of advanced lab work, diagnostic analysis, bioidentical hormone replacement therapy, antiaging peptide therapy, natural medicine, and ultrasound-guided joint injections to address disease and optimize health span. He earned his bachelor's in psychology from UCLA, his doctorate in natural medicine from Western University, and an MBA from Murdoch University in Perth, Australia. In this episode of Conversations for Health, we explore the work that he does to support men's health in their 50s and 60s to promote longevity and anti-aging into their final years. He shares a profile of his typical patient, how he organizes and utilizes collected patient data, and the strategies he has implemented to optimize each patient's integrated and supported in-office experience. He generously shares his approach to aggregating client data for a holistic snapshot, the key metrics and trends that are tracked on every client, and his approach to men's health that utilizes naturopathic medicine, supplements, and preventative lifestyle changes that support longevity and antiaging in men. I'm your host, Evelyne Lambrecht, thank you for designing a well world with us. Episode Resources: Dr. Adam Silberman: https://www.blueprintwellness.org/ Design for Health Resources: Designs for Health - https://www.designsforhealth.com/ Designs for Health Practitioner Exclusive Drug Nutrient Depletion and Interaction Checker - https://www.designsforhealth.com/drug-nutrient-interaction/ Visit the Designs for Health Research and Education Library, which houses medical journals, protocols, webinars, and our blog. https://www.designsforhealth.com/research-and-education/education The Designs for Health Podcast is produced in partnership with Podfly Productions. Chapters: 00:00 Intro. 02:39 Dr. Adam is feeling lit up about early morning soccer games with his kids. 04:00 Adam's bittersweet desire to pursue naturopathic medicine. 10:12 A profile of Adam's current patient. 15:55 Task Force Dagger and specialized programming for first responders. 17:50 Supporting athletes during the off-season. 20:52 Organizing and utilizing collected patient data. 26:02 Optimizing and integrating each client's high-touch experience. 27:10 Aggregating client data for a holistic snapshot. 29:30 Key metrics and trends that are tracked on every client. 36:57 The case for full-body MRIs and DEXA scans. 40:05 Noted differences between CoreViva and other scans. 44:30 HRV and adrenal stress index, and strategies for increasing HRV. 47:35 Dr. Adam's favorite supplements, particularly adaptogens. 50:32 Meeting the increasing demand for focus on men's health. 55:44 Addressing the underlying causes of decreased testosterone. 1:05:01 One thing Dr. Adam does with every male patient. 1:06:22 Dr. Adam's favorite personal supplements, favorite health practices, and his changed view on the use of appropriate pharmaceutical interventions.
Subscribe to our channel: https://www.youtube.com/@optispanGet Our Newsletter (It's Free): https://www.optispan.life/Dr. Matt Kaeberlein reacts to controversial takes on supplements, MRIs, protein, and rapamycin from Dr. Eric Topol. This video breaks down the evidence behind popular health trends, helping you separate science from hype.0:00 - Setting the Stage: Expert Reaction1:03 - Experts Selling Supplements: Credibility Lost?2:30 - MRIs & CGMs: Lifesaving or Misleading?7:16 - Protein "Overdose": What's the Real Risk?11:11 - Rapamycin: Decoding the Data & Hype21:00 - The Hard Truth About Supplements (Matt's Take)39:36 - Biological Age: Can We Really Measure It?46:37 - CGMs: Powerful Tool or Just Trendy?Production: Nicholas Arapis, https://videocastproductions.comDISCLAIMER: The information provided on the Optispan podcast is intended solely for general educational purposes and is not meant to be, nor should it be construed as, personalized medical advice. No doctor-patient relationship is established by your use of this channel. The information and materials presented are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. We strongly advise that you consult with a licensed healthcare professional for all matters concerning your health, especially before undertaking any changes based on content provided by this channel. The hosts and guests on this channel are not liable for any direct, indirect, or other damages or adverse effects that may arise from the application of the information discussed. Medical knowledge is constantly evolving; therefore, the information provided should be verified against current medical standards and practices.More places to find us:Twitter: https://twitter.com/optispanpodcastTwitter: https://twitter.com/optispanTwitter: https://twitter.com/mkaeberleinLinkedin: https://www.linkedin.com/company/optispanInstagram: https://www.instagram.com/optispanpodcast/TikTok: https://www.tiktok.com/@optispanhttps://www.optispan.life/Hi, I'm Matt Kaeberlein. I spent the first few decades of my career doing scientific research into the biology of aging, trying to understand the finer details of how humans age in order to facilitate translational interventions that promote healthspan and improve quality of life. Now I want to take some of that knowledge out of the lab and into the hands of people who can really use it.On this podcast I talk about all things aging and healthspan, from supplements and nutrition to the latest discoveries in longevity research. My goal is to lift the veil on the geroscience and longevity world and help you apply what we know to your own personal health trajectory. I care about quality science and will always be honest about what I don't know. I hope you'll find these episodes helpful!
Your back is an integral part of your body's structure, and it plays an important role in a wide variety of movements. Dealing with back pain can make every day difficult, affecting your ability to walk, drive, or tie your shoes. If you've ever dealt with low back pain, you know that the health of your back can impact your quality of life in every way. On this episode of The Model Health Show, our guest is chiropractor and the founder and CEO of RehabFix, Dr. Grant Elliot. He is passionate about helping people resolve their low back pain so they can live a healthy, full, and functional life. On today's show he's sharing his best tips for eliminating sciatica, low back pain, and symptoms stemming from disc herniation. We're going to talk about how rest and movement impact musculoskeletal issues, how imaging can actually increase your risk for surgery, and how your lifestyle impacts your pain levels. You're going to hear the truth about what back pain is and why it occurs, and realistic tips you can use to improve your symptoms. You're also going to learn about why the traditional model for treating back pain is misguided. Dr. Elliot is going to dispel some of the biggest myths around low back pain, stretching and exercise, imaging, and so much more. If you or someone you love struggles with low back pain, you're going to get a ton of value out of this conversation. Enjoy! In this episode you'll discover: What percentage of American adults struggle with back pain. (4:48) Why Dr. Elliot decided to become a chiropractor. (6:02) The #1 reason why we develop musculoskeletal pain. (13:43) What percentage of back pain is labeled non-specific low back pain. (14:37) How your lifestyle impacts the health of your back. (15:07) Why so many people are misdiagnosed with muscle strain. (15:33) An important reason why rest is not advised for back pain. (17:03) The role that movement plays in joint health. (17:49) How common disc bulges are. (19:20) The anatomy of a disc. (21:41) Why imaging is often overused in modern medicine. (25:03) The various types of disc issues, and how size and severity differ. (25:39) Why your primary provider is unqualified to treat lower back pain. (26:26) The shocking connection between MRIs and surgeries. (29:51) What sciatica is and its root cause. (32:21) Why hamstring stretches can worsen sciatic pain. (35:07) The best exercises for sciatica. (38:04) How to determine how much movement is safe if you're in pain. (45:47) The biggest myths about back pain. (51:19) How stress can manifest as pain and discomfort. (1:02:11) Items mentioned in this episode include: DrinkLMNT.com/model - Get a FREE sample pack of electrolytes with any order! Foursigmatic.com/model - Get an exclusive discount on your daily health elixirs! DM the word PODCAST on Instagram for your free assessment! Connect with Dr. Grant Elliot Website / Instagram / YouTube Be sure you are subscribed to this podcast to automatically receive your episodes: Apple Podcasts Spotify Soundcloud Pandora YouTube This episode of The Model Health Show is brought to you by LMNT and Four Sigmatic. Head to DrinkLMNT.com/model to claim a FREE sample pack of electrolytes with any purchase. Visit foursigmatic.com/model to get an exclusive discount on mushroom and adaptogen-packed blends to improve your life.
What is really going on when you get a bump in your back or neck muscle that hurts when you press on it? Do muscles really get knots? How do they form? Why are they not detected in scans like x-rays or MRIs? Why do deep tissue massages sometimes make them feel more sore? What are ways to prevent muscle knots? ... we explain like I'm five Thank you to the r/explainlikeimfive community and in particular the following users whose questions and comments formed the basis of this discussion: theotherbogart, hearmeroar92, entropynz, iluvtheinternets, shintasama, omanfishesinthesea, littleredbunnyfoot and lsarge442. To the community that has supported us so far, thanks for all your feedback and comments. Join us on Twitter: https://www.twitter.com/eli5ThePodcast/ or send us an e-mail: ELI5ThePodcast@gmail.com
Show Notes: In this episode of the MotherToBaby Podcast, host and genetic counselor Chris Stallman welcomes Dr. Emily Caffrey, a certified health physicist at the Health Physics Society and the University of Alabama at Birmingham. Together, they dive into one of the most frequently asked topics: how radiation exposure may impact breastfeeding. Dr. Caffrey explains the difference between ionizing and non-ionizing radiation, details how imaging procedures like X-rays, CT scans, and MRIs interact with the body, and addresses concerns around contrast agents and radioactive tracers. The episode also covers what breastfeeding women working around radiation should know, including practical safety tips and case-by-case considerations. Key Takeaways: Diagnostic imaging procedures do not make breast milk radioactive or require stopping breastfeeding Some radioactive tracers or therapeutic treatments may require temporary or permanent changes to breastfeeding plans, depending on the specific agent and dose Always inform your healthcare provider that you're breastfeeding and ask questions about any upcoming procedures Expert help is available—don't rely on internet searches alone Resources mentioned in this episode: MotherToBaby.org Health Physics Society American College of Radiology Guidelines Call 866-626-6847 or text 855-999-3525 to speak with a MotherToBaby specialist
Andrew's 10-Year Pain Journey: From Hopeless to Limitless | Whealth Podcast After a decade of dealing with chronic pain — from a high school ankle injury that spiraled into full-body dysfunction — Andrew was ready to give up. He tried it all: orthopedics, physical therapy, chiropractors, massage, even other online holistic health programs. Nothing gave lasting relief.Then he found the Whealth Limitless Program.In just a few months, Andrew went from barely being able to lift his arm without pain… to playing sports again, fixing his posture, improving his sleep, and regaining confidence he thought was lost forever.In this episode, Cam sits down with Andrew to break down:The true cost of chasing conventional treatments that don't workThe mindset shift that helped him take ownership of his recoveryHow his background in exercise science still left him unpreparedWhat finally made the pain start to fade — and fastThis is more than a recovery story. It's a wake-up call for anyone who feels stuck in pain, burnt out by the healthcare system, and ready to reclaim their body.
Join our FREE NCLEX Pharmacology Class every Monday in June at ReMarNurse.com/RNU In this engaging video, Professor Regina Callion, MSN, RN, discusses the critical NCLEX safety points regarding aneurysms. We'll explore what an aneurysm is and why it's crucial for nursing students to understand this topic. Discover the various types of aneurysms, including cerebral, abdominal, and thoracic, and learn how to identify high-risk individuals who need immediate attention. We'll dive into the underlying causes, such as genetic factors and lifestyle choices, and look at the diagnostic tests used, like CT scans and MRIs. You'll also gain insights into management options ranging from monitoring to surgical interventions, along with essential nursing priorities for patient care. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ►NCLEX V2 Free Trial - http://ReMarNurse.com/free ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription
Could your daily bread be behind your head pain?In this episode of The Migraine Heroes Podcast, host Diane Ducarme explores the hidden connection between gluten and migraines—whether or not you have celiac disease. Backed by science and the wisdom of Traditional Chinese Medicine, we unravel how this common protein might be silently triggering inflammation, hormonal chaos, and gut imbalances.You'll learn:● Why gluten can still be a migraine trigger—even if you're not celiac● The top 3 scientific theories linking gluten to neurological inflammation● Practical ways to reduce “dampness,” support digestion, and relieve migraines naturallyPLUS: Diane shares a powerful story of a woman whose 40-years migraine journey taught us a fascinating insight on Migraine, Gluten and MRIs.Tune in for actionable insights and holistic tools that go far beyond the typical migraine advice. Your next breakthrough might start with your fork.New episodes every Monday and Wednesday.✨ Your body holds the wisdom—let's listen to it together.
Goo goo, gah gah, woof woof! Scientists have officially confirmed what all dog mums and dads suspected—your pup loves it when you baby talk them! A new study using doggy MRIs shows that our fur babies’ brains light up like a tennis ball in a tumble dryer when we speak to them in that classic high-pitched, goofy voice. Turns out, female voices get the biggest tail wags. So next time you say, “Who’s a good boyyyy?”—just know, science says he’s really listening.
“Your back will never get better.”That's what a chiropractor told Cam at age 21 — just months after a deadlift left him in debilitating pain.It was a moment that could have ended his active lifestyle, confidence, and future.Instead, it became the starting point of something much bigger.In this special co-founder origin episode, Andrew and Cam sit down for an honest, unfiltered conversation about the pain that brought them together, the flaws in traditional care models, and the fire that fueled the creation of Whealth — a company that's now helped thousands take their health back into their own hands.Cam shares the full arc of his journey:What it was like to lose his identity as a college athlete to chronic back painThe confusion, fear, and isolation of navigating MRIs, sciatica, and endless failed treatmentsHow damaging practitioner language (“you'll never lift again”) nearly sealed his fateWhy a physical therapist who didn't fix him still gave him hopeThe moment he found Andrew online and took a leap of faithHow he went from being a client to becoming a coach and eventually co-founderThe episode also reveals the lesser-known backstory of Whealth — including:The behind-the-scenes fallout from Andrew's removal from MoveUHow five passionate people took a risk and built Whealth from zeroThe early struggles of launching a mission-driven business with no money and no audienceWhy Whealth's approach to movement and mindset goes far beyond exercisesWhether you're in pain, in doubt, or in a season of rebuilding, this episode is a reminder that your story isn't over.It might just be beginning.If you've ever felt dismissed, broken, or stuck in pain — you're not alone. This is your reminder: The body can heal. And you're capable of far more than you've been told.
What good is financial wealth if you don't have the health to enjoy it? That's the question at the center of my eye-opening conversation with Lisa Brooking, CEO of Healthcode Medical. With her background as a critical care nurse and elite marathon runner, Lisa is transforming how we think about health—from reactive “sick care” to proactive wellness optimization.Lisa shares how traditional medicine often waits for symptoms to appear before acting, missing the chance to prevent disease altogether. At Healthcode Medical, her team treats health as a vital asset class, applying strategies similar to wealth management: early detection, ongoing monitoring, and personalized planning.Their cutting-edge diagnostics—from advanced brain scans to specialized MRIs—create a deep baseline to catch issues early and optimize wellness. Lisa's most powerful insight? That poor health quietly restricts your freedom—limiting travel, activity, and quality of life. True luxury, she argues, isn't material—it's the vibrant health to fully enjoy your life.This philosophy mirrors my own approach to managing wealth: be proactive, informed, and intentional. Healthcode's efficient, boutique two-day assessment equips clients with actionable insights and continuous support for sustainable change.Want to invest in your greatest asset—your health? Connect with Lisa and her team at Healthcode to see how strategic health planning can transform your future.About Our GuestCEO of Healthcode Medical, Lisa is a dynamic and engaging health care leader with a proven track record in both the private and public sectors. Lisa holds a deep understanding of the health care sector rooted in a progressive career starting as a critical care nurse. She is passionate about high quality person-centred care and her commitment to prioritize the well-being of patients. She received the 2015 Young Women of the Year Award from the Orillia Business Women's Association, later renamed in her honor to the Lisa Brooking Young Women of the Year Award, which is presented annually.Lisa is also a world-ranked distance runner with numerous podium finishes. Most recently, she was the 2022 winner of the Miami Half-Marathon and placed second at the 2023 Vancouver Half-Marathon.Lisa Brooking, CEO of Healthcode Medical1285 W BroadwayVancouver, BC V6H 3X8, Canada604-283-9811Website: www.healthcode.caLinkedIn: www.linkedin.com/company/healthcodemedicalInstagram: Healthcode MedicalHear Past episodes of the Way2Wealth Podcast!https://theway2wealth.com Learn more about our Host, Scott Ford, Managing Director, Partner & Wealth Advisorhttps://www.carsonwealth.com/team-members/scott-ford/ Investment advisory services offered through CWM LLC, an SEC-registered investment advisor. Carson Partners, a division of CWM LLC, is a nationwide partnership of advisors. The opinions voiced in the Way to Wealth with Scott Ford are for general information only and are not intended to provide specific advice or recommendations for an individual. Past performance is no guarantee of future results. All indices are unmanaged and may not be invested into directly. Investing involves risk, including possible loss of principal. No strategy assures success or protects against loss. To determine what may be appropriate for you, consult with your attorney, accountant, financial or tax advisor prior to investing. Guests on Way to Wealth are not affiliated with CWM, LLC. Legado Family is not affiliated with CWM LLC. Carson Wealth 19833 Leitersburg Pike, Suite 1, Hagerstown, Maryland, 21742.
Worst Seats in the House w/ Michael Russo & Anthony LaPanta - Minnesota Wild Podcast
In front of a packed house at Elsie's, we learn LaPanta unknowingly golfed during a tornado warning and Russo's back is wonky after a year of covering the #mnwild. Plus lots of hockey talk! from Aquarius Home Services Studio (https://aquariushomeservices.com) Supported by: Aquarius Home Services (https://aquariushomeservices.com/) Royal Credit Union (https://www.rcu.org/) Twill Edina Galleria, OnX Maps (https://www.onxmaps.com/), Gigli THC Beverages (www.gigli.com), & Clamshell Beach Resort (https://www.cottagesonwhitefish.com/)
In front of a packed house at Elsie's, we learn LaPanta unknowingly golfed during a tornado warning and Russo's back is wonky after a year of covering the #mnwild. Plus lots of hockey talk! from Aquarius Home Services Studio (https://aquariushomeservices.com) Supported by: Aquarius Home Services (https://aquariushomeservices.com/) Royal Credit Union (https://www.rcu.org/) Twill Edina Galleria, OnX Maps (https://www.onxmaps.com/), Gigli THC Beverages (www.gigli.com), & Clamshell Beach Resort (https://www.cottagesonwhitefish.com/)
Which imaging techniques should you prioritize for TMD patients? Does a panoramic radiograph hold any value? When should you consider taking a CBCT of the joints instead? How about an MRI scan for the TMJ? Dr. Dania Tamimi joins Jaz for the first AES 2026 Takeover episode, diving deep into the complexities of TMD diagnosis and TMJ Imaging. They break down the key imaging techniques, how to use them effectively, and the importance of accurate reports in patient care. They also discuss key strategies for making sense of MRIs and CBCTs, highlighting how the quality of reports can significantly impact patient care and diagnosis. Understanding these concepts early can make all the difference in effectively managing TMD cases. https://youtu.be/NBCdqhs5oNY Watch PDP223 on Youtube Protrusive Dental Pearl: Don't lose touch with the magic of in-person learning — balance online education with attending live conferences to connect with peers, meet mentors, and experience the true essence of dentistry! Join us in Chicago AES 2026 where Jaz and Mahmoud will also be speaking among superstars such as Jeff Rouse and Lukasz Lassmann! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Imaging should follow clinical diagnosis → not replace it. Every imaging modality answers different questions; choose wisely. TMJ disorders affect more than the jaw → they influence face, airway, growth, posture. Think beyond replacing teeth → treatment should serve function, not just fill space. Avoid “satisfaction of search error” → finding one problem shouldn't stop broader evaluation. Highlights of this episode: 02:52 Protrusive Dental Pearl 06:01 Meet Dr. Dania Tamimi 09:04 Understanding TMJ Imaging 16:00 TMJ Soft Tissue Anatomy 21:04 The Miracle Joint: TMJ Self-Repair 24:26 The Role of Imaging in TMJ Diagnosis 28:15 Acquiring Panoramic Images 39:35 Guidelines for Using Different Imaging Techniques 41:26 Case Study: Misdiagnosis and Its Consequences 45:46 Balancing Clinical Diagnosis and Imaging 50:17 Role of Imaging in Orthodontics 53:18 The Importance of Accurate MRI Reporting 58:27 Final Thoughts on Imaging and Diagnosis 01:00:54 Upcoming Events and Learning Opportunities
Host Dr. Davide Soldato and guest Dr. Harriet Kluger discuss the JCO article "Phase II Trial of Pembrolizumab in Combination With Bevacizumab for Untreated Melanoma Brain Metastases." Transcript The guest on this podcast episode has no disclosures to declare. Dr. Davide Soldato Hello and welcome to JCO After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, Medical Oncologist at Ospedale San Martino in Genoa, Italy. Today, we are joined by JCO author Dr. Harriet Kluger. Dr. Kluger is a professor of medicine at Yale School of Medicine, Director of the Yale SPORE in Skin Cancer, and an internationally recognized expert in immuno-oncology for melanoma and renal cell carcinoma. She leads early-phase and translational trials that pair novel immunotherapies with predictive biomarkers to personalized care. Today, Dr. Kluger and I will be discussing the article titled "Phase 2 Trial of Pembrolizumab in Combination with Bevacizumab for Untreated Melanoma Brain Metastases." In this study, Dr. Kluger and colleagues evaluated four cycles of pembrolizumab plus the anti-VEGF antibody bevacizumab followed by pembrolizumab maintenance in patients with asymptomatic non-hemorrhagic melanoma brain metastases that had not previously received PD-1 therapy. Thank you for speaking with us, Dr. Kluger. Dr. Harriet Kluger Thank you for inviting me. The pleasure is really all mine. Dr. Davide Soldato So to kick off our podcast, I just wanted to ask if you could outline a little bit the biological and clinical rationale that led you to test this type of combination for patients with untreated brain metastases from metastatic melanoma. Dr. Harriet Kluger Back in approximately 2012, patients who had untreated brain metastases were excluded from all clinical trials. So by untreated, I mean brain metastases that had not received local therapy such as surgery or radiation. The reason for it was primarily because there was this fear that big molecules wouldn't penetrate brain lesions because they can't pass the blood-brain barrier. Turns out that the blood-brain barrier within a tumor is somewhat leaky and drugs sometimes can get in there. When PD-1 inhibitors were first identified as the next blockbuster class of drugs, we decided to conduct a phase 2 clinical trial of pembrolizumab monotherapy in patients with untreated brain metastases. We actually did it also in lung cancer, and we could talk about that later on. Responses were seen. The responses in the brain and the body were similar. They were concordant in melanoma patients. Now, at approximately that time, also another study was done by the Australian group by Dr. Georgina Long, where they did a randomized trial where patients who didn't require immediate steroid therapy received either nivolumab alone or nivolumab with ipilimumab, and the combination arm was substantially superior. Subsequently, also, Bristol Myers Squibb also conducted a large phase 2 multicenter trial of ipilimumab and nivolumab in patients with untreated brain metastases. And there, once again, they saw that the responses in the brain were similar to the responses in the body. Now, somewhere along the line there, we completed our anti-PD-1 monotherapy trial. And when we looked at our data, we still didn't have the data on ipilimumab and nivolumab. And our question was, “Well, how can we do better?” Just as we're always trying to do better. We saw two really big problems. One was that patients had a lot of perilesional edema. And the other one was that we were struggling with radiation necrosis in lesions that were previously Gamma Knifed. The instance of radiation necrosis was in excess of 30%. So the rationale behind this study was that if we added bevacizumab, maybe we could treat those patients who had some edema, not requiring steroids, but potentially get them on study, get that PD-1 inhibitor going, and also prevent subsequent radiation necrosis. And that was the main rationale behind the study. We had also done some preclinical work in mouse models of melanoma brain metastases and in an in vitro blood-brain barrier model where we showed that bevacizumab, or anti-VEGF, really tightens up those leaky basement membranes and therefore would be very likely to decrease the edema. Dr. Davide Soldato Thank you very much for putting in context the combination. So this was a phase 2 trial, and you included patients who had at least one lesion, and you wanted lesions that were behind 5 and 20 millimeters. Patients could be included also if the brain metastasis was higher in dimension than 20 millimeters, but it had to be treated, and it was then excluded from the evaluation of the primary objective of the trial. So regarding, a little bit, these characteristics, do you think that this is very similar to what we see in clinical practice? And what does this mean in terms of applicability of these results in clinical practice? Dr. Harriet Kluger So that's an excellent question. The brain metastasis clinical research field has somewhat been struggling with this issue of inclusion/exclusion criteria. When we started this, we showed pretty clearly that 5 to 10 millimeter lesions, which are below the RECIST criteria for inclusion, are measurable if you use MRIs with slices that are 1 to 2 millimeters. Most institutions in the United States do use these high-resolution MRIs. I don't know how applicable that is on a worldwide scale, but we certainly lowered the threshold for inclusion so that patients who have a smattering of small brain metastases would be eligible. Now, patients with single large brain metastases, the reason that we excluded those from the trial was because we were afraid that if a patient didn't respond to the systemic therapy that we were going to give them, they could really then develop severe neurological symptoms. So, for patient safety, we used 20 millimeters as the upper level for inclusion. Some of the other trials that I mentioned earlier also excluded patients with very large lesions. Now, in practice, one certainly can do Gamma Knife therapy to the large lesions and leave the smaller ones untreated. So I think it actually is very applicable to clinical practice. Dr. Davide Soldato Thank you very much for that insight, because I think that sometimes criteria for clinical trials, they have to be very restrictive. But then we know that in clinical practice, the applicability of these results is probably broader. So, going a little bit further in the results of the study, I just wanted a little bit of comment from you regarding what you saw in terms of intracranial response rate and duration of response among patients who obtained a response from the combination treatment. Dr. Harriet Kluger So we were actually surprised. When we first designed this study, as I said earlier, we weren't trying to beat out ipilimumab and nivolumab. We were really just trying to exclude those patients who wouldn't have otherwise been eligible for ipilimumab and nivolumab because of edema or possibly even previous radiation necrosis. So it was designed to differentiate between a response rate of 34%, and I believe the lower bound was somewhere in the 20s, because that's what we'd seen in the previous pembrolizumab study. What we saw in the first 20 patients that we enrolled was actually a response rate that far exceeded that. And so we enrolled another cohort to verify that result because we were concerned about premature publishing of a result that we might have achieved just by chance. The two cohorts were very similar in terms of the response rates. And certainly this still needs to be verified in a second study with additional institutions. We did include the Moffitt Cancer Center, and the response rate with Moffitt Cancer Center was very similar to the Yale Cancer Center response rate. Now, your other question was about duration of response. So the other thing that we started asking ourselves was whether this high response rate was really because the administration of the anti-VEGF will decrease the gadolinium enhancement and therefore we might actually just be seeing prettier scans but not tumor shrinkage. And the way to differentiate those two is by looking at the duration of the response. Median progression-free survival was 2.2 years. That's pretty long. The upper bound on the 95% confidence interval was not reached. I can't tell you that the duration is as good as the duration would be when you give ipilimumab. Perhaps it is less good. This was a fairly sick population of patients, and it included some who might not have been able to receive ipilimumab and nivolumab. So it provides an alternative. I do believe that we need to do a randomized trial where we compare it to ipilimumab and nivolumab, which is the current standard of care in this patient population. We do need to interpret these results with caution. I also want to point out regarding the progression-free survival that we only gave four doses of anti-VEGF. So one would think that even though anti-VEGF has a long half-life of three or four weeks, two years later, you no longer have anti-VEGF effect, presumably. So it does something when it's administered fairly early on in the course of the treatment. Dr. Davide Soldato So, in terms of clinical applicability, do you see this combination of pembrolizumab and bevacizumab - and of course, as we mentioned, this was a phase 2 trial. The number of patients included was not very high, but still you saw some very promising results when compared with the combination of ipilimumab and nivolumab. So do you see this combination as something that should be given particularly to those patients who might not be able to receive ipilimumab and nivolumab? So, for example, patients who are very symptomatic from the start or require a high dose of steroids, or also to provide a quicker response in terms of patients who have neurological symptoms, or do you think that someday it could be potentially used for all patients? Dr. Harriet Kluger The third part of your question, whether it can be used someday for all patients: I think we need to be very careful when we interpret these results. The study was substantially smaller than the ipilimumab/nivolumab trial that was conducted by Bristol Myers Squibb. Also going to point out that was a different population of patients. Those were all frontline patients. Here we had a mix of patients who'd had previous anti-CTLA-4 and frontline patients. So I don't think that we can replace ipilimumab and nivolumab with these results. But certainly the steroid-sparing aspect of it is something that we really need to take into consideration. A lot of patients have lesions in locations where edema can be dangerous, and some of them have a hard time coming off the steroids. So this is certainly a good approach for those folks. Dr. Davide Soldato And coming back to something that you mentioned in the very introduction, when you said that there were two main problems, which was one, the problem of the edema, and the second one, the problem of the radionecrosis. In your trial, there was a fair percentage of patients who received some type of local treatment before the systemic one. So the combination of pembrolizumab and bevacizumab. And most of the patients received radiosurgery. So I just wanted a brief comment regarding the incidence of radionecrosis in the trial and whether that specific component of the combination with bevacizumab was reduced. And how do you think that this fares in terms of what we see in clinical practice in terms of radionecrosis? Dr. Harriet Kluger I'm not sure that we really reduced the incidence of radiation necrosis. We saw radiation necrosis here. We saw less of it than in the trial of pembrolizumab monotherapy, but these were also different patients, different time. We saw more than we thought that we were going to see. It was 27%, I believe, which is fairly high still. We only gave the four doses of bevacizumab. Maybe to really prevent radiation necrosis, you have to continue to give the bevacizumab. That, too, needs to be tested. The reason that we gave the four doses of bevacizumab was simply because of the cost of the bevacizumab at the time. Dr. Davide Soldato Thank you very much for that comment on radionecrosis. And I really think that potentially this is a strategy, so continuing the bevacizumab, that really makes a lot of sense, especially considering that the tolerability of the regimen was really very, very good, and you didn't see any significant or serious adverse events related to bevacizumab. So just wondering if you could comment a little bit on the toxicities, whether you had anything unexpected. Dr. Harriet Kluger There was one patient who had a microperforation of a diverticulum, which was probably related to the bevacizumab. It was conservatively managed, and the patient did fine and actually remains alive now, many years later. We had one patient who had dehiscence of a previous wound. So there is some. We did not see any substantial hypertension, proteinuria, but we only gave the four doses. So it is possible that if you give it for longer, we would see some side effects. But still, relative to ipilimumab, it's very, very well tolerated. Dr. Davide Soldato Yeah, exactly. I think that the safety profile is really different when we compare the combination of ipilimumab/nivolumab with the pembrolizumab/bevacizumab. And as you said, this was a very small trial and probably we need additional results. But still, these results, in terms of tolerability and safety, I think they are very interesting. So one additional question that I think warrants a little bit of comment on your part is actually related to the presence of patients with BRAF mutation and, in general, to what you think would be the best course of treatment for these patients who present with the upfront brain metastases. So this, it's actually not completely related to the study, but I think that since patients with BRAF mutation were included, I think that this warrants a little bit of discussion on your part. Dr. Harriet Kluger So we really believe that long-term disease control, particularly in brain metastases, doesn't happen when you give BRAF/MEK inhibitors. You sometimes get long-term control if you've got oligometastatic disease in extracranial sites and if they've previously been treated with a lot of immune checkpoint inhibitors, which wasn't the case over here. So a patient who presents early in the course of the disease, regardless of their BRAF status, I do believe that between our studies and all the studies that have been done on immunotherapy earlier in the course of disease, we should withhold BRAF/MEK inhibitors unless they have overwhelming disease and we need immediate disease control, and then we switch them very quickly to immunotherapy. Can I also say something about the toxicity question from the bevacizumab? I have one more comment to make. I think it's important. We were very careful not to include patients who had overt hemorrhage from brain metastases. So melanoma brain metastases relative to other tumor types tend to bleed, and that was an exclusion criteria. We didn't see any bleeding that was attributable to the bevacizumab, but we don't know for sure that, if this is widely used, that that might not be a problem that's observed. So I would advise folks to use extreme caution and perhaps not use it outside of the setting of a clinical trial in patients with overt hemorrhage in the melanoma brain metastases. Dr. Davide Soldato Thank you very much. I think that one aspect that is really interesting in the trial is actually related to the fact that you collected a series of biomarkers, both circulating ones, but also some that were collected actually from the tissue. So just wondering if you could explain a little bit which type of biomarkers you evaluated and whether you saw any significant results that could suggest higher or lower efficacy of the combination. Dr. Harriet Kluger Thank you for that. So yes, the biomarker studies are fairly exploratory, and I want to emphasize that we don't have anything that's remotely useful in clinical practice at this juncture. But we did see an association between vessel density in the tumors and improved response to this regimen. So possibly those lesions that are more vascular are more fed by or driven by VEGF, and that could be the reason that there was improved response. We also saw that when there was less of an increase in circulating angiopoietin-2 levels, patients were more likely to respond. Whether or not that pans out in larger cohorts of patients remains to be determined. Dr. Davide Soldato Still, do you envision validation of these biomarkers in a potentially additional trial that will evaluate, again, the combination? Because I think that the signals were quite interesting, and they really make sense from a biological point of view, considering the mechanism of action of bevacizumab. So I think that, yeah, you're right, they are exploratory. But still, I think that there is very strong biological rationale. So really I wanted to congratulate you on including that specific part and on reporting it. And so the question is, really, do you envision validation of these biomarkers in larger cohorts? Dr. Harriet Kluger I would hope to see that, just as I'd like to see validation of the clinical results as well. The circulating biomarkers are very easy to do. It's a simple ELISA test. And the vessel density on the tumor is essentially CD34 staining and units per area of tumor. Also very simple to do. So I'd love to see that happen. Dr. Davide Soldato Do you think that considering the quality of the MRI that we are using right now, it would be possible to completely bypass even the evaluation on the tissue? Like, are we going in a direction where we can, at a certain point, say the amount of vessels that we see in these metastases is higher versus lower just based on MRI results? Dr. Harriet Kluger You gave me an outstanding idea for a follow-up study. I don't know whether you can measure the intensity of gadolinium as a surrogate, but certainly something worth asking our neuroradiology colleagues. Excellent idea. Thank you. Dr. Davide Soldato You're welcome. So just moving a step further, we spoke a lot about the validation of these results and the combination. And just wanted your idea on what do you think it would be more interesting to do: if designing a clinical trial that really compares pembrolizumab/bevacizumab with ipilimumab and nivolumab or going directly for the triplet. So we know that there has been some type of exploration of triplet combination in metastatic melanoma. So just your clinical impression: What would you do as an investigator? Dr. Harriet Kluger So it's under some discussion, actually. It's very difficult to compare drugs from different companies in an investigator-initiated trial. Perhaps our European colleagues can do that trial for us. In the United States, it's much harder, but it can be done through the cooperative groups, and we are actually having some discussions about that. I don't have the answer for you. It would be lovely to have a trial that compared the three drugs to ipi/nivo and to pembrolizumab/bevacizumab. So a three-arm trial. But remember, these are frontline melanoma patients. There aren't that many of them anymore like there used to be. So accrual will be hard, and we have to be practical. Dr. Davide Soldato Yeah, you're right. And in the discussion of the manuscript, you actually mentioned some other trials that are ongoing, especially one that is investigating the combination of pembro and lenvatinib, another one that is investigating the combination of nivolumab and relatlimab. So just wondering, do you think that the molecule in terms of VEGF inhibition, so bevacizumab versus lenvatinib, can really make a difference or is going to be just a mechanism of action? Of course, we don't have the results from this trial but just wondering if you could give us a general comment or your opinion on the topic. Dr. Harriet Kluger So that's a really great question. The trial of pembrolizumab and lenvatinib was our answer to the fact that bevacizumab is not manufactured by the same company as pembrolizumab, and we're trying to give a practical answer to our next study that might enable us to take this approach further. But it does turn out from our preclinical studies that bevacizumab and VEGF receptor inhibition aren't actually the same thing in terms of the effects on the blood-brain barrier or the perilesional tumor microenvironment in the brain. And these studies were done in mice and in in vitro models. Very different effects. The lenvatinib has stronger effect on the tumors themselves, the tumor cells themselves, than the bevacizumab, which has no effect whatsoever. But the lenvatinib doesn't appear to tighten up that blood-brain barrier. Dr. Davide Soldato Thank you. I think that's very interesting, and I think it's going to be interesting to see also results of these trials to actually improve and give more options to our patients in terms of different mechanism of action, different side effects. Because in the end, one thing that we discussed is that some combination may be useful in some specific clinical situation while others cannot be applicable, like, for example, an all immunotherapy-based combination. Just one final comment, because I think that we focused a lot on the intracranial response and progression-free survival. You briefly mentioned this but just wanted to reinforce the concept. Did you see any differences in terms of intracranial versus extracranial response for those patients who also had extracranial disease with the combination of pembro and bevacizumab? Dr. Harriet Kluger So the responses were almost always concordant. There were a couple of cases that might have had a body response and not an intracranial response and vice-versa, but the vast majority had concordant response or progression. We do believe that it's a biological phenomenon. The type of tumor that tends to go to the brain is going to be the type of tumor that will respond to whatever the regimen is that we're giving. In the previous trial also, we saw concordance of responses in the body and the brain. Dr. Davide Soldato Thank you very much. Just to highlight that really the combination is worth pursuing considering that there was not so much discordant responses, and the results, even in a phase 2 trial, were very, very promising. So thank you again, Dr. Kluger, for joining us today and giving us a little bit of insight into this very interesting trial. Dr. Harriet Kluger Thank you for having me. Dr. Davide Soldato So we appreciate you sharing more on your JCO article titled "Phase 2 Trial of Pembrolizumab in Combination with Bevacizumab for Untreated Melanoma Brain Metastases," which gave us the opportunity to discuss current treatment landscape in metastatic melanoma and future direction in research for melanoma brain metastasis. If you enjoy our show, please leave us a rating and review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
Send us a message with this link, we would love to hear from you. Standard message rates may apply.Back pain affects 80% of people at some point in their lives, but the good news is that approximately 90% of cases improve within 6-12 weeks with proper care and movement. Understanding the causes, treatments, and prevention strategies for back pain can help you navigate this common but often debilitating condition.• Most back pain is "non-specific" with muscle strain being the most common cause• Common types include lumbosacral strain, SI joint dysfunction, and disc herniations• Imaging (X-rays, MRIs) usually unnecessary in first 4-6 weeks unless "red flags" present• Many people with no pain have abnormal findings on imaging• Brief rest is okay but prolonged inactivity makes recovery worse• Heat, over-the-counter pain medications, and lidocaine patches can provide temporary relief• Physical therapy with core strengthening exercises significantly improves outcomes• Your core includes abs, obliques, back muscles, pelvic floor, and diaphragm• Good posture means stacking head, shoulders, spine, and pelvis vertically• Common posture mistakes: tech neck, slouching, crossed legs, improper work setups• Movement is medicine - think of your body as cement waiting to harden• Seek medical attention for numbness, weakness, loss of bowel/bladder control, or persistent painIf you learned something today, pass this episode along to a friend or neighbor who's dealing with back pain. You can sign up for our email list to receive written content and updates about future episodes.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski
In this episode of Building the Base, Hondo Geurts and Lauren Bedula sit down with John Maslin, Co-founder and CEO of Vulcan Elements, for an insightful conversation about the critical importance of rare earth magnets to U.S. national security. Drawing from his background as a Navy Supply Corps officer and his entrepreneurial journey, Maslin offers a candid look into the challenges and opportunities in rebuilding America's rare earth magnet manufacturing capabilities.Five key takeaways from today's episode:Rare earth magnets are essential "invisible building blocks" of our economy, found in virtually all electronic devices from smartphones to MRIs, as well as critical defense applications - yet China currently manufactures over 90% of the global supply while the U.S. produces less than 1%.The rare earth challenge isn't primarily about access to raw materials but rather about processing and manufacturing capabilities, with China having made a strategic decades-long investment that has given them near-complete control of this critical supply chain.Transitioning from government service to entrepreneurship, Maslin emphasizes the importance of mission-driven leadership when tackling strategic manufacturing challenges that are "too important to fail."Scaling domestic manufacturing of critical components requires addressing three fundamental challenges: developing skilled technical workforces, streamlining permitting processes, and creating manufacturing champions who can build complete ecosystems.For maintaining resilience as a founder in the challenging manufacturing space, Maslin recommends focusing on first principles, expectation management with stakeholders, and surrounding yourself with mission-driven team members who understand the strategic importance of the work.
Celebrate Nurses Week starting May 6, 2025! Sign up now at ReMarnurse.com/NursesWeek In this engaging video, Professor Regina Callion, MSN, RN, discusses the critical NCLEX safety points regarding aneurysms. We'll explore what an aneurysm is and why it's crucial for nursing students to understand this topic. Discover the various types of aneurysms, including cerebral, abdominal, and thoracic, and learn how to identify high-risk individuals who need immediate attention. We'll dive into the underlying causes, such as genetic factors and lifestyle choices, and look at the diagnostic tests used, like CT scans and MRIs. You'll also gain insights into management options ranging from monitoring to surgical interventions, along with essential nursing priorities for patient care. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ►NCLEX V2 Free Trial - http://ReMarNurse.com/free ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription
Send us a message with this link, we would love to hear from you. Standard message rates may apply.• Full body MRIs cost around $2,500 and are being promoted as the "gold standard" for preventative health without proper medical context• Unlike established screening tests, these scans haven't been evaluated by medical societies for appropriate use in healthy populations• 15-30% of diagnostic images have at least one incidental finding, which can lead to unnecessary anxiety and further testing• The marketing tactics use fear-based messaging about finding cancer early, which might be ethically concerning• These services create healthcare disparities since they're only accessible to those with financial resourcesSign up for our email list in the show notes to receive notifications about new episodes and access our written materials as we expand our content.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski
This week, Brittany Schmitt and Brittany Furlan Lee discuss why saving money is boring, fake IDs, and the best fast food chains. Then, the girls chat about the power of prayer, MRIs, and the truth of luxury goods. ---------------------------------------------------------------- SUBSCRIBE ON PATREON - patreon.com/ThisIsTheWorstPodcast - A place for the Worsties to be even more feral! We'll be doing exclusive content, bonus episodes and SO much more! SHOP OUR MERCH HERE: https://shop.justmediahouse.com/collections/this-is-the-worst ---------------------------------------------------------------- Thank you to our sponsors this week: Presented by Olipop: https://drinkolipop.com/BRITT & Tru Fru: https://trufru.com/ #Olipoppartner #TruFruPartner Factor: Get started at https://www.factormeals.com/BRITTS50 and use code BRITTS50 to get 50 percent off plus FREE shipping on your first box. ---------------------------------------------------------------- Stay connected and follow us: • Instagram - https://www.instagram.com/thisistheworstpod/ • TikTok - https://www.tiktok.com/@thisistheworstpod • Facebook - https://www.facebook.com/thisistheworstpod/ What's YOUR worst? Want our BADvice? Email us at thisistheworstpod@justmediahouse.com ---------------------------------------------------------------- Time Stamps: 00:00:00 Welcome back WORSTIES! 00:00:40 BS's sleep issues 00:06:10 Chiropractors, MRI and being a hypochondriac 00:19:12 Worsts of the week 00:25:50 Saving money sucks 00:28:55 A tour of fast food chains 00:40:02 Fake IDs 00:47:16 Wins of the week 00:56:40 Nose job update 01:01:08 BADvice 01:07:35 LOVE YOU WORSTIES! Powered by: Just Media House -- https://www.justmediahouse.com/ Hosted and Executive Produced by: Brittany Furlan Lee and Brittany Schmitt Studio: Kandoo Films -- https://www.kandoofilms.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices
Celebrate Nurses Week starting May 6, 2025! Sign up now at ReMarnurse.com/NursesWeek In this engaging video, Professor Regina Callion, MSN, RN, discusses the critical NCLEX safety points regarding aneurysms. We'll explore what an aneurysm is and why it's crucial for nursing students to understand this topic. Discover the various types of aneurysms, including cerebral, abdominal, and thoracic, and learn how to identify high-risk individuals who need immediate attention. We'll dive into the underlying causes, such as genetic factors and lifestyle choices, and look at the diagnostic tests used, like CT scans and MRIs. You'll also gain insights into management options ranging from monitoring to surgical interventions, along with essential nursing priorities for patient care. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ►NCLEX V2 Free Trial - http://ReMarNurse.com/free ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription
Imagine your hospital gets hacked—the MRIs are down, billing's frozen, and suddenly you're faxing patient records like it's 1999. No, that's not a “Twilight Zone” rerun—it's real life in health care. This week, we're diving into what the Health Sector Coordinating Council (HSCC) is doing about it, including their recent trip to Congress to lay it all out. From legacy devices clinging to life like old Tamagotchis to cybersecurity plans that don't sound half bad, we break it all down with just the right amount of snark. More info at HelpMeWithHIPAA.com/505
Send us a textIt's Holy Week.We remember Christ's Passion—but are we chasing comfort instead of the Cross?One man spends $2 million a year trying to stop aging. Supplements. MRIs. Oxygen masks. All to avoid what none of us can escape. And yet… he's still empty.St. Anselm of Canterbury, Doctor of the Church, reveals a greater truth:
Optic neuropathies encompass all congenital or acquired conditions affecting the optic nerve and are often a harbinger of systemic and central nervous system disorders. A systematic approach to identifying the clinical manifestations of specific optic neuropathies is imperative for directing diagnostic assessments, formulating tailored treatment regimens, and identifying broader central nervous system and systemic disorders. In this episode, Gordon Smith, MD, FAAN speaks with Lindsey De Lott, MD, MS, author of the article “Optic Neuropathies” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. De Lott is an assistant professor of neurology and ophthalmology at the University of Michigan in Ann Arbor, Michigan. Additional Resources Read the article: Optic Neuropathies 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: @gordonsmithMD Guest: @lindseydelott 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 Smith: Hello, this is Dr Gordon Smith. Today I'm interviewing Dr Lindsey De Lott about her article on optic neuropathies, which appears in the April 2025 Continuum issue on neuro-ophthalmology. Lindsey, welcome to the podcast, and perhaps you can introduce yourself to our audience. Dr De Lott: Thank you, Dr Smith. My name is Lindsey De Lott and I am a neurologist and a neuro-ophthalmologist at the University of Michigan. I also serve as the section lead for the Division of Neuro-Ophthalmology, which is actually part of the ophthalmology department rather than the neurology department. And I spend a good portion of my time as a researcher in health services research, and that's now about 60% of my practice or so. Dr Smith: I'm super excited to spend some time talking with you. One, I'm a Michigan person. As we were chatting before this, I trained with Wayne Cornblath and John Trobe, and it's great to have you. I wonder if we maybe can begin- and by the way, your article is outstanding. It is such a huge topic and it was actually really fun to read, so I encourage our listeners to check it out. But you begin by talking about misdiagnosis as being a common problem in this patient population. I wonder if you can talk through why that is and if you have any pearls or pitfalls in avoiding it? Dr De Lott: Yeah, I think there's been a lot of great research looking at misdiagnosis in specific types of optic neuropathies; in particular, compressive optic neuropathies and optic neuritis. A lot of that work has come out of the group at Emory and the group at Washington University. But a lot of neuro-ophthalmologists across the country really contributed to those data. And one of the statistics that always strikes me is that, you know, for example, in patients with optic nerve sheath meningiomas, something like 70% of them are actually misdiagnosed. And a lot of those errors in diagnosis, whether it's for compressive optic neuropathy or some other type of optic neuropathy, really comes down to the way that physicians are really incorporating elements of the history in the physical. For example, in optic neuritis, we know that physicians tend to anchor pretty heavily on pain in general. And that often tends to lead them astray when optic neuritis was never the diagnosis to begin with. So, it's really overindexing on certain things and not paying attention to other features of the physical exam; for example, say presence of an afferent pupillary defect. So, I think it just really highlights the need to have a really relatively structured approach to patients that you think have an optic neuropathy when you're trying to sort of plan your diagnostic testing and your treatment. Dr Smith: I do maybe five or six weeks on our hospital service each year, and I don't know if it's just a Richmond thing, but there's always at least two people in my week who come in with an optic neuropathy or acute vision loss. How common is this in medical practice? Or neurologic practice, I should say? Dr De Lott: Optic neuropathies themselves… if you look across, unfortunately we don't have any great data that puts together all optic neuropathies and gives us an actual sort of prevalence estimate or an incidence estimate from year to year. We do have some of those data for specific types of optic neuropathies like optic neuritis and NAION, and you're probably looking around five-ish per one hundred thousand. So, these aren't that common, but at the same time they do get funneled to- often to emergency rooms and to neurologists from our ophthalmology colleagues and optometry colleagues in particular. Dr Smith: So, one other question I had before kind of diving into the topic at hand is how facile neurologists need to be in recognizing other causes of acute visual loss. I mean, we see acute visual loss as neurologists, we think optic neuropathy, right? Optic neuritis is sort of the go-to in a younger patient, and NAION in someone older. But what do neurologists need to know about other ophthalmologic causes? So, glaucoma or acute retinal disorders, for instance? Dr De Lott: Yeah, I think it's really important that neurologists are able to distinguish optic neuropathies from other causes of vision loss. And so, I would really encourage the listeners to take a look at the excellent article by Nancy Newman about vision loss in this issue where she really kind of breaks it down into vision loss that is acute and chronic and how you really think through distinguishing optic neuropathies from other causes of vision loss. But it is really important. For example, a patient with a central retinal artery occlusion may potentially be eligible for treatments. And that's very different from a patient with optic neuritis and acute vision loss. So, we want to be able to distinguish these things. Dr Smith: So maybe we can pivot to that a little bit. Just for our listeners, our focus today is going to be on- not so much on optic neuritis, although obviously we need to talk a little bit about how we differentiate optic neuritis from non-neuritis optic neuropathies. It seems like the two most common situations we encounter are ischemic optic neuropathies and optic neuritis. Maybe you can talk a little bit about how you distinguish these two? I mean, some of it's age, some of it's risk factors, some of it's exam. What's the framework, of let's say, a fifty-year-old person comes into the emergency room with acute vision loss and you're worried about an optic neuropathy? Dr De Lott: The first step whenever you are considering an optic neuropathy is just making sure that the features are present. I think, really going back to your earlier question, making sure that the patient has the features of an optic neuropathy that we expect. So, it's not only vision loss, but it's also the presence of an apparent pupillary defect in a patient with a unilateral optic neuropathy. In a person who has a bilateral optic neuropathy, that apparent pupillary defect may not be present because it is relative. So, you really would have to have asymmetric vision loss between the two eyes. They should also have impairment of their color vision, and they're probably going to have some kind of visual field defect, whether that's central scotoma or an arcuate scotoma or an altitudinal defect that really respects the horizontal meridian. So, you want to make sure that, first and foremost, you've got a patient that really meets most of those- most of those features. And then from there, we're looking at the other features on their history. How acute is the onset of the vision loss? What is the progression over time? Is there pain associated or not associated with the vision loss? What other medical issues does the patient have? And you know, one of the things you already brought up, for example, is, what's the age of the patient? So, I'm going to be much more hesitant to make a diagnosis of optic neuritis in a much older patient or a diagnosis on the other side, of ischemic optic neuropathy, in a much younger patient, unless they have really clear features that push me in that direction. Dr Smith: I wonder if maybe you could talk a little bit about features that would push you away from optic neuritis, because, I mean, people who are over fifty do get optic neuritis- Dr De Lott: They do. Dr Smith: -and people who get ischemic optic neuropathies who are younger. So, what features would push you away from optic neuritis and towards… let's be broad, just a different type of optic neuropathy? Dr De Lott: Sure. We know that most patients with optic neuritis do have pain, but that pain is accompanied---within a few days, typically---with vision loss. So, pain alone going on for a number of days without any visual symptoms or any of those other things I listed, like the afferent papillary defect, the visual field defect, would push me away from optic neuritis. But in general, yes, most optic neuritis is indeed painful. So, the presence of optic disc edema is unfortunately one of those things that an optic neuritis may be present, may not be present, but in somebody with ischemia that is anterior---and that's the most common type of ischemic optic neuropathy, would be anterior ischemic optic neuropathy---they have to have optic disc edema for us to be able to make that diagnosis, and that is a diagnosis of NAION, or nonarteritic ischemic optic neuropathy. An APD in this case, again, that's just a feature of an optic neuropathy. It doesn't really help you to distinguish, individual field defects are going to be relatively similar between them. So then in patients, I'm also looking, like I said, at their history. So, in a patient where I'm entertaining a diagnosis of ischemic optic neuropathy, I want to make sure that they have vascular risk factors or that I'm actually doing things like measuring their blood pressure in the office if they haven't seen a physician recently or checking a lipid panel, hemoglobin A1c, those kinds of things, to look for vascular risk factors. One of the other features on exam that might push me more- again, in a patient with ischemic optic neuropathy, where it might suggest ischemia over optic neuritis, would be some other features on exam like a crowded optic disc that we sometimes will see in patients with ischemic optic neuropathy. I feel like that was a bit of a convoluted answer. Dr Smith: I thought that was a great answer. And when you say crowded optic disc, that's the- is that the “disc at risk”? Dr De Lott: That is the “disk at risk,” yes. So, crowded optic disk is really a disk that is smaller than what we see in the average population, and the average cup to disk ratio is 0.3. So, I think that's where 30% of the disk should be. So, this extra wiggle room, as I sometimes will explain to my patients. Dr Smith: And then, I wonder if you could talk a little bit about more- just more about exam, right? You raised the importance of recognizing optic disc edema. Are there aspects of that disc edema that really steer you away from optic neuritis and towards ischemia-like hemorrhages or whatnot? And then a similar question about the importance of careful visual field testing? Dr De Lott: So, on the whole, optic disc edema is optic disc edema. And you can have very severe optic neuritis with hemorrhages, cotton wool spots, which is essentially just an infarction of the retinal nerve fiber layer either overlying the disc or other parts of the retina. And ischemia, you can have some of the same features. In patients who have giant cell arteritis, which is just one form of anterior ischemic optic neuropathy, patients can have a pallid optic disc edema where the optic disc is swollen and white-looking. But on the whole, swelling is swelling. So, I would caution anyone against using the features of the optic nerve swelling to make any type of, sort of, definitive kind of diagnosis. It's worth keeping in mind, but I just- I would caution against using specific features, optic nerve swelling. And then for visual field testing, there are certain patterns that sometimes can be helpful. I think as I mentioned earlier, in patients with ischemic optic neuropathy, we'll often see an altitudinal defect where either the top half or, more commonly, the bottom half of the vision is lost. And that vision loss in the field corresponds to the area of swelling on the disk, which is really rewarding when you're actually able to see sectoral swelling of the disk. So, say the top half of the disk is swollen and you see a really dense inferior defect. And other types of optic neuropathy such as hereditary optic neuropathies, toxic and nutritional optic neuropathies, they often cause more central field loss. And in patients who have optic neuropathies from elevated intracranial pressure, so papilladema, those folks often have more subtle visual field loss in an arcuate pattern. And it's only once the optic nerves have sustained a pretty significant injury that you start to see other patterns of field loss and actual decline in visual acuity in those patients. I do think a detailed visual field assessment can often be pretty helpful as an adjunct to the rest of the exam. Dr Smith: So, we haven't talked a lot about neuroimaging, and obviously, neuroimaging is really important in patients who have optic neuritis. But how about an older patient in whom you suspect ischemic optic neuropathy? Do those patients all need a MRI scan? And if so, is it orbits and brain? How do you- how do you protocol it? Dr De Lott: You're asking such a good question, totally controversial in in some ways. And so, in patients with ischemic optic neuropathy, if you are confident in your diagnosis: the patient is over the age of fifty, they have all the vascular, you know, they have vascular risk factors. And those vascular risk factors are things like diabetes, hypertension, high blood pressure, hyperlipidemia, obstructive sleep apnea. They have a “disc at risk” in the fellow eye. They don't have pain, they don't have a cancer history. Then doing an MRI of the orbits is probably not necessary to rule out another cause. But if you aren't confident that you have all of those features, then you should absolutely do an MRI of the orbit. The MRI of the brain probably doesn't provide you with much additional information. However, if you are trying to distinguish between an ischemic optic neuropathy and, say, maybe an optic neuritis, in those patients we do recommend MRI orbits and brain imaging because the brain does provide additional information about other CNS demyelinating disorders that might be actually the cause of a patient's optic neuritis. Dr Smith: I wonder if you could talk a little bit about posterior ischemic optic neuropathy. That's much less common, and you mentioned earlier that those patients don't have optic disk edema. So, if there's a patient who has vision loss that- in a similar sort of clinical scenario that you talked about, how do you approach that and under what circumstances do we see patients who have posterior ischemic optic neuropathy? Dr De Lott: So, you're going to most often see patients with posterior ischemic optic neuropathy who, for example, have undergone a recent surgery. These are often associated with things like spinal surgeries, cardiac surgeries. And there are a number of risk factors that are associated with it. Things like blood pressure, drain surgery, the amount of blood loss, positioning of patient. And this is something that the surgeons and anesthesiologists are very sensitive to at this point in time, and many patients are often- this can be part of the normal informed consent process at this point in time since this is something that is well-recognized for specific surgeries. In those patients, though… again, unless you're really certain, for example, maybe the inpatient neurology attending and you've been asked to consult on a patient and it's very clear that they went into surgery normal, they came out of surgery with vision loss, and all the rest of the features really seem to be present. I would recommend that in those cases you think about orbital imaging, making sure you're not missing anything else. Again, unless all of the features really are present- and I think that's one of the themes, definitely, throughout this article, is really the importance of neuroimaging in helping us to distinguish between different types of optic neuropathy. Dr Smith: Yeah, I think one of the things that Eric Eggenberger talks about in his article is the need to use precise nomenclature too, which I plan on talking to him about. But I think having this very structured approach- and your article does it very well, I'll tell our listeners who haven't seen it there's a series of really great tables in the article that outline a lot of these. I wonder, Lindsey, if we can switch to talk about arteritic optic neuropathy. Is that okay? Dr De Lott: Sure. Yeah, absolutely. Dr Smith: How do you sort that out in an older patient who comes in with an ischemic optic neuropathy? Dr De Lott: Yeah. In patients who are over the age of fifty with an ischemic optic neuropathy, we always need to be thinking about giant cell arteritis. It is really a diagnosis we cannot afford to miss. If we do miss it, unfortunately, patients are likely to lose vision in their fellow eye about 1/3 to 1/2 the time. So, it is really one of those emergencies in neuro-ophthalmology and neurology. And so you want to do a thorough review systems for giant cell arteritis symptoms, things like headache, jaw claudication, myalgias, unintentional weight loss, fevers, things of that nature. You also want to check their inflammatory markers to look for evidence of an elevated ESR, elevated C-reactive protein. And then on exam, what you're going to find is that it can cause an anterior ischemic optic neuropathy, as I mentioned earlier. It can cause palette optic disc swelling. But giant cell arteritis can also cause posterior ischemic optic neuropathy. And so, it can be present without any swelling of the optic disc. And in fact, you know, you mentioned one of my mentors, John Trobe, who used to say that in a patient where you're entertaining the idea of posterior ischemic optic neuropathy, who is over the age of fifty with no optic disc swelling, you should be thinking about number one, giant cell arteritis; number two, giant cell arteritis; number three, giant cell arteritis. And so, I think that is a real take-home point is making sure that you're thinking of this diagnosis often in our patients who are over the age of fifty, have to rule it out. Dr Smith: I'll ask maybe a simple question. And presumably just about everyone who you see with a presumed ischemic optic neuropathy, even if they don't have clinical features, you at least check a sed rate. Is that true? Dr De Lott: I do. So, I do routinely check sedimentation rate and C-reactive protein. So, you need to check both. And the reason is that there are some patients who have a positive C-reactive protein but a normal sedimentation rate, so. And vice versa, although that is less common. And so both need to be checked. One other lab that sometimes can be helpful is looking at their CBC. You'll often find these patients with giant cell arteritis have elevated platelet counts. And if you can trend them over time, if you happen to have a patient that's had multiple, you'll see it sort of increasing over time. Dr Smith: I'm just thinking about how you sort things out in the middle, right? I mean, so that not all patients with GCF, sky-high sed rate and CRP…. And I'm just thinking of Dr Trobe's wisdom. So, when you're in an uncertain situation, presumably you go ahead and treat with steroids and move to biopsy. Maybe you can talk a bit about that pathway? Dr De Lott: Yeah, sure. Dr Smith: What's the definitive diagnostic process? Do you- for instance, the sed rate is sky-high, do you still get a biopsy? Dr De Lott: Yes. So, biopsy is still our gold-standard diagnosis here in the United States. I will say that is not the case in all parts of the world. In fact, many parts of Europe are moving toward using other ancillary tests in combination with labs and exam, the history, to make a definitive diagnosis of giant cell arteritis. And those tests are things like temporal artery ultrasound. We also, even though we call it temporal artery ultrasound, we actually need to image not only the temporal arteries but also the axillary arteries. The sensitivity and specificity is actually greater in those cases. And then there's high-resolution imaging of the vessels and the- both the intracranial and extracranial distributions. And both of those have shown some promise in their predictive values of patients actually having giant cell arteritis. One caution I would give to our listeners, though, is that, you know, currently in the US, temporal artery biopsy is still the gold standard. And reading the ultrasounds and the MRIs takes a really experienced radiologist. So, unless you really know the diagnostic accuracy at your institution, again, temporal artery biopsy remains the gold standard here. So, when you are considering giant cell arteritis, start the patient on steroids and- that's high dose, high dose steroids. In patients with vision loss, we use high dose intravenous methylprednisolone and then go ahead and get the biopsy. Dr Smith: Super helpful. And are there other treatments, other than steroids? Maybe how long do you keep people on steroids? And let's say you've got a patient who's, you know, diabetic or has other factors that make you want to avoid the course of steroids. Are there other options available? Dr De Lott: So, in the acute phase steroids are the only option. There is no other option. However, long term, yes, we do pretty quickly put patients on tocilizumab, which is really our first-line treatment. And I do that in conjunction with our rheumatology colleagues, who are incredibly helpful in managing and monitoring the tocilizumab for our patients. But when you're seeing the patients, you know, whether it's in the emergency room or in the hospital, those patients need steroids immediately. There are other steroid-sparing agents that have been tried, but the efficacy is not as good as tocilizumab. So, the American College of Rheumatology is really recommending tocilizumab as our first line steroid-sparing agent at this point. Dr Smith: Outstanding. So again, I will refer our listeners to your article. It's just chock-full of great stuff. This has been a great conversation. Thank you so much for joining me today. Dr De Lott: Thank you, Dr Smith. I really appreciate it. Dr Smith: The pleasure has been all mine, and I know our listeners will be enjoying this as well. Again, today I've been interviewing Dr Lindsey De Lott about her article on optic neuropathies, which appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum Audio episodes from this and other issues. I already mentioned Dr Eggenberger and I will be talking about optic neuritis, which will be a great companion to this discussion. Listeners, thank you for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
Celebrate Nurses Week starting May 6, 2025! Sign up now at ReMarnurse.com/NursesWeek In this engaging video, Professor Regina Callion, MSN, RN, discusses the critical NCLEX safety points regarding aneurysms. We'll explore what an aneurysm is and why it's crucial for nursing students to understand this topic. Discover the various types of aneurysms, including cerebral, abdominal, and thoracic, and learn how to identify high-risk individuals who need immediate attention. We'll dive into the underlying causes, such as genetic factors and lifestyle choices, and look at the diagnostic tests used, like CT scans and MRIs. You'll also gain insights into management options ranging from monitoring to surgical interventions, along with essential nursing priorities for patient care. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ►NCLEX V2 Free Trial - http://ReMarNurse.com/free ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription
Katy Perry, Gayle King and 4 other women have taken a quick trip to space. Full body MRIs: good or bad.
Celebrate Nurses Week starting May 6, 2025! Sign up now at ReMarnurse.com/NursesWeek In this engaging video, Professor Regina Callion, MSN, RN, discusses the critical NCLEX safety points regarding aneurysms. We'll explore what an aneurysm is and why it's crucial for nursing students to understand this topic. Discover the various types of aneurysms, including cerebral, abdominal, and thoracic, and learn how to identify high-risk individuals who need immediate attention. We'll dive into the underlying causes, such as genetic factors and lifestyle choices, and look at the diagnostic tests used, like CT scans and MRIs. You'll also gain insights into management options ranging from monitoring to surgical interventions, along with essential nursing priorities for patient care. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ►NCLEX V2 Free Trial - http://ReMarNurse.com/free ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription
Celebrate Nurses Week starting May 6, 2025! Sign up now at ReMarnurse.com/NursesWeek In this engaging video, Professor Regina Callion, MSN, RN, discusses the critical NCLEX safety points regarding aneurysms. We'll explore what an aneurysm is and why it's crucial for nursing students to understand this topic. Discover the various types of aneurysms, including cerebral, abdominal, and thoracic, and learn how to identify high-risk individuals who need immediate attention. We'll dive into the underlying causes, such as genetic factors and lifestyle choices, and look at the diagnostic tests used, like CT scans and MRIs. You'll also gain insights into management options ranging from monitoring to surgical interventions, along with essential nursing priorities for patient care. Don't forget to like, comment, and subscribe for more informative content on nursing and healthcare topics. Download the ReMar V2 App: ►For iOS: https://apps.apple.com/us/app/remar-v2/id6468063785 ►For Android: https://play.google.com/store/apps/details... ► Find JOBS: http://ReMarNurse.com/jobs ► NCLEX for Africa - http://ReMarNurse.com/KENYA ► Get NCLEX V2: http://www.ReMarNurse.com ►NCLEX V2 Free Trial - http://ReMarNurse.com/free ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ ► Subscribe Now on YouTube - http://bit.ly/ReMar-Subscription
Got a super cute pup or kitty? I chat with the creator behind The Oreo Cat on how to make your pet a social media superstar — and even make a little cash doing it. Plus, scientists clone direwolves (kind of), and AI is outpacing doctors on MRIs.
Connect with the Hosts! Dr. Charlie Website Instagram Membership Nurse Lauren Website Instagram Email List Amazon StoreFront Membership E-Book on Natural Remedies Check out our website: https://www.redpillyourhealthcast.com/ Welcome back to Red Pill Your Healthcast! Dr. Charlie Fagenholz and Nurse Lauren Johnson are tackling listener-submitted health questions. This week, we dive into: Risks of MRIs and Ultrasounds Gallstones Transitioning Toddlers Drinking Raw Milk Vaccine Boosters Stinky Feet Mentioned Supplements & Tools: Shop VerVita Supplements Shop Supreme Supplements Lauren's Fullscript: https://us.fullscript.com/welcome/naturalnursemomma Dr. Charlie's Fullscript: https://us.fullscript.com/welcome/cfagenholz MRI & Ultrasound: QT Imaging: https://www.qtimaging.com/ Dr. Connealy: https://cancercenterforhealing.com/team/dr-leigh-erin-connealy-md/ Cancer Screening Podcast: https://open.spotify.com/episode/4fFJBHkadv27DFDLoZrVaB Cancer Revolution Podcast with Dr. Leah Connealy: https://open.spotify.com/episode/1ge5TcpXxa2I2HPt93zAus?si=0O02AAVGQv-5FXpuGFLoNQ Gallstones: Smidge Digestive Enzymes- Shop in Fullscript Gallbladder Post : https://www.instagram.com/p/CuejQrmr-fa/?igsh=b3hnemNkdmdsc2cy Check the Gallbladder Video available In The Trenches membership (cancel at anytime) Body Guard Supreme: Shop Here CellCore Tudca: Shop Here Standard Process Phosfood Liquid Shop in Fullscript Golden Thread Supreme: Shop Here Melia Supreme: Shop Here Morinda Supreme: Shop Here Vaccine Boosters: H2 Molecular Hydrogen- Shop in Fullscript Check the Vaccine Video available In The Trenches membership (cancel at anytime) Check the Vaccine Information available Nurse Lauren's Membership (cancel at anytime) The Elephant in the Room - Part One: https://podcasts.apple.com/us/podcast/the-elephant-in-the-room-part-one/id1645517159?i=1000579672491 The Elephant in the Room - Part Two: https://podcasts.apple.com/us/podcast/the-elephant-in-the-room-part-two/id1645517159?i=1000579672567 The Elephant in the Room - Part Three: https://podcasts.apple.com/us/podcast/the-elephant-in-the-room-part-three/id1645517159?i=1000580452630 Stinky Feet: Fringe Magnesium Powder: Shop Here Use code Charlie10 for 10% off Melia Supreme: Shop Here Ver Vita Klenz + : Shop Here VerVita Black Cumin Oil: Shop Here Majistha Supreme: Shop Here Schisandra Supreme: Shop Here Search full library of our favorite supplements - Shop VerVita Supplements Shop Supreme Supplements Lauren's Fullscript: https://us.fullscript.com/welcome/naturalnursemomma Dr. Charlie's Fullscript: https://us.fullscript.com/welcome/cfagenholz Thanks for listening y'all!
The crew heads to the iconic clay courts of Monte Carlo, swapping stories of fast cars and what makes the tournament feel like a blend between a Grand Slam and a luxury getaway. From Sam's quarterfinal run to unexpected off-court adventures, they unpack the beauty, chaos, and quirks of one of tennis's most picturesque—and unpredictable—events.Things heat up with a Monte Carlo Trivia, as the guys team up in a desperate attempt to cover up just how little they actually know about the tournament's history. From wild guesses to accidental brilliance, it's a hilarious ride through Rafa stats, surprise American finalists, and a few facts that might have been made up on the spot.The episode wraps with the Part 2 of Reilly Opelka interview. The NextGen Servebot reflects on injury recovery, court fashion, and shares his controversial take on doubles—before stepping into the Hot Seat for a round of rapid-fire questions.(00:00) Welcome to the show!(01:03) Sam's Friday rant: Road bikers are the worst(05:32) Monte Carlo memories: One-time wonders & quarterfinal magic(10:57) Why Americans skip Monte Carlo (and love Houston)(12:11) Supercars, casinos & Davis Cup in Monaco(14:57) Jack's regret: Never playing Monte Carlo(18:00) Monte Carlo trivia time: Rafa, history & some wild guesses(23:18) Mailbag: Which U.S. city deserves a pro tournament?(26:09) Do we overrate American tennis players?(27:02) Opelka interview Part 2: Injury, MRIs & the Yes Man World Tour(31:28) Tennis is cooler now?(35:04) Fashion icons on tour(38:03) What tennis needs(39:43) The doubles debate: “Get rid of it?”(44:53) Met Gala picks: Opelka's dream invite list(47:08) Wrap-up + fan shoutouts(48:03) Fan roast time + goodbye! Hosted on Acast. See acast.com/privacy for more information.
Does a new low-cost home screening evaluation for cognitive impairment pass the smell test? It's never too late to build social networks that prevent dementia; Study yields surprise findings on marriage's impact on cognitive decline; Senate hearing calls for reinstatement of full-fat milk in school lunches—as science overturns assumption dairy's saturated fat promotes cardiovascular disease; Top cardiologist explains how novel supplement (Vitality) incorporates 7 key cardioprotective nutraceuticals.
In this episode, we're joined by Dr. Anjali Malik, a board-certified, fellowship-trained breast imaging radiologist and passionate women's health advocate. Together, we tackle the most common questions women ask about breast imaging—straight from the OB/GYN office.From the differences between mammograms, ultrasounds, and MRIs, to when and why you need each one, Dr. Malik breaks it all down with clarity and compassion. We also dive into breast density, risk factors, and how to advocate for your breast health with confidence.
In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Valérie Biousse, MD, who served as the guest editor of the Continuum® April 2025 Epilepsy issue. They provide a preview of the issue, which publishes on April 3, 2025. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Biousse is a professor in the departments of neurology and ophthalmology, as well as the Reunette Harris Chair of Ophthalmic Research, at Emory University in Atlanta, Georgia. Additional Resources Read the issue: Neuro-ophthalmology Subscribe to Continuum®: shop.lww.com/Continuum More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @vbiouss 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 subscribing to the journal, listening to verbatim recordings of the articles, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Valerie Biousse, who recently served as Continuum's guest editor for our latest issue on neuro-ophthalmology. Dr Biousse is a professor in the departments of neurology and ophthalmology at Emory University in Atlanta, Georgia where she's also the Renette Harris Chair of Ophthalmic Research. Dr Biousse, welcome and thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Biousse: In addition to what you just mentioned, I would like to highlight that I have a French accent because I was born and raised and went to medical school in France in Saint Pete Pierre, where I trained as a neurologist. And I even practiced as a stroke neurologist and a headache specialist in the big university in Paris before I decided to move to the US to pursue my passion, which was really neuro-ophthalmology. And at the time, it was impossible to get a license in the US, so I had to repeat a residency and became an ophthalmologist. And this is what led me where I am today. Dr Jones: We're fortunate that you did that. I'm glad you did all that extra work because your contributions to the field have obviously been magnificent, especially this issue, which I think is an incredibly important topic for neurologists. This is why we include it in the rotation of Continuum topics. We all know the saying that the eyes are the windows to the soul, but for neurologists they are also the windows to the brain. The only part of the CNS that's visible to us is the optic disc. I think in spite of that, I think neurologists, our readers and our listeners would acknowledge the importance of the ophthalmic exam and respect the importance of that aspect of the neurologic exam. It's an area that feels challenging to us, and many of us, even with lots of years of experience, don't always feel very comfortable with this. So, it's a really important topic and I'm glad you have edited this. And let's start off with, you know, as you've reviewed all these articles from, really, the pinnacle experts in their specific topics in neuro-ophthalmology, as you were editing this issue, Dr Biousse, what would you say is the one biggest, most important practice-changing message about neuro-ophthalmology you would want to convey to our listeners? Dr Biousse: I think its technology, advances in technology. Without any doubt. The ophthalmology world cannot evaluate a patient anymore without access to fundus photography, optical coherence tomography (OCT) of the back of the eye, not just the optic nerve, but the retina. These advantages in technology have completely changed the way we practice ophthalmology. The same applies to neuro-ophthalmology. And these techniques can really help neurologists do a basic eye exam. Dr Jones: So, let's get right into that. And I'm glad you started with that because I still feel, even though I've done it thousands of times, I still feel a little fumbly and awkward when I'm trying to examine and fundus through an undilated pupil, right? And so, this is I think where technology has helped us quantitate with, as you mentioned, OCT, but I think from an accessibility perspective, I think nonmydriatic fundus photography is a very interesting tool for neurologists and non-neurologists. Tell us how, how does that work and how could neurologists implement that in their practice? Dr Biousse: It's a very important tool that of course neurology should be able to use every day. You can take fundus photographs of the back of the eye without dilating the pupil. The quality of the photographs is usually very good. You only have access to what we call the posterior pole of the eye, so the optic nerves and the macula and the vascular arcade. You don't see the periphery of the retina, but in neuro-ophthalmology or neurology you don't need access to the periphery of the retina, so it doesn't matter. What is remarkable nowadays is that we have access to very highly performing fundus cameras which can take pictures through very, very small pupils or in patients of all ages. You can use it on a two-year-old in a pediatric clinic. You can use it on a much older person who may have a cataract or other eye problems. And what's really new and what this issue highlights is that it's not just that we can take pictures of the back of the eye, we can also perform OCT at the same time using the same camera. So, that's really a complete game changer for neurologists. Dr Jones: And that's extremely helpful. If I'm in a neurology clinic and I would like to use this technology, how would I access that? Do I need special equipment? Can I use my smartphone and an app? How would that work in terms of getting the image but also getting an interpretation of it? Dr Biousse: It all depends on what your ultimate goal is. The fundus cameras, they are like regular cameras or like any technology that would allow you to get brain imaging. The more sophisticated, the better the quality of the image, the more expensive they are. You know, that's the difference between a three-tesla MRI and a head CT. You buy a camera that's more expensive, you're going to have access to much easier cameras and to much higher resolution of images, and therefore you're going to be much happier with the results. So, I always tell people be very careful not to get a tool that is not going to give you the quality of images you need or you may make mistakes. You basically have two big sorts of cameras. You have what we call the tabletop cameras, which is a little more bulky camera, a little more expensive camera that's sitting on the table. The table can be on wheels, so you can move the table to the patient or you can move the patient to the table. That's very convenient in a neurology clinic where most patients are outpatient. It works in the emergency department. It's more difficult at bedside in the hospital. Or you can have a handheld camera, which can be sophisticated, a device that just uses a handheld camera or, as you mentioned, a small camera that you place on your smartphone, or even better, a camera that you can attach to some of the marketed direct ophthalmoscopes. In all situations, you need to be able to transfer those images to your electronic medical records so that you can use them. You can do that with all tabletop cameras, most handheld cameras; you cannot do it with your smartphone. So that gives you an idea of what you can use. So yes, you can have a direct ophthalmoscope with a little camera mounted. This is very inexpensive. It is very useful at bedside for the neurologists who do- who see patients every day, or the resident on call. But if you really want to have a reliable tool in clinic, I always recommend that people buy a tabletop camera that's connected to the electronic medical record. Dr Jones: You know, the photos always make it so much more approachable and accessible than the keyhole view that I get with my direct ophthalmoscope in clinic. And obviously the technology and the tools are part of the story, but also, it's access to the expertise. Right? There are not many neuro-ophthalmologists in the world, and getting access to the experts is a challenge, I think, everywhere, everywhere in the world really. When you think about how technology can expand that---and here I'm getting at AI, which I hesitate to bring up because it feels like we talk about AI a lot---are there tools that you think are here now or will be coming soon that will help clinicians, including neurologists, interpret fundus photography or other neuro-ophthalmologic findings, maybe eye movements, to make that interpretation piece a little more accessible? Dr Biousse: Absolutely. It's going to happen. It's not there yet. OK? I always tell people, AI is very important and it's a big part of our future without any doubt. But to use AI you need pictures. To get pictures, you need a camera. And so I tell people, first you start with the camera, you implement the camera, you incorporate the camera in your electronic medical record. Because if you do that, then the pictures become accessible to everyone, including the ophthalmologist who's maybe offsite and can review the pictures and provide an official interpretation of the pictures to help you. You can also transfer those pictures using secure mode of transfers and not your smartphone text application, which you really don't want to use to transfer medical information. And that's why I insist on the fact that those pictures should definitely appear in the patient's medical record. Otherwise you're going to break HIPAA laws, and that's an issue that comes up quite often. Once you have the pictures in the electronic medical record and once you have the pictures in the camera, you can do three things. You can look at them yourself. And many of my neurology colleagues are very competent at declaring that an optic nerve is normal or an optic nerve is swollen or an optic nerve is pale. And very often that's all we need. You can say, oh, I don't know about that one, and page the ophthalmologist on call, give the patient 's medical record number, have them look at the pictures, provide an interpretation, and that's where you have your answer. And this can be done in real time, live, when you're at bedside, no problem. Or you can use AI as what I call “Diagnostic A.” I always compare it as, imagine if you had a little robot neuro-ophthalmologist in your pocket that you could use at any time by just taking a picture, clicking submit on the AI app. The app will tell you never, it's normal or it's papilledema or it's pale. The app will tell you, the probability of this optic disk of being normal is 99% or the probability that this is papilledema. And when I say papilledema, I mean papilledema from rest intracranial pressure that's incredible as opposed to optic disc edema from an optic neuritis or from an ischemic optic neuropathy. And the app will tell you, the probability that this is papilledema is eighty six percent. The probability that it's normal is zero. The probability that it's another cause of disc edema is whatever. And so, depending on your probability and your brain and your own eyes, because you know how to interpret most fundus photographs, you really can make an immediate diagnosis. So that is not available for clinical use yet because the difficulty with the eye, as you know, is to have it have a deep learning algorithm cleared by the FDA. And that's a real challenge. But many research projects have shown that it can be done. It is very reliable, it works. And we know that such tools can either be either incorporated inside the camera that you use---in which case it's the camera that gives you the answer, which I don't think is the ideal situation because you have one algorithm per camera---or you have the algorithm on the Cloud and your camera immediately transfers in a secure fashion the images to the Cloud and you get your answer that way directly in your electronic medical record. We know it can be done because it happens every day for diabetic retinopathy. Dr Jones: Got it. And so, it'll expand, and obviously there has to be a period of developing trust in it, right? Once it's been validated and it becomes something that people use. And I get the sense that this isn't going to replace the expertise of the people that use these tools or people in neuro-ophthalmology clinics. It really will just augment. Is that a fair statement? Dr Biousse: Absolutely. Similar to what you get when you do an EKG. The EKG machine gives you a tentative interpretation, correct? And when the report is “it's normal,” you really can trust it, it's normal. But when it says it's not normal, this is when you look at it and you ask for a cardiology consultation. That's usually what happens. And so, I really envision such AI tools as, “it's normal,” in which case you don't need a consultation. You don't need to get an ophthalmology consultation to be sure that there is no papilledema in a patient with headache, in a patient with possible cerebrospinal fluid shunt malfunction. You don't need it because if the AI tool tells you it's normal, it's normal. When it's not normal, you still need the expertise of the ophthalmologist or the neuro-ophthalmology. The same applies to the diagnosis of eye movement. So that's a little more difficult to implement because, as you know, to have an AI algorithm, you need to have trained the algorithm with many examples. We have many examples of pathology of the back of the eyes, because that's what we do. We take pictures every day and there are databases of pictures, there are banks of pictures. But how many examples do we have of abnormal line movement in myasthenia, of videos or downbeat nystagmus? You know, even if we pulled all our collections together, we would come up with what, two hundred examples of downbeat nystagmus around the world? That's not enough to train an AI system, and that's why most of the research on eye movement right now is devoted to creating algorithm that mimic abnormal eye movements so that we can make them and then train algorithm which job will be to diagnose the abnormal eye movement. There's an extra difficult step, it's actually quite interesting. But it's going to happen. You would be able to have the patient look at the camera on the computer and get a report about “it's normal” or “the saccades, whatever, are not normal. It's most likely an internucleosomal neuralgia” or “it is downbeat nystagmus.” And that's not, again, science fiction. There are very good groups right now working on this. Dr Jones: That's really fascinating, and that- you anticipated my next question, which is, I think neurologists understand the importance of the ocular motor exam from a localizing perspective, but it's also complex and challenging. And I think that's certainly an area of potential growth. And you make a good point that we need some data to train the models. And until we have these tools, Dr Biousse, that will sort of democratize and provide access through technology to diagnosis and, you know, ultimately management of neuro-ophthalmology disorders, we know that there are gaps in the care of these patients right now in the modern day. In your own practice, in your own work at Emory, what do you see as the biggest gap in practice in caring for these patients? Dr Biousse: I think there is a lack of confidence amongst many neurologists regarding their ability to perform a basic eye exam and provide a reliable report of their finding. And the same applies to most ophthalmologists. And that's very interesting because we have, often, a large cohort of patients who are in between the two specialties and are getting a little bit lost. The ophthalmologist doesn't know what to do. The neurologist usually knows what to do, but he's not completely sure that it's the right thing to do. And that's where the neuro-ophthalmologist comes in. And when you have a neuro-ophthalmologist right there, it's fantastic, okay? We bridge the two specialties, and we often just translate what the ophthalmologist said to the neurologist or what the neurologist said to the ophthalmologist and suddenly everything becomes clear. But unfortunately, there are not enough neuro-ophthalmologists. There is a definite patient access issue even when there is a neuro-ophthalmologist because not only is there a coverage heterogeneity in the country and in the world, but then everybody is too busy to be able to see a patient right away. And so, this gap impairs the quality of patient care. And this is why despite all this technology, despite the future, despite AI, we teach ophthalmologists and neurologists how to do a neuro-op examination, how to use it for localization, how to use it to increase the value and the power of a good neurologic examination so that nothing is missed. And I'm taking a very simple example. Neurologists see patients with headaches all the time. The vast majority of those headaches are benign headaches. 90% of headache patients are either migraine or tension headache or analgesic abuse headaches, but they are not secondary headache that are life threatening or neurologically threatening. If the patient has papilledema, it's a huge retina that really should prompt immediate workup, immediate prevention of vision loss with the help of the ophthalmologist. And unfortunately, that's often delayed because the patients with headaches do not see eye doctors. They see their primary care providers who does not examine the back of the eye, and then they reach neurology sometimes too late. And when the neurologist is comfortable with the ophthalmoscope, then the papilledema is identified. But when the neurologist is not comfortable with the ophthalmoscope, then the patient is either misdiagnosed or sent to an eye care provider who makes the diagnosis. But there is always a delay in care. You know, most patients end up with a correct diagnosis because people know what to do. But the problem is the delay in appropriate care in those patients. And that's where technology is a complete life-changing experience. And, you know, I want to highlight that I am not blaming neurologists for not looking at the back of the eye with a direct ophthalmoscope without pharmacologic dilation of the pupil. It is not possible to do that reliably. The first thing I learned when I transitioned from a neurologist to an ophthalmologist is that no eye care provider ever attempts to look at the back of the eyes without dilating the pupils because it's too hard. Why do we ask neurologists to do it? It's really unfair, correct? And then the ophthalmoscope is such an archaic tool that gives only a very small portion of the back of the eye and is extraordinarily difficult to use. It's really not fair. And so, until we give the appropriate tools to neurologists, I don't think we should complain about neurologists not being reliable when they look at the back of the eye. It's a major issue. Dr Jones: I appreciate you giving us some absolution there. I don't think we would ask neurologists to check reflexes but then not give them a reflex hammer, right? So maybe that's the analogy to not dilating the pupil. So, for you and your practice, in our closing minutes here, Dr Biousse, what's the most rewarding thing for you in neuro-ophthalmology? What do you find most rewarding in the care of these patients? Dr Biousse: Well, I think the most rewarding is the specialty itself. I'm a neurologist at heart. This is where my heart belongs. What's great about those neuro-ophthalmology patients is that it is completely unpredictable. They are unpredictable. They can have anything. I am super specialized because I'm a neuro-ophthalmologist, but I am a general neurologist and I see everything in neurology. So my clinic days are fascinating. I never know what's going to happen. So that's, I think, the most rewarding part of my job as an neuro-ophthalmologist. I'm having fun every day because it's never the same, I never know what's going to happen. But at the same time, we are so useful to those patients. When you use the neuro-ophthalmologic examination, you really can provide exquisite localization of the disease. You're better than the best of the MRIs. And when you know the localization, your differential diagnosis is always right, always correct, and you can really help patients. And then I want to highlight one point that we made sure was covered in this issue of Continuum, which is the symptomatic treatment of patients who have visual disturbances from neurologic disorders. You know, a patient with chronic diplopia is really disabled. A patient with decreased vision cannot function. And being able to treat the diplopia and provide the low vision resources to those patients who do not see well is extremely important for the quality of life of our patients with neurologic disorders. When you don't walk well, if you don't see well, you fall. When you're cognitively impaired, if you don't see well, you are very cognitively impaired. It makes everything worse. When you see double, you cannot function. When you have a homonymous anopia, you should not drive. And so, there is a lot of work in the field of rehabilitation that can greatly enhance the quality of life of those patients. And that really covers the entire field of neurology and is very, very important. Dr Jones: Clearly important work, and very exciting. And your enthusiasm is contagious, Dr Biousse. I can see how much you enjoy this work. And it comes through, I think, in this interview, but I think it also comes through in the articles and the experts that you have. And I'd like to thank you again for joining us today for a great discussion of neuro-ophthalmology. I learned a lot, and hopefully our listeners did too. Dr Biousse: Thank you very much. I really hope you enjoyed this issue. Dr Jones: Again, we've been speaking with Dr Valerie Biousse, guest editor of Continuum's most recent issue on neuro-ophthalmology. Please check it out, 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 this 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.
Lauren Rosenberg, a highly experienced Physician Associate, has dedicated nearly two decades to Internal Medicine and Health Optimization. Driven by a passion for preventative care, Lauren founded Vent Health to shift the focus from disease treatment to prevention. She specializes in a personalized approach that blends genetics, epigenetics, biomarkers, and lifestyle factors to tailor health interventions that extend and optimize each patient's health span. Lauren's practice includes prescribing peptides (GLP, CLP/GIP) for weight loss, insulin resistance, pre-diabetes, etc. This episode concentrates on all the questions about GLP's, the prescription based Ozempic and others, as well as the Compound Pharmacy GLP's that can often times be less expensive. Heather and Lauren also cover the common side effects, and how to manage them. In this episode you will learn other health benefits of these peptides, and who can benefit from them as well as practical tips for getting started on GLP-1 Therapy. Lauren is a frequent speaker at the Age Management Medicine Group (AMMG) and the American Academy of Anti-Aging Medicine (A4M) conferences. Lauren's practice includes Cardiology prevention: Diagnostics and AI analysis to detect dangerous plaque and calcium; advanced lipid testing and cardiovascular genetics Longevity biomarkers: DNA methylation for biological age, VO2 max testing, Telomere health; Therapeutic plasma exchange Cancer prevention: methylated DNA screens, preventative MRIs, tumor marker testing. We will have Lauren back to discuss all these other longevity and optimum health subjects. This episode concentrates on the information pertaining to Peptides, GLP's etc as they are so popular right now. If you want to contact Lauren for more info, you can reach her via her site: https://myventhealth.com and go to the contact page. Or email: vent@myventhealth.com Social Media: IG: https://www.instagram.com/iamheathert/ You Tube: https://youtube.com/@iamheathert?si=ZvI9l0bhLfTR-qdo Learn more about your ad choices. Visit megaphone.fm/adchoices
Thom Thornton is joining me this week for a conversation about his first rod and learning from everyond around, streamers, working as a woodchuck, MRIs and claustrophobia, soccer coaching, his start to steelheading, fly tying, competitive casting, baseball, dam removal, and so much more.
What happens when a legendary NFL team partners with a tech giant to fuel regional innovation?In this episode of The TechEd Podcast, host Matt Kirchner sits down with Jill Enos, Managing Partner at TitletownTech — the one-of-a-kind venture firm backed by the Green Bay Packers and Microsoft. Jill unpacks how TitletownTech is redefining early-stage investing by embedding startups directly into industry, education, and community. From AI labs and autonomous robotics to sustainable agtech and nuclear fusion, Jill reveals how the Midwest is quietly leading a new era of tech-driven economic development.Listen to learn:How TitletownTech blends NFL roots with global tech leadership to drive innovationWhy Microsoft chose Wisconsin for its new $3.3B data center and AI Co-Innovation LabWhat makes the Midwest the perfect launchpad for startups solving real-world problemsHow venture-backed founders are tackling challenges in energy, logistics, and healthcareWhy exposure to problems — not solutions — is the secret to educating tomorrow's innovators3 Big Takeaways from this Episode:Public-private partnerships can fuel real innovationTitletownTech was founded through a unique partnership between the Green Bay Packers and Microsoft, later joined by 25+ corporate investors like Schneider, Kohler, and AT&T. This model provides startups with not only capital but direct access to strategic partners, industry leaders, and market feedback that accelerates growth.The Midwest is a powerful engine for emerging technologiesTitletownTech has invested in over 30 companies, including Realta Fusion (nuclear energy), Fork Farms (agtech), GenLogs (freight intelligence), and Cobionics (healthcare robotics). Microsoft's $3.3 billion data center in Mount Pleasant and the launch of the AI Co-Innovation Lab in partnership with UW-Milwaukee are cementing Wisconsin's place as a tech and AI hub.Solving the right problem matters more than having the right answerJill Enos emphasizes that successful founders are “obsessed with the problem” rather than fixated on one solution — a mindset educators should instill in students. Startups like Springbok Analytics, which uses AI to create digital twins of MRIs, thrive by iterating solutions through real-time market feedback and strategic industry partnerships.Resources in this Episode:Learn more about TitletownTech: https://www.titletowntech.com/Partnerships mentioned in this episode:AI Co-Innovation Lab (UWM + Microsoft + TitletownTech)Microsoft Data Center (listen to our conversation with Microsoft VP Mary Snapp)Dive deeper into some of TitletownTech's portfolio companies that were featured in this episode:Fork Farms - Indoor hydroponicsCobionix - Heathcare robotics & autonomous ultrasoundsGenLogs - Freight intelligenceRealta FusWe want to hear from you! Send us a text message.Instagram - Facebook - YouTube - TikTok - Twitter - LinkedIn
In this episode, Steph discusses the power of moments. She reflects on the concept of 'pit moments' and how they can be transformed into more positive experiences. Through the story from a book by Dan Heath about a GE designer Doug Dietz and his innovative approach to redesigning MRI experiences for children, she emphasizes how we as humans have the ability to reimagine difficult situations and change someone's entire experience. Steph talks candidly about how it can be challenging to accept help from other during low times, but encourages listeners to embrace both giving and receiving support, highlighting the ripple effects of kindness and connection.Chapters00:00 The Power of Moments00:56 Facing Challenges: A Personal Journey08:01 Reimagining Experiences: Transforming Pit Moments09:43 The Importance of Support and Connection
Dr. Natalie Crawford discusses uterine factor infertility, emphasizing the importance of understanding uterine development and potential abnormalities. She explains various uterine anomalies, including unicornuate, bicornuate, and uterine septums, and their impact on fertility. Dr. Crawford highlights the significance of proper diagnostic tools like saline sonograms and MRIs for accurate detection. She addresses common issues such as polyps, fibroids, and adenomyosis, and their effects on fertility. Want to receive my weekly newsletter? Sign up at nataliecrawfordmd.com/newsletter to receive updates, Q&A, special content and my FREE TTC Starter Kit and Vegan Starter Guide! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today! Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/aaw to start Ritual or add Essential For Women 18+ to your subscription today. Air Doctor - Go to AirDoctorPro.com and use promo code AAW to get UP TO $300 off today! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode of Creators Podcast, hosts Sarah Dandashy and Jeff Morris sit down with Kevin Peake, the co-founder and president of Next Health, the trailblazing health optimization and longevity center that started right here in West Hollywood. From pioneering biomarker testing to cutting-edge services like stem cell therapy, full-body MRIs, and therapeutic plasma exchange, Kevin shares how Next Health is changing the game in preventative wellness and personal health data. He talks about their mission to make wellness both cool and accessible, their roots in West Hollywood's trendsetting culture, and how they've grown from a single location to a rapidly expanding global brand. We also dive into Kevin's entrepreneurial journey, what makes West Hollywood the perfect launchpad for wellness innovation, and how Next Health empowers people to take control of their health before problems arise. Whether you're wellness-curious or already deep into the optimization lifestyle, this episode is packed with insight, inspiration, and some seriously futuristic health talk.
Gadolinium contrast agents used in MRIs can cause severe toxicity in 1 out of 10,000 people, leaving patients with debilitating symptoms often misdiagnosed as other conditions. Dr. Richard Semelka, a world-renowned expert in MRI safety and gadolinium toxicity, exposes the alarming reality behind gadolinium deposition disease (GDD). This condition has left countless patients struggling with brain fog, burning skin pain, stabbing bone pain, muscle spasms, and chronic fatigue—often without answers from their doctors. In today's episode, Dr. Semelka explains how gadolinium toxicity happens, the warning signs to watch for, and the treatment protocols that work. He shares why traditional medicine is so slow to recognize this condition, the shocking prevalence of misdiagnoses, and how you can protect yourself from unnecessary gadolinium exposure. Plus, learn how chelation therapy with DTPA can help remove this toxic metal and why certain supplements and lifestyle changes can support your body's recovery. "There are people with gadolinium toxicity who have been admitted to mental health facilities as inpatients. ~ Dr. Richard Semelka In This Episode: - Dr. Semelka's background and experience with GDD - How gadolinium enters the body and MRI concerns - Alternatives to gadolinium contrast scans - Key symptoms of gadolinium deposition disease - Who's most vulnerable to gadolinium toxicity - Treatment options and chelation therapy - Why chelation requires multiple sessions - Managing side effects of chelation - Anti-inflammatory supplements that help - Commonly misdiagnosed conditions - Patient stories and success with treatment For more information, visit https://www.myersdetox.com Ready to detox heavy metals? Take the quiz: http://www.heavymetalsquiz.com Resources Mentioned: Purity Woods Age-Defying Dream Cream: Get 27% off with code WENDY at: https://puritywoods.com/wendy Puori PW1 Whey Protein: Get 20% off with code WENDY at: https://puori.com/wendy About Dr. Richard Semelka: Dr. Richard Semelka is a world-renowned expert in MRI safety and medical imaging. As the leading authority on gadolinium toxicity, he ranks in the top 0.05% of scholars worldwide in his field (ranked #10 in MRI and #14 in medical imaging by Scholar GPS). Dr. Semelka treats patients with gadolinium toxicity from around the world and has pioneered effective chelation protocols. His work at gadtrack.org has helped thousands understand and address gadolinium deposition disease. Learn more at https://gadttrac.org or contact Dr. Semelka at https://www.richardsemelka.com/ Disclaimer The Myers Detox Podcast was created and hosted by Dr. Wendy Myers. This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast, including Wendy Myers and the producers, disclaims responsibility for any possible adverse effects from using the information contained herein. The opinions of guests are their own, and this podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guests' qualifications or credibility. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.
Bad knees can feel like a roadblock to living your best life, but modern treatments and techniques can offer real solutions. Whether you're exploring the cutting-edge possibilities of PRP injections, weighing up the benefits of physical therapy, or curious about the latest in meniscus repair, this episode breaks down the pros, cons, and science behind today's knee health strategies. Listen and learn: Why exercise is crucial to healing and long-term joint health Surgical, injection, and other options to consider The confusing paradox of MRIs and scans ABOUT OUR GUEST Dr. Daniel K. White is an Associate Professor in Physical Therapy at the University of Delaware and an expert in knee osteoarthritis and rehabilitation. Like the Show? Leave us a review Check out our YouTube channel
In this episode, hosts Dr. Erin Faules and Dr. Jeff Graham dive deep into advanced testing methods that detect health risks before they become life-threatening. They highlight cardiovascular disease prevention, cancer screening, and metabolic health monitoring, emphasizing how new tools like Cleerly heart scans, full-body MRIs, and CGMs can transform modern healthcare. The conversation also covers VO2 Max, Dexa scans, and epigenetic testing, offering listeners a data-driven approach to optimizing health and longevity.
Full-body MRIs. Red light therapy. Vitamin B12 supplements. Seemingly every day, there's a new wellness fad taking over the internet. But how do we know which health claims are backed by science – and which are just hype? In this episode of Everyday Better, we're demystifying the latest health and wellness trends with medical journalist Dr. Trisha Pasricha. Trisha discusses the pros and cons of magnesium supplements, breaks down the science behind ‘leaky gut syndrome' and sets the record straight on seed oils. She also answers listener questions about cortisol, glucose monitoring and more. If you liked this episode, your next listen should be this one: The Number One Predictor of a Long and Happy Life with Dr. Robert Waldinger.
Renee improved CIDP, gastroparesis, anxiety, depression, migraines, eczema, and perimenopausal symptoms. Instagram: @eatingmeattowalk YouTube: @eatingmeattowalk Timestamps: 00:00 Trailer 01:14 Introduction 05:34 Overcoming setbacks with IVIG treatment 09:53 Healing with carnivore diet 13:36 Medication weaning and lifestyle changes 15:12 Drug company influence and desperation 18:22 Normal EMG results discussion 21:38 Diet regret: harmed husband's health 26:09 Choosing health over heart risk 29:11 Reevaluating veganism and health 30:16 Veganism and misdiagnosed grip issues 34:16 Oncology: a revolving door experience 36:50 Struggles with suicide and anxiety 40:41 Vaccination experience and COVID challenges 44:54 Demyelination and nerve recovery process 48:31 Carnivore diet for chronic illness 51:57 Diagnostics beyond MRIs 52:51 Where to find Renee Join Revero now to regain your health: https://revero.com/YT Revero.com is an online medical clinic for treating chronic diseases with this root-cause approach of nutrition therapy. You can get access to medical providers, personalized nutrition therapy, biomarker tracking, lab testing, ongoing clinical care, and daily coaching. You will also learn everything you need with educational videos, hundreds of recipes, and articles to make this easy for you. Join the Revero team (medical providers, etc): https://revero.com/jobs #Revero #ReveroHealth #shawnbaker #Carnivorediet #MeatHeals #AnimalBased #ZeroCarb #DietCoach #FatAdapted #Carnivore #sugarfree Disclaimer: The content on this channel is not medical advice. Please consult your healthcare provider.
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