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Best podcasts about msk

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Latest podcast episodes about msk

The Words Matter Podcast with Oliver Thomson
The Clinical Reasoning Series – Navigating uncertainty with Dr Nathalia Costa

The Words Matter Podcast with Oliver Thomson

Play Episode Listen Later May 19, 2022 68:29


Welcome to another episode of The Words Matter Podcast.So we are up to the 8th episode of the Clinical Reasoning Series and on today I'm speaking with Dr Nathalia Costa about clinical uncertainty. Nathalia is a Brazilian physiotherapist who completed PhD studies in Australia used mixed-methods to investigate the nature of low back pain flares (see here). This PhD work was won the Lumbar Spine Research Prize awarded by the Society for Study of the Lumbar Spine in 2021 (see Nathalia's other research here).Nathalia is currently working as a Postdoctoral Research Fellow at the Universities of Queensland (UQ) and Sydney (USyd) investigating how both clinicians and people with low back pain navigate uncertainty during clinical encounters. And as such we speak about her work investigating uncertainty and talk around a paper, she and her colleagues published this year titled 'Uncertainty in low back pain care – insights from an ethnographic study', published in the journal Disability and Rehabilitation (see paper here) and a previous podcast on ethnography here with Dr Fiona Webster here).So on this episode we speak about: What uncertainty is and allude to the different ways and taxonomies used to describe it. Different sources of uncertainty and use the ambiguous nature of low back pain as an exemplar. The ways that we as clinicians might neglect uncertainty or attend to it. How we often seek to reduce uncertainty through the use of clinical reasoning or the application of evidence for examples through clinical guidelines. We talk about how an intolerance to uncertainty may prompt binary thinking and cause us to retreat to the comfort of the biomedical model and biomedical thinking. Occasions when we really do want to be certain as we can possibly be, and that there may be some ethical and therapeutic merit in communicating this to our patients. How uncertainty with low back pain is imbued with emotions – on both patient and clinician's part. How clinicians may emphasise uncertainty to patients, intentionally or unintentionally and the resulting impact that this might have on the balance of power within the relationship And we reflect on ways that clinicians better navigate uncertainty. So this was another brilliant conversation. Uncertainty, whether we like it or not surrounds and often defines our clinical work and is the omnipresent elephant in the clinical room and lives of our patients. Nathalia's work provides some crucial insights into the slippery and uncomfortable nature of clinical uncertainty which can allow us to reflect on how it make us and our patients feel and consider how we react in the face of it.As always, I have linked Nathalia's paper in the show notes, but please look out for a follow up paper which adopts a theory-driven post-qualitative approach to explore clinicians' experiences navigating uncertainty when working with patients with low back pain (see podcasts here on post-qualitative research here and here).Find Nathalia on Twitter @nathaliaccosta1Support the podcast and contribute via Patreon hereIf you liked the podcast, you'll love The Words Matter online course and mentoring to develop your clinical expertise  - ideal for all MSK therapists.Follow Words Matter on:Instagram @Wordsmatter_education @TheWordsMatterPodcastTwitter @WordsClinicalFacebook Words Matter - Improving Clinical CommunicationFind Nathalia on Twitter @nathaliaccosta1★ Support this podcast on Patreon ★

ASCO eLearning Weekly Podcasts
Oncology, Etc. – Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 2)

ASCO eLearning Weekly Podcasts

Play Episode Listen Later May 17, 2022 30:03


In the second of this two-part conversation Drs. Patrick Loehrer and David Johnson sit down with Dr. Deborah Schrag, the current Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center to continue the discussion of her roles as a leader, researcher, oncologist, public health expert, and more. If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.     TRANSCRIPT Dr. Dave Johnson: Hi everyone, welcome back to Oncology, Etc. an ASCO educational podcast. My name is Dave Johnson. I'm at UT Southwestern Medical Center in Dallas. And I'm here with my good friend Dr. Pat Loehrer who serves as a director of Global Oncology and Health Equities at Indiana University. In the second half of our conversation with Dr. Deborah Schrag, the current chair of Medicine at Memorial Sloan Kettering Cancer Center in New York. In part one, we heard about Dr. Schrag's early life and background, as well as the importance of affordable cancer care and much more. Let's jump back into the conversation and hear about her current goals and initiatives at Memorial Sloan Kettering. I have a question for you. Jumping ahead a little bit. But I mean, you're such a role model for all of us. But you're now in a very powerful position as head of medicine at the preeminent cancer center in the world. So, I'd be interested in knowing what are your top initiatives? What did you come to this role wanting to do short-term and long-term? I'd be curious to hear from you about that. Dr. Deborah Schrag: Yeah. So, I have lots of specific initiatives, all the things that are probably very similar across medical cancer centers. We have to figure out the role of immuno-oncology. We have to figure out the role of CAR T-cell Therapy. There are lots of specific things, but let me tell you about three sort of overarching principles and things that I think we need to think about. So, one of the reasons why I decided to leave my job where I really focused on training researchers and building a research program to lead a department of medicine that has a mix of clinicians, educators, and investigators is that there's really a profound sense of exhaustion and disconnection. I'll use the word even burnout or people get the sense of losing the joy in the practice of medicine. And as corny as it sounds, and I know I'm going a little corny here, Dave. But I really want to help bring back and connect people to the joy in the practice of medicine. It's the joy that we experience when we crack a tough case, when we help a patient, when our patients make us laugh, when our patients and their families make us cry, when they drive us bananas, when they cook us food that is inedible, just reconnecting us to the joy, to the stories. I really wanted to try to be a different kind of leader because I felt that I could make a contribution to the field of academic medicine in general and oncology in particular, by working with faculty to set them up to tap into that joy, because I know they all started with it. I know they all went into medicine because they care about those human stories, because they do want to make a difference. This past week, a fellow intern of mine who you may know, passed away. His name was Paul Farmer. He was the head of Partners in Health and he was an infectious disease physician. There's a book about him by Tracy Kidder that's really moving. There's also a documentary about him called, Bending the Arc, which I would highly recommend. Paul was an incredible inspiration, just incredible, but he brought so much joy to the practice of medicine. I remember when Paul was going to some of the poorest places on the planet, specifically Cange, Haiti. He got an idea that he needed to bring chemotherapy because there were large cancers that were untreated. And he wanted to get leftover chemotherapy from the Dana-Farber. So, in the 1990s, when I was a fellow, he would ask me whether I could get him any leftover Taxol. I was like, ‘Paul, I can't do that. It's not safe. You can't take leftover Taxol to Cange'. And he said, ‘Deb, just wait, the drugs will be oral soon, and then I'll get it'. But guess what? Paul came back to me in 1999, and capecitabine had been approved. The oral equivalent of 5-FU. He held my feet to the fire. He said, ‘Every time you have a dead patient, if there's any leftover capecitabine, I want you to get it for me'. Inspirational leadership, connecting people to the joy in the practice of medicine. I would say that's number one. There's no one simple formula or way to do that. It's hard work. It requires a team I think a lot more teamwork into the practice of medicine. I think we're coming out of a hard two years where we've been confined to Zoom boxes. But it's a lot easier when we can sit together in a room and have a pizza and a beer on a Friday afternoon. But we have to figure this out, and we will, step by step. The other big thematic area, I think, has to do with the patient experience. Dave, I mean, when I started out as a fellow, patients with advanced lung cancer were living for 10 months, 10-12 months, that was a pretty good run with advanced metastatic non-small cell lung cancer. Well, these days, it's 2-3 years, and there's even quite a tale of patients who were living 4-5 years. And that is a long journey. It's no longer the 800-meter sprint, it's a half marathon, turning into a marathon and even an ultra-marathon. So, the way we deliver care needs to change. So, we're really rethinking here, how we deliver care. So, as an example of some, if you go back to the 80s and 90s, cancer chemotherapy was something that happened in the hospital. And in the last quarter century, we've transitioned that to an outpatient practice. I think in the next quarter century, we won't transition all of it, but we will transition a lot of it to home. As an example, I'm struck by when patients undergo IVF, they get handed some Lupron and are taught how to self-administer Lupron every day, so they can undergo a fertility cycle. But when those same women get breast cancer, they have to come into the clinic and sit and wait and take half a day off of work to get the same Lupron. The same is true for men with prostate cancer. Why is that? It's because of policies, and it's not safety, it's not patient-centered. So, I think we have an opportunity to change the patient experience. I think we'll be able to give immunotherapy at home, and HER-2 agents at home. We have to do the trials and make sure that it's safe, but we have to make cancer care more patient-centric and improve the experience. And that's just essential when it's a marathon that we're asking our patients to run, not these 12-month sprints. Families need this also. So, those are a few of the challenges that I want to take on. Joy in medicine, patient experience, and of course, the physician-scientist pathway needs to be strengthened. Dr. Pat Loehrer: I love it. You can imagine between Dave and me, I think that resonates so much about having joy in medicine. I've not heard other people talk about that, but I really think that's an important vocation. But I'm going to ask you something else too because, in the efforts of being joyful and being a role model for that, there's the other side of it, where you can't actually let your hair down, and really be depressed, if you will, or down because you can't let the other side see that. And so, who do you lean on if you will, your confessor that you can talk to when you're feeling down when you're trying to fight the anti-joy part of your job? Dr. Deborah Schrag: I have lots of friends outside of medicine. And I've always found that that's really helpful to make time for friends outside of medicine. They help connect me to humor and other things. I'm coming up on a big high school reunion. My high school classmates and I still meet for picnics in Central Park. And there are about 120 in our graduating class. And I think we'll have about 110 of us getting together. We still have picnics with 40-50 people attending. So, there's nothing like old friends from childhood who now do all kinds of different things. So, that's really helpful. But I've also found that my mentors and colleagues who trained me and who know me really well, are a great source of advice. So, leaders in academic medicine, and I've always found that I've been able to get advice from people who were senior and leaders, people such as Dr. Mayer, Dr. Benz, Dr. Jim Griffin, and also junior colleagues. I now increasingly as I get old, I rely more and more on my trainees and my mentees. So, some of the folks I know best are people who I trained. So, I'll just give you one example. Many of you may know Ethan Basch. We worked together when we were both just coming up. I was an assistant professor. He was a couple of years behind me. I mentored him. Well, he's now chief of the Division of Oncology at UNC. He and I have written lots of grants together. We're really partners now. But it's been a lifelong professional friendship. Sometimes when I just need to let my hair down, I get on the phone with Ethan, and yeah, there's a little bit of commiserating. But I'll give you an example that runs through Dave. Some really valuable experiences had to do with being asked to serve on committees. I think it's great. I just want to give a shout-out to ASCO. Some of my earliest professional relationships were with superstars that I met through ASCO. So, people like Joe Simone, reading his Simone's Maxims everyone needs to read Simone's Maxims if you haven't. There was a guy by the name of Christopher Desh, who sadly passed on. But he was an ASCO member who practiced at the Virginia Commonwealth University back in the late 1990s. Boy, did that guy understand the joy in medicine, some of the early folks who started QOPI. Being introduced to those individuals who practiced in different parts of the country and who had different kinds of challenges - having that sort of rich network has been incredible. At some point, I think through such a connection, maybe it was through Dr. Mayer, I was referred to Dr. Johnson, who was then running the American Board of Internal Medicine committee that wrote the oncology exam. I participated in that for a few years that was led by Dr. Johnson. And I met incredible people on that committee, including Dr. Johnson, just Dr. Johnson's stories could inspire anyone and get them back on track just in terms of the humor and the joy and the love, and really the pride in the profession. But I met Jamie Von Roenn that way, who's now leading educational efforts at ASCO, she was on that committee. Lynn Schuchter became a good friend of mine as a result of that. So, I would just say, sometimes you need to get out of your own space. And sometimes I need to get out of Dodge, as they say, I need to get out of New York, get out of Boston, and being connected to colleagues across the country has been so rewarding. I have a network of friends at other institutions who I rely on. Serving on external advisory boards is a great place to meet people. Study section, if anyone has the opportunity to be on study section. That's a fabulous opportunity. So, I think participating in peer review, showing up at meetings, serving on ASCO committees, or ASH or AACR. These are really important experiences. And I will say in my leadership role, I'm really trying to make it clear to faculty that I encourage them to take time to participate in these activities and attend these events and even travel because the traveling is important, too. I could not have gotten the same dose of Dave Johnson, if I had not actually gone to the meeting, spent all day writing board review questions, and then having a nice meal afterward. That was part of the experience. I don't know what you would say, Dave, but that was my view. Dr. Dave Johnson: So, one of the things that Osler talked about was the fellowship of the profession, and how important it is to have those relationships. Even if one can't physically be with that individual, developing that spiritual relationship is really critically important. I'm so glad you brought this up and expanded on it in the way you did because I think it's absolutely critical to retain the joy of medicine. It's our colleagues, as well as our patients that make it such a marvelous, majestic profession, in my view. Dr. Pat Loehrer: I was going to just add something if I could. So, Deb, replace me on the ABIM, just to let you know, because we had certain slots on there. One of the not sure if it was the rules or guidelines that were mandated is that everyone needed to take the oncology boards, even though we wrote the questions, we had to take the test. And you knew that and you had such unbridled enthusiasm for this. I still remember this deeply, and that not only did you recertify for the oncology board, but you also studied to take the medicine boards too. Your love of medicine is so contagious. And I'm sure everyone at Memorial benefits from this. Dr. Deborah Schrag: Thank you. That's very nice to say. I do, I love the stories. I've been rounding with the house staff on the inpatient service. I think both of you know, inpatient oncology, as we're able to do more and more in the outpatient setting, our inpatients are very, very sick. And we often get a front-row seat to what I would call the social determinants of health challenges. In other words, if you've got relatives and resources, you may be able to be at home. But if you have severe pain or symptoms, and you lack the relatives, or you live on a fifth floor, walk-up, or just don't have the resources to get the home care that you need, you're more likely to be in our hospital. But as I round with the house staff, I find myself asking them to tell me more about the patient stories. Because when I round and they tell me that it's a 74-year-old with peritoneal carcinomatosis, jaundice, and abdominal pain. I'm so old that I've seen so many hundreds of those patients and the management hasn't changed very much. But what's really the privilege is to understand the journeys that got people where they are, and to learn a little bit about who these people are. I try to do that when I round with house staff and I find that it makes the experience better for them. I have to say that I do worry about how we train young physicians in oncology because what they see on the inpatient side is really the hardest of the hard, that's obviously less true in a leukemia service, where they're delivering lots of curative therapy or a stem cell transplant service. But in solid tumor oncology, it's really hard. I think it's something we have to have to tackle. We have to rethink education and medical oncology. I'm hoping that we're going to do that. That's also on the bucket list, by the way. I think we have to do that as a profession. And I know both of you are passionate champions and advocates for education, as is ASCO. But I think it's really imperative that we do that if we are to keep attracting talent. And then I just want to make one more point, which is that New York City is one of the most diverse places in the United States. I don't know about the planet, because I don't know the whole planet. But in the United States, we are incredibly diverse. But the oncology workforce does not yet look like that. So, we have a lot of work to do to train a much more diverse workforce. We're doing well with respect to gender, very well. We're literally about 50/50, we may even have a little bit higher proportion of women on the faculty here at MSK. And I think that's true nationally as well. But with respect to Blacks and Hispanics, and other underrepresented communities, Native Americans, we've got a long way to go. And we have a pipeline problem. And that's going to be hard. But it's hard work that we have to do, and I know you guys are working on that in your own centers as well. Dr. Dave Johnson: Let me follow up on that. What attributes are you looking for in trainees and newly hired faculty? Whether they be junior or senior faculty? What are the characteristics or attributes you seek that you think predict, or certainly you want your individuals to possess? Dr. Deborah Schrag: We all want people who have everything, but I would say creativity, the willingness to take risks, and the ability to ask a question. I say this to the trainees, frankly, I say it to my own children as well. ‘It's okay, take a harder course. Yes, you may get a B minus by trying something new and different, that doesn't play to your strengths. But try something new. Take risks. Yes, the trial may fail. Yes, you may not get that grant.' But I think a willingness to take risks, a willingness to put yourself out there, a willingness to stretch. I'm also looking for people who can work in teams because there is no aspect of medical care that happens in MSK, I suspect that it's also true that maybe medicine in Antarctica, but even medicine in Antarctica is probably a team sport. Medicine has become a very complicated team sport. It's a very complicated dance with pharmacists, nurses, and APPs. It takes a village to give a course of immunotherapy. It is very complicated. And so, when people like to control things and like to do everything themselves, they're going to have a hard time. And that's true I find for teaching, laboratory investigation, wet lab, dry lab, most good, impactful, important science in oncology these days, clinical trials, wet, dry, all of it gets done in teams. Teams that have people with different levels of training, different skill sets, early stage, late stage, people who are quantitative, people who can write, people who can program, people who can do lab experiments, and people who know what an organoid is. People who know how to program an in R. All different kinds of skill sets but they have to be able to work in teams. People who can't do that are going to struggle to achieve maximum impact. I'm not saying that there isn't room at the end for the occasional genius person who likes to work solo. But that's not really what we need to move the needle. So, I need team players. I think there is a big emphasis on collegiality. Of course, we want smart and we want brilliance. But sometimes a drop less brilliance and a drop more collegiality and being able to work together in a team, it goes a long way and it's the difference between doing something impactful and not. That's what I look for. I also think that it takes all different kinds of people. And no one has to excel at everything, but it's great for people to be able to excel at something. So, passion, drive, and ability to ask questions, and not being afraid to occasionally fail and having some tolerance for that and trying to make sure that leaders are able to tolerate that, too. We have to be able to. Dr. Dave Johnson: Yeah, I think those are great suggestions. We're getting near the end of our time today, and we have a lot more questions to ask. But what's your biggest fear, as the head of the Department of Medicine, looking to the future, what causes you to lose sleep at night? Dr. Deborah Schrag: I think the business of medicine. If medicine turns into something that feels just like [inaudible] work, and losing physicians, if we don't respect physicians' need to take care of themselves, to take care of their families, and yeah, to find that joy, then we will not attract the top talents. I think we need great minds and great hearts and people from all walks of life to enter the profession, because that's the talent that we need, to quote my friend, Paul Farmer, ‘Bend the arc'. And you know, we need to bend Kaplan-Meier curves in the right direction. And we need the talent to come into the profession, and if they see that we are not happy and not thriving, the next generation is going to go elsewhere. I don't want to begrudge my wonderful endocrinology colleagues. We need people to tackle diabetes, and we need great surgeons and great anesthesiologists, too. So, it's not just oncology. In medicine, I'm responsible for all kinds of discipline. And boy, we need a lot of cardio-oncologists because we've created all kinds of new challenges. So, it's all of the sub-disciplines of medicine, but I think physician well-being and attracting talent to the field is really essential and making sure that the business side of medicine doesn't take over and destroy the core promise and premise of academic medicine. It is a spectacular profession and calling, and it has led to so many advances that have really changed the world. And we have to, I think, preserve the good in that. My fear is that that gets further eroded. Dr. Pat Loehrer: Just one last question from me. Thank you for all your wonderful comments. But I think I have to ask this because it's such an unusual thing as they brought up at the beginning that you're the first female Head of Medicine at Memorial and Lisa DeAngelis is the first Physician in Chief. And so, although there is gender equity in medicine, there is not gender equity and leadership around the academic world. And this is a very unique situation there. Can you reflect a little bit about the significance of this and perhaps, lessons learned, particularly if you're speaking to a younger version of yourself or a young woman who's thinking about a career? What are the lessons between you and Dr. DeAngelis mean? Dr. Deborah Schrag: I'm not sure I've been at it long enough to have lessons. I'm just so grateful. So, I'm not in the generation that was a trailblazer. I'm a beneficiary. So, I've had the privilege of being trained by Dr. Jane Weeks, by Dr. Judy Garber. I, myself, had so many great mentors who were women. I would say to women, that you can have it all. You just may not be able to have it all at once. Women and men have to make choices. Can you have a lab and be a laboratory investigator? Yes. Can you do that and have a family? Yes. I think running a high-power lab and having a gigantic clinical practice and running clinical trials, I think the three-legged stool and the so-called triple threat is really, really hard. But I think it's hard for women and men. What I would also say to women is you don't have to be the boys - be yourself. I think the best advice I can give to leaders is to be authentic. Because everyone, men, women, people smell a phony and no one likes to phony. So, I think if you know how to partner, you understand that it's a team sport. I think women do that really well. So, I think being authentic, and I think women need to hear that, you don't have to emulate male role models. You have to be yourself. I would love to emulate the two of you. I have to thank both of you because the Indiana Miracle and Dave from his Vanderbilt days, Vandy, as Dave likes to call it, from his Vanderbilt days to his Texas days, like, the two of you are such incredible thought leaders and inspirational leaders in oncology, but I can't be you. The best we can be is sort of the best version of ourselves but we can be inspired by the great qualities that we see in other leaders and carry a little bit of that with us. So, I think that goes for women and for men. Dr. Pat Loehrer: Thank you! Well said, and I appreciate the thoughts. We've kind of gone through this and we're going to have to wrap it up. One of the questions that we often times ask our visitors is if there's a book that they're reading, a documentary that they're watching, a movie they're seeing, or anything you'd recommend? Dr. Deborah Schrag: That's a good question. So, yes, actually. One of the ways that I learn about leadership that I find, actually a fun way that's both relaxing and educational, is to read a biography. I love reading biographies. I'm going to name two. And these are popular books - for scholars these may not be. First really fun book is ‘The Splendid and the Vile', by Erik Larson. It's a book about Winston Churchill in 1940, and how he has to try to persuade the United States to enter World War Two, but it's really about a particular year in history and Winston Churchill. Dr. Dave Johnson: It's a great book. Dr. Deborah Schrag: It's called, The Splendid and the Vile. I just learned so much about leadership from that book and the decisions that Winston Churchill makes in his bathtub. So, just read that book and think about what Winston Churchill does in his bathtub. I can't lead from my bathtub, I live in a New York City apartment, but that's one. Then more recently, I guess there's a little German theme happening here, is, The Chancellor. It's about the life of Angela Merkel. It's long, I haven't finished it yet. But it's incredible. What a story, East Germany, her leadership style, how she studies chemistry, how she rises. It's a fantastic book. It's called, The Chancellor. So, I will recommend that one. Then the last one, my beloved nephew who's like a son to me. He's about 36 years old, and he has ALS. And he's completely paralyzed. He is on a vent and he has two little kids. But he released a documentary that actually won at the Tribeca Film Festival called, Not Going Quietly, which is about a cross-country trip that he made. He's a pretty inspirational character, despite the fact that my nephew was completely locked in, he communicates only with his eyes. He is living a remarkable life. I think that documentay, I know this is a shameless plug for my nephew, but he's a pretty inspirational character. I don't necessarily agree with 100% of his policy prescriptions and recommendations. But there are lots of ways to make meaning in the world. So, that's another documentary. Dr. Pat Loehrer: That's incredible. Thank you so much for sharing that. I'm going to look it up. People think cancer is the worst thing you can get but there are worse diseases to have. Dr. Deborah Schrag: Yeah, I think this one might change your idea. And then I would also say Paul Farmer's Bending the Arc. I think for young physicians who haven't seen that movie, I would recommend Bending the Arc. Dr. Pat Loehrer: Thank you. Dr. Deborah Schrag: Thank you! It's been great to chat with you. Dr. Pat Loehrer: It's great. So, that's all the time we have for today. And I really want to thank you, Deb, for joining us and for all your insight. It's been wonderful. I also want to thank all our listeners for tuning in to Oncology, Etc. This is an ASCO Education podcast where we'll talk about just about anything and everything, if you've heard. If you have an idea for a topic or guest you'd like to see on the show or a host that you would like not to see on the show, just email us at education@asco.org. Thanks again. And Dave, I just have a riddle for you here. How do you make an octopus laugh? Dr. Dave Johnson: Show him your picture. Dr. Pat Loehrer: Ten-tickles. That's all we have for today. You guys have a good evening. Take care.   Thank you for listening to the ASCO Education podcast. To stay up to date with the latest episodes, please click subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive education center at education.asco.org.   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.

The Physio Matters Podcast
Chewing It Over #250 - ACL Injury Prevention with Tom Jacobs

The Physio Matters Podcast

Play Episode Listen Later May 16, 2022 30:56


Today Tom Jacobs is here so we're Chewing Over what is often considered the holy grail of prevention work in MSK; ACL injury prevention! A serious and often career +/- life changing injury, so where are we with the evidence? Your lunchtime show 12:30-13:00 on Mondays and Fridays with Jack Chew chatting about whatever is topical. Usually healthcare and education, occasionally current affairs, always honest.

The Gestalt Education Show
Clinical Savant Series: Shawn Eno, Pedorthist

The Gestalt Education Show

Play Episode Listen Later May 11, 2022 58:11


As we all know, the orthotic industry is somewhat dirty and custom doesn't always mean custom. We had the opportunity to tour Shawn Eno's lab in Idaho Springs, Colorado, and let me tell you, these things are custom! Shawn Eno has built Brett Winchester's orthotics for the last 15-plus years and is a true artist. The thing that really separates Shawn's orthotics is the communication with the ordering physician. Shawn really wants it to be a collaborative process and expects things like a gait evaluation, static and dynamic posturing of the foot and ankle, and also other MSK issues up the chain. We dove deep into casting, the differences in posting, and when and where orthotics give you the biggest bang for your buck. This is a perfect extension of our conversations with Dr. Tom Michaud and for all of the foot nerds out there! Enjoy! Show Notes Xtreme Footwerks --- Support this podcast: https://anchor.fm/gestalt-education/support

Physiotutors Podcast
Episode 040: Achilles Tendon Rupture with Lizzie Marlow

Physiotutors Podcast

Play Episode Listen Later May 7, 2022 68:03


On this episode of the podcast I talk with Lizzie Marlow, an MSK physiotherapist & educator specialising in lower limbs with special interests in running injuries, lower limb tendinopathies & of course management & treatment of achilles ruptures. We talk about everything surrounding Achilles tendon rupture rehabilitation. From the initial assessment to the rehabilitation - as well as what is important at the initial stages of identifying the rupture (I have unfortunately seen a 1 or 2 missed...) - utilising ultrasound to get the optimal position for the torn tendon to repair as well as decisions on whether or not to operate, then guiding through the rehabilitation process itself! 

Our MBC Life
S04 E10 - ER Progression and Resistance: Causes, Consequences, and Hope

Our MBC Life

Play Episode Listen Later May 5, 2022 64:28


About 80% of breast cancers are ER+, meaning that the cancer cells have estrogen receptors, and estrogen is likely to make them grow. Here's the good news/bad news story for ER+ MBC patients. First, the good news: there are a number of effective medications that either reduce available systemic estrogen or block its ability to stimulate cancer growth. The bad news: over time, ER+ cancers develop resistance to these medications, resulting in cancer progression and signaling the need for a new treatment. Fortunately, there is more good news: the best minds in cancer research are on the case. In this episode, the Our MBC Life team hears from two dynamic MSK oncologists  Dr. Pedram Razavi and Dr. Komal Jhaveri on treatment strategies and the latest research around the problem of endocrine resistance Thanks for listening!More info is available on our website:www.ourmbclife.org Got something to share? Feedback?Email:  ourmbclife@sharecancersupport.orgSend us a voice recording via email or through speakpipe on our website.  Follow us on Facebook, Instagram, and Twitter @ourmbclife.

The Words Matter Podcast with Oliver Thomson
The Clinical Reasoning Series - Should we always give patients the treatments they want? Ethical reasoning with Prof. Clare Delany

The Words Matter Podcast with Oliver Thomson

Play Episode Listen Later May 5, 2022 62:20


Welcome to another episode of The Words Matter Podcast.If you're enjoying the Clinical Reasoning Series and the podcast more generally, please consider supporting the show via Patreon. You can pledge as little as a pound or a couple of dollars per episode. Your support really makes a difference and helps ensure the quality and regularity of the episodes.Following on my previous episodes in the series with Bjørn Hofmann (here and here) where we spoke about the ethics of disease and the moral obligations that flowed from being given a disease label - on this episode we are going to speak more explicitly about clinicians' thinking directed towards ethical problems and the resulting moral judgments they should endeavour to make and the processes which delivers them to those judgments.And so today I'm speaking with Professor Clare Delany. Clare is a Professor in Clinical Education at the University of Melbourne, Department of Medical Education, and a Clinical Ethicist at the Royal Children's Hospital Children's Bioethics Centre and Peter MacCallum Cancer Centre in Melbourne. She also chairs the University of Melbourne Central Human Research Ethics Committee.  Clare's health professional background is in physiotherapy. For the past 15 years, Clare's research and professional work has focused on a combination of clinical education and clinical ethics. Her research interests  include applied health ethics, paediatric bioethics, clinical reasoning, and critical reflection and she has authored more than 100 publications in peer-reviewed journals covering these areas of applied clinical ethics and clinical education.Clare has co-edited the books ‘Learning and Teaching in Clinical Contexts: A Practical Guide' and ‘When Doctors and Parents Disagree: Ethics, Paediatrics and the Zone of Parental Discretion.'So on this episode we speak about: What ethics is in the context of healthcare practice including the ethical principles of autonomy, non-maleficence, beneficence and justice About the interaction and occasional tension between evidence-based practice and ethics-based practice and how ethics can help settle clashes between research evidence, patient values and clinician judgement and experience. What ethical reasoning is and the processes involved In making moral judgements. How it feels to identify an ethical problem which is often intuitive or as Clare describes an ‘ikiness'. Ethical reasoning when the consequences or stakes are high. Communicating risk to patients prior to treatment. Some case examples including patients requesting seemingly ineffective treatments or treatments which the clinician may feel is potentially harmful or not in the patients best interest. How the ethical principles should apply to all healthcare settings, whether public or private but in reality there are differences on how these principles are interpreted and applied in these respective settings. And finally we speak about how ethical reasoning motivates us to be aware of our own assumptions and of the assumptions and values of others which enriches our clinical work and also the therapeutic bond with our patients. So, this was such a wonderful conversation with Clare. She beautifully highlighted the foundational nature yet often prickliness of the ethical dilemmas we all face in practice and shares some extremely useful reasoning strategies to identify, manage and resolve the inevitable ethical moments in our clinical practice.Support the podcast and contribute via Patreon here.If you liked the podcast, you'll love The Words Matter online course and mentoring to develop your clinical expertise  - ideal for all MSK therapists.Follow Words Matter on:Instagram @Wordsmatter_education @TheWordsMatterPodcastTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication★ Support this podcast on Patreon ★

The Run Strong Podcast
Episode 127: It's a runners responsibility to stay injury free, with Joao Luciano

The Run Strong Podcast

Play Episode Listen Later May 4, 2022 58:02


Todays show: Joao is Physiotherapist who graduated from the Escola Superior de Saúde Egas Moniz (ESSEM). He has vast experience in managing musculoskeletal disorders. As a Sports Physiotherapist, he was part of the Medical Department of the major Portuguese rugby team, CDUL, and was also Head Physiotherapist from 2016 to 2019. After graduation he focused on gaining more experience in manual therapy degrees such as Methode Busquet, Mulligan, kinesio and dynamic taping, joint and soft tissue mobilisation and exercise therapies. In the last 3.5 years, he has been practicing in Dubai with MSK and Sports injuries - Assessing and designing rehabilitation, injury prevention and performance enhancement protocols. He encourages an active and effective therapy for long lasting results catered to each individual's needs, and aiming for an improvement in health and performance. Don't forget to rate and review the show! https://podcasts.apple.com/ie/podcast/the-run-strong-podcast/id1483567507 To get in touch please email Endurance@innerfight.com #Therunstrongpodcast From our friends at Precision Fuel and Hydration; · Quick Carb Calculator · Free online Sweat Test · Book a free 20-minute hydration and fueling strategy video consultation · Why do athletes suffer from cramp? · How much carbohydrate do athletes need per hour? · Why sodium is crucial to athletes performing at their best · Which energy products are right for you? Didn't catch the discount code to get 15% off your first order of fuel and hydration products, drop Andy and the team an email at hello@precisionfuelandhydration.com and they'll be happy to help you

ASCO eLearning Weekly Podcasts
Oncology, Etc. – Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 1)

ASCO eLearning Weekly Podcasts

Play Episode Listen Later May 3, 2022 27:10


In part one of a two-part conversation, Drs. Patrick Loehrer and David Johnson sit down with Dr. Deborah Schrag to discuss her roles as a leader, researcher, oncologist and public health expert. The current Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York, Dr. Schrag discusses the joy and passion she has found throughout her career, and more. If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.   TRANSCRIPT Dr. Pat Loehrer: I'm Pat Loehrer. I'm the Director of the Center of Global Oncology and Health Equity at Indiana University. Dr. David Johnson: Yes. And hello, I'm David Johnson. I'm at UT Southwestern in Dallas, Texas. Dr. Pat Loehrer: And welcome to another version of Oncology, Etc. Dr. David Johnson: Yeah, great guest today, before we get started with our guests, though, Pat, what are you reading these days? What can you recommend to me? Dr. Pat Loehrer: Well, I'm reading Jamie Raskin's book, which is about his son and about the insurrection. It's really a wonderful read so far, particularly I think about the family nature and how much he deeply respected his son who unfortunately committed suicide. Dr. David Johnson: Right before one of the impeachment trials as I recall, right? Dr. Pat Loehrer: It was right before the January 6 insurrection. Dr. David Johnson: Yeah, terrible situation. I have a book I've been meaning to recommend for a while. It's one that I've given to all the chief residents I've worked with over the last several years. And today's guests made me think about this book. It's entitled, Osler: Inspirations from a Great Physician. It's written by Charles Bryan, who's the former Chair of Medicine at the University of South Carolina in Columbia. Dr. Pat Loehrer: You trained with Osler, didn't you? Dr. David Johnson: I was a couple of years behind him. He was my senior resident. For anyone who's an Oslerphile, it's a great book to have. But even if you're not, it's got some wonderful lessons to be learned about how to interact with one's colleagues, and a lot of information about leadership, which is why it made me think of today's guest, Dr. Deborah Schrag who we're really excited to welcome to Oncology, Etc. Dr. Schrag is the Chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York. She's a highly accomplished healthcare leader, clinician-researcher, and expert in public health and population science. Deborah received her medical degree from Columbia University and completed her residency in internal medicine at Brigham and Women's. She obtained her medical oncology training at Dana-Farber in Boston and also received an MPH degree from the Harvard School of Public Health. After a brief stint on the faculty at DFCI and Brigham and Women's, she joined the division of gastrointestinal Oncology at Memorial Sloan Kettering, where she was an associate member and Associate Professor of Public Health and Medicine. In 2007, I believe it was, she returned to Dana-Farber and Brigham, where she continued her work focused on improving the delivery, quality, and effectiveness of cancer care. While there, she served as chief of the Division of Population Sciences until this past year when she returned to Memorial to chair the Department of Medicine. I also think she's the first woman to hold this position, but we'll learn about that momentarily. Deb is internationally recognized as a pioneer for her work engaging patients in reporting outcomes as a way to improve care. She has led pragmatic trials using informatics strategies to optimize patient and clinician wellbeing, efficiency and quality, and equity of care. In short, she's a true superstar, leading the department, the major department, in one of the world's foremost Cancer Institutes. Deb, welcome to Oncology, Etc. Thank you so much for accepting our invitation. This is a relatively new oncology podcast, but already, we're known for our incisive, deeply penetrating questions. So, I have a question for you to start off. Do you have any carpentry skills? Dr. Deborah Schrag: Absolutely none whatsoever, Dave. None. Dr. David Johnson: I'm disappointed. It's my understanding that Schrag is German for cross or a slant and people who build cross-legged tables. So, I was hoping, my house was destroyed recently, and I'm looking for replacement furniture, and I was hoping you might be able to help me. Dr. Deborah Schrag: I apologize. But I'm not going to be able to help. The name, you're correct, though, David, is a German name. So, my family does hail from Germany and they made malt, which is the major ingredient in beer. I'm not sure where the name comes from. But they ran malt factories and shipped malt all over to all the beer, before there were craft beer distilleries, that's what they did. Dr. Pat Loehrer: That may come in handy by the end of this podcast, by the way. Dr. Deborah Schrag: Could be. Dr. David Johnson: Well, speaking of your family, tell us a little bit about your background and where you were raised, and your family members. Dr. Deborah Schrag: Sure! I'm glad you asked that because I really have been very influenced by where I grew up. And as I think about it, experiences that go back to first grade got me where I am today. So, I am from New York City. I grew up in Manhattan in the 1970s. And as you may know, that was a pretty rough time in the history of New York, what's often referred to as the 'bad old days', although it didn't feel that way to me. But I started out attending New York City public schools. And at that time in my neighborhood on the Upper West Side of Manhattan, my first-grade class had about 45 students, and one teacher, there were about five or six of us who spoke English, and everyone else was a recent Puerto Rican immigrant. I pretty much sat in the corner and read to myself. Now I didn't stay in the public school system for long, but I saw in first grade, how things weren't fair. And I saw and felt my own privilege, acutely. And even as a little kid, I had that sense. Eventually, my parents transferred me to private school later on. And there were kids in the neighborhood who didn't have the same privileges that I did. But living in New York, you walk around, you're confronted with disparities every day. We still see it today with homelessness on the streets. At that time, there was a lot of alcoholism and the use of drugs. And they were two blocks north that were safe to walk and two blocks east that were not safe to walk. So, this really stuck with me from a very early age. As a student in summer jobs, I worked lots of interesting jobs. I started at 14 scooping ice cream at Baskin Robbins, I worked at a famous Deli in New York called Zabar's, selling coffee. Lots of interesting jobs that I worked during holidays and vacation times. But one of my first jobs was working in an organization called the Floating Hospital, which was a big old ferry boat that circumnavigated Manhattan, and it provided a summer camp. And we would take 1800 people on a boat around Manhattan every day. And my job was to do lead testing. And I learned how to stick kids, test them for lead because there were incredible amounts of lead poisoning in New York City in the early 1980s. And then we would work on tracing the kids and these were toddlers, two-year-old, three years old. There were many families who were living in homeless shelters in New York City in the early 1980s. And that was really the beginning of my interest in public health and inequities. And really the marriage of medicine and public health. That had a deep and long-lasting impression on me and really stayed with me throughout my career. That early experience, I think it propelled me into medicine and to medical school and also to marry medicine and public health. Dr. Pat Loehrer: Tell me a little bit, Deb, about your parents. Dr. Deborah Schrag: Sure! My mother was born in the United States. She was a teacher who many years later after having three children went to law school and she became a litigator. And actually, her boss was Rudolph Giuliani. My father is a child of World War II. He was a child of German Jewish parents who had to flee the Nazis. Probably the most interesting story is that my paternal grandfather was an OB-GYN. So, I am a fifth-generation physician. My paternal grandfather was an OB-GYN at Charité, which is a very famous Hospital in Berlin. He was the head of OB-GYN there in the 1930s. But he had, I think he was half Jewish, and the Gestapo asked him to leave and he had to leave. He was an expert in version, which is essentially flipping babies and the setting of placenta previa. He then left for Lebanon, where he was in the French Resistance and had a thriving OB-GYN practice in Beirut, Lebanon, during World War II. And at night, there was a curfew, and he was part of the resistance and passed secrets around from the Russians to the French, so very dramatic. My father was born in this setting, and arrived as a new immigrant to the United States in the 1940s, where it was very hard to be a child whose parents had a German accent, given the prejudice against Germans at that time, but also went to New York City public schools, had a tremendous opportunity. It's really kind of the classic New York immigrant success story. You know, arrived in the United States with the shirts on their back and managed to work their way to a better life and achieve success and good education through public education for all their offspring. I will also say that my father had a public health stint. He worked in North Carolina as an alternative to going and serving in the Vietnam War, he was in the Public Health Service. And he worked in North Carolina in the textile mills and worked on a disease called byssinosis, which is also known as the brown lung. It's an occupational health disease that affects textile mill workers. As a child, I spent many dinners, hearing about byssinosis and brown lung, and black lung. I think at an early age I really came to understand how the world wasn't fair, and how it was instilled in me early on that it was important to work to try to make things better, particularly for people who didn't have privilege. And I think when you come from an immigrant family, and you realize how much privilege has been bestowed on you, that really leaves an indelible mark. I have to say, as Chair of Medicine at MSK, it is staggering to me the proportion of faculty here at MSK, but also at Dana-Farber, where I worked previously, we have lots and lots of immigrants who've been able to accomplish just amazing things through just motivation and drive and energy and creativity. And so, I'm a big believer in how much immigrants have powered this country. Dr. Pat Loehrer: Deborah, are your parents still alive? Dr. Deborah Schrag: My parents are still alive. They're both in their early 80s. And they both still live on the Upper West Side of Manhattan. So, I'm very privileged and fortunate to have living parents. Dr. Pat Loehrer: I can imagine the pride that they have for you. Dr. David Johnson: I just want to jump in and let our listeners know that Deb mentioned Charité in Berlin. That's the home of multiple Nobel laureates that all of us would know like Ernst Chain, who was one of the individuals involved in the development of penicillin, but Paul Ehrlich, Robert Koch, Hans Krebs, and for cancer doctors, Otto Warburg, among others. So, it truly is a world-renowned institution. Dr. Deborah Schrag: Well, my paternal grandfather was famous for this technique called version, which essentially involves putting your stethoscope next to the uterus, figuring out where the placenta was, and then essentially trying to flip the baby without disrupting the placenta or causing any harm, which required incredible skills with a stethoscope because you had to appreciate, I guess, the placental vessels. I'm not aware that this skill is still in existence, it was an important skill to have in the 1930s. When, if you did a C-section, there was a high probability of endometritis. So, you could save the baby, but you would often lose mom to endometritis. Or you could save mom, but you might not save the baby. So, at that time it was a big deal, but thankfully no longer. Dr. David Johnson: This is why we call it an Oncology, Etc. Our listeners didn't know that we're gonna get OB information in this particular podcast. Dr. Deborah Schrag: Or a digression on the history of medicine. I do find that, you know, I am inspired by the generations that came before me. I think it's also true that there are many physicians who are first-generation physicians in their families and some of us are privileged to have lots of healthcare professionals and sort of feel it as a calling. Dr. David Johnson: I think of you with many, many talents. But one of the things that I think stood out to me is, many years ago, you were in the van, talking about the financial cost of health care. I remember a very influential paper you wrote in the New England Journal, talking about the cost of treating GI cancer, colon cancer in particular. But where did your interest in that particular aspect of health care begin? What was the stimulus there? I mean, obviously you had a lot of stimulus from your family. What else? Dr. Deborah Schrag: That's really interesting. This is a little bit of a history of oncology. At that time, I was an assistant professor and assistant attending in the GI oncology service, seeing lots of patients with colorectal cancer. And we were working on a clinical trial of a drug called ImClone C225. And that was the name of the protocol. And we were putting patients in that clinical trial. And you know what? This drug was working. We were getting excited and the drug was moving ahead. We looked at the Phase 1 data and we launched Phase 2. We had meetings with the research protocol nurse and the research assistants, team meetings, and I would say there were about 50 people who were aware between the GI oncologists and the nurses and all the research assistants. You guys know that it takes a village and even though the villages were smaller then and it wasn't a particularly large trial, there are many, many people involved and everyone had the sense that this drug might be working. Just for context for our younger listeners, this is back in the early aughts, and basically, the drug that we had to treat colorectal cancer was 5-FU in many different formats and Irinotecan. And that was it. Some people thought mitomycin might work a little bit, but it was so horrible that it really barely worked. But that was what we had in our bag of tricks. So, the fact that we had this ImClone drug that eventually came to be known as Cetuximab, was remarkable. So, here's what happened. It turned out that this is the drug made by the company ImClone. And there were some shenanigans, some insider trading. And one of the people caught up in insider trading, in addition to some people involved with the company itself was none other than Martha Stewart, sort of the famous homemaker who still publishes magazines to this day. And you may know that she actually did some time in federal prison as a result of insider trading on this drug. I remember being a junior attending, and all the people involved in the trial and all the cancer professionals, we all knew this was working. But everyone respected the confidentiality of the situation, of the patients, and all the integrity that goes into academic medicine. And I remain inspired by the integrity of all the professionals, the doctors, the residents. These were not affluent people. I can tell you. we were not paying research assistants a whole hunk of money. They investigated every trade made by this company. There were absolutely no shenanigans or improprieties from the hard-working folks who helped bring this drug to market. So, as this was going on, we had many patients who were not eligible for the trial who were interested in getting the trial. So, of course, we followed as this drug got FDA approved and came to market. You could check me but I believe it was February 2004, it was FDA approved. It came out with a huge price tag. It was approximately $10,000 per month. I was mad because I was taking care of regular New Yorkers at that point. I had public school teachers, I had patients on Medicare and they couldn't afford the 20% copay. Because $10,000 a month for Cetuximab, if you have a 20% copay and you're New York City, public school cafeteria worker, is not yet eligible for Medicare with a typical plan that a New York City public school system employee would have, that was $2,000 a month. And that did not work for one of my patients who is essentially what we used to call a lunch lady. I was so mad that I decided to channel that anger into writing what I think is a perspective for the New England Journal called, “The Price Tag on Progress”. I wrote that piece. I know that many, many people and many of my esteemed colleagues have continued to work in that area and do research on the economics of drug pricing and there are many, many experts. I didn't stick with that. Not that it's not interesting, and not that it's not important. It's incredibly interesting and important, but I felt that the solution needed to happen in the legislature, state legislature, federal legislature. I think that this is about social policies, and we need to advocate for appropriate health insurance programs to make it possible for people to get coverage when they have catastrophic illnesses, and we need to think about the entire approach to drug pricing in this country. I still think that's important. I'm not convinced that what we need is more research on the topic. I think we need more policymaking and laws on the topic. I think we're still dealing with this. I'm sad to say that it's been nearly 20 years since I wrote that perspective. But I think it was motivated by frustration, not being able to get my patient what she needed, and many patients thereafter. And just the incongruity between some people benefiting from insider trading and all the good people who were doing the right thing. Dr. Pat Loehrer: I just want to throw in one thing if I can. Len Saltz, who's one of your partners, it was a piece of that trial that he presented at ASCO talking about ImClone C225. And ironically, it had a 22.5% response rate. And Len said, it's a bummer that ImClone didn't call it C995. Dr. Deborah Schrag: You have no idea how often we used to talk about that, joke about that in the clinic. I have another good story about that drug, which I think really illustrates something I believe and I think it's actually something that Osler said but it's also something I have to say I learned from both of you. And it has to do with listening to your patient. So, I had a patient named Matthew, who was a young man, 34 years old. He walked into my clinic with a diagnosis of diffuse metastatic colorectal cancer with multiple bilateral pulmonary metastases, which came to light when his tennis game was off. He was, at that time, an early employee of a newly started company called Google. And he was working on advertising algorithms, and Matt got the drug Cetuximab. And unfortunately, he was on it for quite some time. He was on it for about five or six months. But eventually, it was pretty clear that we were coming to the end of the road. And he and his wife planned a vacation. This was part of his end-of-life process planning. It was their fifth wedding anniversary in the Berkshires. We worked so hard to get Matt to the Berkshires to a beautiful inn, and on Saturday night, my pager goes off, and Matt cannot sit up. He's weak. And he'd been complaining of terrible fatigue for weeks, to me, and I really hadn't quite figured out why Matt was so fatigued. I mean, I just didn't understand it. And we get into this inn and I get a call from the Berkshire Medical Center, a small community hospital, 'Dr. Schrag, your patient is here. He's so weak and he can't sit up.' 'What's going on?' The ER doctor says, 'Well, he has a Chvostek sign', which is a sign of severe hypocalcemia. 'So, call me back with the calcium.' The calcium is low. Well, I think those of your listeners who are closer to medical school know that when the calcium is low, you have to check the mag. And Matt's magnesium was 0.2. And he got some magnesium in the Berkshire Medical Center. And all of a sudden, he felt great. He was able to go on and enjoy the second half of his fifth anniversary weekend at the Berkshire Inn and he came back. And I felt terrible because he'd been complaining to me of fatigue for six weeks and I hadn't checked his magnesium. I was like, 50 bilateral pulmonary metastases on chemotherapy. That's a fatigue explanation. Suffice it to say that we went on to start checking magnesium on everyone getting Cetuximab. Now mind you, the drug is FDA approved and FDA labeled at this point. So, we started checking magnesium, and we find that it was low. I start getting on the phone and calling my mentors. I called Dr. Bob Mayer, who was the head of my fellowship director and was like a revered mentor to me. 'Hey, Bob, does anyone up there in Boston have low magnesium from Cetuximab?' 'We don't check magnesium.' I said, 'But can you check?' I started calling around and that's a great example of the community of oncology. We are a community. I just started working the phones and calling friends and saying 'You guys checking magnesium for any of these folks on Cetuximab?' Suffice it to say, we figured out that their EGFR receptors in the ascending loop of Henle - so, again, back to biology and pathophysiology - the drug Cetuximab was blocking reabsorption of magnesium in the kidney, and it was Cetuximab that caused a terrible magnesium wasting. Oral magnesium did not work. You had to give it intravenously, repeatedly. And we helped eliminate fatigue for a bunch of patients. About six months later, I showed up at ASCO with these little cardboard slides and a little poster back in the corner and put up our little case series, very little. But I'm proud to say that we changed the label of Cetuximab and it's now on the label that it causes hypomagnesemia. It might be one of my more cited papers, paradoxically. But I think it's a principle that really has stuck with me, and I've tried to impart it to all the students and residents and fellows, 'Listen to your patients because - I think it comes from Osler- they're telling you something. We have to pay attention.' Again, I have never forgotten that. But really listening and trying to figure out how we can use our understanding of pathophysiology and what our patients tell us to ask questions and not just accept dogma and try to figure out what we can do. And you know, I couldn't have figured that out on my own. I happened to find a really smart nephrologist who happened to be able to sort of go to animal models and knew the right studies and the right people to talk to. Dr. David Johnson: It's one of the reasons why we are a multidisciplinary specialty. And we use the expertise of our colleagues. I think that's such a wonderful example of listening to one's patient and it really profoundly impacted our understanding of how that drug works and renal physiology, actually. That wraps up part one of our interview with Dr. Deborah Schrag, Chair of Medicine at Memorial Sloan Kettering Cancer Center. We hope you've enjoyed learning about her background and her early career. In part two of our conversation, Dr. Schrag will discuss her programmatic goals at Memorial Sloan Kettering, the importance of mentorship and leadership, and what it means to have joy in the profession of medicine, and, frankly, much more. So, please be sure to join us. As always, we want to thank you for tuning in to Oncology, Etc. an ASCO educational podcast, where we will talk about just about anything and everything. So, if you have an idea for our topic or a guest, please email us at education@asco.org. Unknown Speaker: Thank you for listening to the ASCO Education Podcast. To stay up to date with the latest episodes, please click subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive education center at education.asco.org.   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.

The Medbullets Step 1 Podcast
MSK | Ulnar nerve

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 25, 2022 13:16


In this episode, we review the high-yield topic of Ulnar nerve from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Medbullets Step 1 Podcast
MSK | Bone Formation

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 24, 2022 13:41


In this episode, we review the high-yield topic of Bone Formation from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Medbullets Step 1 Podcast
MSK | Brachial Plexus Lesions

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 23, 2022 13:57


In this episode, we review the high-yield topic of Brachial Plexus Lesions from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Medbullets Step 1 Podcast
MSK | Paget Disease of Bone

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 22, 2022 15:20


In this episode, we review the high-yield topic of Paget Disease of Bone from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Medbullets Step 1 Podcast
MSK | Sjogren Syndrome

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 21, 2022 13:29


In this episode, we review the high-yield topic of Sjogren Syndrome from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Words Matter Podcast with Oliver Thomson
The Clinical Reasoning Series - Narrative ways of hearing and knowing with Sanja Maretic

The Words Matter Podcast with Oliver Thomson

Play Episode Listen Later Apr 21, 2022 58:16


Welcome to another episode of The Words Matter Podcast.In this episode of the clinical reasoning series, I'm speaking with Sanja Maretic. Sanja is an osteopath who works in a non-traditional osteopathic role as a pain clinician in the pain management service.Sanja has a background in humanities and passion for the intersection between healthcare and humanities and as such she published a qualitative study titled “Understanding patients' narratives” A qualitative study of osteopathic educators' opinions about using Medical Humanities in undergraduate education (see paper here). And Sanja wrote a truly captivating review for the CauseHealth book which I have linked here.So on this episode we speak about, Narrative-based approaches and the role and function of narratives in the care of people. Structural competency (see paper here by Metzl and Hansen) as a framework to appreciate the complex social contexts and structures which guide people health, illness and recovery (see paper on narrative humility here by DasGupta). How hearing our patients' narratives enables us to know and see them, the social structures surrounding their lives and environment How narrative analysis can be used to think critically about our practice and the narratives which surround our clinical realities. How incorporating the arts, poetry and humanities into healthcare education will help widen the therapeutic gaze of clinicians beyond the mere biomedical. Sanja's experience of journeying and finding her way into a multidisciplinary pain setting. The notion of ‘listening hands' in relation to touch and palpation in manual therapy and how this may or may not facilitate the construction and understanding of a person's narrative and life-world. This was such a wonderful conversation; Sanja speaks truly as a clinician in the way she passionately describes her work and her endeavour to better understand and the lives of those people she cares for.Find Sanja on Twitter @MareticSanja and Instagram @MareticSanjaSupport the podcast and contribute via Patreon hereIf you liked the podcast, you'll love The Words Matter online course and mentoring to develop your clinical expertise  - ideal for all MSK therapists.Follow Words Matter on:Instagram @Wordsmatter_education @TheWordsMatterPodcastTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication★ Support this podcast on Patreon ★

Cancer Straight Talk From MSK
What's the Hash on the Little Green Plant and Cancer?

Cancer Straight Talk From MSK

Play Episode Listen Later Apr 20, 2022 20:50


What makes a good pain remedy – chemically, mentally, legally? Is it better as an edible, oil or vapor? And how does one even begin to figure out dosing? These are the questions Dr. Diane Reidy-Lagunes explores in this discussion with MSK's Director of Pediatric Integrated Medicine, Dr. Nirupa Raghunathan, and cancer survivor and winner of TV's “Survivor: Africa”, Ethan Zohn. In this episode, Dr. Raghunathan and Ethan break down the chemical components of one of nature's best pain remedies and outline what we still don't know about the little green herb that's going from taboo to commonplace on prescriptions across America. See omnystudio.com/listener for privacy information.

A Healthy Curiosity
Why Acupuncture is the Best for Musculoskeletal Pain

A Healthy Curiosity

Play Episode Listen Later Apr 20, 2022 46:05


The musculoskeletal system sees a lot of both acute and chronic pain issues given our lifestyles today. Acupuncture is a powerful and lasting medicine that can address a wide swath of those painful, mobility limiting conditions in a way that other healing modalities can't. This episode is for you if you have a body, since we all will probably experience some sort of pain in our lives, or if you know someone that's living with a painful condition that's getting in the way of them bring able to do what they love. Dr. Anthony Lombardi joins this conversation to share why acupuncture should be the treatment of choice for many conditions affecting muscles, joints, and tendons. Using neuromodulation, he works in his practice to return the musculoskeletal system to homeostasis. On Today's Episode of A Healthy Curiosity: How Dr. Lombardi's journey to acupuncture began in chiropractic school What advantages he sees in acupuncture compared to chiropractic therapies What motor points are and how they overlap with acupuncture points Why a series of treatments is typically necessary for lasting change Dr. Anthony Lombardi is a 2002 graduate of the New York Chiropractic College and McMaster Contemporary Medical Acupuncture program in Hamilton, Ontario, and has been practicing acupuncture for 19 years. Upon graduation, he founded Hamilton Back Clinic and since then has become a private consultant to athletes in the NFL, CFL, and NHL. Over the past 19 years Anthony has given over 100,000 acupuncture treatments. In addition to practicing, Dr. Lombardi was also an instructor in the Contemporary Medical Acupuncture Program at McMaster University from 2004 to 2013. He developed his EXSTORE® system, which he currently teaches along with motor points and electro-acupuncture, to physicians and practitioners the world over. He regularly writes and contributes articles on motor points in the Canadian Chiropractic and Chiropractic Economics magazines. Dr. Lombardi's library continues to grow, with some 60 webinars available on a variety of MSK and pain conditions, as well as patient practice management topics. He holds live courses throughout the U.S. and Canada, and has a mentorship/education community on dranthonylombardi.locals.com. Links: Dr. Lombardi's Webinars EXSTORE Certification Connect With Dr. Anthony Lombardi: Website Locals Profile Instagram Email -- Learn more about Brodie's Classes and Meditations Enjoying the show?  Help support us and keep the show going with the tip jar!

The Medbullets Step 1 Podcast
MSK | Rickets / Osteomalacia

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 20, 2022 17:56


In this episode, we review the high-yield topic of Rickets / Osteomalacia from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Medbullets Step 1 Podcast
MSK | Brachial Plexus

The Medbullets Step 1 Podcast

Play Episode Listen Later Apr 19, 2022 16:02


In this episode, we review the high-yield topic of Brachial Plexus from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The PMRExam Podcast
Tricyclics Revisited

The PMRExam Podcast

Play Episode Listen Later Apr 18, 2022 18:00


Tricyclics Revisited- Tricyclics and Chronic Pain! Dr. Rosenblum reviews the indications, considerations, side effects, contraindications and treatment of toxicity of these commonly used anti-depressants which are often used to treat chronic pain... The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/Aj2gSk Upcoming Events... ASIPP's 24th Annual Meeting- May 5th-May 7th, 2022! American Society of Interventional Pain Physicians 24th Annual Meeting is organized by ASIPP and will be held from May 5th–7th, 2022 at the Ceaser's Palace in Las Vegas, Nevada. Get Your Tickets to ASIPP's 24th Annual Meeting Register Now! Ultrasound Experts & NRAP's Ultrasound Workshop May 14th, 2022! 1 day workshop for physicians of all levels who treat pain, perform regenerative medicine procedures, joint injections, and nerve blocks. Get Your Tickets to the Advanced Ultrasound Training Workshop! Register Now! Live Webinar Event- May 18th, 2022! How to Implement Digital Health Tools and Billing Codes to Optimize and Grow your Pain Practice The emergence of new CMS codes in the space of remote physiologic monitoring, remote therapeutic monitoring, chronic care management and more offers a unique opportunity for clinicians and practice owners to get reimbursed for bringing digital health tools into their practice. However, if not done correctly, they can increase the clinical and administrative burden and decrease the patient experience. In this webinar, industry experts will explain the details of these codes and the best ways to introduce them into your practice for optimal growth, without taking on additional burden or risk. Register Now! Advanced Pain Board Review Conference Multi Day June 10-12th, 2022 Multi-Day Advanced Pain Board Review Conference- June 10-12th, 2022 This 2-3 day intensive advanced pain board review workshop has been developed for both novices and advanced pain physicians providers who would like to further advance their skills in pain management procedures. Additional 3rd day is for the Advanced Ultrasound Guided Injection Training CME Course. Participants will have up to 5 hours of hands on ultrasound scanning on live models of different body habitus to learn and identify different sono‐anatomy. Get Your Tickets to the Multi-Day Advanced Pain Board Review & Ultrasound Guided Training Workshop! Register Now! ASPN's Annual Conference- July 14th-17th, 2022! American Society of Pain and Neuroscience Annual Conference is organized by ASPN and will be held from July 14th-17th, 2022 at the Loew's Hotel in Miami Beach, FL.   Get Your Tickets to ASPN's Annual Conference Today! Register Now!   Clarius Discount! Click on the following link and you can enter your credit card info, billing and shipping and your code (DARO) for 20% off! https://store.clarius.com/collections/accessories/products/package-2-in-1-charging-station-hd Podcast Resources: Beyond depression: Other uses for tricyclic antidepressants. Joanne Schneider, Mary Patterson, Xavier F. Jimenez Cleveland Clinic Journal of Medicine Dec 2019, 86 (12) 807-814; DOI: 10.3949/ccjm.86a.19005 Moraczewski J, Aedma KK. Tricyclic Antidepressants. [Updated 2021 Nov 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557791/ New Updates- New 1 on 1 Training Service! New Hospital and Medical Network Group Training Program! Exclusive Dr/Medical Professional affiliate program! Leverage Your Social Network! PainExam "Complete" Complete CME Course now available! Subscribe to PMRExam mailing list for Free Board Prep Material & More! * indicates required Email Address * Email Format html text Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos

The PainExam podcast
Tricyclics Revisited

The PainExam podcast

Play Episode Listen Later Apr 18, 2022 18:00


Tricyclics Revisited- Tricyclics and Chronic Pain! Dr. Rosenblum reviews the indications, considerations, side effects, contraindications and treatment of toxicity of these commonly used anti-depressants which are often used to treat chronic pain... The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/Aj2gSk Upcoming Events... ASIPP's 24th Annual Meeting- May 5th-May 7th, 2022! American Society of Interventional Pain Physicians 24th Annual Meeting is organized by ASIPP and will be held from May 5th–7th, 2022 at the Ceaser's Palace in Las Vegas, Nevada. Get Your Tickets to ASIPP's 24th Annual Meeting Register Now! Ultrasound Experts & NRAP's Ultrasound Workshop May 14th, 2022! 1 day workshop for physicians of all levels who treat pain, perform regenerative medicine procedures, joint injections, and nerve blocks. Get Your Tickets to the Advanced Ultrasound Training Workshop! Register Now! Live Webinar Event- May 18th, 2022! How to Implement Digital Health Tools and Billing Codes to Optimize and Grow your Pain Practice The emergence of new CMS codes in the space of remote physiologic monitoring, remote therapeutic monitoring, chronic care management and more offers a unique opportunity for clinicians and practice owners to get reimbursed for bringing digital health tools into their practice. However, if not done correctly, they can increase the clinical and administrative burden and decrease the patient experience. In this webinar, industry experts will explain the details of these codes and the best ways to introduce them into your practice for optimal growth, without taking on additional burden or risk. Register Now! Advanced Pain Board Review Conference Multi Day June 10-12th, 2022 Multi-Day Advanced Pain Board Review Conference- June 10-12th, 2022 This 2-3 day intensive advanced pain board review workshop has been developed for both novices and advanced pain physicians providers who would like to further advance their skills in pain management procedures. Additional 3rd day is for the Advanced Ultrasound Guided Injection Training CME Course. Participants will have up to 5 hours of hands on ultrasound scanning on live models of different body habitus to learn and identify different sono‐anatomy. Get Your Tickets to the Multi-Day Advanced Pain Board Review & Ultrasound Guided Training Workshop! Register Now! ASPN's Annual Conference- July 14th-17th, 2022! American Society of Pain and Neuroscience Annual Conference is organized by ASPN and will be held from July 14th-17th, 2022 at the Loew's Hotel in Miami Beach, FL.   Get Your Tickets to ASPN's Annual Conference Today! Register Now!   Clarius Discount! Click on the following link and you can enter your credit card info, billing and shipping and your code (DARO) for 20% off! https://store.clarius.com/collections/accessories/products/package-2-in-1-charging-station-hd Podcast Resources: Beyond depression: Other uses for tricyclic antidepressants. Joanne Schneider, Mary Patterson, Xavier F. Jimenez Cleveland Clinic Journal of Medicine Dec 2019, 86 (12) 807-814; DOI: 10.3949/ccjm.86a.19005 Moraczewski J, Aedma KK. Tricyclic Antidepressants. [Updated 2021 Nov 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557791/ New Updates- New 1 on 1 Training Service! New Hospital and Medical Network Group Training Program! Exclusive Dr/Medical Professional affiliate program! Leverage Your Social Network! PainExam "Complete" Complete CME Course now available! Subscribe to the PainExam mailing list * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos

The Physio Matters Podcast
Session 100 - Part 1 - The Upper Limb - Debs Stanton and Val Jones

The Physio Matters Podcast

Play Episode Listen Later Apr 17, 2022 51:59


The Physio Matters Podcast Session 100 was 24 hours long!! To help you out a bit we have grouped the guests into topics :) In this first part Debs Stanton discusses the hand and wrist, simple things that MSK clinicians can do, and where the line is with requesting specialist input. This is followed by Val Jones who tells us why if your elbow doesn't work you will probably die and how we make the elbow sexy again! This podcast was raising money for Freehab.co.uk if you enjoy the content and think Jack did amazingly well to live stream for 24 straight hours then please head to the page and donate.

MIB Agents OsteoBites
A Phase 1/2 Study of ZN-c3 Plus Gemcitabine in Relapsed or Refractory Osteosarcoma

MIB Agents OsteoBites

Play Episode Listen Later Apr 15, 2022 55:33


Discussion of a new, early phase clinical trial for patients with metastatic osteosarcoma targeting the DNA damage repair pathway. Dr. Vishu Avutu attained his M.D. from the University of Texas Southwestern Medical School and began his research endeavors with the Pediatric Oncology Education Program at St. Jude Children's Research Hospital; finding a passion for working with adolescents and young adults, Vishu matched to the internal medicine-pediatric residency at Harvard's Brigham and Women's/Boston Children's Hospitals. In addition to serving as Chief Resident, Vishu helped develop and launch the Center for Adolescent and Young Adult Oncology at the Dana Farber Cancer Institute. He then completed his medical oncology fellowship at Memorial Sloan Kettering Cancer Center. He is a co-founder of MSK's Adolescent and Young Adult Oncology Program, where his work has garnered MSK's Patient and Family Centered Care Grant Initiative and the Young Investigator Award from the American Society of Clinical Oncology. He is an assistant attending in the Departments of Medicine and Pediatrics and cares for AYAs with sarcomas.

AnesthesiaExam Podcast
Tricyclics Revisited

AnesthesiaExam Podcast

Play Episode Listen Later Apr 12, 2022 18:00


Tricyclics Revisited- Tricyclics and Chronic Pain! Dr. Rosenblum reviews the indications, considerations, side effects, contraindications and treatment of toxicity of these commonly used anti-depressants which are often used to treat chronic pain... The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/Aj2gSk Upcoming Events... ASIPP's 24th Annual Meeting- May 5th-May 7th, 2022! American Society of Interventional Pain Physicians 24th Annual Meeting is organized by ASIPP and will be held from May 5th–7th, 2022 at the Ceaser's Palace in Las Vegas, Nevada. Get Your Tickets to ASIPP's 24th Annual Meeting Register Now! Ultrasound Experts & NRAP's Ultrasound Workshop May 14th, 2022! 1 day workshop for physicians of all levels who treat pain, perform regenerative medicine procedures, joint injections, and nerve blocks. Get Your Tickets to the Advanced Ultrasound Training Workshop! Register Now! Live Webinar Event- May 18th, 2022! How to Implement Digital Health Tools and Billing Codes to Optimize and Grow your Pain Practice The emergence of new CMS codes in the space of remote physiologic monitoring, remote therapeutic monitoring, chronic care management and more offers a unique opportunity for clinicians and practice owners to get reimbursed for bringing digital health tools into their practice. However, if not done correctly, they can increase the clinical and administrative burden and decrease the patient experience. In this webinar, industry experts will explain the details of these codes and the best ways to introduce them into your practice for optimal growth, without taking on additional burden or risk. Register Now! Advanced Pain Board Review Conference Multi Day June 10-12th, 2022 Multi-Day Advanced Pain Board Review Conference- June 10-12th, 2022 This 2-3 day intensive advanced pain board review workshop has been developed for both novices and advanced pain physicians providers who would like to further advance their skills in pain management procedures. Additional 3rd day is for the Advanced Ultrasound Guided Injection Training CME Course. Participants will have up to 5 hours of hands on ultrasound scanning on live models of different body habitus to learn and identify different sono‐anatomy. Get Your Tickets to the Multi-Day Advanced Pain Board Review & Ultrasound Guided Training Workshop! Register Now! ASPN's Annual Conference- July 14th-17th, 2022! American Society of Pain and Neuroscience Annual Conference is organized by ASPN and will be held from July 14th-17th, 2022 at the Loew's Hotel in Miami Beach, FL.   Get Your Tickets to ASPN's Annual Conference Today! Register Now!   Clarius Discount! Click on the following link and you can enter your credit card info, billing and shipping and your code (DARO) for 20% off! https://store.clarius.com/collections/accessories/products/package-2-in-1-charging-station-hd Podcast Resources: Beyond depression: Other uses for tricyclic antidepressants. Joanne Schneider, Mary Patterson, Xavier F. Jimenez Cleveland Clinic Journal of Medicine Dec 2019, 86 (12) 807-814; DOI: 10.3949/ccjm.86a.19005 Moraczewski J, Aedma KK. Tricyclic Antidepressants. [Updated 2021 Nov 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557791/ New Updates- New 1 on 1 Training Service! New Hospital and Medical Network Group Training Program! Exclusive Dr/Medical Professional affiliate program! Leverage Your Social Network! PainExam "Complete" Complete CME Course now available! Subscribe to the AnesthesiaExam mailing list! * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos

No Gimmicks Needed Podcast
211. FROM SUNNY TO NASH CARTER WTF IS HAPPENING IN WRESTLING THIS WEEK!

No Gimmicks Needed Podcast

Play Episode Listen Later Apr 11, 2022 133:00


Loaded show for you today as we dive into all the drama that has been happening this week. As we said before that Sunny would end up killing someone if she stays on this path and unfortunately that happen. Nash Carter from MSK has been released and the case between him and his wife are pretty messy. Dwayne Johnson has the XFL coming out next year but there us something familiar with that logo, we "wonder" what it is, season 5 of fantasy is over and now we go into season 6. All this and more so come enjoy good wrestling talk with No Gimmicks Needed! JOIN THE COALITION:

Solomonster Sounds Off
Sound Off 751 - TONY KHAN'S BOT INVASION + WHY TAMMY SYTCH DESERVES NO ONE'S SYMPATHY

Solomonster Sounds Off

Play Episode Listen Later Apr 10, 2022 105:40


It was just two months ago that Solomonster wondered if it would take killing someone to wake up Tammy Sytch after being hit with 11 charges in the state of New Jersey.  Sadly, someone has now lost their life as a result of her reckless actions.  He talks about exactly what happened, why she isn't behind bars right now and minces no words in making it clear how he feels about the situation.  He also addresses Tony Khan and his independent study into fake accounts posting, and bots boosting, negative social media posts about AEW.  While that may be true, he didn't come off well in this at all.  Plus, the messy situation involving Nash Carter being FIRED by WWE and MSK being stripped of the NXT tag team titles... Samoa Joe debuts in AEW and the big match announced for him on Dynamite this week... why Cody Rhodes should be the man to dethrone Roman Reigns as champion... WWE set to UNIFY the Raw and Smackdown tag team titles?... WALTER/GUNTHER makes his Smackdown debut with one face mysteriously missing... praise for the Lacey Evans return promo... Rick Steiner as the latest KIDNAPPING victim on NXT... and what is the best post-Wrestlemania edition of Raw?  Get an extra THREE MONTHS FREE with EXPRESSVPN when you visit EXPRESSVPN.COM/SOLOMONSTER and support the Sound Off!

The Pope's Point of View
Post Wrestlemania Edition of Pope's Point of View (Ep:124)

The Pope's Point of View

Play Episode Listen Later Apr 9, 2022 112:20


Pope and Polo Del Mar review the results of Wrestlemania 38, The Raw After Mania, In Da Newz, Tammy Sytch latest run in with the law, MSK's Nash Carter's release from WWE, Samoa Joe's AEW Dynamite Debut, Tim Storm vs Matt Cardona, Pope cashes in and more!

Getting Over: Wrestling Podcast
NXT, AEW: Banger matches, Samoa Joe debuts, Nash Carter released

Getting Over: Wrestling Podcast

Play Episode Listen Later Apr 7, 2022 39:19


NXT looked prepared to set the stage for post-Stand & Deliver storylines but instead reverted much of its booking despite putting on a good show, while AEW purposely showcased a workrate edition of Dynamite after WrestleMania week while setting multiple title matches. Host Adam Silverstein opens with NXT [4:20] where Bron Breakker randomly defended his NXT championship against GUNTHER, Imperium appeared headed for a split, new champions MSK got new tag team title challengers before Nash Carter was released, and the women's tag team belts changed hands again. Next, "The Silver King" dives into AEW [23:30], which featured the TV match of the year in FTR vs. Young Bucks, Samoa Joe debuted on Dynamite, Keith Lee and Powerhouse Hobbs banged meat, Christian Cage and Adam Cole tried to one-up Edge and AJ Styles, and the Hardys were involved in a convoluted tables match. Follow Getting Over on Twitter @GettingOverCast.

Down 4 the Count
NASH CARTER HAS BEEN RELEASED FROM WWE

Down 4 the Count

Play Episode Listen Later Apr 7, 2022 89:25


NASH Carter 1/2 of MSK has been released over abuse allegations and a racially insensitive photo --- Send in a voice message: https://anchor.fm/down-4-the-count/message

Just Pro Wrestling News
WWE Reportedly Releases NXT Tag Champ Nash Carter.

Just Pro Wrestling News

Play Episode Listen Later Apr 7, 2022 3:47


Listen and subscribe at www.JustProWrestlingNews.com Like the show? Support the show and get bonus content at https://www.patreon.com/justprowrestlingnews I'm Matt Carlins and this is JUST Pro Wrestling News for Thursday, April 7, 2022. A special welcome to those of you listening on TheWrestlingRevolution.com. If you want to bring our updates to your website...email us: desk@justprowrestlingnews.com. (STINGER: WWE) WWE has released one-half of the NXT Tag Team Champions. Fightful and Post Wrestling reporting Wednesday that MSK's Nash Carter was let go…following weeks of allegations of domestic abuse and a picture that surfaced online. MSK just won the NXT Tag Titles last Saturday. They were scheduled to defend the titles against Grayson Waller & Sanga on next Tuesday's NXT. Obviously, that won't be happening. The NXT UK Championship is on the line today. Ilja Dragunov defends his title against Roderick Strong. Also on today's episode…Wolfgang vs. Charlie Dempsey and Wild Boar vs. Primate. (STINGER: AEW) Hangman Page will defend the AEW Championship against Adam Cole…on a live episode of Rampage on April 15th…in a Texas Death Match. Cole beat Christian Cage on last night's Dynamite. Thunder Rosa's first defense of her AEW Women's Championship will be at Battle of the Belts II on April 16th…against Nyla Rose. FTR are still the Ring of Honor & AAA Tag Team Champions. They beat the Young Bucks in the main event of last night's Dynamite. Samoa Joe made his AEW debut last night and beat Max Caster to qualify for the Owen Hart Foundation Men's Tournament. Hikaru Shida qualified for the Owen Hart Women's Tournament with a win over Julia Hart. Captain Shawn Dean scored another upset win on Dynamite. He rolled up and pinned Shawn Spears amid the chaos of Wardlow bursting into the arena. The Hardys beat The Butcher & The Blade in a Tables Match. Leyla Hirsch appeared to injure her knee during a match being taped for Dark: Elevation. The match was immediately halted. (STINGER: Impact) Tonight's Impact will feature action from last week's Multiverse of Matches pay-per-view - including the entire match between Speedball Mike Bailey and Alex Shelley. Before the Impact will feature the Knockouts Tag Title 4-way from Multiverse of Matches. Alex Hammerstone will defend the MLW Heavyweight Title against Richard Holliday at MLW's Kings of Colosseum TV tapings in Philadelphia on May 13th. (STINGER: New Japan) Scott Norton is returning to New Japan - and Bullet Club - for a 12-man tag on the Windy City Riot pay-per-view on April 16th. Police in Florida say WWE Hall of Famer Sunny - Tammy Sytch - was involved in a fatal car crash late last month. An investigation is underway. Criminal charges could be coming. That's JUST Pro Wrestling News for Thursday, April 7th. Our next update comes your way tomorrow morning, so be sure to subscribe to this feed. We also thank you in advance for leaving a glowing rating or review.. I'm Matt Carlins. Thank YOU for listening. ~~~Full run down at www.justprowrestlingnews.com ~~~ • • • • • wwe #wrestling #prowrestling #smackdown #wwenetwork #wweraw #romanreigns #ajstyles #NXT #raw #njpw #wwenxt #SethRollins #TNA #johncena #RandyOrton #wrestlemania #ROH #WWF #summerslam #tripleh #aewdynamite #professionalwrestling #aew #allelitewrestling #aewontnt #DeanAmbrose #nxt #KevinOwens #wwesmackdown 

Pro Wrestling Report Today
Nash Carter, Sunny, Dynamite review |PWR Today 4-07-22

Pro Wrestling Report Today

Play Episode Listen Later Apr 7, 2022 28:09


Host the Man they call "Meathead" has joining him once again the M.O.T.S. Matthew Thomas to talk about his WrestleMania experience, Sunny is arrested again with possible manslaughter charges, MSK member released n alleged domestic abuse charges, changes to the main roster plus a review of Dynamite form last night and more for Thursday April 7th 2022   https://store.collarandelbowbrand.com promo code "LindaKay" will save you 10%!

The Words Matter Podcast with Oliver Thomson
The Clinical Reasoning Series - Making the familiar strange - Epistemic reflexivity with Dr Euson Yeung

The Words Matter Podcast with Oliver Thomson

Play Episode Listen Later Apr 7, 2022 42:01


Welcome to another episode of The Words Matter Podcast.A quick note to thank all of you that support the podcast via Patreon, your contributions make a big difference (contribute here).We're about halfway through the clinical reasoning series and today I'm speaking with Dr Euson Yeung. Euson is a physiotherapist and an Assistant Professor in the department of Physical Therapy University of Toronto.His primary area of teaching and research interest is in orthopaedic manual therapy as well as the assessment and facilitation of clinical reasoning among health professional learners. Euson completed his Masters in Education at the University of Toronto (Adult Education) and his PhD with the Rehabilitation Sciences Institute at the University of Toronto.In this episode we hover around a research paper he published year titled ‘Making Strange': Exploring the Development of Students' Capacity in Epistemic Reflexivity published in the Journal of Humanities in RehabilitationSo on this episode we speak about: How the process of reflexivity and in particular epistemic reflexivity calls us to question, or to ‘make strange' the taken-for granted ways in which we practice. We talk about the organizational and social structures which surround healthcare interactions, and the embedded assumptions within our practice. We talk about how reconceptualising practice also entails Imagining other ways of how our practice could be. We talk about the challenges of becoming more enraging in reflexivity. And we discuss ways that clinicians can better support the more reflexive aspect of their practice and thinking. So I really enjoyed talking with Euson; the work he is doing within physical therapy education is fundamental.Support the podcast and contribute via Patreon hereIf you liked the podcast, you'll love The Words Matter online course and mentoring to develop your clinical expertise  - ideal for all MSK therapists.Follow Words Matter on:Instagram @Wordsmatter_education @TheWordsMatterPodcastTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication★ Support this podcast on Patreon ★

Fantasy Bookers
NXT Stand and Deliver

Fantasy Bookers

Play Episode Listen Later Apr 6, 2022 53:13


It is the first big show of Wrestlemania Weekend, as Joe, Tony, Ace, and Marlon all discuss NXT Stand and Deliver. Did Grayson Waller survive the opening ladder match? Why do MSK seem to get little reaction? But most importantly, will Tony ever again join the Dolph Ziggler train? We also talk about the potential of Mandy Rose, LA Knight, and Tony D'Angelo. Meanwhile, we can celebrate Bronn Breakker is now the two-time NXT Champion! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/fantasy-bookers/support

Wharton Digital Health Podcast
V Bento, SWORD Health, on precision musculoskeletal (MSK) care through AI

Wharton Digital Health Podcast

Play Episode Listen Later Apr 5, 2022 50:51


In this episode, we sat down with Virgílio “V” Bento, Founder & CEO of SWORD Health. SWORD Health aims to bring world-class musculoskeletal (MSK) care to patients around the world by connecting members with physical therapists and digital therapists through a member app that combines sensor technology with telemedicine to prevent, relieve, and accelerate the healing of acute conditions, chronic pain, and post-surgical recovery. SWORD Health raised $163M in their latest Series D round led by Sapphire Ventures. This latest fundraising round brings SWORD's valuation at $2B. We discussed Drawing inspiration for the genesis of SWORD Health after V's brother got into a car accident and could not access the high quality physical therapy he needed for a speedy recovery. Delivering precision care through AI that generates personalized care plans for each patient with the guidance of physical therapists. How SWORD Health's proven clinical model, created to address MSK-related issues, could target other conditions in the future.

Just Pro Wrestling News
Late Addition To WrestleMania Sunday Card.

Just Pro Wrestling News

Play Episode Listen Later Apr 3, 2022 5:07


Listen and subscribe at www.JustProWrestlingNews.com Like the show? Support the show and get bonus content at https://www.patreon.com/justprowrestlingnews I'm Matt Carlins and this is JUST Pro Wrestling News for Sunday, April 3, 2022. This update is brought to you by IndyWrestling.us. (STINGER: WWE) It's WrestleMania Sunday tonight at AT&T Stadium in Arlington, Texas. The main event - Universal Champion Roman Reigns vs. WWE Champion Brock Lesnar. It's “winner take all”. RKBro defends the RAW Tag Titles in a 3-way against Alpha Academy and the Street Profits. The WWE Women's Tag Titles are on the line in a 4-way. Carmella & Queen Zelina defend against Sasha Banks & Naomi…Rhea Ripley & Liv Morgan…and Natalya & Shayna Baszler. Also tonight, Sami Zayn vs. Johnny Knoxville in an Anything Goes match…AJ Styles vs. Edge…Bobby Lashley vs. Omos…Austin Theory vs. Pat McAfee… And a late addition to the Sunday card - Kofi Kingston & Xavier Woods and Sheamus & Ridge Holland. It was supposed to happen on Saturday but was cut due to time. WrestleMania Saturday saw ”Stone Cold” Steve Austin wrestle his first match in 19 years. At the age of 57, Austin beat Kevin Owens in a No Holds Barred main event that lasted about 14 minutes. Cody Rhodes is officially back in WWE. He returned…and beat Seth Rollins last night. Rhodes' representatives later announced he has signed a multi-year contract with WWE. Bianca Belair is the new RAW Women's Champion. She got her revenge on Becky Lynch and handed Lynch her first title match loss in nearly two years. Charlotte Flair is still the SmackDown Women's Champion. She handed Ronda Rousey her first singles loss in WWE. The show opened with The Usos beating Shinsuke Nakamura & Rick Boogs to retain the SmackDown Tag Titles. But the big story was Boogs suffering a major leg injury during the match. Michael Cole later announced Boogs suffered a torn quadricep patella. He'll need surgery. The Miz & Logan Paul beat Rey & Dominik Mysterio. After the match, Miz turned on Paul! Also last night, Drew McIntyre beat Happy Corbin. WWE confirmed that WrestleMania 39 next year will be two nights - on April 1st and 2nd. NXT Stand & Deliver on Saturday… Dolph Ziggler is still the NXT Champion. He beat Bron Breakker in the main event. Mandy Rose held on to the NXT Women's Title. She pinned Io Shirai to win a 4-way that also included Cora Jade and Kay Lee Ray. Cameron Grimes is the new North American Champion. He won the title from Carmelo Hayes in a ladder match that also had Solo Sikoa, Grayson Waller, and Santos Escobar. MSK are the new NXT Tag Champs. They dethroned Imperium in a 3-way that also included the Creed Brothers. Tony D'Angelo beat Tommaso Ciampa. This was presented as Ciampa's NXT farewell and Triple H greeted him on stage after the match. Also, Gunther beat LA Knight. More indies are running shows in the Dallas-Fort Worth metroplex on Sunday. Some are even running DURING WrestleMania Sunday. There's a TexasMania show late Sunday night…with Shane Taylor vs. Low Ki on the card. PCO was a late scratch from GCW's Joey Janela's Spring Break 6 Part 2. PCO suffered a shoulder injury during Impact's Multiverse of Matches show Friday night but it's not believed to be serious. Also at Spring Break Part 2… Chris Dickinson beat Matt Cardona and Minoru Suzuki beat Effy. That's JUST Pro Wrestling News for Sunday, April 3rd. Our next update comes your way tomorrow morning, so be sure to subscribe to this feed. We also thank you in advance for leaving a glowing rating or review.. I'm Matt Carlins. Thank YOU for listening. ~~~Full run down at www.justprowrestlingnews.com ~~~ • • • • • wwe #wrestling #prowrestling #smackdown #wwenetwork #wweraw #romanreigns #ajstyles #NXT #raw #njpw #wwenxt #SethRollins #TNA #johncena #RandyOrton #wrestlemania #ROH #WWF #summerslam #tripleh #aewdynamite #professionalwrestling #aew #allelitewrestling #aewontnt #DeanAmbrose #nxt #KevinOwens #wwesmackdown 

Surfing the Nash Tsunami
S3-E17.1 - Potential Breakthrough in Anti-Fibrotic Therapies Through mRNA/CAR-T Combined Therapies

Surfing the Nash Tsunami

Play Episode Listen Later Apr 2, 2022 15:03


Professors Scott Friedman and Neil Henderson join the Surfers (including the returning Stephen Harrison) to discuss some truly exciting advances in the basic science and technology of defining, diagnosing and treating NAFLD and NASH. This conversation focuses largely on mRNA/CAR-T anti-fibrotic therapies.Scott Friedman starts this conversation by reviewing the historical sequence that led to the development of an mRNA vaccine that can create CAR-T cells in mice for the express purposes of attacking fibrotic tissue.Originally, CAR-T was developed to create cells that kill certain lymphomas. In the original design, white cells were extracted from the patient's body and modified via DNA to include a special type of receptor on the cell. This receptor can target tumor cells and destroy them. Late in the last decade, researchers at Memorial Sloan Kettering in New York and the University of Pennsylvania published work demonstrating that when appropriately modified, CAR-T cells could destroy fibrogenic cells in mouse models, both in the liver (MSK) and the heart (UPenn).Two challenges with current CAR-T therapy is that cells must be removed from the patient's body to create the CAR-T cells (costly and carrying some risk) and that the original genetic material has been found in some patients' bodies as long as a decade after therapy. A third challenge revolves around the high percentages of patients (12-20%) exhibiting Level 3 or higher Cytokine Response Syndrome (CRS) as an effect of therapy.The UPenn group addressed the first two of these challenges by adapting mRNA technology (which underlies the Pfizer/BioNTech and Moderna COVID-19 vaccines) to modify white cells in the body to attack fibrogenic cells in the heart, with similar effect to the externally generated cells. This addresses the first challenge because you can take "off the shelf" mRNA proteins and inject them into any patient's body and expect highly consistent results (similar to the COVID-19 vaccine). It addresses the second challenge because mRNA is a protein packet that, after completing its work, dissolves into the body and is excreted.While there are still many vital questions to be answered (CRS issues and transferability from mouse models to humans, to name two), this technology can provide a uniquely powerful way to regress late-stage NASH fibrosis and cirrhosis.Before this conversation ends, I raise the point about impact on CRS (no answer at this time) and Jörn Schattenberg asks Neil Henderson which cell type and receptor this therapy should address (and whether there are more than one). This question arises in the next discussion.

Just Pro Wrestling News
WrestleMania Saturday Preview.

Just Pro Wrestling News

Play Episode Listen Later Apr 2, 2022 6:28


Listen and subscribe at www.JustProWrestlingNews.com Like the show? Support the show and get bonus content at https://www.patreon.com/justprowrestlingnews I'm Matt Carlins and this is JUST Pro Wrestling News for Saturday, April 2, 2022. A special welcome to those of you listening on WrestleMap.com. If you want to bring our updates to your website...email us: desk@justprowrestlingnews.com. (STINGER: WWE) Night 1 of WrestleMania 38 comes to us from AT&T Stadium in Dallas, Texas tonight. The big piece still missing from the announced card is Seth Rollins' opponent. He will be revealed once Rollins is in the ring tonight. “Stone Cold” Steve Austin returns to WWE. He'll appear on a special KO Show segment with Kevin Owens. Charlotte Flair defends the SmackDown Women's Title against Ronda Rousey. Becky Lynch puts her RAW Women's Title on the line against Bianca Belair. The Usos defend the SmackDown Tag Titles against Shinsuke Nakamura & Rick Boogs. Also on Saturday's card, Drew McIntyre vs. Happy Corbin…Rey & Dominik Mysterio vs. The Miz & Logan Paul…and Kofi Kingston & Xavier Woods vs. Sheamus & Ridge Holland. The start time is 8 PM Eastern on Peacock in the U.S. and the WWE Network around the rest of the world. The Kickoff Show begins at 6. That's not the only big show from WWE today. NXT presents Stand & Deliver early this afternoon from the American Airlines Center in Dallas. Bron Breakker challenges Dolph Ziggler for the NXT Championship. The North American Championship will be defended in a ladder match. The champ Carmelo Hayes vs. Cameron Grimes vs. Santos Escobar vs. Solo Sikoa vs. Grayson Waller. Mandy Rose defends the NXT Women's Championship in a 4-way against Cora Jade, Io Shirai, and Kay Lee Ray. The NXT Tag Titles are on the line in a 3-way. Imperium's Fabian Aichner & Marcel Barthel defend against the Creed Brothers and MSK. The NXT Women's Tag Titles will be defended. Dakota Kai & Raquel Gonzalez get a shot at Toxic Attraction's Gigi Dolin & Jayce Jane. Plus, Tommaso Ciampa vs. Tony D'Angelo…and Gunther vs. LA Knight. The show starts at 1 PM Eastern on Peacock and the WWE Network. There's a Kickoff Show starting at Noon. Ricochet is still the Intercontinental Champion. He won a 3-way over Angel and Humberto on last night's Smackdwon. Also, Madcap Moss won the Andre The Giant Memorial Battle Royal. (STINGER: ROH) Big happenings at Ring of Honor's Supercard of Honor. Jonathan Gresham beat Bandido in the main event to become the undisputed ROH World Title. Gresham was confronted after the match by Jay Lethal, who used a low blow earlier in the night to steal a win over Lee Moriarty. But Lethal's attack on Gresham drew out the BIG surprise - Samoa Joe. He returned to Ring of Honor and Tony Khan later announced Joe is also now signed with AEW. FTR are the NEW ROH Tag Champs. They dethroned The Briscoes last night. After the match, the Young Bucks showed up to attack The Briscoes. The Bucks have a match with FTR on Wednesday's Dynamite. New Japan's Minoru Suzuki is the new ROH TV Champion. He beat Rhett Titus. Wheeler Yuta is the new Pure Champion. He took the title from Josh Woods. Tony Khan then announced Yuta is officially All Elite. Mercedes Martinez beat Willow Nightingale to become the Interim ROH Women's Champion. Tully Blanchard unveiled his new faction - Tully Blanchard Enterprises. It includes Brian Cage, who beat Ninja Mack last night…and the tag team of Kaun & Toa Liona, who beat Cheeseburger & Eli Isom on the pre-show. (STINGER: AEW) Jamie Hayter is the latest woman to qualify for the Owen Hart Foundation Tournament. She won a qualifying match over Skye Blue on last night's Rampage. Also, the Young Bucks beat Top Flight…Keith Lee beat Powerhouse Hobbs and the House of Black beat Fuego Del Sol, Stu Grayson & Evil Uno. (STINGER: Impact) Impact's Multiverse of Matches last night. Trey Miguel retained the X-Division Title in an Ultimate X Match. The Influence held onto the Knockouts Tag Titles. Deonna Purrazzo's Champ Champ Challenge was answered by Faby Apache. Purrazzo held onto the AAA women's title, but after the match, Taya Valkyrie showed up to challenge Purrazzo to a title match at the Rebellion pay-per-view. Chris Sabin beat Jay White. He reversed the Bladerunner into a rollup for the pin. White later helped the Good Brothers beat The Briscoes. Nick Aldis & Mickie James beat Matt Cardona & Chelsea Green. Also, Tomohiro Ishii beat Eddie Edwards. Ace Austin has signed a new multi-year contract with Impact. (STINGER: New Japan) Killer Kross' New Japan debut was a loss. Minoru Suzuki pinned him with a Gotch-style piledriver at the Lonestar Shootout in Dallas yesterday. Tomohiro Ishii beat Chris Dickinson…Jay White beat Speedball Mike Bailey…and Ren Narita beat Rocky Romero. More indie shows running on Saturday. Starting at Noon Eastern, it's USA vs. The World at WrestleCon. Michael Oku defends his British Cruiserweight Championship against Rich Swann. Effy's Big Gay Brunch also starts at Noon Eastern…with Effy vs. Pimpenal Escarlata and Allie Katch vs. Dango. Mission Pro has a show starting at 4 PM Eastern with Thunder Rosa vs. Shazza McKenzie. There's also a late-night show from Black Label Pro starting at midnight local time - 1 AM Eastern…with the Faces of Fear vs. the Work Horsemen…Jake Something vs. PCO…and Effy vs. Charlie Haas. That's JUST Pro Wrestling News for ______. Our next update comes your way ____, so be sure to subscribe to this feed. We also thank you in advance for leaving a glowing rating or review.. I'm Matt Carlins. Thank YOU for listening. ~~~Full run down at www.justprowrestlingnews.com ~~~ • • • • • wwe #wrestling #prowrestling #smackdown #wwenetwork #wweraw #romanreigns #ajstyles #NXT #raw #njpw #wwenxt #SethRollins #TNA #johncena #RandyOrton #wrestlemania #ROH #WWF #summerslam #tripleh #aewdynamite #professionalwrestling #aew #allelitewrestling #aewontnt #DeanAmbrose #nxt #KevinOwens #wwesmackdown