Podcasts about new england journal

In medical school, Aaron Baugh, like most doctors in training, was taught that Black people have smaller lungs than white people. His professors explained that it came down to evolution and body proportions.A spirometer measures lung capacity and helps doctors diagnose and treat most lung diseases, including asthma, COPD, and cystic fibrosis. And for generations, it had a so-called race equation built into it. When a patient breathes into the machine, their lung capacity is compared to what is considered normal for their age, gender, and race. For Black patients, that normal range was 10 to 15 percent lower than for white patients. For years, doctors believed that a race “correction” made the test more accurate.But after becoming a pulmonary and critical care physician, Baugh discovered that historical assumptions embedded in the spirometer were not only wrong, but were based on racist science that can be traced back to American slavery. And they were leading to misdiagnoses in thousands of Black patients, including military veterans. “This is not a small test,” Baugh says. “It is used in diagnosis of lung disease. It is used for job hiring. It is used for disability assignments. It is used for different medical treatments. So it can touch people in a lot of important ways if you're doing this wrong.”This week on Reveal, we team up with The Race Equation podcast series from the New England Journal of Medicine to examine a standard medical test with a brutal history that is harming Black patients and is still being used in hospitals across the country. Support Reveal's journalism at Revealnews.org/donatenow Subscribe to our weekly newsletter to get the scoop on new episodes at Revealnews.org/weekly Connect with us on Bluesky, Facebook and Instagram Learn about your ad choices: dovetail.prx.org/ad-choices

Hayden Panettiere died suddenly in Greenville, South Carolina at 36. TMZ reports that Narcan, the nasal spray used to reverse an opioid overdose, was found in the apartment. Dr. Drew is joined by his Celebrity Rehab costars – addiction counselor Bob Forrest and certified chemical dependency counselor Shelly Sprague-Foster – to discuss Hayden's opioid addiction, postpartum depression, and what we know about her tragic and sudden death. Panettiere told People in 2022 that she had been in a cycle of self-destruction, and wrote in her memoir that a doctor warned she would be dead within 5 years if she did not stop drinking. She said she was given pills as a teenager before red carpet appearances, developed an opioid dependency after being prescribed painkillers for an injury, and experienced withdrawal severe enough to send her to a liver specialist. Page Six reports, through a friend, that she had severe back problems in the months before her death. NBC News reports her ex-boyfriend was at the scene when she died. Also on today's show: Dr. James Thorp, a maternal fetal medicine specialist with more than 40 years in practice who was fired by SSM Health after speaking out about COVID-19 vaccines in pregnancy. He says federal officials and the New England Journal of Medicine knew about adverse pregnancy outcomes in early 2021 and hid them. Bob Forrest is a musician, author, and addiction counselor. He served as a counselor on VH1's Celebrity Rehab, works with DNA4Addiction, and authored Running with Monsters: A Memoir. Follow at https://x.com/bobforrestmusic Shelly Sprague-Foster is a Certified Chemical Dependency Counselor–Certified Addiction Specialist who has worked with individuals affected by substance use disorders since 1997. She co-founded Hollywood Recovery Services with Bob Forrest and now directs We Care Outpatient. Find more at https://wecareinla.com Dr. James Thorp is an obstetrician-gynecologist and maternal fetal medicine specialist who served in the SSM Health System in Saint Louis, Missouri. He earned his medical degree from Wayne State University School of Medicine and has practiced for more than 40 years. Follow at https://x.com/jathorpmfm 「 SUPPORT OUR SPONSORS 」 • BIOPRO - BioPro+® is a natural formula of growth factors and peptides that support how you look, feel & perform. Learn more at ⁠⁠https://drdrew.com/biopro⁠⁠ • FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. 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Meanwhile his campaign against James Talarico runs almost entirely on ads about medical transition and children, while he trails in the polling. Second, Michigan Republican Lisa McClain went on Fox and attributed a claim about COVID vaccines and first trimester miscarriage rates to the New England Journal of Medicine. The journal published no such finding. Third, Fox host Sandra Smith cannot work out why Democrats are winning on affordability, an issue Donald Trump ran on in 2024 and now calls a hoax. Hawk's answer is that DSA backed candidates campaign on it and voters respond, and that the segment's fallback to blaming Joe Biden is doing a lot of work eighteen months in. SUPPORT & CONNECT WITH HAWK- Support on Patreon: https://www.patreon.com/mdg650hawk - Hawk's Merch Store: https://hawkmerchstore.com - Connect on TikTok: https://www.tiktok.com/@mdg650hawk7thacct - Connect on TikTok: https://www.tiktok.com/@hawkeyewhackamole - Connect on BlueSky: https://bsky.app/profile/mdg650hawk.bsky.social - Connect on Substack: https://mdg650hawk.substack.com - Connect on Facebook: https://www.facebook.com/hawkpodcasts - Connect on Instagram: https://www.instagram.com/mdg650hawk - Connect on Twitch: https://www.twitch.tv/mdg650hawk ALL HAWK PODCASTS INFO- Additional Content Available Here: https://www.hawkpodcasts.comhttps://www.youtube.com/@hawkpodcasts- Listen to Hawk Podcasts On Your Favorite Platform:Spotify: https://spoti.fi/3RWeJfyApple Podcasts: https://apple.co/422GDuLYouTube: https://youtube.com/@hawkpodcastsiHeartRadio: https://ihr.fm/47vVBdPPandora: https://bit.ly/48COaTB

Dr Swapnil Pawar is joined by Dr Jose Chacko to discuss the LOGICAL trial, published in the New England Journal of Medicine in June 2026. Does limiting oxygen after cardiac arrest protect the brain from reperfusion injury? LOGICAL (the largest randomised trial of oxygen therapy after cardiac arrest to date) randomised 1,840 patients across 53 ICUs in Australia, New Zealand and Ireland to conservative versus liberal oxygen therapy. In this episode: – The pathophysiological rationale: hypoxic-ischaemic encephalopathy, reperfusion injury and free radical damage – Where LOGICAL sits alongside EXACT, ICU-ROX, HOT-ICU and the Danish BOX trial – The Mega-ROX master protocol design, and why the sepsis and non-HIE brain injury arms are still to come – Trial design: SpO₂ upper limit of 95% and FiO₂ down to 0.21 in the conservative arm versus no upper limit and a floor of FiO₂ 0.3 in the liberal arm – The results: no difference in favourable neurological outcome at 180 days (38.2% vs 39.7%), survival, length of stay, quality of life or cognitive function – Strengths, limitations, and what it means at the bedside, including why the hosts have landed in different places on titrating down to room air Reference: The LOGICAL Investigators and the ANZICS Clinical Trials Group. Conservative Oxygen for Unresponsive Patients after Cardiac Arrest. N Engl J Med. 2026 Jun 10. Full summary, outcome tables and references at critcareedu.com.au

What if everything men are told about a prostate cancer diagnosis, biopsy first, surgery next, is built on evidence that was never actually there?In this episode of Integrative Cancer Solutions, Dr. K sits down with Dr. Stephen Petteruti, board certified family physician and author of Fight Cancer Like a Man, to break down the 2023 New England Journal of Medicine study that found no survival difference between surgery, radiation, and doing nothing at all for early stage prostate cancer. Dr. Petteruti explains why he stopped recommending biopsies, how a needle can spread the very cancer it's meant to detect, and why watching PSA and MRI trends over time is often safer than rushing into treatment. He also covers the overlooked role of testosterone in prostate cancer care, including bipolar androgen therapy, and makes the case for tracking the disease like a chronic condition instead of chasing a cure that costs a man his vitality.If you or someone you love is facing a prostate cancer diagnosis, or just navigating an elevated PSA, this conversation lays out the questions worth asking before agreeing to anything.Key Takeaways:0:00 Introduction2:33 The prostate trial that shattered the surgery-first model5:19 Why a biopsy can spread the very cancer it's meant to find8:23 Castration's hidden cost on testosterone and quality of life17:12 Tracking prostate cancer with MRI and PSA instead of biopsy21:58 Repurposed drugs and why DIY protocols backfire38:10 BAM therapy: using testosterone as a weapon against advanced cancer Schedule a Free 15-Min Cancer/Lyme Consultation at The Karlfeldt Center: 208-338-8902Resources:Fight Cancer Like a Man (book) - https://www.intellectualmedicine.com/dr-stephen-petteruti-booksIntellectual Medicine, Dr. Petteruti's practice - https://www.intellectualmedicine.com/The Prostate Protocol - https://assets.ctfassets.net/psmhuxrqomif/4iFYGN6rh0cloFTQyxdit9/a2c3e8e20e335df0ad22f70ca0e0af48/the-prostate-protocol-pdf.pdfProtecT Trial, New England Journal of Medicine, 2023 - https://www.nejm.org/doi/full/10.1056/NEJMoa2214122Johns Hopkins Bipolar Androgen Therapy Research - https://www.hopkinsmedicine.org/news/articles/2023/12/bipolar-androgen-therapy-trials-under-way Medical Disclaimer: This content is for educational purposes only and is not intended to diagnose, treat, cure, or replace professional medical advice. Always consult your physician or qualified healthcare provider regarding any medical condition or treatment decisions.

Today's guest, Dr. Meena Seshamani, ran Medicare at CMS and is now Secretary of Health in Maryland. She is leading one of the country's most ambitious health reform efforts: evolving Maryland's all-payer model, expanding investment in primary care, and using data infrastructure to strengthen coverage and population health—all while navigating the implementation of HR1. In this conversation, recorded at Aspen Ideas Health, Meena makes the case that policy design matters, but implementation is where its promise is realized or lost.Meena and Claudia discuss:How Maryland saved $1.6 billion for MedicareNew primary care investment strategiesHow the state is leveraging CRISP, the state's HIE, to implement HR1 and streamline enrollment in public programsMeena shares how Maryland is strengthening food systems using rural health transformation funding:“We are also taking rural health transformation dollars and investing in cold storage, food aggregators, and distribution hubs for our local Maryland farms, so that when we are doing outreach on healthy eating and providing nutritious food to people, that's actually coming from our local Maryland farms. So it's boosting the local economy in our rural areas as well.“Relevant LinksMaryland's Total Cost of Care Model: Evaluation of the First Four YearsArticle on the impact of Maryland's modelHow CRISP supports Medicaid redeterminationThe state's Rural Health Transformation planAbout Our GuestMeena Seshamani, MD, PhD serves as the Secretary of Health for Maryland in the Moore-Miller Administration, where she stewards a $20 billion health system that encompasses public health, Medicaid, disability, behavioral health, and 11 state-run hospitals. She leads the state's mission to improve the health and well-being of all Marylanders through a focus on accessibility, affordability, and equity.Under her leadership, Maryland has emerged as a national laboratory for healthcare innovation. Dr. Seshamani successfully negotiated a first-of-its-kind, multi-billion dollar healthcare payment model with federal partners and secured $168 million in inaugural funding to transform rural health delivery. Her tenure is also marked by a proactive approach to public health, exemplified by ensuring broad vaccine access in the state through the creation of a landmark program providing free vaccines to uninsured and underinsured residents—codifying health security as a statewide priority.Prior to her cabinet appointment, Dr. Seshamani served as Deputy Administrator and Director of the Center for Medicare at CMS. There, she executed the most significant pharmaceutical reform in decades: the Medicare Drug Price Negotiation program, achieving $6 billion in first-year savings. Her work at CMS fundamentally shifted the Medicare model to value-based care by introducing payments for community health services, caregiver training, and navigating patient care, while simultaneously tightening accountability and oversight.A board-certified head and neck surgeon and an Oxford-trained health economist, Dr. Seshamani's perspective is grounded in how health care policy and operations impact the real lives of patients. She previously served as Vice President of Clinical Care Transformation at MedStar Health, maintaining a surgical practice while leading large-scale system changes.A widely published author in the New England Journal of Medicine and JAMA, her insights are frequently sought by The New York Times, The Wall Street Journal, and major news networks. Dr. Seshamani holds her MD from Johns Hopkins University and her PhD from the University of Oxford, where she was a Marshall Scholar.SourceConnect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedInSubscribe to The Other 80 on YouTube so you never miss our video extras or special video episodes!

Send us Fan MailIs aspirin alone enough to prevent venous thromboembolism after total hip or knee arthroplasty?In this episode of CLOT Conversations, Dr. Jameel Abdulrehman speaks with Dr. Sudeep Shivakumar, lead author of the EPCAT III trial, recently published in the New England Journal of Medicine.EPCAT III randomized more than 5,400 patients undergoing hip or knee arthroplasty to receive aspirin alone or rivaroxaban for five days followed by aspirin. Dr. Shivakumar discusses the study's findings, including the low rates of symptomatic VTE observed in both groups, bleeding outcomes, the significance of distal DVT, and how EPCAT III builds on the earlier EPCAT trials.They also explore whether modern surgical care has changed the baseline risk of VTE following arthroplasty and which higher-risk patients may still warrant an anticoagulant-based approach.A practical discussion about translating an important Canadian clinical trial into individualized thromboprophylaxis decisions.Reference:Shivakumar, Sudeep, et al. "Rivaroxaban Then Aspirin vs. Aspirin Alone after Total Hip or Knee Arthroplasty." New England Journal of Medicine (2026). https://www.nejm.org/doi/abs/10.1056/NEJMoa2603649Support the showhttps://thrombosiscanada.caRegister today for our upcoming conference on November 7, 2026 in Montreal at https://thrombosiscanada.ca/2026ConferenceTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Welcome to the latest episode (August 2026) of DOC Updates, where every month Neil Skolnik, MD and John Russell, MD review the most important articles on diabetes, obesity, and cardiometabolic disease. This month on DOC Updates: Hirsh Elhence, Jennifer L. Dodge, Stephen Fuest, et al. National Prevalence of Clinical Obesity by BMI Class: A National Cross-Sectional Study. Ann Intern Med. [Epub 2 June 2026]. doi:10.7326/ANNALS-25-05287 Eva Johnsen, et al. Achieving at Least 15% Weight Loss Within 2 Years of Type 2 Diabetes Diagnosis Is Associated With Lower Risks of Macrovascular and Microvascular Complications: A U.K. Cohort Study. Diabetes Care 20 July 2026; 49 (8): 1480–1489. doi.org/10.2337/dc26-0937 Carel W. le Roux, et al. Survodutide Once Weekly for the Treatment of Adults with Obesity. The New England Journal of Medicine June 2026 DOI: 10.1056/NEJMoa2600751 Yu Wang, Shichao Tang, Xilin Zhou, Ping Zhang. National Trends in Out-of-Pocket Cost for Glucose-Lowering Drugs Among U.S. Adults With Diabetes, 2000–2022. Diabetes Care 20 July 2026; 49 (8): 1414–1419. https://doi.org/10.2337/dc25-2040 Jelle M. Beernink, et al. Effect of Finerenone on Albuminuria in Type 1 Diabetes by Baseline HbA1c Level and Diabetes Duration: An Exploratory Analysis of the FINE-ONE Trial. Diabetes Care 20 July 2026; 49 (8): 1434–1441. https://doi.org/10.2337/dc26-0882 Welch M, Forst T, Jia W et al. Orforglipron compared with dapagliflozin in adults with type 2 diabetes and inadequate glycaemic control with metformin (ACHIEVE-2): a multicentre, randomised, non-inferiority, open-label, phase 3 trial. The Lancet, 2026; 408, 125-140 DOI: 10.1016/S0140-6736(26)00800-7 Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health DOC Updates is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's three science and medical journals—Diabetes, Diabetes Care, and Diabetes, Obesity, and CardioMetabolic CARE. Intended for practicing physicians and health care professionals, DOC Updates discusses how the latest research is relevant in clinical practice. For information about the American Diabetes Association's scholarly journals, visit diabetesjournals.org. For more about this podcast, click here.

Our kidneys do an incredible job filtering our blood every hour of every day. Most of us have two kidneys, and each one has about a million microscopic filters called glomeruli. Unlike the filters in our HVAC system, though, these filters cannot be replaced. But they do their work so well and unobtrusively that most of us don't even think about our kidney function. Although 37 million Americans have kidney trouble, the majority are unaware of their situation. Two tests could reveal how well the kidneys are working. What are they, and how often should you ask about them? At The People's Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, August 8, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can't listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on August 10, 2026. What Are the Two Tests That Reveal Kidney Trouble? Chronic conditions like high blood pressure and diabetes put a strain on the kidneys. They are very common problems that signal the need for kidney function monitoring. Our guest expert, Dr. Samir Parikh, suggests that all of us should know our numbers. One is derived from the level of creatinine in the blood. This is normally part of a basic metabolic panel. Usually, the panel results will include a number for the estimated glomerular filtration rate (EGFR) calculated from the value for blood creatinine. The other crucial test is a urine test for protein. Keeping Kidneys Healthy by Staying Properly Hydrated One of the simplest tactics to keep kidneys healthy is to provide them with enough liquid. We get some fluid from the food we eat, which may be one reason eating fruits and vegetables seems to be good for us. They are full of water! We also need to drink fluid, and plain water is probably the best choice. It would be smart to use thirst as a guideline and make sure to drink when thirsty. We do avoid overdoing water consumption, though, as overloading the kidneys with more fluid than they can handle is dangerous as well. Medicines That Are Hard on the Kidneys We mentioned to Dr. Parikh the experience of an older friend, a devoted runner, who discovered that taking ibuprofen after a run reduced the likelihood of having to get up overnight to urinate. He reminded us and our listeners that nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, celecoxib or meloxicam can be hard on the kidneys. That doesn't mean we shouldn't ever take such pain relievers, but perhaps we should try not to make it a habit. When we asked about other medicines that might be tough on the kidneys, he mentioned PPIs. Proton pump inhibitors such as omeprazole (Prilosec) or esomeprazole (Nexium) are often used to treat heartburn or other digestive symptoms. Regular use can put a strain on the kidneys, although the gastroenterologist recommending the medicine might not warn you of that side effect. We asked about environmental toxins and learned that heavy metals such as lead or arsenic can harm the kidneys along with other organs. We should make sure that the food we eat and the water we drink are not contaminated with such compounds. The Possible Benefits of Vitamin B Dr. Parikh has been studying how the kidneys respond to the B vitamin nicotinamide. The preliminary work he and his colleagues have done so far is promising. However, they have not conducted clinical trials to find out whether the vitamin could help people with early kidney disease. Because kidneys work so hard, they need a lot of energy to be produced by the mitochondria in their cells. Those mitochondria need NAD+ (nicotinamide adenine dinucleotide) to function at their best. Providing additional nicotinamide appears to help (Nature Reviews. Nephrology, Feb. 2020).  One to three grams a day appears to be safe and may be beneficial. Medications That Can Promote Kidney Health Some medicines initially developed for other conditions are proving to be helpful in treating kidney disease. In particular, these include diabetes drugs known as SGLT2 inhibitors like dapagliflozin (Farxiga) or empagliflozin (Jardiance). They help slow the decline of kidney function (New England Journal of Medicine, Nov. 4, 2022). GLP-1 agonists may also be familiar because they too are used to treat diabetes. Medications such as semaglutide (Ozempic, Rybelsus, Wegovy) and tirzepatide (Mounjaro, Zepbound) have made headlines as weight loss and diabetes meds, but they also can reduce the risk of kidney failure and other bad outcomes (Lancet. Diabetes & Endocrinology, Jan. 2025). The benefits of these types of drugs should give us hope that we can go from slowing the progression of kidney disease to stopping it in its tracks Taking Care of Your Kidneys We asked Dr. Parikh what we should be doing to care for our kidneys and keep them healthy. He urged us once again to know our numbers: most importantly, the numbers from the two tests we discussed, blood creatinine and urine protein. Other numbers that are important for kidney are our blood pressure and, for those with diabetes, HbA1c. In addition to paying attention to all those numbers, we need to embrace a lifestyle that will help keep them where they belong. That means following a heart-healthy diet, staying physically active and getting adequate sleep. This Week’s Guest Samir M. Parikh, M.D., FASN, is Professor of Internal Medicine and Pharmacology and Chair of Internal Medicine at the University of Texas Southwestern. He holds the Donald W. Seldin Distinguished Chair in Internal Medicine and the Ruth W. and Milton P. Levy, Sr., Chair in Molecular Nephrology. Dr. Samir Parikh, University of Texas Southwestern Listen to the Podcast The podcast of this program will be available Monday, August 10, 2026, after broadcast on Aug. 8. This week's podcast has additional information on a possible role for sodium bicarbonate (baking soda) for kidney function. We also discussed medical silos, and how that leads to gastroenterologists overlooking the kidney risks from PPIs. Also, what should prospective kidney donors consider? You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Why Self-Insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD. The Sleeping Giants of Healthcare: Why Employers and Clinicians Keep Missing Each Other. Episode 523. Dr. Suhas Gondi, MD, MBA, chief medical officer at Health Strategy and an attending physician at Massachusetts General Hospital, co-wrote a New England Journal of Medicine article — "A Sleeping Giant of Health Care Affordability—Self-Insured Employers" — because most clinicians, he found, have little idea a self-insured employer, not an insurance carrier, is the one actually paying for their patients' care. Talking with Stacey Richter, Dr. Gondi argues that self-insured employers and clinicians are both "sleeping giants," each holding real power over cost and access, who rarely communicate directly — leaving patients caught in the gap. WHAT YOU'LL LEARN ✅ Why Dr. Suhas Gondi and his NEJM co-author, Zirui Song, MD, PhD, wrote for clinicians who, they found, have little sense that a self-insured employer — not the carrier name on the card — actually pays for a patient's care ✅ How a GLP-1 prescription can get denied at the pharmacy counter even after a clinician verifies coverage, because the employer has quietly moved GLP-1 coverage exclusively through a single third-party prescribing and coaching vendor ✅ Why GLP-1 spending alone can push a self-insured employer's pharmacy costs up 9% to 20% in a year, and why the roughly eight-year payback period employers are counting on assumes patients stay adherent far longer than most actually do ✅ How oncology site-of-care steering — an employer declining to pay a roughly 40% premium for infusion at a hospital-owned center instead of a physician's office — can look to the patient and oncologist like a denied cancer drug ✅ Why Dr. Gondi says EHRs like Epic are built to optimize revenue for hospital-system customers, not to surface a lower-cost site of care for patients or plan sponsors ✅ Dr. Gondi's advice for closing the gap: clinicians and employers should communicate directly, especially before a coverage change lands on patients, rather than assuming direct contracting is the only fix WHY THIS MATTERS Roughly half to 60% of the US population has commercial insurance, and nearly three-quarters of large employers self-insure that coverage — yet most clinicians have no visibility into the plan-level decisions those employers make, and most employers have no channel to explain those decisions to the doctors whose patients are affected. Both sides, Dr. Gondi says, usually believe they're doing the right thing — covering the GLP-1, covering the cancer drug — and the patient still gets lost in between. Closing that gap doesn't require full direct contracting, he argues, just employers and local provider groups actually talking to each other before a coverage change lands on a patient, not after. MENTIONED IN THIS EPISODE Study: New England Journal of Medicine article, "A Sleeping Giant of Health Care Affordability—Self-Insured Employers," by Suhas Gondi, MD, MBA, and Zirui Song, MD, PhD EP406 with Lauren Vela: Apple Podcasts | Spotify | Other Apps EP519 with Lisa Rosenbaum, MD: Apple Podcasts | Spotify | Other Apps EP509 with Patrick Nelli: Apple Podcasts | Spotify | Other Apps EP494 with Sarah Emond: Apple Podcasts | Spotify | Other Apps EP501 with Ivana Krajcinovic, PhD: Apple Podcasts | Spotify | Other Apps EP468 with Matt McQuide: Apple Podcasts | Spotify | Other Apps Article: Acquired's episode on how Epic quietly powers American healthcare === LINKS ===

A new paper in the New England Journal of Medicine—written by two Canadian critical-care physicians and a Harvard Medical School bioethicist—asks whether the dead donor rule should be "reassessed" for MAiD patients. Specifically, it explores whether organs could be retrieved while a patient is sedated, unconscious, and still alive, with the organ retrieval itself becoming the cause of death.As reported by the National Post, the authors argue that requiring a formal declaration of death before organ retrieval may be "ethically arbitrary," and describe the proposal as "a Pareto improvement: no one would be made worse off."In this episode, we break down:- What the paper actually says, including its important caveats. The authors are not calling for the dead donor rule to be abandoned, no jurisdiction is currently considering this proposal, and they explicitly call for "open, transparent dialogue."- Why this proposal has unmistakable Canadian fingerprints. Canada now leads the world in organ donation after MAiD, with 41 cases in 2021 compared with 20 combined across Belgium, the Netherlands, and Spain. Since 2016, there have been more than 155 MAiD organ donors in Canada.- The five-minute "no-touch" protocol that currently separates death from organ retrieval, and why some researchers believe it should be reconsidered.- The objections from within the medical ethics community, including bioethicist Lainie Friedman Ross, who told NPR: "Which I think is murder."- The broader pattern: 2016 (terminal illness only), 2021 (terminal illness requirement removed), and March 2027 (mental illness eligibility). The phrase "No one is proposing that" has often meant "not yet published." This proposal is now published in one of the world's leading medical journals.I warned for years that euthanasia and organ donation were on a path toward convergence and was repeatedly told it was misinformation.Now, the discussion is appearing in a peer-reviewed medical journal.SOURCESSharon Kirkey, "'Death by organ donation': Doctors raise possibility of retrieving organs from MAID patients while they are still alive," National Post (July 23, 2026):https://unpublished.ca/news-feed-item/2026-07-23/death-by-organ-donation-doctors-raise-possibility-of-retrieving-organs"Contextualizing the Dead Donor Rule in an Era of Voluntary Euthanasia," New England Journal of Medicine:https://www.nejm.org/doi/full/10.1056/NEJMms2601611NPR – Lainie Friedman Ross interview:https://www.northcountrypublicradio.org/news/npr/nx-s1-5883714/a-new-proposal-for-organ-donation-sparks-concernCanadian Blood Services – Professional guidance on organ donation and MAiD:https://professionaleducation.blood.ca/en/organs-and-tissues/professional-guidance/deceased-donation-after-maidNational Post (prior reporting) – American recipient of a heart from an Ontario ALS patient who died by MAiD:https://ca.news.yahoo.com/american-man-gets-heart-38-110042532.htmlPRE-ORDERDo No Harm?: How the Healthcare Industry Legalized Murder (Skyhorse, March 2027)https://www.amazon.com/dp/151078893XBuy me a coffee! - https://buymeacoffee.com/kelsisherenDo No Harm? - https://www.amazon.com/dp/1683585763?ref_=cm_sw_r_ffobk_cp_ud_dp_SC8YGT87SPJ1VB8SAYP1Let's connect!Substack: https://substack.com/@kelsisherenRumble - https://rumble.com/user/TheKelsiSherenPerspectiveInstagram - https://www.instagram.com/thekelsisherenperspective?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw%3D%3DX: https://x.com/KelsisherenSUPPORT OUR PEOPLE - - - - - - - - - - - -Ketone IQ- 30% off with code KELSI - https://ketone.com/KELSIGood Livin - 20% off with code KELSI - https://www.itsgoodlivin.com/?ref=KELSIBrass & Unity - 20% off with code UNITY - http://www.brassandunity.com

Cyclospora cases continue to climb in the U.S. but this isn't the first time we've had a multi-state outbreak linked to produce. Back in 1996, there was a major cyclospora outbreak across several states due to imported raspberries. It begs the question, have we learned anything from the past? Or are we repeating history all over again? This week hosts Chris Dall and Dr. Michael Osterholm focus on the cyclosporiasis outbreak, from the latest numbers, to how state and federal officials, as well as the media, have handled it all. They'll break down the latest epidemiologic data and discuss how this response compares to a multi-state outbreak in 1996. Dr. Osterholm also talks about the latest on Ebola in the DRC, the measles outbreaks across the U.S. and a potential uptick in COVID-19 cases.   Links:An Outbreak in 1996 of Cyclosporiasis Associated with Imported Raspberries (The New England Journal of Medicine) When People Got Sick: Cyclospora Outbreak, July 2026 (CDC) The Cyclospora outbreak was, and still is, a communications failure (CIDRAP)  Resources for vaccine and public health advocacy: Voices for Vaccines Families Fighting Flu Vaccinate Your Family Shot@Life Medical Reserve Corps Learn more about the Vaccine Integrity Project MORE EPISODES       SUPPORT THIS PODCAST   Music: "Beauty Flow" Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 License

For decades, we've been told that eating less fat is one of the healthiest things we can do. That advice reshaped the foods we buy, the way we think about weight loss, and even how parents feed their children.But what if we misunderstood fat in the first place?In this episode, nutrition researcher Dr. Arne Astrup traces how the war on fat began, why many of its core assumptions haven't held up under decades of research, and what we've learned instead. Rather than asking whether fat is "good" or "bad," he argues that the more useful questions are: What foods actually keep us healthy? Why do some people gain weight more easily than others? And what happens when we reduce nutrition to single nutrients instead of whole foods?Free course: Improve your metabolic healthGet our free email course on how glucose, nutrition, exercise, sleep, and measurement can help you build habits that support better energy and long-term health: ⁠⁠⁠⁠⁠⁠⁠https://levels.link/wnl⁠

Metabolic Health Show - Twin Health's unique approach to improve health: Meet your AI Digital Twin Today my guests from Twin Health explain how they create a digital twin to actually help you in your health, especially if you're pre-diabetic, along with a number of other issues. We're going to tell you how it works, and what a difference it can make in your life. It's a real-time model of your body's unique metabolism and Ray Holmgren, VP Health Plan Growth, and Doctor Troncoso, their Medical Director, visit with me on this fantastic new way to empower your employees with daily, personalized insights that adapt to heal their metabolism — improving weight, blood sugar, nutrition, activity, and more. Don't miss this episode, which shows how Twin Health's "AI digital twin™" technology pairs with a human clinical care team to deliver hyper-individualized care at scale, an approach with a proven impact on the root causes of chronic metabolic disease. Show Quote: In a landmark Cleveland Clinic trial, published in the New England Journal of Medicine Catalyst, our AI digital twin™ approach achieved results that redefine what's possible in type 2 diabetes care. This is season 22, Episode 14 of America's Healthcare Advocate. I'm Cary Hall. After you watch or listen to the episode, learn more about Twin Health: https://usa.twinhealth.com As always, if you need help or have something to share, contact me using the form on my website and let me know what's on your mind, the issues you are dealing with, or any other health, healthcare, or health insurance questions or concerns. Visit: https://www.americashealthcareadvocate.com/contact-us

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Substackhttps://substack.com/@theoccultrejects?r=7auau0&utm_campaign=profile&utm_medium=profile-pageCash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsCore Sleep Paralysis ScienceSharpless, Brian A., and Jacques P. Barber. “Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review.” Sleep Medicine Reviews 15, no. 5 (2011): 311–315.Sharpless, Brian A. “A Clinician's Guide to Recurrent Isolated Sleep Paralysis.” Neuropsychiatric Disease and Treatment 12 (2016): 1761–1767.Cheyne, J. Allan, Steve D. Rueffer, and Ian R. Newby-Clark. “Hypnagogic and Hypnopompic Hallucinations during Sleep Paralysis: Neurological and Cultural Construction of the Night-Mare.” Consciousness and Cognition 8, no. 3 (1999): 319–337.Cheyne, J. Allan. “Sleep Paralysis and the Structure of Waking-Nightmare Hallucinations.” Dreaming 13, no. 3 (2003): 163–179.Cheyne, J. Allan. “Situational Factors Affecting Sleep Paralysis and Associated Hallucinations: Position and Timing Effects.” Journal of Sleep Research 11, no. 2 (2002): 169–177.Solomonova, Elizaveta. “Sleep Paralysis: Phenomenology, Neurophysiology and Treatment.” In The Oxford Handbook of Spontaneous Thought: Mind-Wandering, Creativity, and Dreaming, edited by Kieran C. R. Fox and Kalina Christoff. Oxford University Press, 2018.Baland Jalal / Panic-Hallucination / TreatmentJalal, Baland. “How to Make the Ghosts in My Bedroom Disappear? Focused-Attention Meditation Combined with Muscle Relaxation (MR Therapy): A Direct Treatment Intervention for Sleep Paralysis.” Frontiers in Psychology 7 (2016): 28. doi:10.3389/fpsyg.2016.00028.Jalal, Baland, and V. S. Ramachandran. “Sleep Paralysis and ‘The Bedroom Intruder': The Role of the Right Superior Parietal, Phantom Pain and Body Image Projection.” Medical Hypotheses 83, no. 6 (2014): 755–757.Jalal, Baland. “The Neuropharmacology of Sleep Paralysis Hallucinations: Serotonin 2A Activation and a Novel Therapeutic Drug.” Psychopharmacology 235, no. 11 (2018): 3083–3091.Jalal, Baland, Lucia Moruzzi, Andrea Zangrandi, Matteo Filardi, Claudio Franceschini, Fabio Pizza, et al. “Meditation-Relaxation (MR Therapy) for Sleep Paralysis: A Pilot Study in Patients with Narcolepsy.” Frontiers in Neurology 11 (2020): 922. doi:10.3389/fneur.2020.00922.Folklore, Myth, and the Old HagHufford, David J. The Terror That Comes in the Night: An Experience-Centered Study of Supernatural Assault Traditions. Philadelphia: University of Pennsylvania Press, 1982.Hufford, David J. “Sleep Paralysis as Spiritual Experience.” Transcultural Psychiatry 42, no. 1 (2005): 11–45.Adler, Shelley R. Sleep Paralysis: Night-mares, Nocebos, and the Mind-Body Connection. New Brunswick: Rutgers University Press, 2011.Davies, Owen. “The Nightmare Experience, Sleep Paralysis, and Witchcraft Accusations.” Folklore 114, no. 2 (2003): 181–203.Bond, John. An Essay on the Incubus, or Nightmare. London: Printed for D. Wilson and T. Durham, 1753.Golzari, Samad E. J., et al. “Sleep Paralysis in Medieval Persia — The Hidayat of Akhawayni (?–983 AD).” Neuropsychiatric Disease and Treatment 8 (2012): 229–234.Cross-Cultural Sleep ParalysisHinton, Devon E., Vuth Pich, Dara Chhean, and Mark H. Pollack. “‘The Ghost Pushes You Down': Sleep Paralysis-Type Panic Attacks in a Khmer Refugee Population.” Transcultural Psychiatry 42, no. 1 (2005): 46–77.Hinton, Devon E., Vuth Pich, Dara Chhean, Mark H. Pollack, and Richard J. McNally. “Sleep Paralysis among Cambodian Refugees: Association with PTSD Diagnosis and Severity.” Depression and Anxiety 22, no. 2 (2005): 47–51.Jalal, Baland, and Devon E. Hinton. “Rates and Characteristics of Sleep Paralysis in the General Population of Denmark and Egypt.” Culture, Medicine, and Psychiatry 37, no. 3 (2013): 534–548.Jalal, Baland, Joseph Simons-Rudolph, Bamo Jalal, and Devon E. Hinton. “Explanations of Sleep Paralysis among Egyptian College Students and the General Population in Egypt and Denmark.” Transcultural Psychiatry 51, no. 2 (2014): 158–175.Jalal, Baland, Andrea Romanelli, and Devon E. Hinton. “Cultural Explanations of Sleep Paralysis in Italy: The Pandafeche Attack and Associated Supernatural Beliefs.” Culture, Medicine, and Psychiatry 39, no. 4 (2015): 651–664.Olunu, Esther, Ruth Kimo, Esther Olufunmbi Onigbinde, Mary-Amadeus Uduak Akpanobong, and Inyene Ezekiel Enang. “Sleep Paralysis, a Medical Condition with a Diverse Cultural Interpretation.” International Journal of Applied and Basic Medical Research 8, no. 3 (2018): 137–142.Sensed Presence / Body Map / Shadow Person NeuroscienceArzy, Shahar, Margitta Seeck, Stephanie Ortigue, Laurent Spinelli, and Olaf Blanke. “Induction of an Illusory Shadow Person.” Nature 443 (2006): 287.Blanke, Olaf, Stephanie Ortigue, Theodor Landis, and Margitta Seeck. “Stimulating Illusory Own-Body Perceptions.” Nature 419 (2002): 269–270.Blanke, Olaf, Theodor Landis, Laurent Spinelli, and Margitta Seeck. “Out-of-Body Experience and Autoscopy of Neurological Origin.” Brain 127, no. 2 (2004): 243–258.Ionta, Silvio, Lukas Heydrich, Bigna Lenggenhager, Michael Mouthon, Eleonora Fornari, Dominique Chapuis, Roger Gassert, and Olaf Blanke. “Multisensory Mechanisms in Temporo-Parietal Cortex Support Self-Location and First-Person Perspective.” Neuron 70, no. 2 (2011): 363–374.Blanke, Olaf, Polona Pozeg, Masayuki Hara, Lukas Heydrich, Andrea Serino, Akio Yamamoto, Toshiro Higuchi, et al. “Neurological and Robot-Controlled Induction of an Apparition.” Current Biology 24, no. 22 (2014): 2681–2686.Alien Abduction / Modern Mythic MaskMcNally, Richard J., and Susan A. Clancy. “Sleep Paralysis, Sexual Abuse, and Space Alien Abduction.” Transcultural Psychiatry 42, no. 1 (2005): 113–122.Clancy, Susan A. Abducted: How People Come to Believe They Were Kidnapped by Aliens. Cambridge, MA: Harvard University Press, 2005.Blackmore, Susan. “Abduction by Aliens or Sleep Paralysis?” Skeptical Inquirer 22, no. 3 (1998): 23–28.Clinical Sleep / Narcolepsy / REM BackgroundAmerican Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed., text revision. Darien, IL: American Academy of Sleep Medicine, 2023.Scammell, Thomas E. “Narcolepsy.” New England Journal of Medicine 373, no. 27 (2015): 2654–2662.Saper, Clifford B., Patrick M. Fuller, Nigel P. Pedersen, Jun Lu, and Thomas E. Scammell. “Sleep State Switching.” Neuron 68, no. 6 (2010): 1023–1042.Brooks, Patricia L., and John H. Peever. “Identification of the Transmitter and Receptor Mechanisms Responsible for REM Sleep Paralysis.” Journal of Neuroscience 32, no. 29 (2012): 9785–9795.Avidan, Alon Y., and Phyllis C. Zee, eds. Handbook of Sleep Medicine. Philadelphia: Lippincott Williams & Wilkins, 2011.Visual / Art HistoryFuseli, Henry. The Nightmare. 1781. Oil on canvas. Detroit Institute of Arts.Myrone, Martin. Gothic Nightmares: Fuseli, Blake and the Romantic Imagination. London: Tate Publishing, 2006.Powell, Nicolas. Fuseli: The Nightmare. London: Allen Lane, 1973.Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. 

A landmark international trial published in the New England Journal of Medicine evaluated whether fluid type impacts patient outcomes.

Ready to go deeper? Join the free masterclass and learn the full 5-stage framework: https://www.amenkaur.com/masterclassEver feel like you're moving through molasses, giving maximum effort for minimal output? This episode unpacks the 8% Battery Rule, a simple way to understand why high-achievers hit sudden walls of exhaustion, and the exact signals your nervous system sends before, during, and after a shutdown.In this episode: Why cortisol isn't the villain it's made out to be, and what its natural daily rhythm should look like. How a "flat" stress curve is actually a sign of chronic overload, not calm. Why your recovery speed after a hard day is a better resilience signal than how you feel in the moment. The hidden cost of suppressing grief, anger, and shame while you're "too busy" to feel them. A simple weekly practice for identifying what's quietly draining your energy.Who this is for: high-achievers, entrepreneurs, and high-functioning professionals who keep pushing through exhaustion and want the biological reason their body keeps shutting down, plus a practical way to reverse it.Frequently asked questions: What is the 8% Battery Rule? It describes the tipping point where the nervous system shifts from functioning under pressure into a protective shutdown, often mistaken for laziness or burnout. Why do high-achievers experience sudden shutdowns? They tend to override early stress signals to keep performing, which pushes the body into functional freeze instead of allowing normal recovery. How do I know if my nervous system is recovering? Faster bounce-back time after a hard day is one of the clearest signs your range and resilience are returning.The science behind this episodeThis episode is science-led. Here are the studies behind each claim, in the order they come up.On the cortisol curve flattening under chronic stress: Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017). Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 25–41. https://doi.org/10.1016/j.psyneuen.2017.05.018On stress shifting the brain from its slower regulating systems to faster threat-driven ones: Arnsten, A. F. T. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience, 10(6), 410–422. https://doi.org/10.1038/nrn2648On why the stress response keeps running as long as you keep thinking about the stressor (the "open tabs"): Brosschot, J. F., Gerin, W., & Thayer, J. F. (2006). The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60(2), 113–124. https://doi.org/10.1016/j.jpsychores.2005.06.074On allostatic load — the cumulative cost carried across the body's systems: McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171–179. https://doi.org/10.1056/NEJM199801153380307A note on the science: These findings describe patterns across large groups of people, not a diagnosis of any individual. The associations are real and consistent, but they're modest in size — which is exactly why nothing in this episode can tell you what's happening in your own body. If you're worried about your symptoms, please see your doctor.Keywords: functional freeze, nervous system shutdown, high functioning anxiety, burnout recovery, why am i so tired, chronic stress, nervous system regulation, cortisol, emotional exhaustion, high achieving women, cant start things, task paralysis, freeze response, allostatic load, HRV, rest and recovery, overwhelm, stress and the body

There is a narrative circulating loudly in certain corners of social media and conventional medicine that what I do is not evidence-based. That functional medicine is supplement selling. That the testing is not validated. That providers like me are operating outside the bounds of legitimate medicine.I want to address that directly. Not because I am interested in a fight. But because the women listening to this deserve to feel certain about the care they are choosing. They deserve not to be destabilized by a confident-sounding voice that has not done the research.This episode is for you. And I am coming with receipts.Inside this episode, we cover:What evidence-based medicine actually means by definition, and why most people using it as a weapon are working with an incomplete version of itWhy the randomized controlled trial is the right tool for certain questions and the wrong tool for others, and what that distinction actually means for root cause medicineWhere the peer-reviewed research supporting functional medicine actually lives: the New England Journal of Medicine, Nature, The Lancet, Frontiers in EndocrinologyThe documented blind spots in conventional medical training: four hours or less of nutritional education across an entire medical school curriculumWhy the Women's Health Initiative may be the single greatest tragedy in women's healthcare, and what has changed in the decades sinceThe supplement accusation: what is true, what is misleading, and what the foundation of functional medicine is actually built onWhy the tests I use are not invented by functional medicine, and what the science actually says about cortisol curves, fasting insulin, comprehensive stool analysis, and full thyroid panelsThe story of a patient who came to me skeptical, and what the data said six months laterWhy the patient getting better is evidence, and why dismissing reproducible clinical outcomes as anecdote is a rhetorical position, not a scientific oneConventional medicine saves lives. Functional medicine restores them. Both of these things are true. And the women who need the second one deserve to pursue it without apology.You are not required to defend your healthcare choices to people who have not examined the research, have not sat with the patients, and have not followed the outcomes. The evidence exists. The research is in the journals. And the medicine that is actually restoring function in women who spent years being managed without being healed deserves to be chosen with confidence.Share this episode with one woman who has been made to second-guess the care that is actually working for her. She deserves the language to stand in it.Your next steps are below:✨ Free Guide: 9 Hidden Signs Your Metabolism Is Stuck in Survival Mode www.drkaceywallace.com/hiddenmetabolicmess✨ Adrenal Optimization Test (see your cortisol rhythm + DHEA clearly) www.drkaceywallace.com/innercalm✨ Hair Tissue Mineral Analysis www.drkaceywallace.com/htma✨ The Anchored Journey (application) www.drkaceywallace.com✨ Get the book: You Are Not Fine www.youarenotfine.com✨ Get our weekly newsletter: Dr. Kacey's Cornerwww.drkaceywallace.com/newslettersignupSupport the show

John Gerardi is joined by Jonathan Keller of California Family Council to unpack the disturbing expansion of Canada's euthanasia program, from proposals to euthanize infants with disabilities to recommendations that minors consent to their own deaths without parental input. This week's mystery clip reveals just how far the MAID program has gone, with roughly half of 2024 recipients citing feeling like a burden rather than terminal illness. The guys then break down how activists quietly corrupt language, sliding from physician assisted suicide to medical assistance in dying to simply assisted death, and why that shift matters. Finally, they take on a New England Journal of Medicine article arguing to contextualize the dead donor rule, a euphemism for harvesting organs from euthanasia patients before death, and explain why the slippery slope keeps proving pro-lifers right.

Reference:  Denninghoff KR et al. Azithromycin for Preschoolers with Wheezing in the Emergency Department. New England Journal of Medicine. May 2026 Date: July 14, 2026 Guest Skeptic: Dr. Zara Ibrahim is a pediatric emergency medicine fellow at Children's National Hospital in Washington DC where she also completed medical school, pediatric residency. Her research interests include […] The post SGEM#515: Now the Azithromycin Don't Work for Preschool Wheeze first appeared on The Skeptics Guide to Emergency Medicine.

Like tens of millions of people, Stephen Dubner thought he had a penicillin allergy. Like the vast majority, he didn't. This misdiagnosis costs billions of dollars and causes serious health problems, so why hasn't it been fixed? We find out in this update of a 2025 episode.   SOURCES: Kimberly Blumenthal, allergist-immunologist and researcher at the Mayo Clinic. Theresa MacPhail, associate professor of science and technology studies at Stevens Institute of Technology. Thomas Platts-Mills, professor of medicine at the University of Virginia. Elena Resnick, allergist and immunologist at Mount Sinai Hospital.   RESOURCES: Allergic: Our Irritated Bodies in a Changing World, by Theresa MacPhail (2023). "Evaluation and Management of Penicillin Allergy: A Review," by Erica S. Shenoy, Eric Macy, and Theresa Rowe (JAMA, 2019). "The Allergy Epidemics: 1870–2010," by Thomas Platts-Mills (The Journal of Allergy and Clinical Immunology, 2016). "Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy," by George Du Toit, Graham Roberts, et al. (The New England Journal of Medicine, 2015).   EXTRAS: "The Freakonomics Radio Guide to Getting Better," series by Freakonomics Radio (2026). "Doctors Know They Prescribe Too Many Antibiotics. Why Don't They Stop?" by Freakonomics, M.D. (2022). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This article is for educational purposes only and is not a substitute for individualized medical advice. Always talk to your own healthcare provider before changing your diet, supplements, or medications.Unlocking the Secrets of Ferritin: What Your Iron Levels Are Telling YouYour “normal” bloodwork might be hiding the real reason you're exhausted, foggy, and losing hairTL;DR: * Ferritin is your iron savings account — and most labs only flag it as “abnormal” once it's nearly empty. * A level of 14 or 22 ng/mL might get a “you're fine” from your doctor, but optimal energy, mood, cognition, and hair growth usually need ferritin closer to 70–100 ng/mL. * Low ferritin can come from menstrual blood loss, poor absorption (celiac disease, low stomach acid, H. pylori), or inflammation-driven hepcidin blocking iron uptake.* If you're fatigued, foggy, cold, or shedding hair, ask for a full iron panel — not just a ferritin number — and talk through the results with your doctor.There's an old Japanese proverb: “When the body speaks, the wise person listens. When the body whispers, the fool waits for it to scream.” In health diagnostics, one of the quietest whispers is your ferritin level. It's often overlooked, yet it can be the missing link behind exhaustion, hair loss, brain fog, or the frustrating experience of bloodwork that comes back “normal” while you still feel terrible.What Is Ferritin?Ferritin is your body's iron storage protein. Think of your iron levels like a financial setup: hemoglobin is your checking account, drawn on daily. Ferritin is your savings account, tapped only when things get tight. Under stress, your body will drain the savings account long before it lets the checking account — hemoglobin — run low. That's why you can have “normal” hemoglobin and still be iron-depleted. A low ferritin level means your reserves are running out, and that shows up as fatigue, brain fog, mood changes, and thinning hair.Normal vs. OptimalMost labs flag ferritin as “normal” above roughly 10–20 ng/mL. That threshold mostly means you're not in immediate danger — not that you're thriving. Levels associated with feeling genuinely well tend to run from 70 to 100 ng/mL. So if you've been told your ferritin of 14 or 22 is fine, but you still feel wiped out, you're not imagining it — you're just being measured against a bar set for avoiding crisis, not for feeling good.Why Your Ferritin Might Be Low* Menstrual blood loss. For many women, the cumulative loss over months and years outpaces dietary iron intake, slowly draining reserves.* Absorption issues. Even a solid iron intake doesn't help if it isn't absorbed. Silent celiac disease, low stomach acid, or an H. pylori infection can quietly block uptake for years.* Inhibitors and hepcidin. Coffee, tea, and dairy consumed close to meals can inhibit iron absorption. Separately, inflammation can push your liver to produce hepcidin, a hormone that shuts down iron uptake even when you're eating enough.Symptoms to WatchPersistent fatigue, thinning hair, feeling cold more easily than others, and brain fog are the classic signs. If two or more of these sound familiar, it's worth getting your ferritin checked specifically — not just assumed to be fine because your CBC looked normal.The Bigger PictureIron does far more than carry oxygen. It's involved in thyroid hormone conversion, dopamine production, mitochondrial energy synthesis, and hair follicle health. That means low ferritin can produce symptoms that look a lot like depression or hypothyroidism — even when your thyroid panel and mood screening come back clean.Taking Action* Review your bloodwork. Look specifically at ferritin. Anything under 70 ng/mL is worth a conversation with your doctor.* Ask for a full iron panel. Ferritin alone isn't the whole story — request serum iron, total iron binding capacity (TIBC), transferrin saturation, and CRP (to rule out inflammation skewing the picture).* Adjust absorption habits. Space coffee and tea away from meals, lean into iron-rich foods, and avoid taking calcium and iron supplements together.* Choose the right supplement, if needed. Ferrous sulfate is harsh on the gut for many people. Iron bisglycinate is gentler and pairs well with vitamin C for better absorption — but check with your provider before starting, especially if high ferritin is a concern.* Loop in a professional. This is especially important before making changes if you suspect elevated ferritin, since iron overload carries its own risks.Listening to Your Body's WhisperYour body is constantly sending signals. Ignored long enough, whispers become screams. Taking ferritin seriously — not just as a checkbox on a lab report, but as a meaningful marker — is one concrete way to catch a problem while it's still easy to fix.Final ThoughtsMonitoring and optimizing ferritin can meaningfully change how you feel day to day. It starts with a simple ask: get the right test, read the number in context, and act on what it's telling you. If you want a more personalized look at your own levels and symptoms, consider scheduling a comprehensive health session.Stay informed, stay healthy, and listen closely to what your body is telling you. Until next time, take care.References* Camaschella, C. (2015). Iron-deficiency anemia. New England Journal of Medicine.* WHO guidance on serum ferritin concentrations for the assessment of iron status.* Clinical literature on ferritin thresholds and symptomatic iron deficiency without anemia.* Hepcidin and inflammation's role in iron regulation — recent reviews in Blood and Haematologica. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit tripleplaydoc.substack.com/subscribe

Could hepatitis B finally have a finite treatment option? Tatyana Kushner, MD, joins hosts Nancy Reau, MD, and Kimberly Brown, MD, to break down the phase 3 B-Well data for bepirovirsen, the first agent to hit functional cure as a primary endpoint in chronic hepatitis B.The conversation covers the phase 3 B-Well 1 and B-Well 2 results, published in the New England Journal of Medicine and presented at EASL 2026, and why quantitative HBsAg testing is becoming essential to patient selection ahead of a potential approval. Kushner, Reau, and Brown also work through what functional cure actually means for patients, how it compares to spontaneous HBsAg loss, and what dosing and monitoring are likely to look like given signals for ALT elevation and renal effects seen in the trials. They discuss which patients are unlikely to be candidates, including those with cirrhosis or decompensated liver disease, and close with a look at what an approval could mean for hepatitis B screening rates and referral patterns between primary care and specialty hepatology.Bepirovirsen is not yet FDA approved. The FDA has accepted the New Drug Application for priority review, with a PDUFA goal date of October 26, 2026.For more: https://www.hcplive.com/view/liver-lineup-bepirovirsen-and-the-push-toward-functional-cure-in-hepatitis-b

「安慰剂」在新药研发过程中处处可见，amylose 和 amylopectin是安慰剂糖丸的主要成分，其实就是淀粉（标题注释）。安慰剂效应究竟是应该被消除的统计噪声，还是一种被低估的真实治疗机制？当一针生理盐水能让帕金森患者的大脑释放出与真药相当的多巴胺，当假手术的疗效与真手术完全持平。我们要回答的问题是：如果安慰剂这么强，新药研发的投入还有意义吗？如果安慰剂能治病，我们可以只给病人吃糖丸吗？这期节目我们一起聊聊安慰剂效应在大脑中究竟通过哪些神经通路起效；它为什么越来越强以至于成为新药研发的障碍；我们可以只用安慰剂来治病吗？时间轴[00:14] 怀特先生的故事：一针盐水就让肿瘤消失了[02:54] 二战护士用生理盐水冒充吗啡止痛，战士不疼了[06:22] 不光吃药，手术也有安慰剂效应[12:32] 安慰剂不光能安慰，还能「反安慰」[19:10] 安慰剂管用的三条神经通路：内源性阿片系统、多巴胺奖赏系统、HPA 轴[28:32] 安慰剂成了新药上市的绊脚石[39:31] 临床试验如何对付安慰剂效应[44:14] 只用安慰剂能治病吗？

Cognitive Atrophy, Referral Incentives, Fragmented Care: Is Primary Care Inevitable or Fixable? Episode 519. Primary care physicians are leaving traditional practice for concierge medicine in visible numbers—and the question is whether that exodus is an unavoidable consequence of how the system is built, or something we've simply chosen not to fix. Stacey Richter talks with Dr. Lisa Rosenbaum, a cardiologist at Beth Israel Deaconess Medical Center (BIDMC) and national correspondent for the New England Journal of Medicine, who recently devoted an entire season of her NEJM podcast, Not Otherwise Specified, to the state of primary care. Together they test three forces reshaping the field—cognitive atrophy, referral incentives, and care fragmentation—against a single question: inevitable, or fixable? WHAT YOU'LL LEARN ✅ Why Dr. Lisa Rosenbaum calls the risk of "cognitive atrophy" among primary care physicians a generational threat rather than an individual one—and why she believes it is not inevitable ✅ How financial incentives that pay far more for a specialist visit than a primary care visit (roughly 5% of healthcare dollars for close to 35% of outpatient visits) structurally push referrals earlier and more often than necessary ✅ Why "relational expertise"—the judgment a doctor builds by knowing a patient over time—is, in Dr. Rosenbaum's view, primary care's real and undervalued skill set ✅ How care fragmentation, illustrated by Miriam Paramore's LinkedIn essay about her father's end-of-life care, leaves patients bouncing among specialists with no one taking ownership of the whole picture ✅ Why Dr. Rosenbaum argues that blaming everything on structural constraints "strip[s] ourselves of our own agency," and what she thinks physicians and healthcare buyers should each do about it WHY THIS MATTERS Roughly 70% of physicians are employed today, and about 5% of every healthcare dollar goes to primary care despite it covering close to 35% of all outpatient visits—numbers that, per Dr. Rosenbaum, reflect choices the system has made, not laws of nature. When primary care doctors lose the time and incentive to build relationships with patients, the system loses its quarterback, and patients end up fragmented across specialists with no one accountable for the whole picture. Dr. Rosenbaum's core argument is that none of this is inevitable, but fixing it requires both structural change and individual physicians and healthcare buyers reclaiming their own agency. MENTIONED IN THIS EPISODE EP504 with Ryan Jacobs: Apple Podcasts | Spotify | Other Apps EP473 with Kenny Cole, MD: Apple Podcasts | Spotify Other Apps EP391 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps Article: "Ordinary Rural Death: My Father's End-of-Life Journey" by Miriam Paramore EP409 with Larry Bauer, MSW, MEd: Apple Podcasts | Spotify | Other Apps === LINKS ===

In this special episode, Howie and Harlan revisit their conversation with trauma surgeon Selwyn Rogers, whose book Healing the Gun Violence Epidemic: Ending Violence, Rebuilding Communities, and a Trauma Surgeon's Vision for Restoring Hope was published on July 7. Show notes: Selwyn Rogers: Healing the Gun Violence Epidemic: Ending Violence, Rebuilding Communities, and a Trauma Surgeon's Vision for Restoring Hope Albert Ko "Selwyn Rogers named associate editor of prestigious New England Journal of Medicine" Selwyn Rogers: "Hope—Beyond Firearm Trauma" Selwyn Rogers: "Structural Racism and Firearm Injury: Operationalizing Health Equity in Trauma Care" Brain Death: What it is, Stages & Criteria New York Times Live Updates: Supreme Court Birthright Citizenship Case Annual Gun Violence Data 2023 In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.

Clinical trial support companies are rapidly adopting AI, but sponsors have been more hesitant. Raj Indupuri, CEO of eClinical Solutions, gives the top three reasons behind the holdup in AI agent deployment. He explains the specific pattern of uptake for these agents, the required human-in-the-loop oversight, and how the agents can improve clinical trial velocity. Host Deborah Borfitz also gives the latest news on a highly acclaimed treatment for pancreatic cancer, filling evidence gaps in drug safety during pregnancy, guidelines for routinely collected health data for research purposes, an innovative portal aiding bidirectional communication with patients, and more. Show Notes News Roundup KRAS inhibitor therapy for pancreatic cancer Study in The New England Journal of Medicine  News on the Fred Hutch Cancer Center website  Target trial emulation in rural areas Perspective in the Medical Journal of Australia News on the Griffith University website   AI for improving drug safety during pregnancy Report from the Journal of Medical Internet Research Guidelines on the use of routinely collected data Article in The BMJ New regulatory framework in the U.K. Press release by the Medicines and Healthcare products Regulatory Agency  Participant Engagement Portal Article in JNCI Cancer Spectrum Press release from the Alliance for Clinical Trials in Oncology The Scope of Things podcast explores clinical research and its possibilities, promise, and pitfalls. Clinical Research News senior writer, Deborah Borfitz, welcomes guests who are visionaries closest to the topics, but who can still see past their piece of the puzzle. Focusing on game-changing trends and out-of-the-box operational approaches in the clinical research field, the Scope of Things podcast is your no-nonsense, insider's look at clinical research today.  

Weniger als vier von 100. So wenige gingen ein Jahr später noch ins Fitnessstudio. Und das lag nicht daran, dass sie nicht wollten.Fitness-Gewohnheiten – ob gesundes Essen, Supplement-Einnahme oder regelmäßiges Training – spielen neurobiologisch in einer eigenen Liga. Am Anfang arbeitet Dein Gehirn gegen Dich. Am Ende dieser Folge weißt Du, warum, und mit welchen drei Strategien Du trotzdem dranbleibst.Du erfährst:Warum sich die ersten Wochen wie ein Kampf anfühlen, und wann sich das drehtWarum die „21-Tage-Regel“ nicht funktioniert – und wie lange Du wirklich brauchst3 simple Strategien, die in Studien zu >50% häufigerem Training führen.Los geht's. Und dann: dranbleiben.____________*WERBUNG: Infos zum Werbepartner dieser Folge und allen weiteren Werbepartnern findest Du hier.

Get the 200+ Page Optimal Living Daily Workbook (PDF) — Free. Want to turn today's episode into an actionable plan? Join the Optimal Living Weekly newsletter and I'll send you our 200-page digital workbook immediately. It's packed with the best takeaways from the show, formatted for easy reading and implementation at home. Get your free PDF workbook here: ⁠https://oldpodcast.eo.page/join⁠ Discover all of the podcasts in our network, search for specific episodes and learn more at:⁠ OLDPodcast.com⁠. Episode 3453: Dr. Jenny Brockis explores the fine line between enjoying caffeine and becoming dependent on it, sharing her own experience of consuming too much tea and the surprising effects it had on her mood and anxiety levels. She also highlights the brain and longevity benefits associated with moderate caffeine intake, offering a balanced perspective on how to find the amount that works best for you. Read along with the original article(s) here: https://drjennybrockis.com/2014/2/3/could-you-be-addicted-to-caffeine/ Quotes to ponder: "It seems that caffeine can be good or bad for you depending on how much you consume on a daily basis. As Goldilocks discovered, it's about not having too much or too little, but just enough." "There are a number of health benefits to the brain that caffeine provides, but like most things, if we overdo it, we can run into trouble." "Certain plants (coffea and citrus) produce nectar that contains just a teensy bit of caffeine, but enough to enhance the honeybee's memory, making them more effective pollinators of those plants." Episode references: Nurses' Health Study: https://nurseshealthstudy.org/ The New England Journal of Medicine – Association of Coffee Drinking with Total and Cause-Specific Mortality: https://www.nejm.org/doi/full/10.1056/NEJMoa1112010 Learn more about your ad choices. Visit megaphone.fm/adchoices

Get the 200+ Page Optimal Living Daily Workbook (PDF) — Free. Want to turn today's episode into an actionable plan? Join the Optimal Living Weekly newsletter and I'll send you our 200-page digital workbook immediately. It's packed with the best takeaways from the show, formatted for easy reading and implementation at home. Get your free PDF workbook here: ⁠https://oldpodcast.eo.page/join⁠ Discover all of the podcasts in our network, search for specific episodes and learn more at:⁠ OLDPodcast.com⁠. Episode 3453: Dr. Jenny Brockis explores the fine line between enjoying caffeine and becoming dependent on it, sharing her own experience of consuming too much tea and the surprising effects it had on her mood and anxiety levels. She also highlights the brain and longevity benefits associated with moderate caffeine intake, offering a balanced perspective on how to find the amount that works best for you. Read along with the original article(s) here: https://drjennybrockis.com/2014/2/3/could-you-be-addicted-to-caffeine/ Quotes to ponder: "It seems that caffeine can be good or bad for you depending on how much you consume on a daily basis. As Goldilocks discovered, it's about not having too much or too little, but just enough." "There are a number of health benefits to the brain that caffeine provides, but like most things, if we overdo it, we can run into trouble." "Certain plants (coffea and citrus) produce nectar that contains just a teensy bit of caffeine, but enough to enhance the honeybee's memory, making them more effective pollinators of those plants." Episode references: Nurses' Health Study: https://nurseshealthstudy.org/ The New England Journal of Medicine – Association of Coffee Drinking with Total and Cause-Specific Mortality: https://www.nejm.org/doi/full/10.1056/NEJMoa1112010 Learn more about your ad choices. Visit megaphone.fm/adchoices

This piece is essential listening for anyone interested in modern academic publishing. Recorded at the Collaborative Clinical Trials Meeting in Prato, Italy, TopMedTalk hosts Kate Leslie and Mike Grocott speak with Eric Rubin (Editor-in-Chief, New England Journal of Medicine) and Jocalyn Clark (International Editor, BMJ) about medical publishing. The conversation covers, engaging with clinical researchers and seeing impactful work. How AI can help authors—especially non-native English speakers—while raising concerns about confidentiality, inaccurate or fabricated content, reviewer misuse, governance policies that struggle to keep pace, and AI-generated correspondence overwhelming journals. They explore how AI affects originality and idea generation, note an NEJM AI experiment using AI reviews, and consider how journals should communicate beyond clinicians to address misinformation and declining attention, while maintaining trust and collaborating more across publishing and science. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org

SCOTUS votes 6-3 to uphold birthright citizenship, Kushner and Witkoff meet Qatari mediators in Doha for Iran talks, Keiko Fujimori wins Peru's presidency by a slim margin, South Korea's parliament confirms Han Seong-sook as prime minister, a Ukrainian businessman is among three people injured in a Monaco bomb attack, SCOTUS upholds state transgender sports bans, a Gallup poll shows that economic pessimism among Russians is at its highest in two decades, the U.K. considers blocking Paramount's takeover of Warner Bros Discovery, The New England Journal of Medicine retracts a Tavneos study over data concerns, and researchers find Antarctic sea creatures that may help treat melanoma. Sources: Verity.News

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers the topic of grief with Dr. Cindy Grief, a Geriatric Psychiatrist at Baycrest Health Sciences in Toronto, where she is the Medical Director for Mental Health Services. She is also an Associate Professor at the University of Toronto and has played active roles in postgraduate and continuing education.The learning objectives for this episode are as followsExplain how acute grief becomes integrated over time, and how the dual process model helps us understand this adaptive process.Recognize the clinical features of Prolonged Grief Disorder, understand factors that may increase vulnerability, and distinguish it from trauma-related disorders and depression.Structure a bereavement-focused clinical history, differentiate the management of normative grief from Prolonged Grief Disorder, and approach suicide risk assessment in the context of grief.Guest: Dr. Cindy GriefHosts: Ahmad Khan (incoming PGY1), Dr. Angad Singh (PGY2), and Sara Abrahamson (MS3)Audio editing: Dr. Angad SinghResources:T⁠he Center for Prolonged Grief (https://prolongedgrief.columbia.edu/)Canadian Virtual Hospice  (MyGrief.ca)Association for Death Education and Counseling (https://adec.org)What's Your Grief (https://whatsyourgrief.com/)Podcasts: AllThere Is; Griefcast⁠⁠Books/Memoirs:Joan Didion, The Year of Magical ThinkingHelen Macdonald, H Is for HawkC.S. Lewis, A Grief ObservedChimamand Ngozi Adichie, Notes on GriefArticles:A.C. Shilton, “There Is No Vaccine for Grief,” New York Times, March 2, 2021M. Stroebe, “The Poetry of Grief: Beyond Scientific Portrayal,” OMEGA: Journal of Death and Dying, 2018, 78(1), 67–96References:Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F., III. (2005). Treatment of complicated grief: A randomized controlled trial. Journal of the American Medical Association, 293(21), 2601–2608. https://doi.org/10.1001/jama.293.21.2601Simon, N. M., & Shear, M. K. (2024). Prolonged grief disorder. New England Journal of Medicine, 391(13), 1227–1236. https://doi.org/10.1056/NEJMcp2308707Zisook, S., & Shear, K. (2009). Grief and bereavement: What psychiatrists need to know. World Psychiatry, 8(2), 67–74. https://doi.org/10.1002/j.2051-5545.2009.tb00217.x

Contributor: Travis Barlock, MD Educational Pearls:   First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma.  Complication rate for patients intubated on the first pass is 14% Complication rates increase to 47% after two attempts, 64% after three, and 71% after the fourth attempt   How to improve likelihood of first-pass success: Use Video laryngoscopy (VL). VL increases chance of first-pass success to 85% from 71% Use a bougie, especially in patients with anatomically difficult or otherwise obstructed airways. The BEAM study cites a success rate in these patients of 96% with a bougie, compared to 82% without Use a Checklist mnemonic (SOAPME) Suction – On, ready, and within reach Oxygen – Patient is preoxygenated Adjuncts – Oral/nasal adjuncts and BVM ready Positioning - Patient positioned properly; consider obesity, using semi-Fowler/head-up positioning Medications – Rapid sequence intubation (RSI), sedation, vasopressor, and other medications prepared as necessary Equipment – Laryngoscope (blade), tube, bougie/stylet, syringe, scalpel/cric kit, others ready as necessary References Sakles, J.C., Chiu, S., Mosier, J., Walker, C. and Stolz, U. (2013), The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Acad Emerg Med, 20: 71-78. https://doi.org/10.1111/acem.12055 Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. New England Journal of Medicine. 2023;389(5). doi:https://doi.org/10.1056/nejmoa2301601 Driver BE, Prekker ME, Klein LR, et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. JAMA. 2018;319(21):2179–2189. doi:10.1001/jama.2018.6496 ‌Turner JS, Bucca AW, Propst SL, et al. Association of Checklist Use in Endotracheal Intubation With Clinically Important Outcomes: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(7):e209278. doi:10.1001/jamanetworkopen.2020.9278 Turner, Joseph S et al. "Feasibility of  upright patient positioning and intubation success rates At two academic EDs." The American journal of emergency medicine vol. 35,7 (2017): 986-992. doi:10.1016/j.ajem.2017.02.011   Summarized by Sam Pahl | Edited by Sam Pahl & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf  

World-leading behaviour change expert Katy Milkman details how to change your habits.  --- Become an FSB member: https://get.fsb.org.uk/nudge/ Unlock the Nudge Vaults: https://www.nudgepodcast.com/vaults Katy's book: https://amzn.to/3RF63xA  Katy's podcast: https://www.schwab.com/learn/choiceology  Katy's newsletter: https://www.katymilkman.com/newsletter-milkman-delivers  Subscribe to my newsletter: https://www.nudgepodcast.com/mailing-list  Connect on LinkedIn: https://www.linkedin.com/in/phill-agnew/  --- Today's sources: Beshears, J.Beshears, J., Dai, H., Milkman, K. L., & Benartzi, S. (2021). Using fresh starts to nudge increased retirement savings. Organizational Behavior and Human Decision Processes, 167, 72–87. Dai, H., Milkman, K. L., & Riis, J. (2014). The fresh start effect: Temporal landmarks motivate aspirational behavior. Management Science, 60(10), 2563–2582. Eskreis-Winkler, L., Fishbach, A., & Duckworth, A. L. (2018). Dear Abby: Should I give advice or receive it? Psychological Science, 29(11), 1797–1806. Eskreis-Winkler, L., Milkman, K. L., Gromet, D. M., & Duckworth, A. L. (2019). A large-scale field experiment shows giving advice improves academic outcomes for the advisor. Proceedings of the National Academy of Sciences, 116(30), 14808–14810. Schroeder, S. A. (2007). We can do better — Improving the health of the American people. New England Journal of Medicine, 357(12), 1221–1228.

Your body has been talking to you your whole life. The question is whether anyone ever taught you to listen. In this episode, I want to widen the lens on how you read your own body. We have lost so much of the generational knowledge our mothers and grandmothers once passed down, and now we tend to wait until something hurts before we pay attention. But your body speaks in subtleties long before that. I share one of my great loves, Ayurveda, the 5,000-year-old healing system I studied for three years, and its practice of observation called the eightfold examination. What fascinates me most is how closely it aligns with modern functional nutrition's Nutrition Focused Physical Exam. We walk through what your tongue, skin, hair, nails, and eyes may be reflecting about your gut health, your nutrient status, your oxidative stress, and even your blood sugar, backed by research going back nearly 80 years. Here is what matters most. This is not about self-diagnosis. None of these signs are proof of anything on their own. They are invitations to pay attention, not verdicts to fear. My hope is that noticing your body builds confidence instead of anxiety, the quiet confidence of a woman in a loving conversation with her body rather than at war with it. If you take one small thing from this episode, try this. Tomorrow morning, look at your tongue and just notice. Do it for a week. That is the practice.   Resources Mentioned: Work with Laura: https://www.thebreastcancerrecoverycoach.com/health  Download for iPhone:  https://apps.apple.com/us/app/kajabi/id1485646310 Download for Android:  https://play.google.com/store/apps/details?id=kajabi.kajabiapp&hl=en_US Here is the link to the FREE Ayurveda Mini-Course that I talked about in this episode: https://www.thebreastcancerrecoverycoach.com/mybody   Here are the references: Foundational Asif T, Mohiuddin A, Hasan B, Pauly RR. Importance of Thorough Physical Examination: A Lost Art. Cureus. 2017;9(5):e1212. Newton C. The Functional Nutrition-Focused Physical Exam. IFNA Track 3 Module 2. Tongue Jeghers H. Nutrition: the appearance of the tongue as an index of nutritional deficiency. New England Journal of Medicine. 1942;227:221-8. Khayamzadeh M, Najafi S, Sadrolodabaei P, Vakili F, Kharrazi Fard MJ. Determining salivary and serum levels of iron, zinc and vitamin B12 in patients with geographic tongue. J Dent Res Dent Clin Dent Prospects. 2019;13(3):221-226. Chiang CP, Chang JY, Wang YP, Wu YH, Wu YC, Sun A. Atrophic glossitis: Etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. J Formos Med Assoc. 2020;119(4):774-780. Skin Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol. 2018;9:1459. Wang X, Li Y, Wu L, et al. Dysregulation of the gut-brain-skin axis and key overlapping inflammatory and immune mechanisms of psoriasis and depression. Biomed Pharmacother. 2021;137:111065. Jafferany M, Franca K. Psychodermatology: Basics Concepts. Acta Derm Venereol. 2016;96(217):35-7. Reunala T, Salmi TT, Hervonen K, Kaukinen K, Collin P. Dermatitis Herpetiformis: A Common Extraintestinal Manifestation of Coeliac Disease. Nutrients. 2018;10(5):602. Stefanadi EC, Dimitrakakis G, Antoniou CK, et al. Metabolic syndrome and the skin: a more than superficial association. Diabetol Metab Syndr. 2018;10:9. Hair O'Connor K, Goldberg LJ. Nutrition and hair. Clin Dermatol. 2021;39(5):809-818. Arck PC, Overall R, Spatz K, et al. Towards a "free radical theory of graying": melanocyte apoptosis in the aging human hair follicle is an indicator of oxidative stress induced tissue damage. FASEB J. 2006;20(9):1567-9. Zhang B, Ma S, Rachmin I, et al. Hyperactivation of sympathetic nerves drives depletion of melanocyte stem cells. Nature. 2020;577(7792):676-681. Poonia K, Bhalla M. Premature Graying of Hair: A Comprehensive Review and Recent Insights. Indian Dermatol Online J. 2024;15(5):721-731. Nails Singal A, Arora R. Nail as a window of systemic diseases. Indian Dermatol Online J. 2015;6(2):67-74. Cashman MW, Sloan SB. Nutrition and nail disease. Clin Dermatol. 2010;28(4):420-5. Eyes Knapp A. The Eye as a Guide to Latent Nutritional Deficiency Diseases. Bull N Y Acad Med. 1946. Wakamatsu TH, Dogru M, Tsubota K. Tearful relations: oxidative stress, inflammation and eye diseases. Arq Bras Oftalmol. 2008;71(6 Suppl):72-9. Seydou A, Arnould L, Gabrielle PH, et al. Plasma Fatty Acids Pattern and Dry Eye Disease in the Elderly: The Montrachet Population-Based Study. Nutrients. 2022;14(11):2290. Bu Y, Shih KC, Tong L. The ocular surface and diabetes, the other 21st Century epidemic. Exp Eye Res. 2022;220:109099. Rahman A, Yahya K, Ahmed T, Sharif-Ul-Hasan K. Diagnostic value of tear films tests in type 2 diabetes. J Pak Med Assoc. 2007;57(12):577-81. Seifart U, Strempel I. Trockenes Auge und Diabetes mellitus [The dry eye and diabetes mellitus]. Ophthalmologe. 1994;91(2):235-9. Campagnoli LIM, Varesi A, Barbieri A, Marchesi N, Pascale A. Targeting the Gut-Eye Axis: An Emerging Strategy to Face Ocular Diseases. Int J Mol Sci. 2023;24(17):13338. Let's Connect! If this episode helped you breathe a little easier, please share it with a friend or leave a review. Every share helps spread this message of hope, healing, and whole-person wellness.

────────────────────────────────────────[00:02:09]Trump Unilaterally Rewrites the MOU — Demands Iran Spend Frozen Funds Only on US Farm GoodsPoint 11 of the signed MOU says funds are released without conditions; Trump invented the escrow-for-American-corn clause after Kushner pressed him.────────────────────────────────────────[00:05:00]Senate Votes to Halt the Iran War — Resolution Has No Force of Law, White House Dismisses ItPassed 50-48; does not go to the president for signature or veto; four Republicans broke ranks including Rand Paul and Bill Cassidy.────────────────────────────────────────[00:10:18]Ben Gvir: All of Lebanon Must Be Our Playground — For Every Israeli Tear, a Thousand Lebanese Must WeepIsraeli finance minister refuses any restriction on Lebanese territory and demands it all burn; Netanyahu confirmed forces are not leaving.────────────────────────────────────────[00:46:01]Rand Paul's Wife Bought Gilead Stock During Remdesivir Push — Knight Says He Has No Credibility on FauciFauci declared remdesivir standard of care one day after a WHO trial showed it ineffective; Paul's wife held Gilead shares throughout.────────────────────────────────────────[00:47:41]Trump Orders Ford and GM to Make Bombs Instead of Cars — Same Defense Production Act Used for VentilatorsKnight: they don't want people to have independent transportation; commandeering auto production is the same playbook used in 2020.────────────────────────────────────────[00:56:37]VA Study Claims COVID Vaccine Lowers Cardiac Risk — Knight: They Caused the Heart Disease and Now Claim the CureSeven children confirmed dead from the jabs per FDA data; New England Journal of Medicine ex-editor said the journal lost all credibility.────────────────────────────────────────[01:29:16]Tulsi Gabbard's Entire Career Was Guided by a Hare Krishna Cult Leader Named Chris ButlerYear-long Washington Post investigation; former cult members handed over internal records showing Butler shaped her public decisions.────────────────────────────────────────[01:43:44]Ben Gvir Repeats: All of Lebanon Must Burn — No Distinction Between Hezbollah and Lebanese CiviliansSame doctrine applied in Gaza; Knesset member adds they want to drag Hamas leaders across Gaza in front of cameras before prison.────────────────────────────────────────[01:47:00]Jared Kushner Invented the Escrow-for-Farm-Goods Clause — JD Vance Selling It as a Trump DealMOU says nothing about escrow or American goods; Kushner and Qataris fabricated it after signing; Vance repeating the lie publicly.────────────────────────────────────────[01:51:28]Zionist Lobbyist Brags About Sanctioning UN Rapporteur Albanese, Freezing Her Bank Accounts, Demoting Her HusbandAfter boasting of controlling Albanese's finances and barring her from the US, lobbyist Hillel Neuer insists the Jewish lobby does not control America. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.

────────────────────────────────────────[00:02:09]Trump Unilaterally Rewrites the MOU — Demands Iran Spend Frozen Funds Only on US Farm GoodsPoint 11 of the signed MOU says funds are released without conditions; Trump invented the escrow-for-American-corn clause after Kushner pressed him.────────────────────────────────────────[00:05:00]Senate Votes to Halt the Iran War — Resolution Has No Force of Law, White House Dismisses ItPassed 50-48; does not go to the president for signature or veto; four Republicans broke ranks including Rand Paul and Bill Cassidy.────────────────────────────────────────[00:10:18]Ben Gvir: All of Lebanon Must Be Our Playground — For Every Israeli Tear, a Thousand Lebanese Must WeepIsraeli finance minister refuses any restriction on Lebanese territory and demands it all burn; Netanyahu confirmed forces are not leaving.────────────────────────────────────────[00:46:01]Rand Paul's Wife Bought Gilead Stock During Remdesivir Push — Knight Says He Has No Credibility on FauciFauci declared remdesivir standard of care one day after a WHO trial showed it ineffective; Paul's wife held Gilead shares throughout.────────────────────────────────────────[00:47:41]Trump Orders Ford and GM to Make Bombs Instead of Cars — Same Defense Production Act Used for VentilatorsKnight: they don't want people to have independent transportation; commandeering auto production is the same playbook used in 2020.────────────────────────────────────────[00:56:37]VA Study Claims COVID Vaccine Lowers Cardiac Risk — Knight: They Caused the Heart Disease and Now Claim the CureSeven children confirmed dead from the jabs per FDA data; New England Journal of Medicine ex-editor said the journal lost all credibility.────────────────────────────────────────[01:29:16]Tulsi Gabbard's Entire Career Was Guided by a Hare Krishna Cult Leader Named Chris ButlerYear-long Washington Post investigation; former cult members handed over internal records showing Butler shaped her public decisions.────────────────────────────────────────[01:43:44]Ben Gvir Repeats: All of Lebanon Must Burn — No Distinction Between Hezbollah and Lebanese CiviliansSame doctrine applied in Gaza; Knesset member adds they want to drag Hamas leaders across Gaza in front of cameras before prison.────────────────────────────────────────[01:47:00]Jared Kushner Invented the Escrow-for-Farm-Goods Clause — JD Vance Selling It as a Trump DealMOU says nothing about escrow or American goods; Kushner and Qataris fabricated it after signing; Vance repeating the lie publicly.────────────────────────────────────────[01:51:28]Zionist Lobbyist Brags About Sanctioning UN Rapporteur Albanese, Freezing Her Bank Accounts, Demoting Her HusbandAfter boasting of controlling Albanese's finances and barring her from the US, lobbyist Hillel Neuer insists the Jewish lobby does not control America. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.

Bio: Sean Duffy is the Co-founder and CEO of Omada Health, a between-visit care provider that addresses cardiometabolic conditions like diabetes, hypertension, prediabetes, and obesity, as well as musculoskeletal issues. He has dedicated his professional life to bridging technology, design, and care delivery to transform care experiences for patients. As a former MD/MBA candidate at Harvard, he also holds a BS in neuroscience from Columbia University. He has written extensively about digital health and the future of healthcare in The New England Journal of Medicine, The Wall Street Journal, Forbes, and TechCrunch, among other publications. Prior to Omada, Sean worked at both Google and IDEO.Company: Omada Health (Nasdaq: OMDA) is reverse engineering the way healthcare is delivered in America, putting the space between doctor visits–where health is won or lost–at the center of care. Today's healthcare system poorly serves chronic conditions that require ongoing support outside of the exam room, like obesity, diabetes, hypertension, cholesterol, and musculoskeletal conditions. Omada's virtual-first model combines human-led care teams, connected devices, and AI-enabled technology to deliver personalized care at scale, including support for GLP-1 therapy. Omada has served more than two million members since launch across 2,000+ employers, health plans, pharmacy benefit managers, and health systems. Learn more at omadahealth.com.

CardioNerds (Amit and Dan), Billy Joe Mullinax, and Saahil Jumkhawala discuss the long term management of pulmonary embolism with Dr. Soophia Naydenov.  The episode focuses on the approach to patients who struggle with persistent symptoms like dyspnea and fatigue even after completing the acute phase of anticoagulation. This spectrum of disease, ranging from mild post-PE impairment to chronic thromboembolic pulmonary hypertension (CTEPH), requires a structured follow-up. The discussion covers the critical importance of identifying CTEPH early, the necessary timelines for follow-up, and the appropriate objective screening tools and invasive testing to guide patient care toward full functional recovery. Audio editing by CardioNerds academy intern, Grace Qiu. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Acronyms PE: Pulmonary Embolism PERT: Pulmonary Embolism Response Team CTEPH: Chronic Thromboembolic Pulmonary Hypertension QL: Quality of Life VTE: Venous Thromboembolism DASH: D-dimer, Age, Sex, History of non-provoked PE (a risk score) CPET: Cardiopulmonary Exercise Testing PFTs: Pulmonary Function Tests VQ Scan: Ventilation-Perfusion Scan DOACs: Direct Oral Anticoagulants TPA: Tissue Plasminogen Activator (Thrombolytics) ECMO: Extracorporeal Membrane Oxygenation Pearls: Post-PE “Syndrome” is a Spectrum: It is more accurately a spectrum of disease (sequelae of PE) rather than a single syndrome, ranging from mild fatigue/dyspnea to the most severe form, CTEPH. Structured Follow-up is Mandatory: All PE survivors need a structured follow-up, typically with checkpoints at 3, 6, 12, and 16–24 months, with the primary goal being to detect CTEPH, the deadliest, yet potentially curable, disease on the spectrum. Screening Should Be Objective and Practical: When screening for persistent symptoms, use objective assessment tools like the Post-VTE Functional Status (PVFS) scale or the Modified Medical Research Council (MMR-C) scale, as highly comprehensive but cumbersome tools (like the PE Quality of Life questionnaire) may not be practical for routine clinical use. Recurrence Risk Scores Aid in Anticoagulation Duration: Simple scores like the DASH score or the HERDO2 score (for women) can provide guidance when considering the continuation versus discontinuation of anticoagulation after the initial treatment phase. Invasive Testing for Persistent Symptoms: If a patient remains symptomatic at the 6-month mark despite normal non-invasive testing (chest X-ray, ECG, PFTs, six-minute walk, echo, VQ scan, CPET), consider invasive testing such as Right Heart Catheterization (RHC) at rest or with exercise, or an invasive CPET. Notes: Notes drafted by Saahil Jumkhawala. 1. The Spectrum of Post-PE Disease The term “post-PE syndrome” should be used with caution, as it refers to a spectrum of disease rather than a single entity. This spectrum includes symptoms (sequelae) that exist in a patient’s life following an incidental PE event that they did not have before. On one extreme is Chronic Thromboembolic Pulmonary Hypertension (CTEPH): The definition is clear, but it is the most deadly type, though thankfully rare (2% to 4%). It involves a residual clot and pulmonary hypertension identifiable at rest. In the middle is Chronic Thromboembolic Disease (CTED): Patients may have residual defects seen on a VQ or CT scan, but they do not have pulmonary hypertension. On the other side is a milder disease, which can include fatigue, dyspnea, or a patient’s perceived impairment, where the definitions of CTEPH and CTED are not met, but the patient remains symptomatic. 2. Structured Follow-up and Screening for Post-PE Symptoms Structured follow-up is key for all PE survivors, though the structure may vary based on available resources (PCP, Cardiology, Pulmonary, or multidisciplinary clinic). Recommended Timeline for Follow-up: Data from studies like ELOPE and FOCUS suggest checkpoints at 3, 6, 12, and up to 16 to 24 months. This timeline is designed to identify patients who may develop CTEPH. 88% of patients who develop CTEPH will be identified within about a year. A structured follow-up can reduce the delay in CTEPH diagnosis from 10–12 months to 4–6 months. Personal Practice Note: A quick 2–3 week/30-day check-in is recommended for severely ill patients (e.g., those who had TPA, profound shock, or ECMO support) to ensure medication compliance, manage symptoms, and identify red flags. Screening Tools (Objective Assessment): The first step is an inventory of patient symptoms, leaning toward objective rather than subjective assessment. Recommended Simple Tools: Modified Medical Research Council (MMR-C) for dyspnea evaluation. Post-VTE Functional Status (PVFS) scale. The Pulmonary Embolism Quality of Life (QL) questionnaire is comprehensive but long, making it tedious and better suited for research. Future Utility: Technology (AI/electronic tools) may assist in administering these questionnaires before the clinic visit, presenting the information as a “dashboard” for the provider. 3. Management of Persistent Symptoms and Further Testing Initial Non-Invasive Tests (Often done at 3 months): Echocardiogram VQ Scan Full PFTs Six-minute walk CPET Further Evaluation for Persistent Symptoms (e.g., at 6 months): If non-invasive tests (Chest X-ray, ECG, CPET) are normal but symptoms persist, more invasive testing should be considered as the patient has not returned to baseline. Repeat VQ scan or echocardiogram if symptoms have changed. Right Heart Catheterization (RHC) at rest or with exercise. Invasive CPET. PA gram (Pulmonary Angiogram) to assess vasculature. 4. Recurrence Risk and Anticoagulation Duration The decision to continue or discontinue anticoagulation depends on the patient’s risk factors, the situation of the PE (provoked or unprovoked), presence of active cancer, and patient preference. Recurrence Risk Scores: Simple scores are preferred for practicality. DASH Score. HERDO2 Score (particularly for women). The Vienna Score can be considered if the question is whether to restart anticoagulation after a disruption. Role of D-dimer in Abbreviation: While D-dimer can be used to guide the decision to restart anticoagulation after a planned pause (if D-dimer is high, resume), patient symptoms are preferable to guide management decisions like early abbreviation. 5. Prevention of Post-PE Syndrome Currently, there is no clear tool known to prevent the post-PE syndrome/spectrum of disease. Best Current Advice for Prevention/Recovery: Anticoagulation compliance. Pulmonary rehabilitation, which aids in faster recovery. General precautions, such as smoking cessation and body weight management. Future Research: Ongoing trials are investigating whether acute management strategies (e.g., using thrombolytics in intermediate-risk PE) can prevent long-term sequelae. (The PYTHO trial did not show a reduced rate of CTEPH in intermediate-risk PE patients who received thrombolytics). References: Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. “Venous Thromboembolism.” The Lancet, vol. 398, no. 10294, 2021, pp. 64-77. doi:10.1016/S0140-6736(20)32658-1. Kearon, C., & Kahn, S. R. “Long-Term Treatment of Venous Thromboembolism.” Blood, vol. 135, no. 5, 2020, pp. 317-325. doi:10.1182/blood.2019002364. Kahn, S. R., & de Wit, K. “Pulmonary Embolism.” The New England Journal of Medicine, vol. 387, no. 1, 2022, pp. 45-57. doi:10.1056/NEJMcp2116489. Di Nisio, M., van Es, N., & Büller, H. R. “Deep Vein Thrombosis and Pulmonary Embolism.” The Lancet, vol. 388, no. 10063, 2016, pp. 3060-3073. doi:10.1016/S0140-6736(16)30514-1. Chopard, R., Albertsen, I. E., & Piazza, G. “Diagnosis and Treatment of Lower Extremity Venous Thromboembolism: A Review.” JAMA, vol. 324, no. 17, 2020, pp. 1765-1776. doi:10.1001/jama.2020.17272.

In today's episode, Dr. Lisa Oldson breaks down the science of microplastics and endocrine-disrupting chemicals, and why they may be quietly working against your weight loss efforts. From a landmark New England Journal of Medicine study linking microplastics in arterial plaque to a 4.5x higher risk of heart attack and stroke, to the growing evidence that BPA and phthalates disrupt fat cell formation, hormones, and gut health, Dr. Oldson explains what the research actually shows, and offers five practical, evidence-informed steps you can take starting today.Thanks for listening! If you'd like more support during your SMART weight loss & health focused journey, sign up for our FREE newsletter, or check out our program at: www.SmartWeightLossCoaching.com. We would love to help you reach your happy weight, and transform the way you talk to yourself about your body and the number on the scale. Negative thoughts about yourself don't have to take up so much brain space, and we'd be honored to help you reframe those thoughts. Also, we'd be grateful if you'd follow us and share our podcast with your friends & family. We're here to help you live longer, healthier, and lose weight the SMART way! This episode was produced by The Podcast Teacher: www.ThePodcastTeacher.com.The Smart Weight Loss Coaching Podcast is for informational purposes only and does not constitute medical advice. Always consult your physician or a qualified healthcare provider before starting, stopping, or changing any medication.

Doctor Mau Informa ®️ #drmauinforma Durante medio siglo, la endocrinología consideró al glucagón como el "villano" del metabolismo: la hormona responsable de subir el azúcar en la sangre. Sin embargo, ¿qué pasaría si pudiéramos domesticar a este villano para activar la quema extrema de grasa de forma segura. En este episodio de Doctor Mau Informa, analizamos la fascinante evolución científica que nos llevó desde tumores pancreáticos hasta el desarrollo del Retatrutide, un revolucionario fármaco "triple agonista". Descubre cómo la ciencia logró combinar tres señales hormonales (Glucagón, GLP-1 y GIP) en una sola inyección semanal para alcanzar resultados de pérdida de peso metabólica que antes solo le pertenecían al bisturí de la cirugía bariátrica. En este episodio aprenderás: → La balanza de la pérdida de peso: Por qué los medicamentos anteriores solo te quitaban el hambre, y cómo la nueva generación también acelera tu gasto energético. → El secreto del Glucagón: Cómo esta hormona del ayuno saca la grasa del hígado y eleva el metabolismo. → La evolución del GLP-1: El papel protector de la insulina natural para contrarrestar el azúcar y permitir una pérdida de peso segura. → Cirugía vs. Fármacos: Por qué los resultados de los nuevos tratamientos crónicos están cambiando el paradigma médico para siempre. → La realidad clínica: Efectos secundarios, la importancia de la titulación médica y por qué esto no es una "dieta milagro".

Many mothers go to the doctor because they feel exhausted, overwhelmed, and they aren't sleeping - and leave with a depression diagnosis and a prescription. The message is: your brain isn't working right, and medication will help you cope. But what if the problem isn't your brain at all? In this episode, I talk with journalist Bob Whitaker, who has spent decades investigating psychiatric treatment in the U.S. We look at how women's distress has been medicalized instead of taken seriously as a response to impossible circumstances. We look at how antidepressants work, which is quite different from what the drug companies have been telling us for years.  He also shares the results of a New Zealand study on postpartum depression that should have changed how we support new mothers - but didn't. Questions this episode will answer Is it burnout or depression? Burnout and depression share a lot of the same symptoms - exhaustion, low mood, difficulty functioning - but they have different roots. Burnout is a response to sustained, unmanageable circumstances. Depression, as it's currently diagnosed and treated, is framed as a brain malfunction. This episode looks at why this difference matters, and why so many mothers get a depression diagnosis when they're experiencing burnout. Why are mothers more likely to be diagnosed with depression? Mothers in the US are frequently carrying an unequal share of household work, childcare, and mental load - often while also working full time - with little support. When that situation becomes unsustainable, the distress it causes is then treated as an individual brain problem rather than a response to a broken system. What prevents postpartum depression? A study out of New Zealand found that consistent, practical support - help with the actual work of running a household - significantly reduced postpartum depression. But even though the findings were significant, more support has not become the standard of care. Should I take antidepressants? Antidepressants may reduce symptoms for some people, but research shows they are far less effective than we've been told - and for mothers whose distress is rooted in unsustainable circumstances, medication addresses the symptom rather than the source. If antidepressants are helping you, that's OK (and do keep taking them!). But antidepressants should be used to help create space for other interventions to work, rather than used long-term. How does society affect women's mental health? When we treat women's distress as a potentially life-long medical problem rather than a signal about unsustainable circumstances, we direct attention away from the structural changes that would actually help. This episode traces how that pattern developed - and what a different approach might look like. What you'll learn in this episode Why the mental load of motherhood is a structural problem, not a brain problem that medication should fixHow psychiatry functions as social control when it diagnoses individuals instead of the broken systems they're living inWhat the New Zealand postpartum depression study found - and why its results were largely ignoredHow drug advertising has shaped what we believe about women's distress - from Valium in the 1960s to antidepressants todayHow to shift from asking "what's wrong with my brain" to "what would actually need to change in my situation" If you want to learn more about Bob's work and the research on depression and antidepressants, go to https://madinamerica.com/. Want to go deeper? The full one-hour conversation with Bob is available to Parenting Membership members. In it, Bob traces exactly how depression came to be understood as a chemical imbalance - not because research proved it, but because psychiatry in the U.S. wanted to rebrand itself as a legitimate medical discipline in the 1980s.  He walks us through how pharmaceutical companies funneled money to academic psychiatrists to become "thought leaders," how Prozac was marketed as making people "feel better than well," and how the industry captured the entire profession so thoroughly that by 1998, the New England Journal of Medicine couldn't find a single academic expert on depression in the US who wasn't taking money from pharmaceutical companies. We went deep on the STAR*D trial - the largest antidepressant study ever conducted. The public was told 70% of patients got better. The actual stay-well rate at one year, once a researcher used a Freedom of Information request to get the raw data: 3%. Bob walks through exactly how that number was inflated - the protocol violations, the patients who were already in remission when they enrolled, the switched measurement scales - and why he calls it a straight-out public betrayal. The whole episode is available to you in your private podcast feed immediately after joining the Parenting Membership.  Inside the membership, you'll find research-based modules on the specific challenges that make family life hard - from navigating parenting as a team to raising siblings who get along. Monthly group coaching calls give you a chance to talk through your specific situation directly with me. And you'll find a community of parents who share your values and are working through parenting challenges together, and with my support. If you've been told the problem is your brain, and something in this episode made you wonder whether that's the whole story - the membership is where you get help to figure out what's right for you and your family. Click the banner to learn more Jump to highlights: 01:50 Introduction to today's episode and guest 05:04 Just remember what the disease model does. It focuses on the problems in the head of the individual, not in the social way we arrange our society. 06:25 From hysteria and electroshock therapy (mostly given to women) in the 1800s, to marketing benzodiazepines to wives in the 1960s, the pattern of pathologizing women's distress has been consistent. 08:32 When benzodiazepines were recognized as addictive in the late 1970s, psychiatry reframed anxiety as a type of depression and switched women to antidepressants, another numbing drug that keeps women quiet and functioning in an impossible situation. 13:31 In the New Zealand study, it says that when women got daily help with housework for six months, postpartum depression was prevented. Yet this support became standard care nowhere, because the system still believes the problem is in people's brains, not in their circumstances. 14:17 Wrapping up today's topic

Myoscience GlyNAC (20% off, exclusive to this community): https://bit.ly/4auv3xW  Pre-order Keto Flex Revised and get free bonuses at: https://bit.ly/4wKG1sM    A 2026 randomized controlled trial called the PERTH trial found that people reduced plastic-related chemicals in their bodies by up to 60% in just seven days by swapping their food, kitchenware, and personal care products. The research behind this is not fringe. A study in the New England Journal of Medicine found microplastics embedded in arterial plaque in over half of 257 surgical patients. Those patients had a 4.5 times higher risk of heart attack, stroke, or death. A 2025 Nature Medicine study found the average human brain now holds roughly a spoonful of microplastic particles, up 50% in just eight years. In dementia brains, the concentration was ten times higher. In this episode, Ben walks through exactly where exposure comes from, what these plastics are doing to your hormones, your metabolism, your inflammation, and your brain, and the simple five-step protocol you can start today. Key takeaways: A single liter of bottled water contains around 240,000 microplastic particles on average One plastic teabag releases 11.6 billion plastic particles into a single cup of hot water BPA mimics estrogen at receptor sites, disrupting testosterone in men and fertility in women Your body stores these chemicals in fat cells through a pathway called PPAR gamma, creating new fat cells if it runs out of room Glutathione is the master molecule your liver uses to neutralize and eliminate these toxins, and modern life depletes it constantly NAC supplies the cysteine your liver needs to produce glutathione internally The five-step protocol: stop heating plastic, filter your water, eat real food, sweat daily, prioritize fiber and hydration Find All The Ben Azadi Show Sponsorship Deals ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.ketokamp.com/sponsorship-deals Learn more about your ad choices. Visit megaphone.fm/adchoices

Scroll down for a transcription of this episode.Intention to Treat: The Race Equation is a new series from the New England Journal of Medicine, investigates how race-specific diagnostic tools harm Black patients and contribute to growing health inequities.Transcription: https://tinyurl.com/36bne7hd

A University of Kentucky epidemiologist convinced 678 Catholic nuns to donate their brains and their entire life records to science, and the autopsies he performed quietly rewrote everything modern medicine thought it knew about Alzheimer’s disease. The findings have been published in JAMA and the New England Journal of Medicine. Almost nobody outside the field… Continue reading The Power of Gratitude

A 25-year-old pregnant woman presents with a 1-day history of progressive pain and swelling. The foot is cold, pulseless and neurologic function is deteriorating by the hour. Imaging shows a massive iliofemoral DVT. Now both the limb and the pregnancy are threatened. Do you anticoagulate, thrombolyse or operate? Join us as we break down the management and decision making behind this rare but devastating case.Hosts:·      Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center·      Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center·      Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center·      Lucio Flores, Vascular surgery, Brookdale Hospital Medical CenterLearning objectives:-       Recognize the clinical presentation and pathophysiology of phlegmasia cerulea dolens-       Describe how pregnancy affects decision making in patients with phlegmasia and venous thromboembolic disease-       Discuss the goals of treatment for patients with DVT's and identify when operative intervention is indicated-       Describe the sequelae of DVT's and how this relates to post thrombotic syndrome-       Review the indications, risks, and limitations of anticoagulation, catheter-directed thrombolysis, thrombectomy, and fasciotomy in the management of DVT and phlegmasia.-       Explain the role of IVUS in managing venous thromboembolic disease and May Thurner syndromeReferences:-       Vedantham, S., Goldhaber, S. Z., Julian, J. A., Kahn, S. R., Jaff, M. R., Cohen, D. J., Magnuson, E., Razavi, M. K., Comerota, A. J., Gornik, H. L., Murphy, T. P., Lewis, L., Duncan, J. R., Nieters, P., Derfler, M. C., Filion, M., Gu, C.-S., Kee, S., Schneider, J., … Kearon, C. (2017). Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis. New England Journal of Medicine, 377(23), 2240–2252. https://doi.org/10.1056/NEJMoa1615066-       Gomes, M. S., Guimarães, M., & Montenegro, N. (2019). Thrombolysis in pregnancy: A literature review. Journal of Maternal-Fetal & Neonatal Medicine, 32(14), 2418–2428. https://doi.org/10.1080/14767058.2018.1438402-       Mangla, A., & Hamad, H. (2023). May-Thurner syndrome. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554377/-       Bates, S. M., Rajasekhar, A., Middeldorp, S., McLintock, C., Rodger, M. A., James, A. H., et al. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: Venous thromboembolism in the context of pregnancy. Blood Advances, 2(22), 3317–3359. https://doi.org/10.1182/bloodadvances.2018024802-       Kahn, S. R., Comerota, A. J., Cushman, M., Evans, N. S., Ginsberg, J. S., Goldenberg, N. A., et al. (2014). The postthrombotic syndrome: Evidence-based prevention, diagnosis, and treatment strategies. Circulation, 130(18), 1636–1661. https://doi.org/10.1161/CIR.0000000000000130 https://pubmed.ncbi.nlm.nih.gov/25246013/Sponsor URL: https://www.goremedical.com/If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

We bring you an episode of "Intention to Treat: The Race Equation." It's a new series from the New England Journal of Medicine that investigates how race-specific diagnostic tools harm Black patients and contribute to growing health inequities.

Equip Foods Protein (grass-fed beef isolate, no seed oils, third-party tested) Code: BENAZADI - https://bit.ly/49xXaMq  Keto Flex Revised by Ben Azadi (pre-order now, releases July 21st, includes exclusive bonus chapters as a downloadable PDF): https://bit.ly/4wKG1sM    In this episode, Ben Azadi reveals the five foods he eliminated that ended his chronic cravings and led to losing 19 pounds in 30 days. The root issue is not willpower. It's hormones and inflammation. A 2019 NIH study by Kevin Hall had participants eating ultra-processed vs. whole foods at matched calories. On the ultra-processed diet, they ate 500 extra calories per day without realizing it. The food was driving the overconsumption, not a lack of discipline. The five foods to remove: Liquid sugar. Sodas, juices, sports drinks, and flavored coffee drinks don't register as fullness. The Harvard Nurses' Health Study found adding one sugary drink per day led to 358 extra calories consumed daily. Swap for black coffee, plain tea, or sparkling water. Ultra-processed breads and tortillas. Stripped of nutrition and engineered for shelf life, modern bread spikes blood sugar as much as a Snickers bar according to Dr. William Davis. Opt for fermented sourdough or sprouted grain, or remove bread entirely for 30 days. Boxed pastas and processed comfort foods. Hyper-palatable combinations of salt, sugar, fat, and starch that overstimulate the brain's reward centers while leaving the body nutritionally depleted. A follow-up to Hall's study found people eating these foods consumed up to 1,000 extra calories per day. Seed oil-laden dressings, sauces, and condiments. Soybean, canola, corn, sunflower, and related oils produce carcinogenic aldehydes during processing and are in roughly 80% of the food supply. Replace with avocado oil, extra virgin olive oil, grass-fed butter, ghee, coconut oil, beef tallow, or duck fat. Look for seed oil-free brands like Primal Kitchen and Chosen Foods. Alcohol. A 1992 New England Journal of Medicine study found moderate alcohol consumption drops fat oxidation by 70% for hours. The liver prioritizes clearing alcohol above all else, including fat burning, while simultaneously increasing appetite and lowering the brain's stop-eating signals. Find All The Ben Azadi Show Sponsorship Deals ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.ketokamp.com/sponsorship-deals Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back, everyone. Today we're diving into one of the most hotly debated topics in obstetrics- should we be treating preeclampsia without severe features with antihypertensive medications during expectant management? Now, if you've been following the literature- and our show, you know that the landmark CHAP trial changed the game for chronic hypertension in pregnancy. It showed us that targeting a blood pressure below 140 over 90 reduces serious maternal complications, without harming the baby. That was a big deal. But here's the thing, CHAP studied chronic hypertension. Then there was the CHIP trial- that also found that tight control of gestational hypertension and nonproteinuric chronic hypertension was also beneficial. These did not address preeclampsia without severe features, and yet, the ripple effects of that trial have sparked a global conversation about whether we should be extending those same treatment principles to women with preeclampsia who don't yet have severe features. And this is where it gets really interesting, because the guidelines don't agree. In the United States, ACOG and the Society for Maternal-Fetal Medicine still say: hold off on antihypertensives unless blood pressures hit the severe range at 160/110. But step outside the US, and you'll find the World Health Organization, the International Society for the Study of Hypertension in Pregnancy, FIGO, NICE, and Hypertension Canada all recommending treatment at 140 over 90, regardless of whether the diagnosis is chronic hypertension, gestational hypertension, or preeclampsia. So who's right? And more importantly what does this mean for the patient sitting in front of you right now, at 34 weeks, with a blood pressure of 150 over 95, some proteinuria, but no severe features? Today, we're going to break this down. We'll review the controversy, walk through the divergent guidelines, and most importantly talk about the real, practical implications that favor treating these patients during expectant management. Because when you're watching someone with preeclampsia, waiting for the right time to deliver, there's a strong argument that controlling their blood pressure isn't just reasonable…may be protective. So grab your coffee, settle in, and let's get into it.1. Society for Maternal-Fetal Medicine Statement: Antihypertensive Therapy For mild chronic Hypertension in Pregnancy-The Chronic Hypertension And Pregnancy Trial. American Journal of Obstetrics and Gynecology. 2022. Society for Maternal-Fetal Medicine; Publications Committee. 2. Preeclampsia. The New England Journal of Medicine. 2022. Magee LA, Nicolaides KH, von Dadelszen P.3. Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy.The Cochrane Database of Systematic Reviews. 2018. Abalos E, Duley L, Steyn DW, C.4. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement From the American Heart Association. Stroke. 2026. Miller EC, Bello NA, Chen PR, et al.5.Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association. Hypertension. 2022. Garovic VD, Dechend R, Easterling T, et al.