Podcasts about PAH

You Can Grieve and Still Fight: Love, Loss, and Living with PAH She cried for the life she lost. Then, she fought for the one she has. PAH patient, Jasmine Wells discusses what it really means to grieve the old you while finding purpose in the new. From navigating relationships, infections, and fear of transplant, to leading support groups and fighting misinformation. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.global 

Der Big-N-Club Podcast wünscht Frohe Weihnachten!Micha, Ruben, Fabi und Dome haben ihren großen Auftritt in der klassischen "Weihnachtsgeschichte" von Charles Dickens, neuinterpretiert von Oli Watroba.Der hartherzige sowie gnadenlose Podcastler und Quizmaster Micha wird von drei Geistern auf eine Reise durch seine Vergangenheit, Gegenwart und Zukunft geschickt. Dabei erkennt er letztlich doch die wahre Bedeutung von Gastfreundschaft und Gaming-Podcasts. "Der Kühne Podcastler - eine BIG-N-Club-Weihnachtsgeschichte" ist ein Hörspiel voller Humor und Wärme für Jung und Alt, 8BIT und 4K, das alle Gamer-Herzen höher schlagen lässt. Time Codes:  00:00 – Intro00:32 – Tutorial: Kölle im Winter02:50 – Level 1: Pah, Wind Waker06:29 – Level 2: Rubens Schatten11:59 – Level 3: Der erste Geist17:16 – Level 4: Der zweite Geist22:52 – Level 5: Der dritte Geist27:16 – Postgame: Michas Wandlung31:18 – Outro Podcast-Credits:Idee und Text: Oli WatrobaSprecher: Oli Watroba (Erzähler), Michael Breuer (der Kühne Podcastler), Ruben Esch (Geist), Fabian Frenzel (Geist der Vergangenheit), Dominik Christ (Geist der Gegenwart), Wattes Patenkind (1. Kinderstimme), Wattes Sohn (2. Kinderstimme), Wattes Frau (weibliche Stimmen)Audioproduktion: Michael Breuer und Christoph KreerMusik: Christoph Kreer Besucht uns auf ⁠⁠⁠⁠www.bign-club.de⁠⁠⁠⁠ und werdet Mitglied!

Jennifer Keeley and Mary Whittenhall, experienced nurse practitioners in the field of pulmonary hypertension, discuss the management of cough in patients receiving inhaled therapies for pulmonary hypertension and interstitial lung disease. #GossamerBioPartner #sponsored This Special Edition episode is sponsored by Gossamer Bio. Jennifer Keeley, DPN: My name's Jennifer Keeley. I'm a nurse practitioner and I practice in a large academic institution in Pittsburgh, Pennsylvania, Allegheny Health Network, specifically Allegheny General Hospital. I am a nurse practitioner there and have been in the clinic over 10 years, and in the PH space as a nurse practitioner for over 15 years, as a registered nurse for almost 20 years. So, I have a lot of experience and I'm really excited to be here today to talk about inhaled therapies and cough. Mary Whittenhall, MSN: My name is Mary Whittenhall. I'm also a nurse practitioner. I am currently an advanced practice provider at Pulmonary and Sleep Associates in East Providence, Rhode Island. I've been in pulmonary hypertension for about 11 years now. In that time, I have worked in a variety of settings, both inpatient and outpatient, managing patients with pulmonary vascular disease, and have also touched upon patients with interstitial lung disease and pulmonary hypertension.  I get very excited when I hear about new opportunities for our PH patients. I think a lot about even when I started in pulmonary hypertension and the therapies that were available to our patients. Many of these therapies had been around for a little bit of time. But also something that I think is extremely exciting is that there's just been a rapid progression in development of therapies. And now, with the focus of looking at these therapies as potentially disease modifying, not necessarily slowing the progression of disease. With the advent of all of these new therapies, there become more options for our patients, as well. Often, patients can't tolerate some of the medications that we have due to side effects and despite lots of work to manage these side effects, the patients are not always successful. One of the great things being involved in an academic center is that we have the ability to help link patients to cutting edge research, particularly looking at a new drug that is an inhaled therapy that has shown significant promise in improving the lives of patients with pulmonary hypertension. As a part of the PH community, we all do quite a bit of networking with each other, as well as with our patients and other colleagues in the space. In that time, we did network regarding the study and have participated in some activities where we're looking at the data from the Phase 2 part of this trial and then also looking at some of the side effect management related to the medication, which seemingly is well tolerated. However, for some patients it may not come extremely easy. I think that's where the role of the nurse or the advanced practice provider really comes in this space is that we have a real strong dedication to helping educate patients about ways to manage these side effects. We want patients to be able to continue with therapies. We don't want them to say, "Well, this isn't working for me, it's time to move on." I think that we have a lot of strategies and a lot of experience with trying to help patients really figure out the best way to manage these things and to be confident that they can continue on with obviously the biggest benefit of improving their pulmonary vascular disease. Jennifer Keeley, DPN: We actually met at an advisory board last year. It was an advisory board consistent of registered nurses and nurse practitioners who, just like Mary and myself, have vast experience with patients and therapies, not just in the inhaled space, but more conventional pulmonary vasodilator medications that have been used in our patients for many, many years. As Mary had suggested before, when we start to think about newer agents, many, many of them are not the conventional pulmonary vasodilator medications, but disease modifying agents. Now, we've acquired an armamentarium of medications. So, inhaled delivery is just a really great option to avoid systemic side effects on top of each other. Our PH patients today, many of them are on more than three therapies, many of them are on four or even more therapies, so the delivery of the medication is just one aspect. When we talk about cough and side effects, I like to think about it and explain to my patient when we talk about side effects, particularly cough, to imagine a Venn diagram with cough being in the middle and what affects cough. You see this outward circle, how we deliver it, what kind of device we deliver it in. The drug, how small, large are the particle size? Is it easy enough to use for our patients? The formulation, is it dry powdered versus inhaled aerosolized? And then finally, just the patient themselves. What's their background? What type of PAH do they have? So, we can talk a little bit more about this, but just to get us started, this is how this developed and we had a lovely advisory board meeting with seralutinib and Gossamer Bio, and this was the outcome of it. We produced a lovely poster. This is a conversation if you will, that Mary and I are going to have based on what we talked about and the poster production, that came out of that wonderful advisory board. Mary Whittenhall, MSN: Inhaled therapies are unique in a way in that they actually have direct access to the lungs. So, when you think of an oral medication, an oral medication needs to be digested in the gut and sometimes that systemic digestion takes a while. Additionally, it's also often that we see patients that have more systemic side effects when we're using an oral formulation. Intravenous or subcutaneous formulations of these medications tend to cause pretty strong systemic side effects for patients, and there tends to be a lot of management that we need to do to help make these side effects more tolerable. For most of our patients, I say to them, "You're going to think I'm cruel because I don't really want these side effects to go away." In a way, we look at them almost as if you have a cup and your cup is full of water and after the top of the water hits the rim of the cup, then the water starts to spill over onto the sides of the cup. I think of other medications that we typically prescribe for patients in that way that when we get that spill over, so to speak, it's an indication that we've actually targeted all of those receptors that we want to help with vasodilation. Now that we're looking at other medications that don't really necessarily look at vasodilation, we're looking more at treating the blood vessels in a different way or affecting the process for which those blood vessels become diseased. I think that the side effects become different and I think they become less. In working with inhaled therapies, as you can imagine, the number one side effect that most patients will complain of is cough. Sometimes we have patients who have an underlying cough already, and that's usually not related to PAH, but in PH-ILD where we now have an FDA indication to use another inhaled therapy, we've seen in treating these patients that baseline cough is something that is extremely problematic for them before they even start therapies. So, trying to find ways to improve that baseline cough, treat any underlying symptoms, things like acid reflux as well, that may cause that, treating seasonal allergies, et cetera, and then, obviously, managing any additional overlapping side effects that may occur because of the new therapy that they're on. Jennifer Keeley, DPN: I think that's a really important part, is to talk with the patient, educate the patient on these inhaled therapies. First and foremost, that cough is almost an expected side effect. These are patients particularly with our interstitial lung disease patients that have PAH, cough is a part of their daily life. It's important to document and ascertain what these patients' baseline cough is. In many, many clinics, particularly pulmonary PAH clinics, and I'm sure much like Mary's, many of my colleagues have recommended using validated cough questionnaires so that we can get a really, really good baseline of what that patient's baseline cough is. Are you coughing at night? Do you have mucus? How long have you been coughing? Does it interfere with the quality of your life? Do you cough at night? Does it keep you up? Does it interrupt your sleep? Those kinds of things that help differentiate acute cough versus chronic cough. Many of these patients cough every day. They also have other inhaled therapies such as our ILD patients that are also on corticosteroids, many of them on inhaled corticosteroid therapy that can thin the oral pharynx, the posterior pharynx, and really affect the degree of nerve innervation in the posterior pharynx in the mouth. So, just really understanding what the patient's baseline cough is and educating them on the fact that cough is likely going to be a side effect with the use of this inhaled therapy. Certainly, as we continue to use the therapy, we would hope that the cough can be mitigated either through some lifestyle modifications, some natural remedies, and even some medical remedies such as bronchodilators. But really teaching the patient about the medication and inherently that this is likely going to induce a cough, but that we have mitigation strategies to help dissipate the cough. I always like to tell my patients also in the clinical trials, particularly the Phase 2 clinical trials that are out there that patients had a lot of cough. The patients on drug that were in most of the Phase 2 clinical trials for seralutinib and even for treprostinil inhaled, 30 to 40% of them experienced cough. But at the same token, the placebo-based patients that did not receive drug in these Phase 2 clinical trials also had a lot of cough. So, what that's telling you is yes, you're going to get probably some more cough, but it's likely not going to be that much or more far advanced than the cough that you're already experiencing. I also think it's important to tell these patients, many, many patients that experienced cough did not stop the medication. Actually, in these Phase 2 clinical trials, very few stop the medication. So, that gives you a really good big picture that we are pretty good at educating our patients how to mitigate cough, and if we aren't, then we should learn how to do so. Mary Whittenhall, MSN: I think it's important for us to set some expectations for patients when we're talking about cough. We've already discussed a bit that cough can happen for people from other things outside of their lung disease, but it's important to also look at what may be causing the cough when we are giving a patient an inhaled therapy. So, any type of inhaled therapy, whether that be a dry powder, a mist, whether that's nebulized or through in actuated inhaler, there are particles inside of that medication as it's going in and those little particles, when your lungs inhale that medication, those particles are penetrating your lungs and your lungs are not accustomed to them being there. It's almost as if your lungs are saying, "I don't recognize this. I don't know why this is here," and it may feel like it's an irritant, so you may start coughing as a result of that, but the cough is not necessarily a bad thing. Those particles are there, and the job is to essentially help deliver the medicine to penetrate that lung tissue and then for your body then to absorb the medicine. Your airways and your blood vessels inside of your lungs are extremely close to each other. So, when you inhale that medication, those little blood vessels are also right next to where those airways are, and then that is how those blood vessels then absorb that medication, because they're so close to the site at which those particles come into your lungs. Jennifer Keeley, DPN: I think this is an important concept to understand. They choose the form of delivery based on the goal of delivering the most medication efficiently to the distal bronchioles. That's where the disease is. It's in the distal arteries. So, trying to formulate how we get these very powerful, oftentimes disease modifying agents into the periphery of the lungs can be very challenging. Dry powdered inhaler is one form that the variability of delivery is not as dispersed as an aerosolized. So, it's more efficient delivery to the place where the medication needs to work the best, and that's in the distal periphery of the lungs. Unfortunately, one thing you have to deal with is that oftentimes these medications, dry powdered medications, not just in the PH space, but there's a lot of other dry powdered inhalers in the COPD space, as well. Oftentimes, what happens is these powdered particles get dispersed extra thoracically. So, they get dispersed in the oral mucosa, in the posterior pharynx, on the way down into the stomach. That's wherein we have to deal with mitigating side effects. The biggest side effect of these particles, even though they're very small, is cough. So, technique comes into play. Mitigating things to coat the posterior pharynx come into play. Re-education comes into play. Show me again how you're doing this inhalation, because I don't think that you're holding this okay. In one instance, I had a patient that was inhaling dry powdered inhaler with the medication right out of the refrigerator. So, the medication was cold. It was clumping at the back of her throat. All of these things really take into consideration how we most efficiently get the medicine to these pulmonary arterial hypertension patients where their disease is oftentimes very difficult to get to, and other forms of medications that are systemic, orals, parenterals that have first pass metabolism, and so you're going to get more side effects from those medications. So, I always teach my patients, "Hey, we're a couple steps ahead because we're bypassing the type of metabolism that you get with orals and even parenterals." Mary Whittenhall, MSN: There are so many challenges that these patients face. Oftentimes, patients have never been sick before they develop this, and now we're putting them on multiple therapies, multiple modalities, telling them that there's going to be side effects and they need to learn how to manage them. It's certainly a lot to handle. But I think one of the best things that we have in our PH community is that we really work so hard to partner with the patients and their loved ones and forming this relationship, fostering that relationship as time goes on, I believe that these patients really do trust us and that what we're telling them is things are going to be okay. We are going to be there by your side. We're not going to give you this medicine and then say, "See you in six months. Hope everything goes well." We're really going to be working with them. In some cases in my specialty clinic, we have nurses, we have a pharmacist, a pharmacy tech, and then our advanced practice providers that check in with these patients quite regularly. We are actually taking the initiative to reach out to them versus the patient who may be having trouble advocating for themselves or feeling like, "Really, I don't want to be a pain, but this is challenging for me." We are really in touch with them, and that connection also helps to keep patients on therapy. So, what are some of the specific techniques to manage or mitigate cough? This is something that was a real hot topic at our last advisory meeting. We put together a bunch of folks in the room who deal with other inhaled therapies and patients that have cough and said, "Well, what do you tell patients to do?" First and foremost is to look at any other potentially underlying conditions that may be causing cough and ensure that treatment of those underlying conditions is optimized. I think cough is actually the number one referral for any type of pulmonary practice, but it is a really, really broad differential when it comes down to it. We obviously look first at things like environmental factors. If this could be seasonal allergies, then we try treating patients with antihistamines. Perhaps some of those are intranasal, as well, that may help with some things like rhinorrhea or post nasal drip. Acid reflux is actually a huge, huge reason for cough. Many patients say, 'Well, I don't get acid reflux. I don't feel that burning in my chest after I eat," but come to find out that it can actually be a silent trigger. So, treating patients with medicines that help to reduce acid or suppress acid will oftentimes help with that cough. On top of that, when we're dealing with patients that are on inhalers and now we're adding another inhaled therapy. I find that for some patients that are on actual inhalers that sometimes they do better with nebulized treatments. The nebulized treatments are slower, and may have a bit of a better penetration into the lungs and the patients tend to like it. It is one of those things that you do need to be compliant with in order to really see the benefits to it. I will say that oftentimes, again, partnering with the patient, giving them specific instructions about how to do all of this, we can really see some improvement to those symptoms. Then, there's just basic over-the counter measures and precautions, things like making sure that when you're eating that you're not laying down at least for 60 minutes after you've been eating. If you do have acid reflux, trying to sleep with two pillows or a wedge pillow, that can help to keep the head of your bed elevated. Some of our patients have those really fancy adjustable beds that are also quite helpful for that. I think that sometimes things like basic cough drops actually can be quite wonderful and helpful. Drinking very cold or very warm water or tea, adding some honey to that if a patient isn't diabetic, things like that tend to really help with cough. We reinforce these measures when we start therapies like this. Jennifer Keeley, DPN: In terms of mitigation, I think it's really important on technique. This is why, as Mary had alluded to, it's so important to follow up closely with these patients, particularly our elderly patients who sometimes don't, if they have connective tissue disease or scleroderma, have a lot of good fine motor coordination. A couple of things that I wanted to touch on with regards to that… One, these inhalers are typically high resistance, low flow. So, these are not the type of patients that need to be taking in very forceful inhalations with these inhalers and thank goodness, because we're talking about patients that have inflammatory interstitial lung disease, as well as pulmonary vascular disease. So their degree of inspiratory effort is actually minimal to disperse that medication to the distal pulmonary bronchials. It's equivalent to them taking a deep breath in when you ask them to auscultate their lungs. So it's not a big forceful breath. The other thing is too, a lot of times, sometimes more variability in the disbursement of the drug is better in compliance with some patients. Dry-powdered inhalers, again, do not take a very big forceful effort, but some of them, because they are powder, some of the medication will actually hit the back of the throat as it goes down and can cause some irritation, whereas the nebulized form does have a variability in disbursement and can be more easily tolerated in some. The other issue is the technique itself. Oftentimes, we ask them in some of the inhaled therapies to lower the device itself so that the tongue doesn't protrude and get in the way, because if medication gets on the tongue, the next swallow that they take, that medication is going to hit their posterior pharynx, and they're going to probably cough pretty aggressively. I always start off by telling my patients, "Cough is not a bad thing. It's actually a protective reflex and it's involuntary. So, if you cough, don't actually negate it. Don't think it's a bad thing." It's actually a very protective mechanism that avoids irritation in most of our patients probably already irritated mucosa. So, that's how I like to start the conversation. There's so many good techniques that we can share with them over time, and I might add that each patient is different. Each patient needs to have a personalized plan. When we talk about giving patients warm tea, typically chamomile, chamomile tea in itself is anti-inflammatory. Then, when you add something like honey, which is also a soothing, anti-inflammatory natural remedy, you have to really think to yourself, "They're getting honey. If they're diabetic, we don't want to give them too much honey." But, you have to make sure that their swallowing technique is good. There's no aspiration there, particularly if we give them cough drops. Then, just simple things that actually numb or anesthetize the back of the throat are very, very helpful for elderly patients who do have very friable tissue and mucosa from previous therapies like inhaled corticosteroids, as I had talked about before. Dairy products, I tend to ask my patients to avoid those. They can produce a lot of mucus, which these coughs that we see in our inhaled therapy patients are typically tend to be dry coughs, but some patients that have concomitant asthma, COPD, along with their ILD that are using these inhaled therapies can actually have more of a congested mucoid cough. So, avoiding dairy before and after use is always very smart. Avoiding alcohol, avoiding acidic drinks like orange juice, also very, very helpful. Mary Whittenhall, MSN: The part about technique I think is so, so important here. Oftentimes, when patients start these therapies, when they are approved in that space, the specialty pharmacy has a nurse educator that will come out to the patient's home and provide education not only about the medication, but about the administration of that medication. In many cases, the patients will take their first dose while the nurse is present so that the nurse can then critique whether or not the patient took it appropriately and how they tolerated it. I'm going to give a shout out to our nurse educators from the specialty pharmacies, because they are also a really crucial set of eyes and ears for us out in the community. They do provide education to the patients in the home. We have had situations where the patient has done well while the nurse is there, and then two weeks later we get a call from the patient saying, "I can't do this. This isn't working for me." And I'll say, "Okay. Well, you have a couple options. We can have you come in to the clinic and I want you to bring your device with you, and I would like to watch you do a treatment, or I can have the nurse come out and see you again and go over that." And they'll say, "I already know what I'm doing. I don't need that." But in many instances, we have found that they have adjusted their technique. They might've gotten into some bad habit since the nurse has left them. So, really reinforcing that is important. The other thing that I wanted to bring up is that some of our patients with connective tissue disease also have thickness in their tongues. So, their tongues become thicker and more sclerotome as their connective tissue disease progresses. For some of those patients, it is actually hard for them to get their tongue flat enough so that they can get the medication down into their lungs. So, working with those patients to find strategies to help rectify that. I will say that it is not impossible, it just takes maybe a little extra work. Jennifer Keeley, DPN: Inhaled therapies in themselves are pretty portable. Mary had alluded to a little bit earlier, our patients with pulmonary vascular disease, PAH, that are on parenteral therapies, delivering the conventional pulmonary vasodilator therapies. As we get into the new disease modifying agents such as seralutinib, which are anti-fibrotic, anti-inflammatory, anti-prolific medications, these are portable therapies that are actually modifying the disease. So they're portable. They're easy to use. They're easy to use for our patients, again, that are elderly or are younger and are still working, they have a professional life, they don't have to wear a pump that's 24/7 oftentimes. They can use these inhaled therapies first to see if they can avoid parenteral therapy with prostacyclins. Their quality of life is improved immensely. When you can take an inhaled therapy two to four times a day and really improve quality of life, decrease cough, decrease dyspnea, or shortness of breath on exertion. Sometimes, these patients that do very, very well can actually reduce their supplemental oxygen needs. Just improving their walk distances without having to stop or have excessive dyspnea, improves their quality of life. More time spent with loved ones and more time spent in social environments rather than sitting at home. These wonderful inhaled portable therapies have significantly changed our patients' lives and improved their quality of lives. Mary Whittenhall, MSN: This community I think is phenomenal. It's made up of so many great people. There are many patients who have been a part of this space for a long time who really want to help other patients who may be newer to the journey than them. I'm a big advocate for support groups. We've had an extremely active support group in our area for a long time, and I often partner some of my patients that have been with me for quite some time with some of the new patients that may need a bit more help. I can tell them things and my colleagues can tell them things. Oftentimes, the same message doesn't resonate. It resonates differently, I think when it comes from a peer, a patient who may have experienced the same thing as them. One of the things that I really try to drive home with our patients is just that sense of empowerment. Connect with these other folks in the community. They want to help you. They remember what it feels like being newly diagnosed or starting a new therapy or transitioning from another therapy. What that change is like. One of the other things I tell my patients is that we all sit at the same table. I'm not better than you. Maybe I have this information, but this information is for you. It's for you to take and to improve your life. If that information doesn't work for you, then you come back to me with some feedback and we come up with something else that's going to be more helpful to you. I really think having an equal playing field with them and having a very open and honest dialogue is what is going to help our patients do the best. If patients don't feel comfortable reaching out to other local patients or connecting with an in-person support group, there are tons of online resources through the PHA, through phaware®, Team Phenomenal Hope, lots of great groups out there that do things virtually. I think in some ways for some patients, anonymity is important, so being able to protect that is an option for them, but to be able to still get what they need so they can become the best advocate for themselves that they can. Jennifer Keeley, DPN: I stress so importantly to my patients, we are here today in this great environment and we have the armamentarium of medications to treat because of patients just like you that have contributed to the science of the disease and implemented themselves and engaged in these clinical trials. Right now we have an ongoing clinical trial for seralutinib called PROSERA, that's enrolling as we speak. Patients are the best advocates, not only for themselves, but for other patients, and they talk. There's a lot of social media out there where patients communicate amongst themselves and they say, "Through the help of my provider and through the help of my family, I was hesitant to start this additional therapy." They do have, at this juncture, and I don't think it's such a bad thing, they do have a little bit of a pharmacy burden now. Again, these aren't our patients that are on one or two therapies. They're on four or more oftentimes. When you take in our ILD patients, they're also on disease modifying agents, as well, for their interstitial lung disease. So again, I think it's really important for patients to communicate amongst themselves and share their ups and downs in the disease, but also share the rewards that come with surviving and living with PAH. I think one thing that we really do have to understand though is like many other chronic diseases, PH is a personalized disease. You need to have a personalized approach for your patients. That's why it's so very important to do a really good history of your patients and understand not only what their baseline cough is, but who they are, what their personal history is. Are they working? Who's helping to care for them? Who's helping to make that chamomile tea with honey? Who's going to the store to get that? A personalized approach is so important for these patients, I can't stress that enough. Mary Whittenhall, MSN: Special thanks to everybody involved in this project. This was extremely exciting. To my co-podcaster, Jennifer Keeley, who is amazing, and all of us in the PH community are extremely lucky to have her. We are all aware that you are all rare, and we are grateful to be able to help you in this journey. Jennifer Keeley, DPN: Thank you so much, Mary, and what a pleasure it's been to speak with you about cough and inhaled therapies, and thank you to Gossamer Bio for this opportunity and for the opportunity that led to this podcast, which was a significant advisory board amongst specialists in our field, advanced practice providers and registered nurses who were able to convene in a great open space and talk about this. I think this moves our science forward. It helps us to talk about the disease and take better care of our patients. Again, my name is Jennifer Keeley. It's been such a pleasure to deal with my good friend Mary Whittenhall today, and we're aware that our patients are very rare. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on instagram, facebook and x.com @phaware. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD #PHILD @GossamerBio @AHNtoday

No podcast do Balde do Odo de hoje, Alexandre Bortuluci, Mariana “Kira” Gamberger e Luiz “Morn” Castanheira recebem Muryllo Von Grol para discutir sobre o quinto episódio da quinta temporada de Deep Space Nine, “The Assignment”. O’Brien se prepara para receber Keiko que está voltando de uma expedição. Mas para a sua completa surpresa, ela foi possuída por um Pah-wraith. O alienígena é da mesma raça dos Profetas, que foram expulsos do Templo Celestial e agora querem vingança. O Pah-wraith controla Keiko e obriga O’Brien a realizar determinadas ações. O chefe não tem muita opção se não atender as demandas do Pah-wraith para preservar a vida de sua esposa e filha. Ouça em nosso player agora ou baixe nos agregadores de podcast. Acompanhe o Trek Brasilis nas redes sociais para ficar por dentro de todas as novidades de Star Trek: YouTube | Telegram | Facebook | Instagram | Twitter | TikTok Para saber mais sobre Deep Space Nine, acesse o Guia de Episódios de Deep Space Nine! O post Balde do Odo #105 The Assignment apareceu primeiro em Trek Brasilis.

"Der einzige Grund, warum ich heute noch hier sitze, ist, dass ich als Mama für meine Kinder da sein musste”, sagt Katharina. Die Diagnose der schweren Erkrankung PAH (pulmonal-arterielle Hypertonie, Lungenhochdruck) hat sie komplett aus der Bahn geworfen. Um sich zurück ins Leben zu kämpfen, war auch die Unterstützung, die sie in der Selbsthilfe gefunden hat, ein wichtiger Baustein. Genau wie für Julia. Aktuell engagieren sich die beiden Frauen in einer Selbsthilfegruppe und unterstützen andere. Im Podcast erzählen sie, wie man das richtige Angebot für sich findet, was im Alltag mit Lungenhochdruck wichtig ist und warum man nie den Mut verlieren sollte. Lungenhochdruck ist eine seltene Erkrankung, die oft erst spät diagnostiziert wird. Prof. Hanno Leuchte vom Zentrum für Lungenhochdruck am Krankenhaus Neuwittelsbach in München erklärt wichtige Warnzeichen und womit die Erkrankung häufig verwechselt wird. Und wir sprechen über Behandlungsmethoden, die heute viel besser sind als noch vor zehn Jahren.

In this episode of Own the Build, Paul is joined by Trevor Wilkins, Managing Director of PAH Building & Construction — a contractor working deep inside one of the UK's most complex and least-understood built environments: the defence estate.Trevor shares the unique story of PAH's evolution from a one-client refurb contractor to a £15m business operating across the UK, including the landmark MOD housing portfolio recently brought back into government ownership. He opens up about the early days, the risks he took, and the leadership principles that have helped him build a loyal, long-serving team.In the second half, Paul and Trevor dive into the reality of retrofit — far removed from the glossy headlines of a “retrofit revolution”. Trevor gives a frank assessment of funding gaps, skills shortages, inconsistent standards, and the operational challenges that make large-scale retrofit so difficult today. He also offers practical guidance for contractors considering a pivot into the field.Finally, Trevor discusses PAH's commitment to developing the next generation of tradespeople, including hands-on partnerships with local colleges, mentoring new apprentices, and bringing students onto live sites.This is a grounded, real-world conversation about leadership, resilience, retrofit, and what it actually takes to run a values-driven construction business in 2025.---------------------------------

Mija rok od zmiany władzy w Syrii. 8 grudnia 2024 obalono prorosyjski rząd Baszara el-Asada. Sytuacja wcale się jednak jeszcze nie ustabilizowała. Brakuje infrastruktury, 90% mieszkańców żyje poniżej progu ubóstwa, dzieci nie chodzą do szkół. Ludzie próbują wracać do domów, ale trafiają na gruzy. O tym wszystkim rozmawiam z Magdaleną Foremską z Polskiej Akcji Humanitarnej.Magda Foremska to koordynatorka pomocy natychmiastowej w PAH. Pracowała przy projektach humanitarnych w Iraku i na Madagaskarze. Koordynuje działania PAH na Bliskim Wschodzie – w Palestynie i w Syrii.– Zachęcam do obserwowania Syrii, bo jest to naprawdę ciekawy przypadek – mówi Magda w rozmowie ze mną. Kryzys humanitarny trwa w tym kraju nieprzerwanie od wielu lat. Od 2011 do 2024 roku w Syrii zginęło ponad pół miliona cywilów; ponad 5 milionów ludzi musiało uciec z kraju.Polska Akcja Humanitarna prowadziła działania pomocowe w Syrii w latach 2013-2019. Organizacja wróciła do kraju po tragicznym trzęsieniu ziemi w lutym 2023 roku i zrealizowała programy pomocowe na północnym-zachodzie Syrii. Tu więcej o działalności PAH.Z odcinka dowiesz się m.in.:co się dziś dzieje w Syrii;dlaczego tak mało o niej mówimy w Polsce;gdzie i co dokładnie robi dziś w Syrii PAH;jak zmieniła się praca organizacji humanitarnych w Syrii w ciągu tego roku;jak wygląda codzienne życie Syryjczyków;czego im potrzeba, by wrócić do godnego życia;jak możemy pomóc?Podobają Ci się tematy, które poruszam w podcaście? Więcej znajdziesz tu:Instagram: http://bit.ly/3Vene60YouTube: http://bit.ly/3iddUR7TikTok: http://bit.ly/3gDdaobRealizacja: Karolina Deling-Jóźwik - redakcjaPrzemysław Wałczuk | Studio Podcastowe Syrena - nagrania i montażP & C Paulina Górska | Varsovia Lab. 

What would you do if you were told you only had months to live? That was the reality for Eric Borstein, who faced a heart failure diagnosis and a dire prognosis. Tune in for an inspiring discussion with Eric Borstein, widely known as “The Walking Guy,” as we recognize Pulmonary Hypertension Awareness Month and  he share his remarkable journey supported by CVS Health.Moments with Marianne Radio Show airs in the Southern California area on KMET1490AM & 98.1 FM, an ABC Talk News Radio Affiliate!  https://www.kmet1490am.comEric Borstein is the Director of the Borstein Family Foundation and owner of EB Urban Ventures, a real estate development company. Eric currently is a board member of PS Science and UCLA Mattel Children's Hospital. He is also Chair of the Board of Directors for Team PHenomenal Hope, a nonprofit organization that seeks to empower and serve those living with pulmonary hypertension through support, services, education and medical research.To learn more about Eric's story visit WhereIsEB.orq.  www.cvshealth.comFor more show information visit: https://www.mariannepestana.com

英語と日本語、「はっきり」の根本的な違い「英語は、単語同士を滑らかにつないで発音する（リンキング）のが良い」と聞いたことがあるかもしれません。しかし、「一語一句はっきりと発音した方が丁寧で通じやすいのでは？」と疑問に思いませんか？実は、英語の「はっきり」と日本語の「はっきり」は、根本的に方向性が異なります。

Analizamos el caso de Dani Gago, fotoperiodista sancionado con hasta 30.000€ por documentar un desahucio en Vallecas ejecutado por una deuda de apenas 45€, un ejemplo contundente de cómo la Ley Mordaza sigue funcionando como herramienta de represión contra activistas, periodistas y movimientos por la vivienda. Exponemos la responsabilidad directa del Gobierno, que después de años prometiendo su derogación continúa aplicando una norma diseñada para blindar intereses inmobiliarios y silenciar la protesta social. También abordamos el contexto de criminalización de la pobreza, el papel de la PAH y la incoherencia entre el discurso institucional sobre vivienda digna y la realidad de los desahucios masivos. Mas vídeos de Pandemia Digital: https://www.youtube.com/c/PandemiaDigital1 Si quieres comprar buen aceite de primera prensada, sin intermediarios y ayudar de esa forma a los agricultores con salarios justos tenemos un código de promoción para ti: https://12coop.com/cupon/pandemiadigital/ Este video puede contener temas sensibles, así como discursos de odi*, ac*so, o discr*minación. El objetivo de abordar estos temas es exclusivamente informativo y busca concienciar a la audiencia sobre estos acontecimientos, y denunciar y señalar el origen de los mismos para crear consciencia y evitar su propagación. Si consideras que el contenido puede afectarte, te recomendamos proceder con precaución o evitar su visualización. ----------------------------------------------------------------------------------------------- Únete a nuestra comunidad de YouTube https://www.youtube.com/channel/UCFOwGZY-NTnctghtlHkj8BA/join Se mecenas de Patreon https://www.patreon.com/PandemiaDigital ----------------------------------------------------------------------------------------------- Súmate a la comunidad en Twitch - En vivo de Lunes a Jueves: https://www.twitch.tv/pandemiadigital Sigue nuestro Canal de Telegram: https://t.me/PandemiaDigital Suscríbete en nuestra web: https://PandemiaDigital.net Sigue nuestras redes: Twitter: https://twitter.com/PandemiaDigitaI Facebook: https://www.facebook.com/PandemiaDigitalObservatorio Instagram: https://www.instagram.com/pandemia_digital_twitch TikTok: https://www.tiktok.com/@pandemiadigital #PandemiaDigital

Mejorcita, hoy dedicamos el programa a hablar de algo que nos atraviesa a todas: la vivienda. Porque mientras los precios del alquiler se disparan y los fondos buitre hacen negocio, hay gente que se organiza para defender el derecho a un techo. Nos acompañan Lola del Gallego Noval y Ghita Hachemi el Aydouni, militantes de la PAH de Vallekas, un sindicato que lleva más de una década parando desahucios y plantando cara a bancos, inmobiliarias y mafias.Charlamos sobre cómo ha cambiado la lucha desde la crisis hipotecaria, el auge de los grupos de desokupación paramilitares que actúan con violencia en nuestros barrios, y desmontamos el relato del “pequeño propietario vulnerable” que tanto se repite en tertulias. También hablamos de la SAREB y campañas como #NosQuedamos, porque detrás de la crisis de vivienda hay nombres y apellidos.

Em cobertura para o Canal do Boi, o Fala Carlão marcou presença no Agromkt Summit, direto de Goiânia/GO, reunindo grandes nomes e ideias que impulsionam o marketing e a comunicação do agronegócio brasileiro.O programa contou com participações de Ricardo Nicodemos, presidente da ABMRA; Francis Barros, CEO e fundador do Agromkt Summit; Pahêdra Rios, da FrontBox; e Renato Seraphim, palestrante.Um evento que reforçou o papel da informação, da criatividade e da integração entre marcas, profissionais e produtores na construção de um agro cada vez mais forte, conectado e reconhecido.

How I Survived Meth Addiction, Lung Failure, and Found Purpose Anthony Carrasco was a meth addict by 15, and nearly dead by 35. Diagnosed with PH after years of drug use, his story spiraled from homelessness to hospice. But a double lung transplant and a deep surrender to recovery transformed everything. This Special Edition Episode Sponsored by: Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com @JNJInnovMed

Treating Meth-Associated PAH Without Judgment Dr. Brandon Jakubowski takes us into the underrecognized world of stimulant-induced pulmonary arterial hypertension. From misdiagnoses to under-prescribing life-saving therapies, he lays out the systemic gaps and stigmas preventing patients from getting the care they need. This Special Edition Episode Sponsored by:  Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com #phawareMD @JNJInnovMed @UTSWMedCenter

Buhuhoooo, ihr kleinen Lakenschüttler,wenn sich der Nebel lichtet, könnt ihr die zwei Waschweiber betrachten. Sie reiben hart am Waschbrett die Gaming-Dreckwäsche und murren über ihr anstrengendes Dasein. Was sagen sie?"Ach, Essimeralda! Der grünliche Herr Miniaturweich hat wieder einmal alle Preise erhöht. Kann denn dieses Misere nicht einmal ein Ende nehmen? Nur noch Kohl und Kartoffeln. Jeden Tag." sie reibt kräftiger und ein grüner Streifen zieht sich durch das aufschäumende Wasser.Essimeralda schaut voller Gram auf ihre Freundin Janeinja und holt indes einen scharlachroten Schal aus dem Wäschekorb und legt ihn auf ihr verrottetes Waschbrett. "Hör dir mal zu, Janeinja, jammerst wie eine Dirne ohne Männlein über dein Schicksal, obwohl du es selbst gewählt hast. Wusstest doch was für ein Typ das ist, der Miniaturweich." Beide ziehen die fusseligen Brauen zusammen, schauen einander tief in die Augen und ziehen dann lautstark die letzten Rest Kohlsuppe aus der Speiseröhre und rotzen sie halb rülpsend in den Fluss, der nun in grün-roten Farben getaucht ist. "Hast ja recht, aber dein Handhimmelglück ist ja nicht besser. Nur hinter Öre her. Immer. Bringt sogar diesen gierigen Flaschner immer und immer wieder zurück. Pah, was eine Gier. Wo soll das alles enden, Essimeralda?" "Weiß ich net, Janeinja, aber was ich weiß is', das is' das wir immerhin wissen was wir wollen und nicht wollen. Und sind dabei immer ehrlich zueinander. Reden wie Gott uns das Maul in die Visage geklöppelt hat." Die Weiber drücken ihre knackenden Rücken durch und stehen knietief im Wasser. Die Wäsche hängt belanglos über den Eimern der Waschbretter, als würden sie sich nicht für das Gerede interessieren. Es stimmt auch.Die beiden schroffen Weiber schauen sich wieder an. "Wollen wir Pflaumen pflücken?"Der Wind weht. Das Wasser fließt. Die Wäsche hängt. Tropfend. Die Weiber schweigen. "Erst Podcast." "Was?" Die Zeit vergeht. Der Leuchtstreifen des Gaming ist in Sicht.Sanfte GrüßeJanina & Essi

Wer wird Träger des ersten Instagram-Rings? Das sind doch die Fragen, die uns als Gesellschaft tatsächlich nachhaltig beschäftigen sollten. Und nicht so einen langweiligen Kram wie Urheberrechte in KI-Videowelten, Donald Trump, der sich von der GenZ jetzt Wahlversprechen ermogeln möchte oder gar Regulierungen? Pah. ➡️ ZDFheute über 3 Jahre Twitterübernahme: https://www.zdfheute.de/wirtschaft/unternehmen/musk-twitter-x-3-jahre-100.html ➡️ Techcrunch über Waffeln auf Bluesky: https://techcrunch.com/2025/10/05/waffles-eat-bluesky/

The Face of Addiction Isn't Who You Think It Is Once thought to be a West Coast issue, methamphetamine-associated pulmonary hypertension is now a nationwide and global crisis. Dr. Nicholas Kolaitis reveals how building trust with meth associated-PAH patients can lead to incredible turnarounds, including sobriety, trial participation, and successful transplant. This Special Edition Episode Sponsored by: Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com @JNJInnovMed #PHawareMD @UCSFHospitals @LungTxptMD

Two great stories of translation science leading to beneficial drugs in terrible diseases of the heart and the Sisyphean task of predicting the need for pacing after TAVI are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Sotatercept HYPERION Trial https://www.nejm.org/doi/10.1056/NEJMoa2508170 ZENITH Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415160 Evidence report on treatment for PAH https://icer.org/news-insights/press-releases/icer-publishes-final-evidence-report-on-treatment-for-pulmonary-arterial-hypertension/ PAH Sotatercept Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2503944 II Acoramidis and ATTR Cardiomyopathy ATTRIBUTE-CM Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2305434?logout=true ATTRIBUTE-CM Analysis - Substudy https://www.jacc.org/doi/10.1016/j.jacc.2025.09.013 Tafamadis Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1805689 III Pacing After TAVI Prophylactic pacemaker after TAVI https://www.jacc.org/doi/10.1016/j.jacep.2025.07.028 PROMOTE study https://doi.org/10.1016/j.hrthm.2024.12.019 Evaluation of ESC criteria on RBBB patients undergoing TAVI https://doi.org/10.1016/j.hrthm.2024.11.030 Editorial on Heart Rhythm journal papers https://www.heartrhythmjournal.com/article/S1547-5271(25)00114-6/abstract You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

How Stigma Blocks Meth-PAH Treatment and How to Stop It Patients with methamphetamine-associated-PAH often arrive at clinics already carrying heavy shame. But shame shouldn't be part of their medical history. In this compelling episode, Dr. Peter Leary explains how stigma—from both society and providers—can delay life-saving care. Learn how a change in mindset, language, and compassion can transform outcomes for a neglected and growing patient population. This Special Edition Episode Sponsored by: Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com #phawareMD @uwepidemiology  @JNJInnovMed

The Hidden Epidemic: Meth and PHMeth-Associated PAH is on the rise across the United States, yet many patients are not receiving the treatment they need. Dr. Vinicio de Jesus Perez discusses the shifting demographics of meth users, the challenges of treating addiction in cardiopulmonary care, and the need for compassionate, stigma-free screening. This Special Edition Episode Sponsored by: Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com #phawareMD @PHatStanford  @Viniciodjperez  @JNJInnovMed

When six months is the best a doctor can offer, hope feels like a cruel joke. In this Breakdown edition of Sickboy, we dig into Pulmonary Arterial Hypertension (PAH)—a rare disease that once meant certain death but now has science flipping the script.Through narration and three candid interviews, this audio doc traces PAH's path from despair to possibility. Jane shares what it's like to have her lungs hijacked in her twenties. Dr. David Langleben, who built Canada's first pulmonary hypertension clinic, walks us through decades of grim prognoses. And Jamie Myra of PHA Canada explains why delayed diagnosis is still PAH's deadliest trick. But then comes the plot twist: a new therapy called Sotatercept, a treatment that doesn't just slap a Band-Aid on symptoms but actually targets the root cause. For doctors who've watched patients run out of time, it's nothing short of a game changer.The Breakdown is a new addition to the Sickboy's format! An audio documentary where we crack open one illness at a time and make sense of it with heart, humour, and the occasional “WTF.”Shout out to PHA Canada! This first Breakdown proves that even in the heaviest stories, hope still gets the last word.For more information on how you can help please visit https://www.phacanada.ca/Follow Sickboy: Instagram: https://www.instagram.com/sickboypodcastTiktok: https://www.tiktok.com/@sickboypodcastDiscord: https://discord.gg/expeUDN

When six months is the best a doctor can offer, hope feels like a cruel joke. In this Breakdown edition of Sickboy, we dig into Pulmonary Arterial Hypertension (PAH)—a rare disease that once meant certain death but now has science flipping the script.Through narration and three candid interviews, this audio doc traces PAH's path from despair to possibility. Jane shares what it's like to have her lungs hijacked in her twenties. Dr. David Langleben, who built Canada's first pulmonary hypertension clinic, walks us through decades of grim prognoses. And Jamie Myra of PHA Canada explains why delayed diagnosis is still PAH's deadliest trick. But then comes the plot twist: a new therapy called Sotatercept, a treatment that doesn't just slap a Band-Aid on symptoms but actually targets the root cause. For doctors who've watched patients run out of time, it's nothing short of a game changer.The Breakdown is a new addition to the Sickboy's format! An audio documentary where we crack open one illness at a time and make sense of it with heart, humour, and the occasional “WTF.”Shout out to PHA Canada! This first Breakdown proves that even in the heaviest stories, hope still gets the last word.For more information on how you can help please visit https://www.phacanada.ca/Follow Sickboy: Instagram: https://www.instagram.com/sickboypodcastTiktok: https://www.tiktok.com/@sickboypodcastDiscord: https://discord.gg/expeUDN

Dr. John Kingrey exposes the rising crisis of meth-associated pulmonary hypertension, a condition spreading fast across the U.S. He challenges misconceptions, highlights urgent research, and stresses the need for compassion in treating both PAH and addiction. This Special Edition Episode Sponsored by: Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. @integrishealth @teamphhope @JNJInnovMed #phawareMD

A 200 Mile Journey from LA to San Diego to Raise Awareness for PH When Eric Borstein collapsed in his bedroom in 2020, doctors gave him just months to live. Instead, he fought back with walking, mental health, and the support of his community. Now, he's leading a movement, raising hundreds of thousands for pulmonary hypertension research, and walking 200 miles down the California coast to prove hope has no limits. Learn more about the 2nd Annual Where is EB? 5K Walk and Fundraiser September 7, 2025 Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware  Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com @teamphhope  @where_is_eb @DJLisaFoxx  

Merriam-Webster's Word of the Day for August 31, 2025 is: simpatico • sim-PAH-tih-koh • adjective Simpatico typically describes two or more people or things with shared qualities, interests, etc. It can also describe someone who is agreeable or likeable. // Even though they weren't always simpatico with regard to the direction of their company, the pair managed to be successful partners for more than 35 years. See the entry > Examples: “From the early 2010s, when he was a young teen rapper in Chicago ... Chief Keef was flooding his Instagram with self-documentation, all of which is essentially gone now. Enter Eduard Taberner Pérez, an amateur archivist and professional graphic designer, who compiled ‘Sosa Archive,' a limited-run art book that gathers several thousand photos pulled from Keef's Instagram, presenting then in visually simpatico grids of 12.” — Jon Caramanica, The New York Times, 5 Mar. 2025 Did you know? Simpatico, which comes ultimately from the Latin noun sympathia, meaning “sympathy,” was borrowed into English from both the Italian simpatico and Spanish simpatico. In those languages, the word has been chiefly used to describe people who are well-liked or easy to get along with. Early uses of the word in English reflected those of their forebears, as in Henry James's 1881 novel The Portrait of a Lady, in which one character says of another's dying cousin, “Ah, he was so simpatico. I'm awfully sorry for you.” In recent years, however, the word has gained an additional sense describing things or people who get along well or work well together.

It's Wednesday, August 20th, A.D. 2025. This is The Worldview in 5 Minutes heard on 140 radio stations and at www.TheWorldview.com.  I'm Adam McManus. (Adam@TheWorldview.com) By Jonathan Clark Muslim Nigerians killed 7,000 Christians this year A Nigerian-based nonprofit reports Islamic extremists have killed over 7,000 Christians in the country so far this year. The International Society for Civil Liberties and Rule of Law also found that nearly 8,000 Christians were violently seized and abducted.  The report notes this translates into “an average of 30 Christian deaths per day and more than one per hour.” Since 2009, Jihadists in Nigeria have killed over 125,000 Christians and destroyed nearly 20,000 church buildings.  Please pray for our brothers and sisters in Christ in Nigeria. The country is ranked seventh on the Open Doors' World Watch List of the most difficult countries to be a Christian.  Psalm 14:4 asks, “Have all the workers of iniquity no knowledge, who eat up my people as they eat bread, and do not call on the LORD?” Absurd charges dropped against Scottish pro-life grandmother Authorities in Scotland dropped charges against a 75-year-old grandmother who was arrested for holding a sign near an abortion mill.  Back in February, Rose Docherty held a sign that read: “Coercion is a crime, here to talk, only if you want.” Officials arrested her for violating a “buffer zone” law that restricts free expression near abortion mills. Docherty reacted to her case being dropped. She said, “This is a victory not just for me, but for everyone in Scotland who believes we should be free to hold a peaceful conversation.” Conservative Canadian Pierre Poilievre wins election In Canada, Conservative Leader Pierre Poilievre (pronounced PAH-lee-ev) won a special election in the province of Alberta on Monday.  Poilievre heads back to Canada's parliament after losing his seat earlier this year. He will continue his work as the opposition leader against Canada's ruling Liberal Party. Listen to comments from Poilievre. POILIEVRE: “We will work together. We will fight together. We will sacrifice together to restore the opportunity that our grandparents left for us, so that we can leave it for our grandchildren, so that we can once again restore a country that is strong, self-reliant and sovereign. That is why we stay united. That is why we go forward. May God keep our land glorious and free.” Trump wants to end mail-in ballots In the United States, President Donald Trump said Monday that he wants to end mail-in ballots as well as voting machines. Listen to comments from Trump.  TRUMP:  “You can never have a real democracy with mail in ballots. We, as a Republican Party, are going to do everything possible that we get rid of mail-in ballots. We're going to start with an executive order, that's being written right now by the best lawyers in the country, to end mail-in ballots because they're corrupt.” Trump wrote on Truth Social, “With their HORRIBLE Radical Left policies, like Open Borders, Men Playing in Women's Sports, Transgender and ‘WOKE' for everyone, and so much more, Democrats are virtually Unelectable without using this completely disproven Mail-In SCAM.” Bank of America will stop "debanking" conservatives The New York Post reports that Bank of America scrapped a rule used to “debank” conservatives. Major banks have also used the rule to deny services to religious groups, especially Evangelical ones.  JP Morgan Chase dropped the rule last year. Bank of America finally followed suit.  Jeremy Tedesco with Alliance Defending Freedom said, “Over the past two years, ADF and our partners in both the private and public sectors have repeatedly engaged with Bank of America's leadership to advocate for this change.” Fewer Americans are moving The Wall Street Journal reports that U.S. domestic migration rates are down. Only 7.9% of Americans relocated to a new town or city last year, down from about 20% in the 1950s and 60s. The rate has been steadily declining since then. People are also moving less within their own county. That rate is down 47% over the past three decades.  The falling domestic migration rates are associated with high mortgage rates, dual-income households, an aging population, and remote job opportunities.  Church-engaged Christians have less stress, anxiety, and loneliness And finally, the American Bible Society released the fifth chapter of its State of Bible: USA 2025 report. The chapter measured church engagement as the level of a person's involvement in the life, mission, and community of a local church. Only 34% of self-identified Christians attend church weekly. In terms of generations, Gen Z had the lowest levels of church engagement. Women, married people, Evangelicals, and people in small cities were more likely to be highly engaged with their church. John Plake with the American Bible Society said, “Our survey shows that church-engaged Christians have significantly less stress, less anxiety, less loneliness, and more hope.” Hebrews 10:24-25 says, “And let us consider one another in order to stir up love and good works, not forsaking the assembling of ourselves together, as is the manner of some, but exhorting one another, and so much the more as you see the Day approaching.” Close And that's The Worldview on this Wednesday, August 20th, in the year of our Lord 2025. Follow us on X or subscribe for free by Spotify, Amazon Music, or by iTunes or email to our unique Christian newscast at www.TheWorldview.com.  I'm Adam McManus (Adam@TheWorldview.com). Seize the day for Jesus Christ.

In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Tinestamps: 00:45 – PAH management 03:05 – Hypoxia 06:42 – Decompensated PAH 10:06 – At-home treatments 12:44 – Multidisciplinary teams 14:50 – Novel therapies

In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Timestamps: 01:05 – Diagnostic workflows 03:58 – Non-invasive tools 05:37 – Right heart catheterisation values 09:05 – Vasoreactivity testing 11:10 – Genetic testing 13:08 – Innovative diagnostics

Dr. John Granton, a critical care and transplant physician at Toronto General Hospital, shares his journey in pulmonary hypertension and lung transplantation, detailing the groundbreaking advancements in transplant technology. He discusses the evolution of lung preservation methods, the challenges of chronic rejection, and the hope for longer-lasting transplants. With a passion for improving patient outcomes, Dr. Granton envisions a future where transplant becomes obsolete—replaced by treatments that cure underlying diseases. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. @UHN @teamphhope #phawareMD #PHILD #transplant @phacanada

In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research.  Timestamps:   Part 1:   01:00 – What is PAH  02:34 – Risk factors  04:21 – Misdiagnoses  07:13 – Pathophysiology  10:44 – World Symposium classification 

In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. 

Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going. Today, we're focusing on an often-overlooked peptide called VIP, short for Vasoactive Intestinal Peptide. The name might sound technical, but this peptide plays some important roles in the body. It helps regulate inflammation, supports nerve function, improves blood flow by relaxing blood vessels, and may even have benefits for things like chronic pain, including back pain. Let's get into it. What is VIP? We've talked about VIP before on a previous podcast, but it's been awhile and I'd like to start with the basics as a refresher.  VIP is a 28-amino acid neuropeptide that acts like a signaling molecule in both the central and peripheral nervous systems. Think of it like a chemical messenger that can influence a lot of different body systems. VIP belongs to the glucagon/secretin peptide superfamily, and it's found throughout the body, including your brain, intestines, lungs, and immune cells. Now, what does VIP actually do? Well it does quite a bit. VIP works by binding to specific receptors on cells—called VPAC1 and VPAC2—which trigger a chain reaction inside the body through something known as the cyclic AMP pathway. Once activated:  It relaxes smooth muscles, which helps open up blood vessels (vasodilation) and airways (bronchodilation) It stimulates secretion of water and electrolytes in places like the gut and pancreas—so yes, it helps with digestion too It's a major immune modulator, calming inflammation by regulating immune cell behavior  Neuroprotective role, supporting the survival and adaptability of neurons VIP in Medicine – What's the Buzz? VIP has been studied in a variety of conditions. Inflammatory diseases like rheumatoid arthritis and Crohn's Neurodegenerative conditions like Alzheimer's and Parkinson's Autoimmune diseases like osteoarthritis Respiratory conditions like pulmonary arterial hypertension (PAH), asthma, and chronic obstructive pulmonary disease (COPD) or due to mold toxicity But today, we're zooming in on something more tangible for a lot of people—back pain. VIP and Back Pain – What Do We Know? Let's get into the science here. VIP has recently caught attention for its potential role in intervertebral disc degeneration, which is one of the top causes of chronic low back pain. A 2024 study found that VIP receptors were significantly reduced in degenerated human discs—which is kind of a red flag. When VIP was given to mice for four weeks, researchers saw slowed degeneration, better structural proteins like aggrecan, and overall healthier discs on imaging. Promising, right? But here's the catch—this was a preclinical animal study. We still need human trials to confirm it works outside the lab. VIP and Joint Pain And when it comes to VIP and joint pain, there's a bit more research on VIP and osteoarthritis, especially when the spine is involved. In OA models, VIP was shown to lower pro-inflammatory cytokines—those molecules that contribute to pain and make joints hurt. But here's where it gets complicated: some studies report that VIP accumulation in joints might actually worsen pain. So... it's a bit of a paradox. So what's the takeaway? VIP can be helpful—but its role in pain management seems to depend on how much, where, and what kind of pain we're talking about. VIP in Peptide Therapy – Real-World Use? In peptide clinics—especially those using integrative or regenerative medicine approaches—VIP is sometimes part of treatment protocols for nerve-related pain and inflammation. It's often paired with other peptides like BPC-157 and TB-500. You can find some clinics that list VIP as a go-to for chronic pain, including back pain. But here's the reality check, clinical data is limited, success is anecdotal, it's pricey and results can vary from person to person. So while VIP might help reduce inflammation and slow tissue degeneration, it's not a substitute for tried-and-true pain management peptides like BPC-157. Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Until next time, be well, and as always, have a happy, healthy week.

Dr. Tijana Milinic and Lia Barros, DNP, from the University of Washington take a deep dive into the world of pulmonary arterial hypertension (PAH) clinical trials and discuss why diversity and inclusion matter. They explore the hidden biases in medical research and the real-world consequences of exclusion. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. @uwepidemiology  #phawareMD

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/proms-role-in-clinical-research-and-contributions-to-pah-patient-perspectives/33244/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/a-comparison-of-proms-and-how-to-use-them-in-clinical-practice-for-pah/33241/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/patient-reported-outcome-measures-proms-valuable-insights-into-the-lived-experience-of-pah/33240/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/how-do-patient-experiences-and-pah-perspectives-vary-across-regions-and-cultures-worldwide/33245/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/the-latest-patient-centered-recommendations-from-the-7th-world-symposium-on-ph/33236/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/managing-travel-with-pah-logistics-medications-oxygen-and-emergency-preparedness/33237/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

CME credits: 1.00 Valid until: 15-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/integrating-palliative-care-in-pulmonary-hypertension/33239/ Managing patients with pulmonary arterial hypertension, or PAH, can present certain challenges. PAH is a serious, progressive condition, and its effective management involves the consideration of several factors to meet treatment goals. The utilization of patient-reported outcome measures (PROMs) to enhance shared decision-making can be a valuable tool to help integrate lifestyle, palliative care, and patient goals into a PAH care plan and address diverse and global needs.

Dr. Lana Melendres-Groves dives into her research on racial and ethnic disparities in PAH treatment. From differences in medication access to the role of social determinants of health, she explores how systemic barriers impact care and what steps can be taken to ensure equity and inclusivity in PAH management. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. @UNMHSC #phawareMD

Dr. Roham Zamanian, discusses the concept of "disease modification" in the treatment of pulmonary hypertension. He describes how this idea emerged from discussions with colleagues about the future of pulmonary hypertension therapies, and the potential for treatments to impact the underlying disease process beyond just reducing pulmonary artery pressures. This Special Edition Episode Sponsored by: Johnson & Johnson Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com #phawareMD @PHatStanford @docroham @JNJInnovMed    

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! Top 5 Healthcare Headlines for June 16-22, 2025: Pemvidutide Shows Significant MASH Effects, Weight Loss at 24 Weeks in Phase 2b IMPACT Trial Topline phase 2b data show pemvidutide achieved significant rates of MASH resolution and fibrosis improvement alongside meaningful weight loss at 24 weeks, positioning it as a promising candidate for metabolic liver disease treatment. FDA Approves Belimumab (Benlysta) Autoinjector for Pediatric Lupus Nephritis The FDA approved a belimumab autoinjector for at-home subcutaneous use in children as young as five with active lupus nephritis, providing the first approved biologic self-injection option for pediatric SLE and LN. Phase 3 Trial Results Announced for Sotatercept-csrk in Pulmonary Arterial Hypertension Positive phase 3 results show sotatercept-csrk added to background therapy reduced time to clinical worsening events in adults with PAH, supporting its potential as an effective treatment for this high-risk population. Compass Pathways' COMP360 Psilocybin Shows Benefit in Phase 3 TRD Trial COMP360 psilocybin demonstrated a significant reduction in depression symptom severity in treatment-resistant depression, meeting the primary endpoint in a pivotal phase 3 trial. Once-Monthly Obesity Drug, MariTide, Achieves Weight Loss Up to 16% at 1 Year Phase 2 data indicate once-monthly MariTide induces substantial weight loss of up to 16% over one year, with additional improvements in glycemic control, highlighting its promise for obesity and type 2 diabetes management.

Dr. Rodolfo Estrada, is a seasoned pulmonologists currently at UT Health San Antonio with significant experience in the management of patients with different forms of pulmonary hypertension. In this episode, Dr. Estrada will discuss the technology and clinical development behind YUTREPIA™ (treprostinil) inhalation powder and why it might be a good option for some PAH and PH-ILD patients. This Special Edition episode is sponsored by Liquidia. Please see the Important Safety Information following this podcast. The Prescribing Information and Instructions for Use for YUTREPIA (treprostinil) inhalation powder are available at YUTREPIA.com.  YUTREPIA is approved for the treatment of pulmonary arterial hypertension (PAH; WHO Group 1) and pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) to improve the ability to exercise. Please see the Important Safety Information in the show notes. The Prescribing Information and Instructions for Use for YUTREPIA are available at YUTREPIA.com. Learn more about the INSPIRE study. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD #PHILD @Liquidia_Corp @REstradaMD @UTHealthSA IMPORTANT SAFETY INFORMATION Before you take YUTREPIA, tell your healthcare provider about all of your medical conditions, including if you: Have low blood pressure Have or have had bleeding problems Have asthma or chronic obstructive pulmonary disease (COPD) Are pregnant or plan to become pregnant. It is not known if this product will harm your unborn baby Are breastfeeding or plan to breastfeed. It is not known if this product passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. YUTREPIA and other medicines may affect each other. Especially tell your healthcare provider if you take: Medicines used to treat high blood pressure or heart disease Medicines that decrease blood clotting (anticoagulants) Water pills (diuretics) Gemfibrozil (Lopid®) or rifampin (Rimactane®, Rifadin®, Rifamate®, Rifater®) What are the possible side effects of YUTREPIA? This product can cause serious side effects, including: Low blood pressure (symptomatic hypotension). If you have low blood pressure, this product may lower your blood pressure more. Bleeding problems. This product may increase the risk of bleeding, especially in people who take blood thinners (anticoagulants). The most common side effects of YUTREPIA are cough, headache, throat irritation and pain, nausea, reddening of the face and neck (flushing), fainting or loss of consciousness, dizziness, diarrhea, and shortness of breath. Like other inhaled prostaglandins, you may have trouble breathing after taking YUTREPIA because it may cause the muscles around your airway to tighten (bronchospasm). These are not all the possible side effects. Call your doctor for medical advice about side effects or if you have trouble breathing. You may report side effects to the FDA at www.fda.gov/MedWatch or call 1–800-FDA-1088. The risk information provided here is not comprehensive. To learn more about YUTREPIA, talk with your healthcare provider. Please see Full Prescribing Information for YUTREPIA and Instructions for Use. For additional information, call 1–888–393–5732.

Seth Hall, MBA, RRT, takes listeners on a journey through the past, present, and future of inhaled therapies. Discover how these treatments have evolved, the life-changing benefits they offer, and the revolutionary technologies that could redefine outcomes for PAH and PH-ILD patients. This Special Edition episode is sponsored by Liquidia. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD #PHILD @Liquidia_Corp #PRINTTechnology 

Dr. Ron Zolty delves into groundbreaking advancements in treating pulmonary arterial hypertension. From the historical use of vasodilators to the revolutionary promise of sotatercept and seralutinib, Dr. Zolty unpacks how science is moving closer to halting—and possibly even reversing—PAH. This Special Edition episode is sponsored by Gossamer Bio. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD @UNMCCOM @NebraskaMed @GossamerBio #clinicaltrial #PROSERA 

Eric Austin, MD, MSCI discusses early detection among people who are at risk of pulmonary arterial hypertension (PAH), particularly those who would have genetic susceptibility, or who may have congenital heart disease, or who may have connective tissue disease or other features that would make them more at risk of developing pulmonary arterial hypertension than the rest of the population. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com #phawareMD @VUMCDiscoveries @pphnet @VUMCchildren

On this episode, we evaluate current guidelines and evidence-based treatment strategies for managing pulmonary arterial hypertension. We compare and contrast the efficacy, safety profiles, and appropriate use of targeted PAH therapies, adjunct treatments, and patient monitoring techniques.  Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com