Podcasts about PCP

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Put on your flotation devices and keep an eye on the catering table, because today, we're getting a broader understanding of what happened on the set of Titanic when around 80 cast and crew members were drugged with PCP on the last night of filming in Nova Scotia Become a supporter of this podcast: https://www.spreaker.com/podcast/broads-next-door--5803223/support.

Listen to JCO's Art of Oncology article, "The Man at the Bow" by Dr. Alexis Drutchas, who is a palliative care physician at Dana Farber Cancer Institute. The article is followed by an interview with Drutchas and host Dr. Mikkael Sekeres. Dr. Drutchas shares the deep connection she had with a patient, a former barge captain, who often sailed the same route that her family's shipping container did when they moved overseas many times while she was growing up. She reflects on the nature of loss and dignity, and how oncologists might hold patients' humanity with more tenderness and care, especially at the end of life. TRANSCRIPT Narrator: The Man at the Bow, by Alexis Drutchas, MD  It was the kind of day that almost seemed made up—a clear, cerulean sky with sunlight bouncing off the gold dome of the State House. The contrast between this view and the drab hospital walls as I walked into my patient's room was jarring. My patient, whom I will call Suresh, sat in a recliner by the window. His lymphoma had relapsed, and palliative care was consulted to help with symptom management. The first thing I remember is that despite the havoc cancer had wreaked—sunken temples and a hospital gown slipping off his chest—Suresh had a warm, peaceful quality about him. Our conversation began with a discussion about his pain. Suresh told me how his bones ached and how his fatigue left him feeling hollow—a fraction of his former self. The way this drastic change in his physicality affected his sense of identity was palpable. There was loss, even if it was unspoken. After establishing a plan to help with his symptoms, I pivoted and asked Suresh how he used to spend his days. His face immediately lit up. He had been a barge captain—a dangerous and thrilling profession that took him across international waters to transport goods. Suresh's eyes glistened as he described his joy at sea. I was completely enraptured. He shared stories about mornings when he stood alone on the bow, feeling the salted breeze as the barge moved through Atlantic waves. He spoke of calm nights on the deck, looking at the stars through stunning darkness. He traveled all over the globe and witnessed Earth's topography from a perspective most of us will never see. The freedom Suresh exuded was profound. He loved these voyages so much that one summer, despite the hazards, he brought his wife and son to experience the journey with him. Having spent many years of my childhood living in Japan and Hong Kong, my family's entire home—every bed, sheet, towel, and kitchen utensil—was packed up and crossed the Atlantic on cargo ships four times. Maybe Suresh had captained one, I thought. Every winter, we hosted US Navy sailors docked in Hong Kong for the holidays. I have such fond memories of everyone going around the table and sharing stories of their adventures—who saw or ate what and where. I loved those times: the wild abandon of travel, the freedom of being somewhere new, and the way identity can shift and expand as experiences grow. When Suresh shared stories of the ocean, I was back there too, holding the multitude of my identity alongside him. I asked Suresh to tell me more about his voyages: what was it like to be out in severe weather, to ride over enormous swells? Did he ever get seasick, and did his crew always get along? But Suresh did not want to swim into these perilous stories with me. Although he worked a difficult and physically taxing job, this is not what he wanted to focus on. Instead, he always came back to the beauty and vitality he felt at sea—what it was like to stare out at the vastness of the open ocean. He often closed his eyes and motioned with his hands as he spoke as if he was not confined to these hospital walls. Instead, he was swaying on the water feeling the lightness of physical freedom, and the way a body can move with such ease that it is barely perceptible, like water flowing over sand. The resonances of Suresh's stories contained both the power and challenges laden in this work. Although I sat at his bedside, healthy, my body too contained memories of freedom that in all likelihood will one day dissipate with age or illness. The question of how I will be seen, compared to how I hoped to be seen, lingered in my mind. Years ago, before going to medical school, I moved to Vail, Colorado. I worked four different jobs just to make ends meet, but making it work meant that on my days off, I was only a chairlift ride away from Vail's backcountry. I have a picture of this vigor in my mind—my snowboard carving into fresh powder, the utter silence of the wilderness at that altitude, and the way it felt to graze the powdery snow against my glove. My face was windburned, and my body was sore, but my heart had never felt so buoyant. While talking with Suresh, I could so vividly picture him as the robust man he once was, standing tall on the bow of his ship. I could feel the freedom and joy he described—it echoed in my own body. In that moment, the full weight of what Suresh had lost hit me as forcefully as a cresting wave—not just the physical decline, but the profound shift in his identity. What is more, we all live, myself included, so precariously at this threshold. In this work, it is impossible not to wonder: what will it be like when it is me? Will I be seen as someone who has lived a full life, who explored and adventured, or will my personhood be whittled down to my illness? How can I hold these questions and not be swallowed by them? "I know who you are now is not the person you've been," I said to Suresh. With that, he reached out for my hand and started to cry. We looked at each other with a new understanding. I saw Suresh—not just as a frail patient but as someone who lived a full life. As someone strong enough to cross the Atlantic for decades. In that moment, I was reminded of the Polish poet, Wislawa Szymborska's words, "As far as you've come, can't be undone." This, I believe, is what it means to honor the dignity of our patients, to reflect back the person they are despite or alongside their illness…all of their parts that can't be undone. Sometimes, this occurs because we see our own personhood reflected in theirs and theirs in ours. Sometimes, to protect ourselves, we shield ourselves from this echo. Other times, this resonance becomes the most beautiful and meaningful part of our work. It has been years now since I took care of Suresh. When the weather is nice, my wife and I like to take our young son to the harbor in South Boston to watch the planes take off and the barges leave the shore, loaded with colorful metal containers. We usually pack a picnic and sit in the trunk as enormous planes fly overhead and tugboats work to bring large ships out to the open water. Once, as a container ship was leaving the port, we waved so furiously at those working on board that they all started to wave back, and the captain honked the ships booming horn. Every single time we are there, I think of Suresh, and I picture him sailing out on thewaves—as free as he will ever be. Mikkael Sekeres: Welcome back to JCO's Cancer Stories: The Art of Oncology. This ASCO podcast features intimate narratives and perspectives from authors exploring their experiences in oncology. I'm your host, Mikkael Sekeres. I'm Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. What a treat we have today. We're joined by Dr. Alexis Drutchas, a Palliative Care Physician and the Director of the Core Communication Program at the Dana-Farber Cancer Institute, and Assistant Professor of Medicine at Harvard Medical School to discuss her article, "The Man at the Bow." Alexis, thank you so much for contributing to Journal of Clinical Oncology and for joining us to discuss your article. Dr. Alexis Drutchas: Thank you. I'm thrilled and excited to be here. Mikkael Sekeres: I wonder if we can start by asking you about yourself. Where are you from, and can you walk us a bit through your career? Dr. Alexis Drutchas: The easiest way to say it would be that I'm from the Detroit area. My dad worked in automotive car parts and so we moved around a lot when I was growing up. I was born in Michigan, then we moved to Japan, then back to Michigan, then to Hong Kong, then back to Michigan. Then I spent my undergrad years in Wisconsin and moved out to Colorado to teach snowboarding before medical school, and then ended up back in Michigan for that, and then on the east coast at Brown for my family medicine training, and then in Boston for work and training. So, I definitely have a more global experience in my background, but also very Midwestern at heart as well. In terms of my professional career trajectory, I trained in family medicine because I really loved taking care of the whole person. I love taking care of kids and adults, and I loved OB, and at the time I felt like it was impossible to choose which one I wanted to pursue the most, and so family medicine was a great fit. And at the core of that, there's just so much advocacy and social justice work, especially in the community health centers where many family medicine residents train. During that time, I got very interested in LGBTQ healthcare and founded the Rhode Island Trans Health Conference, which led me to work as a PCP at Fenway Health in Boston after that. And so I worked there for many years. And then through a course of being a hospitalist at BI during that work, I worked with many patients with serious illness, making decisions about discontinuing dialysis, about pursuing hospice care in the setting of ILD. I also had a significant amount of family illness and started to recognize this underlying interest I had always had in palliative care, but I think was a bit scared to pursue. But those really kind of tipped me over to say I really wanted to access a different level of communication skills and be able to really go into depth with patients in a way I just didn't feel like I had the language for. And so I applied to the Harvard Palliative Care Fellowship and luckily and with so much gratitude got in years ago, and so trained in palliative care and stayed at MGH after that. So my Dana-Farber position is newer for me and I'm very excited about it. Mikkael Sekeres: Sounds like you've had an amazing career already and you're just getting started on it. I grew up in tiny little Rhode Island and, you know, we would joke you have to pack an overnight bag if you travel more than 45 minutes. So, our boundaries were much tighter than yours. What was it like growing up where you're going from the Midwest to Asia, back to the Midwest, you wind up settling on the east coast? You must have an incredible worldly view on how people live and how they view their health. Dr. Alexis Drutchas: I think you just named much of the sides of it. I think I realize now, in looking back, that in many ways it was living two lives, because at the time it was rare from where we lived in the Detroit area in terms of the other kids around us to move overseas. And so it really did feel like that part of me and my family that during the summers we would have home leave tickets and my parents would often turn them in to just travel since we didn't really have a home base to come back to. And so it did give me an incredible global perspective and a sense of all the ways in which people develop community, access healthcare, and live. And then coming back to the Midwest, not to say that it's not cosmopolitan or diverse in its own way, but it was very different, especially in the 80s and 90s to come back to the Midwest. So it did feel like I carried these two lenses in the world, and it's been incredibly meaningful over time to meet other friends and adults and patients who have lived these other lives as well. I think for me those are some of my most connecting friendships and experiences with patients for people who have had a similar experience in living with sort of a duality in their everyday lives with that. Mikkael Sekeres: You know, you write about the main character of your essay, Suresh, who's a barge captain, and you mention in the essay that your family crossed the Atlantic on cargo ships four times when you were growing up. What was that experience like? How much of it do you remember? Dr. Alexis Drutchas: Our house, like our things, crossed the Atlantic four times on barge ships such as his. We didn't, I mean we crossed on airplanes. Mikkael Sekeres: Oh, okay, okay. Dr. Alexis Drutchas: We flew over many times, but every single thing we owned got packed up into containers on large trucks in our house and were brought over to ports to be sent over. So, I'm not sure how they do it now, but at the time that's sort of how we moved, and we would often go live in a hotel or a furnished apartment for the month's wait of all of our house to get there, which felt also like a surreal experience in that, you know, you're in a totally different country and then have these creature comforts of your bedroom back in Metro Detroit. And I remember thinking a lot about who was crossing over with all of that stuff and where was it going, and who else was moving, and that was pretty incredible. And when I met Suresh, just thinking about the fact that at some point our home could have been on his ship was a really fun connection in my mind to make, just given where he always traveled in his work. Mikkael Sekeres: It's really neat. I remember when we moved from the east coast also to the Midwest, I was in Cleveland for 18 years. The very first thing we did was mark which of the boxes had the kids' toys in it, because that of course was the first one we let them close it up and then we let them open it as soon as we arrived. Did your family do something like that as well so that you can, you know, immediately feel an attachment to your stuff when they arrived? Dr. Alexis Drutchas: Yeah, I remember what felt most important to our mom was our bedrooms. I don't remember the toys. I remember sort of our comforters and our pillowcases and things like that, yeah, being opened and it feeling really settling to think, "Okay, you know, we're in a completely different place and country away from most everything we know, but our bedroom is the same." That always felt like a really important point that she made to make home feel like home again in a new place. Mikkael Sekeres: Yeah, yeah. One of the sentences you wrote in your essay really caught my eye. You wrote about when you were younger and say, "I loved those times, the wild abandon of travel, the freedom of being somewhere new, the way identity can shift and expand as experiences grow." It's a lovely sentiment. Do you think those are emotions that we experience only as children, or can they continue through adulthood? And if they can, how do we make that happen, that sense of excitement and experience? Dr. Alexis Drutchas: I think that's such a good question and one I honestly think about a lot. I think that we can access those all the time. There's something about the newness of travel and moving, you know, I have a 3-year-old right now, and so I think many parents would connect to that sense that there is wonderment around being with someone experiencing something for the first time. Even watching my son, Oliver, see a plane take off for the first time felt joyous in a completely new way, that even makes me smile a lot now. But I think what is such a great connection here is when something is new, our eyes are so open to it. You know, we're constantly witnessing and observing and are excited about that. And I think the connection that I've realized is important for me in my work and also in just life in general to hold on to that wonderment is that idea of sort of witnessing or having a writer's eye, many would call it, in that you're keeping your eye open for the small beautiful things. Often with travel, you might be eating ramen. It might not be the first time you're eating it, but you're eating it for the first time in Tokyo, and it's the first time you've had this particular ingredient on it, and then you remember that. But there's something that we're attuned to in those moments, like the difference or the taste, that makes it special and we hold on to it. And I think about that a lot as a writer, but also in patient care and having my son with my wife, it's what are the special small moments to hold on to and allowing them to be new and beautiful, even if they're not as large as moving across the country or flying to Rome or whichever. I think there are ways that that excitement can still be alive if we attune ourselves to some of the more beautiful small moments around us. Mikkael Sekeres: And how do we do that as doctors? We're trained to go into a room and there's almost a formula for how we approach patients. But how do you open your mind in that way to that sense of wonderment and discovery with the person you're sitting across from, and it doesn't necessarily have to be medical? One of the true treats of what we do is we get to meet people from all backgrounds and all walks of life, and we have the opportunity to explore their lives as part of our interaction. Dr. Alexis Drutchas: Yeah, I think that is such a great question. And I would love to hear your thoughts on this too. I think for me in that sentence that you mentioned, sitting at that table with sort of people in the Navy from all over the world, I was that person to them in the room, too. There was some identity there that I brought to the table that was different than just being a kid in school or something like that. To answer your question, I wonder if so much of the challenge is actually allowing ourselves to bring ourselves into the room, because so much of the formula is, you know, we have these white coats on, we have learners, we want to do it right, we want to give excellent care. There's there's so many sort of guards I think that we put up to make sure that we're asking the right questions, we don't want to miss anything, we don't want to say the wrong thing, and all of that is true. And at the same time, I find that when I actually allow myself into the room, that is when it is the most special. And that doesn't mean that there's complete countertransference or it's so permeable that it's not in service of the patient. It just means that I think when we allow bits of our own selves to come in, it really does allow for new connections to form, and then we are able to learn about our patients more, too. With every patient, I think often we're called in for goals of care or symptom management, and of course I prioritize that, but when I can, I usually just try to ask a more open-ended question, like, "Tell me about life before you came to the hospital or before you were diagnosed. What do you love to do? What did you do for work?" Or if it's someone's family member who is ill, I'll ask the kids or family in the room, "Like, what kind of mom was she? You know, what special memory you had?" Just, I get really curious when there's time to really understand the person. And I know that that's not at all new language. Of course, we're always trying to understand the person, but I just often think understanding them is couched within their illness. And I'm often very curious about how we can just get to know them as people, and how humanizing ourselves to them helps humanize them to us, and that back and forth I think is like really lovely and wonderful and allows things to come up that were totally unexpected, and those are usually the special moments that you come home with and want to tell your family about or want to process and think about. What about you? How do you think about that question? Mikkael Sekeres: Well, it's interesting you ask. I like to do projects around the house. I hate to say this out loud because of course one day I'll do something terrible and everyone will remember this podcast, but I fancy myself an amateur electrician and plumber and carpenter and do these sorts of projects. So I go into interactions with patients wanting to learn about their lives and how they live their lives to see what I can pick up on as well, how I can take something out of that interaction and actually use it practically. My father-in-law has this phrase he always says to me when a worker comes to your house, he goes, he says to me, "Remember to steal with your eyes." Right? Watch what they do, learn how they fix something so you can fix it yourself and you don't have to call them next time. So, for me it's kind of fun to hear how people have lived their lives both within their professions, and when I practiced medicine in Cleveland, there were a lot of farmers and factory workers I saw. So I learned a lot about how things are made. But also about how they interact with their families, and I've learned a lot from people I've seen who were just terrific dads and terrific moms or siblings or spouses. And I've tried to take those nuggets away from those interactions. But I think you can only do it if you open yourself up and also allow yourself to see that person's humanity. And I wonder if I can quote you to you again from your essay. There's another part that I just loved, and it's about how you write about how a person's identity changes when they become a patient. You write, "And in that moment the full weight of what he had lost hit me as forcefully as a cresting wave. Not just the physical decline, but the profound shift in identity. What is more, we all live, me included, so precariously at this threshold. In this work, it's impossible not to wonder, what will it be like when it's me? Will I be seen as someone who's lived many lives, or whittled down only to someone who's sick?" Can you talk a little bit more about that? Have you been a patient whose identity has changed without asking you to reveal too much? Or what about your identity as a doctor? Is that something we have to undo a little bit when we walk in the room with the stethoscope or wearing a white coat? Dr. Alexis Drutchas: That was really powerful to hear you read that back to me. So, thank you. Yeah, I think my answer here can't be separated from the illness I faced with my family. And I think this unanimously filters into the way in which I see every patient because I really do think about the patient's dignity and the way medicine generally, not always, really does strip them of that and makes them the patient. Even the way we write about "the patient said this," "the patient said that," "the patient refused." So I generally very much try to have a one-liner like, "Suresh is a X-year-old man who's a barge captain from X, Y, and Z and is a loving father with a," you know, "period. He comes to the hospital with X, Y, and Z." So I always try to do that and humanize patients. I always try to write their name rather than just "patient." I can't separate that out from my experience with my family. My sister six years ago now went into sudden heart failure after having a spontaneous coronary artery dissection, and so immediately within minutes she was in the cath lab at 35 years old, coding three times and came out sort of with an Impella and intubated, and very much, you know, all of a sudden went from my sister who had just been traveling in Mexico to a patient in the CCU. And I remember desperately wanting her team to see who she was, like see the person that we loved, that was fighting for her life, see how much her life meant to us. And that's not to say that they weren't giving her great care, but there was something so important to me in wanting them to see how much we wanted her to live, you know, and who she was. It felt like there's some important core to me there. We brought pictures in, we talked about what she was living for. It felt really important. And I can't separate that out from the way in which I see patients now or I feel in my own way in a certain way what it is to lose yourself, to lose the ability to be a Captain of the ship, to lose the ability to do electric work around the house. So much of our identity is wrapped up in our professions and our craft. And I think for me that has really become forefront in the work of palliative care and in and in the teaching I do and in the writing I do is how to really bring them forefront and not feel like in doing that we're losing our ability to remain objective or solid in our own professional identities as clinicians and physicians. Mikkael Sekeres: Well, I think that's a beautiful place to end here. I can only imagine what an outstanding physician and caregiver you are also based on your writing and how you speak about it. You just genuinely come across as caring about your patients and your family and the people you have interactions with and getting to know them as people. It has been again such a treat to have Dr. Alexis Drutchas here. She is Director of the Core Communication Program at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School to discuss her article, "The Man at the Bow." Alexis, thank you so much for joining us. Dr. Alexis Drutchas: Thank you. This has been a real joy. Mikkael Sekeres: If you've enjoyed this episode, consider sharing it with a friend or colleague, or leave us a review. Your feedback and support helps us continue to save these important conversations. If you're looking for more episodes and context, follow our show on Apple, Spotify, or wherever you listen, and explore more from ASCO at ASCO.org/podcasts. Until next time, this has been Mikkael Sekeres for the ASCO podcast Cancer Stories: The Art of Oncology. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Show notes: Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio: Dr. Alexis Drutchas is a palliative care physician at Dana Farber Cancer Institute.

Explore how GLP-1 meds can help or harm eating disorders with Dr. Laura Bridge When weight-loss meds meet eating disorders: GLP-1 drugs are reshaping medicine,  but could they also be fueling disordered eating? Join Dr. Laura Bridge as we unpack the risks, red flags, and how to keep “healthy” from turning harmful.  Also, how to approach restrictive eating disorders, bulimia, and binge eating disorder as a PCP. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Introduction Defining Eating Disorders  Screening & Permission to Discuss  Clinical Approach & History Gathering  Treatment Framework  GLP-1 Contraindications Dr. Bridge's Take-Home Points  Credits Producer, writer, show notes, cover art and infographics: Isabel Valdez, PA-C Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Laura Bridge MD, FACP Disclosures Dr. Laura Bridge no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com. Sponsor: Panacea Legal  Panacea Legal is giving Curbsiders listeners one more reason to feel thankful with 50% off any contract review service by using promo code CURB50. But hurry, this offer is only available for the first 10 doctors who use the code. Visit Panacea.Legal today Sponsor: Hydrow  Head over to Hydrow.com and use code CURB to save up to $600 off on Hydrow rower during this holiday season.  Sponsor: Grammarly  Visit Grammarly.com/podcast and Sign up for FREE

Dr. Pedro Barata and Dr. Aditya Bagrodia discuss the evolving landscape of testicular cancer survivorship, the impact of treatment-related complications, and management strategies to optimize long-term outcomes and quality of life. TRANSCRIPT:  Dr. Pedro Barata: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I'm Dr. Pedro Barata. I'm a medical oncologist at University Hospitals Seidman Cancer Center and associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I'm also an associate editor of the ASCO Educational Book. We all know that testicular cancer is a rare but highly curable malignancy that mainly affects young men. Multimodal advances in therapy have resulted in excellent cancer specific survival, but testicular cancer survivors face significant long term treatment related toxicities which affect their quality of life and require surveillance and management. With that, I'm very happy today to be joined by Dr. Aditya Bagrodia, a urologic oncologist, professor, and the GU Disease Team lead at UC San Diego[KI1]  Health, and also the lead author of the recently published paper in the ASCO Educational Book titled, "Key Updates in Testicular Cancer: Optimizing Survivorship and Survival." And he's also the host of the world-renowned BackTable Urology Podcast. Dr. Bagrodia, I'm so happy that you're joining us today. Welcome. Dr. Aditya Bagrodia: Thanks, Pedro. Absolutely a pleasure to be here. Really appreciate the opportunity. Dr. Pedro Barata: Absolutely.  So, just to say that our full disclosures are available in the transcript of this episode.  Let's get things started. I'm really excited to talk about this. I'm biased, I do treat testicular cancer among other GU malignancies and so it's a really, really important topic that we face every day, right? Fortunately, for most of these patients, we're able to cure them. But it always comes up the question, "What now? You know, scans, management, cardio oncology, what survivorship programs we have in place? Are we addressing the different survivorship piece, psychology, fertility, et cetera?" So, we'll try to capture all of that today. Aditya, congrats again, you did a fantastic job putting together the insights and thoughts and what we know today about this important topic. And so, let's get focused specifically about what happens when patients get cured. So, many of us, in many centers, were fortunate enough to have these survivorship programs together, but I find that sometimes from talking to colleagues, they're not exactly the same thing and they don't mean the same thing to different people, to different institutions, right? So, first things first. What do you tell a patient perhaps when they ask you, "What can happen to me now that I'm done with treatment for testicular cancer?" Whether it's chemotherapy or just surgery or even radiation therapy? "So, what about the long term? What should I expect, Doctor, that might happen to me in the long run?" Dr. Aditya Bagrodia: Totally. I mean, I think that question's really front and center, Pedro, and really appreciate you all highlighting this topic. It was an absolute honor to work with true thought leaders and the survivorship bit of it is front and center, in my opinion. It's really the focus, you know, we, generally speaking should be able to cure these young men, but it's the 10, 15, 20 years down the way that they're going to largely contend with. The conversation really begins at diagnosis, pre-education. Fortunately, the bulk of patients that present are those with stage one disease, and even very basic things like before orchiectomy, talking about a prosthetic; we know that that can impact body image and self esteem, whether or not they decide to receive it or not. Actually, just being offered a prosthetic is important and this is something, you know, for any urologist, it's kind of critical. To discussing fertility elements to this, taking your time to examine the contralateral testicle, ask about fertility problems, issues, concerns, offer sperm banking, even in the context of a completely normal contralateral testicle, I think these things are quite important.  So if it's somebody with stage one disease, you know, without going too far down discussing adjuvant therapy and so forth, I will start the conversation with, "You know, the testes do largely two things. They make testosterone and they make sperm." By and large, patients are going to be able to have acceptable levels of testosterone, adequate sperm parameters to maintain kind of a normal gonadal state and to naturally conceive, should that be something they're interested in. However, there's still going to be, depending on what resource you look at, somewhere in the order of 10-30% that are going to have issues. Where I think for the stage one patients, it's really incumbent upon us is actually to not wait for them to discuss their concerns, particularly with testosterone, which many times can be a little bit vague, but to proactively ask about it every time. Libido, erectile quality, muscle mass maintenance, energy, fatigue. All of these are kind of associated symptoms of hypogonadism. But for a lot of kids 18-20 years old, it's going to be something insidious that they don't think about. So, for the stage one patients, it absolutely starts with gonadal function. If they are stage two getting surgery, I think the counseling really needs to center around a possibility for ejaculatory dysfunction. Now, for a chemotherapy-naive, nerve-sparing RPLND, generally these days we should be able to preserve ejaculatory function at high volume centers, but you still want to bring that up and again kind of touch base on thinking about sperm banking and so forth before the operation, scars, those are things I think worth talking about, small risk of ascites. Then, I think the intensity of potential long term adverse effects really ramps up when we're talking about systemic therapy, chemotherapy. And then there's of course some radiation therapy specific elements that come up. So, for the chemotherapy bits of it, I really think this is going to be something that can be a complete multi-system affected intervention. So, anxiety, depression, our group has actually shown using some population resources that even suicidality can be increased among patients that have been treated for germ cell tumor. You know, really from the top down, tinnitus, hearing changes, those are things that we need to ask about at every appointment. Neuropathy, sexual health, that we kind of talked about, including ED (erectile dysfunction), vertigo, dizziness, Raynaud's phenomenon, these are kind of more the symptoms that I think we need to inquire about every time. And what we do here and I think at a lot of survivorship programs is use kind of a battery of validated instruments, germ cell tumor specific, platinum treated patient specific. So we use a combination of EORTC questions and PROMIS questions, which actually serves as like a review of systems for the patient, also as a research element. We review that and then depending on what might be going on, we can dig into that further, get them over to colleagues in audiology or psychology, et cetera.  And then of course, screening for the hypertension, hyperlipidemia, metabolic syndrome with basically you or myself or somebody kind of like us serving, many times it's the role of the PCP, just making sure we're checking out, you know, CBC, CMP, et cetera, lipid parameters to screen for those kind of cardiac associated issues along with secondary malignancies. Dr. Pedro Barata: So that's super comprehensive and thorough. Thank you so much. Actually, I love how you break it down in a simple way. Two functions of the testes, produce testosterone and then, you know, the problem related to that is the hypogonadism, and then the second, as you mentioned, produce sperm and of course related to the fertility issues with that.  So, let's start with the first one that you mentioned. So, you do cite that in your paper, around 5-10% of men end up getting, developing hypogonadism, maybe clinical when they present with symptoms, maybe subclinical. So, I'm wondering, for our audience, what kind of recommendations we would give for addressing that or kind of thinking of that? How often are you ordering those tests? And then, when you're thinking about testosterone replacement therapy, is that something you do immediately or are there any guidelines into context that? How do you approach that? Dr. Aditya Bagrodia: So, just a bit more on digging into it even in terms of the questions to ask, you know, "Do you have any decrease in sexual drive? Any erectile dysfunction? Are your morning erections still taking place? Has the ejaculate volume changed? Physically, muscle mass, strength? Have you been putting on weight? Have you noticed increase in body fat?" And sometimes this is complicated because there's some anxiety that comes along with a cancer diagnosis when you're 20, 30 years old, multifactorial, hair loss, hot flashes, irritability. Sometimes they'll, you know, literally they'll say, "You know, my significant other or partners noticed that I'm really just a little bit labile." So I think, you know, there's the symptoms and then checking, usually kind of a gonadal panel, FSH, LH, free and total testosterone, sex hormone binding globulin, that's going to be typically pretty comprehensive. So if you've got symptoms plus some laboratory work, and ideally that pre-orchiectomy testosterone gives you some delta. If they started out at an 800, 900, now they're 400, that might be a big change for them. And then, when you talk about TRT (Testosterone Replacement Therapy) recommendations, you know, Pedro, yourself, myself, we're kind of lucky to be at academic centers and we've got men's health colleagues that are ultra experts, but at a high level, I would say that a lot of the TRT options center around fertility goals. Exogenous testosterone treats the low T, but it does suppress gonadal function, including spermatogenesis. So if that's not a priority, they can just get TRT. It should be done under the care of a urologist, a men's health, an endocrinologist, where we're checking liver chemistries and CBCs and a PSA and so forth. If they're interested in fertility preservation, then I would say engaging an endocrinologist, men's health expert is important. There's medications even like hCG, Clomid, which works centrally and stimulate the gonadal access. Niche scenarios where they might want standard TRT now, and then down the way, 5, 7 years, they're thinking about coming off of that for fertility purposes, I think that's really where you want to have an expert involved because there's quite a bit of nuance there in recovery of actual spermatogenesis and so forth.  To kind of summarize, you got to ask about it. Checking it is, is not overly complicated. We do a baseline pre-orchiectomy and at least once annually, you can tag it in with the tumor markers, so it's not an extra blood draw. And if they have symptoms of course, kind of developed, then we'll move that up in the evaluation. Dr. Pedro Barata: Got it. And you also touch base on the fertility angle, which is truly important. And I'm just curious, you know, a lot of times many of us might see one, two patients a year, right, and we forget these protocols and what we've got to do about that.  And so I'm interested to hear your thoughts about when you think about fertility, and how proactive you get. In other words, who do you refer for the fertility clinic, for a fertility preservation program? You know, do all cases despite getting through orchiectomy or just the cases that you're going to, you know you're going to seek chemotherapy at some point? What kind of selection or it depends on the chemo, like how do you do that assessment about the referral for preservation program that you might have available at UCSD? Dr. Aditya Bagrodia: Yeah, I mean I feel really fortunate to sit on the NCCN Testis Cancer Guidelines. It's in there that fertility counseling should be discussed prior to orchiectomy. So 100% bring it up. If there are risk factors, undescended testicles, previous history of fertility concerns, atrophic contralateral testicle, anything on the ultrasound like microlithiasis in the contralateral testicle, you kind of wanna get it there. And then again, there's kind of niche scenarios where you're really worried, maybe get a semen analysis and it doesn't look that good, arrange for the time of orchiectomy to have onco-testicular sperm extraction from the, quote unquote, "normal" testis parenchyma. You know, I think you have to be kind of prepared to go that route and really make sure you're doing this completely comprehensively.  So pre-orchiectomy all patients. Don't really push for it too hard if they've got a contralateral testicle, if they've had no issues having children. There's some cost associated with this, sperm banking still isn't kind of covered even in the context of men with cancer. If they've got risk factors, absolutely pre-orchiectomy. Pre-RPLND, even though the rates of ejaculatory dysfunction at a high-volume center should be low single digits, I'll still offer it. That'd be a real catastrophe if they were in that small proportion of patients and now they're going to be reliant on things like intrauterine insemination, where it becomes quite expensive.  Pre-chemo, everybody. That's basically a standard these days where it should be discussed and it's kind of amazing currently, even if you don't have an accessible men's health fertility clinic, there are actually companies, I have no vested interest, Fellow is one such company where you can actually create an account, receive a FedEx semen analysis and cryopreservation kit, send it back in, and all CLIA certified, it's based out of California. The gentleman that runs it, is a urologist and very, very bright guy who's done a lot of great stuff for testis cancer. So, even for patients that are kind of in extremis at the hospital that kind of need to get going like yesterday, we still discuss it. We've got some mechanisms in place to either have them take a semen analysis over to our Men's Health clinic or send it off to Fellow, which I think is pretty cool and that even extends to some of our younger adolescent patients where going to a clinic and providing a sample might be tricky.  So, I think bringing it up every stage, anytime there's an intervention that might be offered, orchiectomy, chemo, surgery, radiation, it's kind of incumbent on us to discuss it. Dr. Pedro Barata: Gotcha. That's super helpful. And you also touch base on another angle, which is the psychosocial angle around this. You mentioned suicidal rates, you mentioned anxiety, perhaps depression in some cases as well as chronic fatigue, not necessarily just because of the low testosterone that you can get, but also from a psychological perspective. I'm curious, what do the recommendations look like for that? Do these patients need to see a social worker or a psychologist, or do they need to answer a screening test every time they come to see us and then based on that, we kind of escalate, take the next steps according to that? Do they see a psychologist perhaps every so often? How should that be managed and addressed? Dr. Aditya Bagrodia: It's an excellent question and again, these can be rather insidious symptoms where if you don't really dig in and inquire, they can be glossed over. I mean, how easy to say, "Your markers look okay, your scans look okay. See you in six months," and keep it kind of brief. First off, I think bringing it up proactively and normalizing it, that, "This may be something that you experience. Many people do, you're not alone, there's nothing kind of wrong with you." I also think that this is an area where support groups can be incredibly useful. We host the Testicular Cancer Awareness Foundation support group here. They'll talk about chemo brain or just like a little bit of an adjustment disorder after their diagnosis. Support groups, I think are critical. As I mentioned, we have a survivorship program that's led by a combination of our med oncs, myself on the uro-onc side, as well as APPs, where we are systematically asking about essentially the whole litany of issues that may arise, including psychosocial, anxiety, depression, suicidality. And we've got a nice kind of fast path into our cancer center support services for these young men to meet with a psychologist. If that isn't going to be sufficient, they can actually see a psychiatrist to discuss medications and so forth. I do think that we've got to screen for these because, as anticipated from diagnosis, those first 2 years, we see a rise. But even 10, 15 years out, we note, compared to controls, that there is an increased level of anxiety, depression, suicidality that might not just take place at that initial acute period of diagnosis and treatment. Dr. Pedro Barata: Really well said. Super important.  So I guess if I were to put all these together, with these really amazing advances in technology, we all know AI, some of us might be more or less aware of biomarkers coming up, including microRNA for example, and others, like as I think of all these potential long term complications for these patients, look at the future, I guess, can we use this as a way to deescalate treatment where it's not really necessary, as a way to actually prevent some of these complications? Like, how do we see where we're heading? As we manage testicular cancer, let's say, within the next 5 or 10 years, do you think there's something coming up that's going to be different from what we're doing things today? Dr. Aditya Bagrodia: Totally. I mean, I think it's as exciting as a time as there's ever been, you know, maybe notwithstanding circa 1970s when platinum was discovered. So microRNAs, which you mentioned, you know, there's a new candidate biomarker, microRNA-371. We are super excited here at UCSD. We actually have it CLIA-certified available in our lab and are ordering these tests for patients kind of in their acute stage, you know, stage one and surveillance, stage two, post-RPLND, receiving chemotherapy. And essentially this is a universal germ cell tumor specific biomarker, except for teratoma, suffice it to say 90% sensitive and specific. And I think it's going to change the way that we diagnose and manage patients. You know, pre-orchiectomy, that's pretty straightforward. Post-orchiectomy, maybe we can really decrease the number of CT scans that are done. Maybe we can identify those patients that basically have occult disease where we can intervene early, either with RPLND or single cycle chemo. Post-RPLND, identify the patients who are at higher risk of relapse that may benefit from some adjuvant therapy. In the advanced setting, look at marker decline for patients in addition to standard tumor markers. Can we modulate their systemic therapy?  So, the international interest is largely on modifying things. There's really cool clinical trials that we have for stage one patients, that treatment would be prescribed based on a post-orchiectomy microRNA. I think the microRNAs are really exciting. Teratoma remains an outstanding question. I think this is where maybe ctDNA, perhaps some radiomics and advanced imaging processing and incorporating AI may allow us to safely avoid a lot of these post-chemo RPLNDs. And then identification using SNPs and so forth of who might be most susceptible to some of the cardiac toxicity, autotoxicity and personalizing things in that way as well. Dr. Pedro Barata: Super exciting, right, what's about to come? And I agree with you, I think it's going to change dramatically how we manage this disease.  This has been a pleasure sitting down with you. I guess before letting you go, anything else you'd like to add before we wrap it up? Dr. Aditya Bagrodia: Yeah, first off, again, just want to thank you and ASCO for the opportunity. And it's easy enough to, I think, approach a patient with the testicular germ cell tumor as, "This is an easy case. We're just going to do whatever we've done. Go to the guidelines that says do X, Y, or Z." But there's so much more nuance to it than that. Getting it done perfectly, I think, is mandatory. Whatever we do is an impact on them for the next 50, 60, 70 years of their life. And I found the germ cell tumor community, people are really passionate about it. If you're ever uncertain, there's experts throughout the country and internationally. Ask somebody before you do something that you can't undo. I think we owe it to them to get it perfect so that we can really maximize the survivorship and the survival like we've been talking about. Dr. Pedro Barata: Aditya, thanks for sharing your fantastic insights with us on this podcast. Dr. Aditya Bagrodia: All right, Pedro. Fantastic. Appreciate the opportunity. Dr. Pedro Barata: And also, thank you to our listeners for your time today. I actually encourage you to check out Dr. Bagrodia's article in the 2025 ASCO Educational Book. We'll post a link to the paper in the show notes. Remember, it's free access online, and you can actually download it as well as a PDF. You can also find on the website a wealth of other great papers from the ASCO Educational Book on key advances and novel approaches that are shaping modern oncology.  So with that, thank you everyone. Thank you, Aditya, one more time, for joining us. Thank you, have a good day. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:         Dr. Pedro Barata  @PBarataMD   Dr. Aditya Bagrodia @AdityaBagrodia Follow ASCO on social media:         @ASCO on X (formerly Twitter)         ASCO on Bluesky        ASCO on Facebook         ASCO on LinkedIn         Disclosures:      Dr. Pedro Barata:  Stock and Other Ownership Interests: Luminate Medical  Honoraria: UroToday  Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon  Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas  Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck   Dr. Aditya Bagrodia: Consulting or Advisory Role: Veracyte, Ferring  

Seguro não quer estar na gaveta da esquerda e acaba por não se comprometer com nada. E o pacote laboral está a ser negociado, mas o PCP quis agitar as ruas e continua a esbarrar contra uma parede.See omnystudio.com/listener for privacy information.

Seguro não quer estar na gaveta da esquerda e acaba por não se comprometer com nada. E o pacote laboral está a ser negociado, mas o PCP quis agitar as ruas e continua a esbarrar contra uma parede.See omnystudio.com/listener for privacy information.

TITANIC A young aristocratic woman named Rose, suffocating in a rigid engagement, falls for free-spirited third-class passenger Jack Dawson aboard the unsinkable ocean liner - Titanic. Their secret romance defies class and her possessive fiancé as the ship sails toward disaster. When it hits an iceberg, their struggle to survive reveals love, sacrifice, and the brutal divide between those rescued and those left behind. Craig, Elisabeth and guest Ryley Brown talk about touchstone cinema, historical fiction, PCP chowder and the movie “Titanic” on this week's Matinee Heroes. Show Notes 1:20 Craig, Elisabeth and Ryley Brown talk about boats. 7:37 Craig, Elisabeth and Ryley discuss "Titanic" 1:08:03 Recasting 1:44:36 Double Feature 1:47:42 Final Thoughts 1:56:31 A preview of next week's episode "Ben-Hur" Our next no-ender is the biblical fiction "Ben-Hur"

Dave and Cody dive deep into House of Dynamite, Kathryn Bigelow's nail-biting new nuclear thriller that's equal parts technical masterpiece and moral Rorschach test. Is it brilliant minimalism—or a cinematic blue screen of death?They also break down the possible sale of Warner Bros. Discovery, what it could mean for movie theaters, and whether James Gunn's fledgling DCU survives a Netflix takeover.It's the perfect PCP blend of wit, wonder, and way-too-much coffee.Cold Open: Dave overshares at the coffee drive-thru ☕Pop Culture News:Why Warner Bros. might be up for saleThe Netflix wildcard and the ripple effect on theatersThe DCU's uncertain future under Gunn & SafranMain Review: House of DynamiteMultiple perspectives, one moral bombThe power of restraint vs. reactionIdris Elba's presidential gravitasWhat works, what fizzles, and why the ending divides everyoneWinner & Loser of the MovieThe Lobby Q&A

Flu season - 1:44 Flu and when to go to the PCP - 1:57 Parenting tip - 8:05 Trivia segment - 9:05 Conclusion - 9:18

Discover why establishing a relationship with a primary care doctor is one of the most important investments in your long-term health. From preventative screenings to managing chronic conditions, we break down what a PCP really does for you.For more, visit https://amanacareclinic.com/ Amana Care Clinic City: Davenport Address: 2162 W Kimberly Rd, Website: https://amanacareclinic.com/

Send us a textHello Fellow Airgun Geeks,The Airgun Geeks Podcast welcomes two of the biggest names in the airgun world—Chris “The Turret” Turek of Up North Airgunner and Officer PJ Clarke of The Wisconsin Airgunner!In this episode, we dive deep into: Chris's first place win at the 2025 Extreme Benchrest (EBR) competition The controversial topic of airgun modifications and how they affect manufacturer warranties The behind-the-scenes mindset of top-tier airgun competitors How far you can push your airgun without crossing the lineWhether you're a PCP shooter, benchrest competitor, or just love precision gear, this conversation is packed with insights, laughs, and pro-level advice.Support the show

Host Nate Kaufman brings Rich Helppie back for a discussion about healthcare access.  A 30-day wait for a first oncology visit after hearing the word leukemia is not an edge case—it's the new normal in a system where demand outpaces supply and incentives reward the wrong behaviors. Nate opens with a personal story that reveals how access feels when the stakes are life and death, then pulls back the lens to explain why it happens: a 12-year training pipeline for specialists, uneven reimbursement that pushes clinicians toward concierge and direct primary care, and payer tactics that encourage consolidation rather than capacity.Kaufman and Helppie then get specific about the economics. Medicaid rates that barely cover overhead lead practices to cap panels, while insurers play separate groups against each other until they merge, gaining leverage but not necessarily improving availability. Primary care, which should function like a straightforward retail experience, is instead forced through insurance mechanics that add friction to simple, high-value services. The result is predictable: over 40 percent of ER visits come from Medicaid patients who couldn't access timely outpatient care, and the most vulnerable pay the highest price in avoidable emergencies.Their conversation wrestles with the big numbers and the real trade offs. Ten percent of patients drive more than 80 percent of spending across Medicare and commercial plans. Pharma's incentives to expand lifelong demand clash with insurers' incentives to deny care. The federal government, the largest health benefits organization in the world, changes leadership every few years, making long-term workforce planning and access expansion difficult. They outline pragmatic moves that can help now: secure continuity with direct primary care or concierge if possible, build a relationship with a PCP who can open specialist doors, and for complex care, shop outcomes rather than prices.If you've felt the squeeze—months-long waits, denials, or a scramble for appointments—this conversation gives language, data, and practical options. Listen to understand why access is collapsing, what levers could ease the pressure, and how to protect your path to timely, high-quality care today. If the ideas resonate, follow and share, and leave a review with your own access story—what worked, what didn't, and what needs to change next.Support the showEngage the conversation on Substack at The Common Bridge!

O respeito pelos deputados do PCP: “Aquele senhor sofreu como eu não sofri”. A matança da Páscoa: “O primeiro exercício de guerra híbrida em Portugal”. O 25 de novembro. E ainda Sá Carneiro, Cunhal, Melo Antunes e Ramos Horta, vistos por Ângelo Correia.See omnystudio.com/listener for privacy information.

O respeito pelos deputados do PCP: “Aquele senhor sofreu como eu não sofri”. A matança da Páscoa: “O primeiro exercício de guerra híbrida em Portugal”. O 25 de novembro. E ainda Sá Carneiro, Cunhal, Melo Antunes e Ramos Horta, vistos por Ângelo Correia.See omnystudio.com/listener for privacy information.

Pop Culture Pastor dives headfirst into the fog. Dave and Cody rewind Frank Darabont's soul-crusher The Mist (2007): why the human breakdown still hits, why Marcia Gay Harden steals the whole movie, and how that ending becomes a parable about quitting one step too soon. They riff on what holds up and what doesn't, then play the show's greatest hits: Muppet-ize the Movie, Which Character Would You Be? and the Winner & Loser of the movie (sorry, Stephen King… Darabont's ending wins).Plus: a spicy news bit on the “least attractive hobbies for men” list (video games, figurines, crypto, trolling, gambling) and why maybe the problem isn't hobbies—it's imbalance.Come for the monsters, stay for the meaning.Agree? Hate it with a white-hot passion? Sound off and tag the show.Subscribe, rate, and check the PCP swag in the Linktree— https://linktr.ee/PopCulturePastorPod

In this episode of the Atomic Anesthesia Podcast, we tackle the complex reality of caring for patients under the influence of drugs or alcohol, a frequent challenge for nurse anesthesia residents and CRNAs. Covering the physiological effects and anesthetic implications of acute and chronic intoxication with alcohol, benzodiazepines, hallucinogens (such as LSD, PCP, and MDMA), cocaine, and cannabinoids, this episode offers fast, practical guidance for optimizing perioperative care and minimizing patient risk. Listeners will learn how substance use alters anesthetic requirements, impacts drug metabolism, and poses unique airway and hemodynamic risks, while also receiving actionable tips for drug class-specific management like when to use or avoid certain agents, the importance of invasive monitoring, and strategies for handling withdrawal or overdose. Tune in for a high-yield rundown that will help you make safer decisions when handling intoxicated patients in the OR.Want to learn more? Create a FREE account at www.atomicanesthesia.com⚛️ CONNECT:

A Esquerda à esquerda do PS e o próprio PS vivem uma crise que se traduz numa perde eleitoral de quase 20 pontos percentuais e uma representação parlamentar que se reduziu a metade em apenas três anos. As autárquicas não serviram para aliviar a crise e o partido que mais perdeu, o BE, vai mudar de liderança. Por onde se começa a engordar novamente este campo politico? Pelos partidos à esquerda do PS ou pelo recentramento do Partido Socialista? São as lideranças que potenciam o momento de crise ou são os partidos colectivamente que deixaram de saber para quem estavam a falar? Perguntas à procura de respostas, numa conversa com Daniel Oliveira, colunista do Expresso e comentador da SIC.See omnystudio.com/listener for privacy information.

Neste episódio do Perguntar Não Ofende, Miguel Carvalho apresenta as principais conclusões do seu livro Por Dentro do Chega, a mais extensa investigação sobre a ascensão e os bastidores do partido liderado por André Ventura. O jornalista descreve um movimento político que se constrói em torno de um culto de personalidade e de uma lógica de poder pessoal, mais do que de uma ideologia estruturada. As vozes de ex-dirigentes, citadas no livro, revelam um ambiente de manipulação interna, gravações clandestinas, disputas de poder e ausência de transparência financeira. Carvalho analisa o crescimento eleitoral do Chega, que se torna a segunda força política portuguesa em apenas seis anos. Explica que o partido capta um eleitorado popular, maioritariamente vindo do PCP e do PSD, desiludido com o sistema e atraído por um discurso de protesto simples e emocional. Compara o fenómeno à transformação populista de outros países europeus, sublinhando que Ventura se adapta ao “ar do tempo” e domina as dinâmicas mediáticas e digitais com grande eficácia. O jornalista destaca ainda o papel das redes sociais, dos media sensacionalistas e de movimentos religiosos radicais na consolidação do partido. Denuncia a ausência de rastreio dos candidatos, a entrada de figuras com antecedentes criminais e a permeabilidade do Chega a grupos extremistas. Para Carvalho, o partido vive numa bolha de desinformação e paranoia, alimentada por uma estrutura centralizada e autoritária. Por fim, Miguel Carvalho reflete sobre o papel do jornalismo na vigilância democrática. Assume ter sentido pressões durante a investigação, mas defende que a missão do repórter é resistir ao medo e expor as contradições do poder.See omnystudio.com/listener for privacy information.

TUTAMÉIA entrevista Manuel Rodrigues, diretor do jornal "Avante!", órgão oficial do Partido Comunista Português, e integrante da comissão política do comitê central do PCP.Inscreva-se no TUTAMÉIA TV e visite o site TUTAMÉIA, https://tutameia.jor.br, serviço jornalístico criado por Eleonora de Lucena e Rodolfo Lucena.Acesse este link para entrar no grupo AMIG@S DO TUTAMÉIA, exclusivo para divulgação e distribuição de nossa produção jornalística: https://chat.whatsapp.com/Dn10GmZP6fV...

Na Vichyssoise, Ana Gomes defende que candidatos apoiados por BE, PCP e Livre devem desistir a favor de Seguro antes da primeira volta. Avalia negativamente desempenho nacional e europeu de Costa.See omnystudio.com/listener for privacy information.

Neste episódio do Perguntar Não Ofende, Miguel Carvalho apresenta as principais conclusões do seu livro Por Dentro do Chega, a mais extensa investigação sobre a ascensão e os bastidores do partido liderado por André Ventura. O jornalista descreve um movimento político que se constrói em torno de um culto de personalidade e de uma lógica de poder pessoal, mais do que de uma ideologia estruturada. As vozes de ex-dirigentes, citadas no livro, revelam um ambiente de manipulação interna, gravações clandestinas, disputas de poder e ausência de transparência financeira. Carvalho analisa o crescimento eleitoral do Chega, que se torna a segunda força política portuguesa em apenas seis anos. Explica que o partido capta um eleitorado popular, maioritariamente vindo do PCP e do PSD, desiludido com o sistema e atraído por um discurso de protesto simples e emocional. Compara o fenómeno à transformação populista de outros países europeus, sublinhando que Ventura se adapta ao “ar do tempo” e domina as dinâmicas mediáticas e digitais com grande eficácia. O jornalista destaca ainda o papel das redes sociais, dos media sensacionalistas e de movimentos religiosos radicais na consolidação do partido. Denuncia a ausência de rastreio dos candidatos, a entrada de figuras com antecedentes criminais e a permeabilidade do Chega a grupos extremistas. Para Carvalho, o partido vive numa bolha de desinformação e paranoia, alimentada por uma estrutura centralizada e autoritária. Por fim, Miguel Carvalho reflete sobre o papel do jornalismo na vigilância democrática. Assume ter sentido pressões durante a investigação, mas defende que a missão do repórter é resistir ao medo e expor as contradições do poder.See omnystudio.com/listener for privacy information.

In true form to the topic this reflection episode is rather playful between Nick and Billy as they explore how to play with kids. We discuss why it can be tough, how to target specific struggles, the role of educators and how play changes from kids to teens. As always there are beautiful reflections, questions and tips from the wonderful PCP community. Thank you as always and we hope you like it.

Daniel Oliveira defende que Bloco e PCP estão condenados a não ter futuro se não aceitarem participar numa reconfiguração da esquerda. Francisco Rodrigues dos Santos acha que José Luís Carneiro podia assinar o Orçamento do Estado de Luís Montenegro. Martim Avilez Figueiredo aplaude a ideia de tirar do Orçamento medidas polémicas para depois serem aprovadas em diplomas seguintes. São temas para esta edição de “Os Comentadores”, com Nuno Ramos de Almeida, Paula Cardoso e Pedro Tadeu, que discutem ainda esta notícia: “Universidades britânicas disponibilizaram-se a empresas de armamento para vigiar redes sociais de estudantes”.Já podes ver e ouvir nestas plataformas. Segue-nos!

If you don't invest in your weaknesses now, they will haunt you down the road.This conversation originally aired on Episode 13 of Long Run Labs, my new podcast on the business of the outdoor industry.Alex is the Founder and CEO of Eternal. Before founding Eternal, Alex was the founder and CEO of The Athletic, a subscription sports media company founded in 2016. The Athletic reached 1M paid subscribers faster than any publishing company in history and sold to The New York Times in 2022 for $550M. Prior to The Athletic, Alex ran Product & Design for Strava, helping the platform go from 800 users to 10s of millions. Originally from Philadelphia, Alex lives in Presidio Heights with his wife, two kids, and golden retriever. Jon chats with Alex about:​Alex's Journey as a Runner and Endurance Athlete​Building Strava's Growth and Community​The Athletic's Creation and Success Story​Founding Eternal and Its Mission​Leadership Philosophy and Team BuildingStay connected:Follow Alex:https://x.com/amatherhttps://www.linkedin.com/in/alexemather/This episode is supported by:​Tifosi Optics: Fantastic sunglasses for every type of run. Anti-bounce fit, shatterproof, and scratch resistant. Get 20% off when you use this link!​Janji: Use code “FTLR” at checkout when shopping at janji.com for 10% off your order and see why Janji is the go-to for runners who want performance gear made to explore. All apparel is backed by a 5 year guarantee, so you know it's meant to last!​Eternal: Eternal is a performance health company for runners, endurance athletes, and anyone serious about their training. Eternal just added PCP capabilities for those in NY and CA to answer the question of, “so, does this mean you're my doctor?”​PUMA: Get your pair at your local Fleet Feet or your favorite local running shop!​AmazFit Check out the T-Rex 3 and a selection of GPS watches at amazfit.com and use code “FTLR” for 10% off.

Matt and Allie are back to discuss this month's clinical corner article! In this case presentation- you'll hear about a patient who experienced consistent gluteal pain even after seeing his PCP, PA and PT. With more and more time passing and worsening symptoms, and a palpable mass finding by the PT, the patient was urged to get an MRI. This uncovered that the mass was identified as advanced-stage non-Hodgkin's lymphoma. Luckily, after treatment and a couple months of PT, the patient resumed walking, golfing, etc with no pain and in complete remission! This article highlights the importance of hands-on PT, self advocacy, and early intervention.Read the article here: https://www.jospt.org/doi/10.2519/josptcases.2025.0126https://www.jospt.org/doi/10.2519/josptcases.2025.0126Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/

Tune in to listen as expert faculty, Dr Christopher L. Bowlus and Dr Sonal Kumar, discuss recent developments in treating primary biliary cholangitis (PBC) with new and emerging agents, as well as strategies to integrate these advances into clinical practice.Topics covered include: Methods of Assessing PBC Disease ProgressionNewer Agents for Second-line Treatment of PBCPrioritizing Symptom Management and Quality of Life With PBC TreatmentPresenters:Christopher L. Bowlus, MDLena Valenta Professor and ChiefDivision of Gastroenterology and HepatologySchool of Medicine University of California Davis Sacramento, CaliforniaSonal Kumar, MD, MPHAssistant Professor of MedicineDivision of Gastroenterology and HepatologyWeill Cornell Medical CollegeNew York, New YorkLink to full program: https://bit.ly/43nHx6UGet access to all of our new podcasts by subscribing to the CCO Medical Specialties Podcast on Apple Podcasts, Google Podcasts, or Spotify.     Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Este domingo, o secretário-geral e o presidente do PS vão defender, na Comissão Nacional — órgão máximo entre congressos —, que o partido deve apoiar a candidatura presidencial do ex-líder António José Seguro. A decisão não é pacífica e o debate fica mais difícil ao saber-se que há um grupo de pessoas à direita, conotadas com o passismo, que consideram Seguro o melhor dos candidatos para assumir a chefia do Estado. Neste episódio, conversamos com a jornalista Rita Dinis.See omnystudio.com/listener for privacy information.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog WHAT YOU WILL LEARN: How to SCULPT YOUR MUSCLES AND TIGHTEN YOUR SKIN after weight loss! How to decrease VISCERAL FAT A new way to IMPROVE MUSCLE MASS by 30% for strength and beauty in 4 weeks DECREASE SUBCUTANEOUS FAT by 25% in 4 weekly treatments INCREASE MUSCLE DEFINITION with Emsculpt Neo A way to REHABILITATE AFTER SURGERY PRE-TREAT BEFORE SURGERY: Improve your post op joint surgery condition by increasing muscle around the joint HOW TO RECOVER Quickly AFTER CHILDBIRTH A Way to IMPROVE CORE AND PELVIC FLOOR STRENGTH How EM-Sculpt-Neo works Most of you know me as the expert in Bioidentical Hormone Pellet Replacement, but I am also expert in Skin and body care.  If my patients have problems that your PCP has not been able to solve.  I will refer you for new therapies, cutting edge treatments that work to treat your problem. The most common problem that my patients complain of is loss of muscle mass and changes in body fat that make them look old.  I found a treatment that is not a laser, but the Emsculpt Neo uses safe and effective magnetic energy plus RF treatment to reduce fat and build muscle in a 30-minute painless treatment. Today I am going to talk about a painless treatment that we offer at my medical spa, BioBalance® Skin that has just been approved by the FDA for rehab after joint surgery.  The magnetic energy (HIFEM) combined with RF energy increases muscle size and strength by 30%, dissolve fat by 25%, as well as tightens skin with the same treatment! EM Sculpt Neo is a 30-minute treatment that uses magnetic energy to make your muscles contract and is equal to thousands of crunches for 30 minutes. The RF portion breaks down subcutaneous fat in the same area.  There is no work on your part, you just lie there, and your muscles respond to the magnetic pull by increasing in size and strength.  Four sessions one week apart is the ideal number of treatments, and they come a in a package of four treatments to one area. The areas that most of us want to build muscle and lose fat in are our abs, upper arms, thighs, calves, love handles, and hips. If you need to do more than one area at a treatment you can do up to three areas, each for 30 minutes. If you have had joint surgery and need to increase your strength around that joint, EMSculpt Neo is very effective, after your doctor releases you to exercise. One of the big concerns with the new weight loss medications is that people often lose muscle as they lose weight.  This is especially common after age 40, in those people who are not on testosterone pellets. EMSculpt Neo adds a tool that can preserve or even increase muscle mass and decrease fat where you want to lose it. EMSculpt Neo for fat loss and muscle building (not for rehabilitation) should be saved for those weight loss patients who lose enough weight to achieve a BMI under 30. For the best results, we suggest a high protein low carb diet, protein, low carb diet, to give your body the building blocks for muscle tissue. We also will suggest supplements for nutrition and to abstain from alcohol to get the best results. Healthy fat loss takes combination of EMSCULPT NEO, Weight Loss Medication, activity, Low carb high protein diet.  We advise our patients over BMI of 30 to get started on weight loss first and continue diet medications while you are receiving EM-Sculpt Neo treatments. How do you lose weight without losing muscle? The Best Combination for the best results while you are losing weight on medication: EMSCULPT NEO to the areas you want to remove fat from Semaglutide or Tirzepatide medication to treat obesity for weight loss Testosterone Pellets if you are a woman over 40, and man over 50. Regular exercise like walking High protein diet Supplements to improve your ability to make muscle Who should do this EMSCULPT treatment? People who are working out but cannot do sit ups because of back injury Those folks who want fast muscle mass increase in specific areas Anyone who is on a weight loss program who is losing muscle and fat, or who has saggy skin in areas where they lost weight Patients anticipating a joint surgery Patients healing from joint surgery after PT Patients who cannot lift weights because of injury Those people who lift weights but cannot develop definition People with a Beer Belly with a lot of visceral fat Some people may not be able to enjoy this sculpting, muscle building method: We will do a free consultation before you sign up for a package of EMSculpt Neo and some patients will not get optimal results if they have any of the factors below: BMI greater than 30 Metal implants anywhere that are not titanium. Titanium is not magnetic, so it is ok to have a treatment if you have a titanium joint implant. No Rods or pins. Any pacemaker implant, pain pump under your skin, nerve stimulator or you are in the first 6 weeks post-surgery for any muscle area in the area. If you have a large abdominal hernia that was not repaired, then abdominal treatment is not advisable. You can still have other areas treated. If you have unrepaired joint damage, you can still have this treatment but let us know so we can slowly work the energy up around that joint. Those people who have a pannus, an apron of skin that hangs down below the vulva, or penis will not get enough relief from this procedure. These patients will need an abdominoplasty. This surgery is done by a plastic surgeon who removes excess skin and fat and repairs the muscles and fascia. You should not waste your money if you continue to drink alcohol while undergoing this treatment. Alcohol is a toxin and will prevent the growth of muscle and loss of body fat. Don't waste your money if you are not going to follow a low carb high protein diet during and after our treatment.  How does EMSCULPT Work? EMSCULPT combines HIFEM (High Intensity Focused Electromagnetic technology) and RF (Radio Frequency). HIFEM uses magnetic energy to contract muscles in a particular area at intensities that are not achievable with routine weightlifting. Fat tissue in the treated area is also reduced by increasing metabolic activity.  This results in Body Contouring. HIFEM is approved by the FDA for Body contouring, muscle stimulation, growth and to rehabilitate patients with injuries or after surgery. The second treatment that occurs at the same time as HIFEM is RF, Radio Frequency treatment. RF is a low frequency electromagnetic wave that heats up fat in 4 minutes to stimulate collagen and elastin to tighten skin. All this happens in 30 minutes with minimal discomfort.  4 treatments, one a month, is all that is needed to increase muscle 25% and to decrease fat by 30%, and to visibly improve skin tone. Answers to questions about this procedure: What should my diet consist of to optimize my treatment? To gain muscle you must eat your weight in pounds equivalent to grams of protein every day. E.g. If you weigh 200 lbs. and you want to gain muscle, you should eat 200 grams of protein a day. What foods should I eat to optimize my treatment? The best most concentrated protein is found in animal products-eggs, milk products, fish, chicken and red meat. What supplements will help support my treatment? You may want to supplement your diet with our BioBalance Magnesium combination twice a day, Probiotics, Creatine or Arginine and Ornithine combination. You should also take a methyl B12 and Methyl Folate while you are sculpting your body. Why can't I eat a lot of carbs and drink alcohol during or after the treatment? If you eat a high carb diet, your fat loss portion of Em-Sculpt will be limited, because whatever carb you eat over-stimulates insulin, which increases insulin resistance, and increases fat deposition. Whatever is eaten goes directly to fat again and replaces what you just lost. When can I start EMSculpt after joint surgery? After PT is completed or your surgeon releases you for exercise. Can I lift weights while I am being treated? Yes, but we advise not to lift weights the day before, the day of or the day after your EMSCULPT treatment. What does hydration have to be optimal for the treatment to work effectively? The human body is almost all water, and hydration is needed for muscle contraction. Muscles don't contract optimally when you are dehydrated. We put you on a body composition machine to both document your muscle mass and fat mass, as well as tell if you are hydrated adequately. Now that you know how EMSculpt Neo can change your body composition and build muscle, I hope you are comfortable enough to let us help you get the body you have always wanted. BioBalance Skin phone for an appointment:

As próximas eleições são presidenciais, mas ainda faltam três meses para lá chegar. Ontem, Luís Marques Mendes anunciou Rui Moreira como mandatário nacional, que faz contraponto ao mandatário de Gouveia e Melo, que é Rui Rio. O PS vai anunciar o apoio a António José Seguro; o Chega volta com André Ventura; Cotrim Figueiredo está de novo em jogo pela IL; o PCP vai a votos com António Filipe e Catarina Martins é outra vez aposta do Bloco. Neste episódio, conversamos com o comentador da SIC Pedro Marques Lopes.See omnystudio.com/listener for privacy information.

O PSD venceu a maioria das câmaras, assim como nas cinco de maior população. O PS perdeu, mas ganhou tempo para respirar. O Chega não brilhou, mas infiltrou-se na rede autárquica. E o PCP, bem ao PCP não correu bem outro vez. Neste episódio da Comissão Política analisamos os resultados das autárquicas, mas colocando-as em perspetiva de futuro. See omnystudio.com/listener for privacy information.

O vice-presidente do PSD, Carlos Coelho acredita que não deve existir uma extrapolação nacional se houver eventuais entendimentos autárquicos com o Chega. Dá o exemplo de acordos no passado com o PCP.See omnystudio.com/listener for privacy information.

As eleições autárquicas deram uma grande vitória à AD, que recupera a liderança da Associação Nacional de Municípios. O PS foi derrotado e dá-se por satisfeito por ter mais capitais de distrito do que tinha. A CDU continuou a descer, mas estancou as perdas, tinha 19 presidências e passou a ter 12. Já o Chega cresceu muito, mas com três autarquias é apenas o quinto partido no poder local. Para fazer a avaliação política destas eleições, conversamos neste episódio com o director-adjunto do Expresso David Dinis.See omnystudio.com/listener for privacy information.

Com 3241 freguesias apuradas de 3259, à 1h50 da noite eleitoral autárquica, Daniel Oliveira analisa os resultados praticamente fechados da reeleição de Moedas. “Para a esquerda não se trata de mais uma eleição que se perde, a mudança demográfica em Lisboa faz com que a esquerda tenha cada vez mais dificuldade em ganhar. Estas eram provavelmente as últimas eleições que a esquerda conseguiria ganhar na cidade”, afirma o comentador SIC.See omnystudio.com/listener for privacy information.

À porta das eleições autárquicas, as sondagens indicam que várias das principais Câmaras Municipais vão ser muito disputadas. O PS luta para manter a Associação Nacional de Municípios, o PSD procura ultrapassar os socialistas e é previsível que o Chega consiga estabelecer-se em vários pontos do país. Os resultados podem obrigar que linhas vermelhas sejam quebradas, para que a governação autárquica não fique paralisada. Vão PS e Chega ter de se aceitar em alguns municípios do país? O PCP vai conseguir manter a sua implementação autárquica? No Expresso da Meia-Noite em podcast, Ângela Silva e Bernardo Ferrão recebem António Gomes, diretor-geral da GfK Metris, os comentadores SIC Nuno Ramos de Almeida e Miguel Morgado e o diretor-adjunto do Expresso David Dinis. O programa foi emitido na SIC Notícias a 10 de outubro.See omnystudio.com/listener for privacy information.

PSD, PS, Chega, Iniciativa Liberal, Livre, PCP, Bloco de Esquerda e PAN discutem a proposta do Orçamento de Estado para 2026, apresentado hoje pelo Governo.See omnystudio.com/listener for privacy information.

Dan & Manny are joined by friend of the show, artist & pop culture enthusiast Andrew Breen to put the 1989 fantasy comedy horror film Little Monsters to the ultimate test—THE NOSTALGIA TEST! “Little Monsters is one of the most repellent, distasteful, truly creepy movies I've seen in a long time, a movie so unpleasant I can't really figure out why anybody wanted to make it, and I don't know why anybody would wanna see it.” -Roger Ebert It's officially Spooky Season and what better way to celebrate than to put one of the weirdest and creepiest movies ever made to the ultimate test. Little Monsters makes the plot of every David Lynch film look totally normal. This movie was suggested by the guest, Andrew Breen, who's an amazing artist and a pop culture nerd like Dan & Manny. Little Monsters looks like a club Bill Hader's SNL character Stefon would be partying at until everyone turns into a pile of clothes. This movie has everything, Fred Savage, Daniel Stern on the verge of murdering his whole family, the woman who owned The Cleveland Indians in Major League, and a monster named Snick, who's a cigarette cross from between the girl who turned into a blueberry before she died in Willy Wonka and a broke down Meatloaf. Not to mention a PCP riddled Howie Mandal as Maurice the monster, who is an eleven-year-old/200-year-old blue lunatic getting children grounded, yelled at, and probably hit (hey, it's the 80s). So set your monster catching traps, make your peanut butter and onion sandwiches, make sure to check the apple juice before you drink it, and come hangout as we see if Little Monsters passes The Nostalgia Test. Email us (thenostalgiatest@gmail.com) your thoughts, opinions, and topics for our next Nostalgia Test! Suggest A Test & Be Our Guest! We're always looking for a fun new topic for The Nostalgia Test. Hit the link above, tell us what you'd like to see tested, and be our guest for that episode! Andrew Breen is a Long Island local artist, his vibrant technicolor-drenched character illustrations immediately transport you back to yournostalgic latch-key kid Saturdays. From Horror icons to cult classics and deep cut 90s animated shows there's something for everyone to love. Check out his art & Follow: @Rocktapusjones_art             Approximate Rundown 00:00 Introduction and Guest Introduction 00:39 Sponsor Shoutout and Guest's Art Background 01:53 Art Style and Inspirations 03:05 Favorite Art Pieces and Meet the Artist Night 03:36 Artistic Journey and Personal Insights 10:34 Transition to Movie Discussion 13:15 Little Monsters Movie Overview 15:33 Movie Analysis and Personal Reactions 19:11 Character and Plot Deep Dive 36:34 Maurice's Performance and Movie Trivia 48:03 Noise and Chaos in the Movie 48:28 Parental Reactions and Monster Logic 49:54 Brian's Actions and Parental Absence 52:12 Monster World Rules and Anarchy 55:38 Design and Production Insights 59:15 The Final Battle and Plot Holes 01:07:26 Maurice's Character and Ending 01:19:01 Nostalgia Test and Final Thoughts   Book The Nostalgia Test Podcast Bring The Nostalgia Test Podcast's high energy fun and comedy on your podcast, to host your themed parties & special events!  The Nostalgia Test Podcast will create an unforgettable Nostalgic experience for any occasion because we are the party! We bring it 100% of the time! Email us at thenostalgiatest@gmail.com or fill out the form at this link. LET'S GET NOSTALGIC!     Keep up with all things The Nostalgia Test Podcast on Instagram | Substack | Discord | TikTok | Bluesky | YouTube | Facebook   The intro and outro music ('Neon Attack 80s') is by Emanmusic. The Lithology Brewing ad music ("Red, White, Black, & Blue") is by PEG and the Rejected

Operação Míscaros: o plano montado em segredo por um comandante da Força Aérea para desviar aviões e reagir ao 25 de novembro, levando ao recuo de Álvaro Cunhal. A descoordenação com os comandos de Jaime Neves no ataque à Polícia Militar. E a desilusão com o ex-ministro do Trabalho que o PCP enviou para Cuba e Angola. Parte II da entrevista ao General Vaz Afonso: “O PCP esteve muito próximo de sair vitorioso, mas nunca mereceu as palavras de Melo Antunes. Nunca foi democrático.”See omnystudio.com/listener for privacy information.

Vasco Lourenço pede união à esquerda em torno de Seguro e critica candidatura de João Ferreira em Lisboa. É justo ónus estar no PCP e no BE? A flotilha serve só carreiras? E os caças de Nuno MeloSee omnystudio.com/listener for privacy information.

O Parlamento aprovou as alterações à Lei de Estrangeiros, com os votos da direita. PS, Livre, PCP, BE e PAN votaram contra. O editor de Política do Observador, Rui Pedro Antunes, é o convidado.See omnystudio.com/listener for privacy information.

O Parlamento aprovou as alterações à Lei de Estrangeiros, com os votos da direita. PS, Livre, PCP, BE e PAN votaram contra. O editor de Política do Observador, Rui Pedro Antunes, é o convidado.See omnystudio.com/listener for privacy information.

O Parlamento aprovou as alterações à Lei de Estrangeiros, com os votos da direita. PS, Livre, PCP, BE e PAN votaram contra. O editor de Política do Observador, Rui Pedro Antunes, é o convidado.See omnystudio.com/listener for privacy information.

On the latest episode of the podcast, Doug wonders if Angel Dust and PCP just don't exist anymore or if they just have new names, Jamie refers to the hero as 'Seed Star' for reasons that she feels are obvious, and we both realize that neither of us would last more than a day or two in the future hellish world that this movie posits (Doug refuses to live in a sewer and Jamie would attempt to bargain with the Terminators). Don't waste perfectly good ice cream playing pranks on a waitress, appreciate things like trees and grass while they're still here, and join us as we constantly get distracted by the little things while we discuss, The Terminator!The Terminator is a 1984 film written and directed by James Cameron and starring Arnold Schwarzenegger, Linda Hamilton, Michael Biehn, Paul Winfield, Lance Henriksen, Rick Rossovich, Bess Motta, Earl Boen, Bill Paxton & Dick Miller.Visit our YouTube ChannelMerch on TeePublic Follow us on TwitterFollow on InstagramFind us on FacebookDoug's Schitt's Creek podcast, Schitt's & Giggles can be found here: https://podcasts.apple.com/us/podcast/schitts-and-giggles-a-schitts-creek-podcast/id1490637008

200 mil candidatos, 308 municípios, muitas listas e partidos. A campanha para as autárquicas arranca este fim de semana com sérios desafios para os partidos. Um estudo da GFK Metris mostra que os socialistas podem enfrentar uma "retração eleitoral sem precedentes" em 122 concelhos. A AD pode registar um "crescimento relevante", mas desigual no território. O Chega pode ficar longe do quase milhão e meio de votos das legislativas, mas terá vereadores instalados em muitas autarquias, e o PCP terá de lutar forte para manter as 19 Câmaras, mas pode ter Évora e Setúbal em grande risco. No Expresso da Meia-Noite desta semana dedicado às eleições autárquicas do próximo mês, Ricardo Costa e Bernardo Ferrão recebem Carlos Carreiras, presidente da Câmara Municipal de Cascais, Nuno Ramos Almeida, comentador SIC, Cecília Meireles, ex-deputada do CDS, e Ascenso Simões, deputado do PS.See omnystudio.com/listener for privacy information.

Welcome back! We are excited to share a new episode, and a revised format. Ever think there might be a connection between nicknames and a commonly-used term in health care? Listen, and find out! This month, Dr Thomas White addresses the term "PCP" - its history, its positive and negative connotations, and (spoiler alert!) why he wishes the term would go away. He interviews two of our popular guests from previous episodes - Dr Shauna Guthrie of Henderson NC and Dr Tommy Newton of Clinton NC - to get their wise perspectives. We hope you find this discussion interesting and thought-provoking. Thank you for your support! And please visit our website, The Family Doctor Podcast.  Dr. Lee Beatty's blog has some more thoughts about PCP.

Smallville Presents: Crimson, Pt. II and Zod's 9/11It's Valentine's Day and Lois refuses to do anything romantic with Clark, but he isn't helping either. After a blast of fairy dust, a.k.a. PCP, laced with Gemstone Kryptonite, Clark now has the ability to "persuade" the people he talks to. Lois becomes a traditional housewife. Chloe somehow gets worse and is a psychotic C.K. bodyguard. Even Clark persuades himself to try and kill Tess after Zod tells him she killed the clone of Jor-El (#9.7)... or did she?

Listen as pulmonologist Peter Dicpinigaitis discusses his approach to the diagnosis and management of patients with refractory chronic cough in the context of a clinically relevant case and provides insights regarding emerging therapies.PresenterPeter Dicpinigaitis, MDProfessor of MedicineAlbert Einstein College of MedicineDivision of Critical Care MedicineMontefiore Medical CenterDirector, Montefiore Cough CenterBronx, New YorkLink to full program:https://bit.ly/4kweynG

In this episode of the Active Bariatric Nutrition Podcast, I discuss:Why reactive hypoglycemia happens after bariatric surgeryHow to spot the difference from dumping syndromeNutrition strategies to keep blood sugar steady & energy stableFueling tips for before, during, and after workouts so you don't crash mid-trainingWhy working with your PCP, surgeon, or endocrinologist and a Registered Dietitian is key in managing this conditionLet me know what you thought of the episode!If you want to learn more about how to adjust your plates based on your activity level, click here to download my FREE Active Bariatric Training Plates handout! To learn more about my new 6-week program, Bariatric STRONG which will open again in Fall, 2025, click HERE to join the waitlist as space is limited and will fill up fast! To learn more about my Bariatric Nutrition Coaching Programs, go to: www.activebariatricnutrition.comFollow Active Bariatric Nutrition at:Instagram - @activebariatricFacebook - Active Bariatric NutritionYouTube - Active Bariatric NutritionTikTok - ActiveBariatricNutrition

Most people get something very wrong about the doctor—they're not meant for a lot of the things we try to use them for. With that in mind, let's talk about how to get the most out of your doctor visit.  We're going to take a look at what you can reasonably expect from a physician during a quick, infrequent visit with them. And then I'm wrapping up with some thoughts on health insurance—what you need to know and what you can expect when searching for a provider who can help you with your vestibular disorder. In this episode, we'll dig into: What most people assume incorrectly about their primary physician The No. 1 thing to avoid during a doctor visit 3 tips to keep in mind for your next medical visit Important information to bring & share with your PCP What you need to know about health insurance & out-of-network providers Since I don't have the power to change the healthcare system, I want to help you navigate it more easily. For even more tips, join us in Vestibular Group Fit (use code GROUNDED for a 15% discount)! Links/Resources Mentioned: Vestibular Group Fit (code GROUNDED at checkout!) More Links/Resources: ⁠The 4 Steps to Managing Vestibular Migraine ⁠The PPPD Management Masterclass⁠ ⁠What your Partner Should Know About Living with Dizziness⁠ ⁠The FREE Mini VGFit Workout⁠ ⁠The FREE POTS - safe Workouts⁠ ⁠Vestibular Group Fit (code GROUNDED at checkout for 15% off your first subscription cycle!) ⁠ Connect with Dr. Madison: ⁠@⁠⁠TheVertigoDoctor ⁠ ⁠@TheOakMethod⁠ ⁠@VestibularGroupFit⁠ Connect with Dr. Jenna @dizzy.rehab.therapist  Work with Dr. Madison 1:1, Vestibular Rehabilitation Therapy Vestibular Group Fit Small Group Coaching (offered throughout the year, sign up for our email list to learn when!) Why The Oak Method? Learn about it here! Love what you heard? Reviews really help us out! Please consider leaving one for us.  This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ————————————— living with vestibular disorder, vestibular support group, vestibular dysfunction, vestibular disorder, vestibular migraine, dizziness, DO, medical provider, PCP, primary physician, tips for going to the doctor, healthcare system, medications & supplements, diagnosis, meniere's disease, BPPV, lifestyle changes, dietary changes, exercises for vestibular disorder, insurance, out of network, HSA, FSA, doctors appointment, doctor visit

Asking questions about mental health is not easy. What's even harder is asking those questions well. But here's the truth: community providers are uniquely positioned to spot the early warning signs of mental health struggles, including suicide risk. In fact, youth who attempt or die by suicide are far more likely to have contact with their PCP compared to a mental health provider in the months leading up to the event. Are providers identifying kids at risk? Are they asking the right questions in ways that open the door to real answers? In this episode, we confront this critical reality in front of a live audience. We are bringing practical tools to the hands of providers in our community. The way providers screen for emotional and mental health challenges can mean the difference between silence and survival. This episode was recorded in front of a live audience as our first community podcast experience. Stay tuned as we announce more opportunities like this across the region. This episode was cosponsored by The Liv Project: a nonprofit organization determined to take the conversation about youth mental health out of the shadows. For this episode, we have three incredible experts. Honey Beuf is the Co-Founder of The Liv Project, Liv's Mother, as well as an educator and advocate. She was on the podcast previously to share the story behind their documentary ‘My Sister Liv.' You can listen to that episode here. Susan Caso, MA LPC, is the Mental Health Advisor for The Liv Project, as well as a licensed therapist and author. Gina Herrmann, MD, is a pediatrician with Arvada Pediatric Associates. Some highlights from this episode include:  How specific word choices or ways to phrase a question can make a huge difference in creating a safe space for children  Ways primary care providers can support families of children experiencing suicidal thoughts  Steps PCP offices can take to implement helpful mental health support processes  Understanding the support systems that exist in communities around the globe  For more information on Children's Colorado, visit: childrenscolorado.org.