Podcasts about placebo controlled

In episode 59 we discuss outpatient low-dose initiation of buprenorphine. Suen LW, Chiang AY, Jones BLH, Soran CS, Geier M, Snyder HR, Neuhaus J, Myers JJ, Knight KR, Bazazi AR, Coffin PO.Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. We also discuss impulse control dysregulation from ropinerole, and the new non-opioid painkiller, suzetrigine. BBC:Prescription medication made me a gambling addict Grall-Bronnec M, et al.Dopamine agonists and impulse control disorders: a complex association. Drug Saf. 2018;41(1):19-75. FDA:FDA Approves Novel Non-Opioid Treatment for Moderate to Severe Acute Pain Vertex Pharmaceuticals: Randomized, Placebo-Controlled, Phase 3 Trials of Suzetrigine, a Non-Opioid, Pain Signal Inhibitor for Treatment of Acute Pain After Abdominoplasty or Bunionectomy --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go tothis link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visitMI CARES. CME:https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music:composed and performed by Benjamin Kennedy Audio editing: Michael Bonanno Executive producer:Dr. Patrick Beeman A podcast fromArs Longa Media --- Learn more about your ad choices. Visit megaphone.fm/adchoices

Scientists Ian Mitchell and Philipp Samor von Holtzendorff-Fehling join the program to unveil groundbreaking research revealing how EMFs may disrupt brainwave activity, effectively cutting humans off from deeper connection with their environment. The findings were so striking that even previously skeptical mainstream scientists were left stunned — and convinced — by the effectiveness of Leela Quantum's technology. Ian and Philipp also share insights from additional trials and explore how, when properly understood, quantum energy holds the potential to create powerful, lasting change.You can join Leela's Telegram group to learn more about Quantum energy, and more here: Telegram GroupNote: Correction from the intro: Sarah Westall said many “Peer Reviewed” studies and she meant to say many “Placebo Controlled” studies. With this technology, Placebo controlled is considered more important and needed to show efficacy. 

Send us a textAzithromycin therapy for prevention of chronic lung disease of prematurity (AZTEC): a multicentre, double-blind, randomised, placebo-controlled trial.Lowe J, Gillespie D, Aboklaish A, Lau TMM, Consoli C, Babu M, Goddard M, Hood K, Klein N, Thomas-Jones E, Turner M, Hubbard M, Marchesi J, Berrington J, Kotecha S.Lancet Respir Med. 2024 Aug;12(8):608-618. doi: 10.1016/S2213-2600(24)00079-1. Epub 2024 Apr 25.PMID: 38679042 Free article. Clinical Trial. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Eli Lilly will start a lcinical trial for tirzepatide for people with type 1 diabetes, more details on Dexcom's 15 day G7 sensor, Ozepmic pill form tested, type 5 diabetes identified and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom   Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Our top story this week.. Eli Lilly takes the first steps toward getting tirzepatide approved for people with type 1 diabetes. Tirzepatide is sold under the brand names Mounjaro for type 2 and Zepbound for obesity. The main purpose of this study is to find out how well and how safely tirzepatide works in adults who have type 1 diabetes and obesity or are overweight. Participation in the study will last about 49 weeks. Official Title A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study Evaluating the Efficacy and Safety of Tirzepatide Once Weekly Compared to Placebo in Adult Participants With Type 1 Diabetes and Obesity or Overweight This is a big deal because, even though many people with type 1 are able to get a prescription for tirzepatide, it's not approved for T1D and so insurers won't usually cover it.   https://clinicaltrials.gov/study/NCT06914895 XX The use of drugs like Ozempic, Wegovy and Zepbound in people with type 1 diabetes has risen sharply over the past decade, a new study finds, even though there's little information on the drugs' safety and effectiveness for the condition. The family of medications called GLP-1 receptor agonists includes drugs like Wegovy, Zepbound, Ozempic, Mounjaro and Victoza. But the clinical trials of these medications specifically excluded people with type 1 diabetes, who are dependent on the hormone insulin to survive because they can't make enough of their own. Drugmakers feared that using the GLP-1 medications with insulin might raise the chance of dangerously low blood sugar events, or hypoglycemia, and were unwilling to take the risk of studying them in people with type 1.   For the study, which was published last month in the journal Diabetes, Obesity, and Metabolism, researchers at Johns Hopkins University reviewed the medical records of more than 200,000 people with type 1 diabetes from 2008 to 2023. They grouped the data in three-year periods, starting with October 2008 to September 2011 and ending with October 2020 to September 2023. GLP-1 medication use spiked, as well. Among adults with the highest category of obesity, about 4% used GLP-1 medications in 2008, and 33% did by 2023 – an 800% increase. But these are anecdotal reports and may not reflect instances in which people have side effects or complications like low blood sugar, which can be life-threatening. But Shin says what's really needed is information from randomized, double-blinded studies, in which participants are followed forward in time and given either a drug or a placebo. https://www.cnn.com/2025/04/09/health/glp-1-type-1-diabetes-study/index.html   XX Later this month the FDA will conduct a final meeting regarding a new, investigational compound (sotagliflozin) soda-GLIFF-a-zin that has been shown to Improve QoL and Reduce Long-term Complications for people with type 1 diabetes (T1D). The patient advocacy group Taking Control of Your Diabetes (TCOYD.org) is working to inform the T1D community about sotagliflozin - and to encourage people to sign a Change.org petition directed towards FDA.  Last fall, the FDA declined to approve sotagliflozin due to concerns about a potential increased risk of diabetic ketoacidosis (DKA), despite this being a condition that people with T1D on insulin face and manage daily. While TCOYD respects FDA's caution, the group stands by T1D patients and their physicians who, as a team, balance risks and benefits every day. https://tcoyd.org/petition/ XX Dexcom receives FDA approval for it's G7 with 15 day wear. We have an interview with Chief Operating Officer Jake Leach coming up on Tuesday – we talk about the planned roll out of this sensor, what else has changed, and the fine print in the press release – it says    “A study was conducted to assess the sensor life where 73.9% of sensors lasted the full 15 days. When using the product per package labeling, approximately 26% of sensors may not last for the full 15 days.   https://investors.dexcom.com/news/news-details/2025/Dexcom-G7-15-Day-Receives-FDA-Clearance-the-Longest-Lasting-Wearable-and-Most-Accurate-CGM-System/default.aspx?utm_source=www.diabetech.info&utm_medium=referral&utm_campaign=dexcom-g7-15-day-sensor-gets-fda-cleared-but-will-it-actually-last-that-long   XX Glucotrack is joining something called  FORGETDIABETES bionic pancreas initiative, - this is an European Union project that aims to develop a long-term automated insulin delivery system for type 1 diabetes patients. Glucotrack's Continuous Blood Glucose Monitor (CBGM) will be integrated into the system to provide real-time glucose readings. The initiative's goal is to create a bionic invisible pancreas that eliminates the need for therapeutic actions and reduces psychological burden.   The architecture of BIP encompasses a ground-breaking, lifelong lasting implanted ip glucose nanosensor; a radically novel ip hormone delivery pump, with unique non-invasive hormone refill with a magnetic docking pill and non-invasive wireless battery recharge; an intelligent closed-loop hormone dosing algorithm, optimized for ip sensing and delivery, individualized, adaptive and equipped with advanced self-diagnostic algorithms.     Pump refilling through a weekly oral recyclable drug pill will free T1D subjects from the burden of pain and awkward daily measurement and treatment actions. Wireless power transfer and data transmission to cloud-based data management system round-up to a revolutionary treatment device for this incurable chronic disease. key feature of BIP is to be fully-implantable and life-long lasting thanks to novel biocompatible and immune-optimized coatings guaranteeing long-term safety and stability https://www.stocktitan.net/news/GCTK/glucotrack-to-participate-in-forgetdiabetes-a-prominent-european-cjjldjb0dq7h.html XX A newly recognised form of diabetes, called Type 5, was announced this week at the World Congress of Diabetes 2025. A global task force will investigate this less-understood condition, which differs from Type 1 and Type 2 diabetes. Type 5 diabetes affects people who are underweight, lack a family history of diabetes and do not show the typical symptoms of Type 1 or Type 2 diabetes. The condition was first observed in the 1960s and referred to as J-type diabetes, after being detected in Jamaica. It was classified by the World Health Organisation in 1985, but removed in 1998 due to lack of physiological evidence. At the time, experts believed it to be a misdiagnosed case of Type 1 or 2 diabetes. New research has since confirmed that Type 5 is different. https://economictimes.indiatimes.com/news/new-updates/a-new-type-of-diabetes-has-been-found-by-scientists-and-it-doesnt-show-the-typical-symptoms-of-type-1-or-type-2/articleshow/120276658.cms?from=mdr   XX Oral semaglutide cuts major heart risks in people with type 2 diabetes by 14%, offering a powerful pill-based option. A new clinical trial, co-led by endocrinologist and diabetes specialist John Buse, MD, PhD, and interventional cardiologist Matthew Cavender, MD, MPH, at the UNC School of Medicine, has demonstrated that the oral form of semaglutide significantly lowers the risk of cardiovascular events in individuals with type 2 diabetes, atherosclerotic cardiovascular disease, and/or chronic kidney disease. Results from the rather large, international trial were published in the New England Journal of Medicine and presented at the American College of Cardiology's Annual Scientific Session & Expo in Chicago, Illinois.     The effect of oral semaglutide on cardiovascular outcomes was consistent with other clinical trials involving injectable semaglutide, but more trials are needed to determine if one method may be more effective than the other at reducing major cardiovascular events. https://scitechdaily.com/new-pill-form-of-semaglutide-shows-major-benefits-for-people-with-diabetes/ XX April 14 (UPI) -- The U.S. Food and Drug Administration on Monday warned consumers and pharmacies that fake versions of Ozempic, a drug to treat Type 2 diabetes, have been found in the United States. Novo Nordisk, the Danish-headquartered manufacturer, informed the FDA on April 3 that counterfeit 1-milligram injections of semaglutide were being distributed outside its authorized supply chain. The FDA and Novo Nordisk are testing the fake products to identify whether they're safe. Patients are asked to obtain Ozempic with a valid prescription through state-licensed pharmacies and check the product for any signs of counterfeiting. People in possession of the fake product are urged to call Novo Nordisk customer care at 800-727-6500 Monday through Friday from 8:30 a.m. to 6 p.m. EDT and report it to the FDA's criminal activity division's website. Side effects can be reported to FDA's MedWatch Safety Information and Adverse Event Reporting Program (800-FDA-1088 or www.fda.gov/medwatch) as well as to Novo Nordisk, at 800-727-6500. https://www.upi.com/Health_News/2025/04/14/FDA-fake-Ozempic-drugs-Novo-Nordisk/6841744666854/ XX Can a digital lifestyle modification program reduce diabetes risk? A new study shows that the lifestyle intervention significantly reduced 10-year diabetes risk among prediabetics by nearly 46% and increased the diabetes remission rate, highlighting the importance of lifestyle changes. However, the study was not a randomized trial, and participation in the lifestyle intervention was voluntary, which may introduce selection bias. The study evaluated 133,764 adults, categorizing them as diabetic (7.5%), prediabetic (36.2%), and healthy (56.3%), based on fasting glucose and HbA1c levels. https://www.news-medical.net/news/20250414/Digital-lifestyle-program-cuts-diabetes-risk-by-4625-in-prediabetics-study-of-130k2b-adults-reveals.aspx XX Chrissy Teigan is speaking out about her son's type 1 diagnosis – teaming up with Sanofi to encourage people to screen early for Type 1 diabetes.   Teigen got a crash course in the risks of undiagnosed Type 1 diabetes when her 6-year-old son, Miles, was hospitalized with complications of the autoimmune disease last year. The family knew nothing about Type 1 diabetes when Miles was diagnosed during an unexpected medical emergency, Teigen said in a Tuesday announcement. “We were confused and scared when Miles was first diagnosed,” she said in a statement. “There is no doubt in my mind that knowing in advance would have made a positive impact for Miles, me, and our entire family. I want everyone to hear me when I say: stay proactive and talk to your doctor about getting yourself or your loved ones screened for type 1 diabetes today!”   Teigen shared her family's story in a two-minute video on ScreenForType1.com, a Sanofi website that discusses how to get screened for the condition. Miles' diagnosis made Teigen feel like she “went from a mom to a doctor overnight,” she said. That experience is why Teigen said she is “begging you: Do this one thing, and screen yourself and your family for Type 1 diabetes.” https://www.fiercepharma.com/marketing/sanofi-signs-chrissy-teigen-diabetes-screening-campaign XX Dr. Richard Bernstein – best known for his advocacy around low carb diets for people with diabetes – died this week at the age of 90. Born in 1934 in Brooklyn, New York, he was diagnosed with type 1 at age 12. In the 1970s he adapted a blood glucose monitor for home use and helped pioneer home glucose monitoring. He published multiple books on Diabetes including the #1 selling Diabetes book on Amazon.Com “Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars” and “Diabetes Type II: Living a Long, Healthy Life Through Blood Sugar Normalization”.  He practiced and saw patients right up until his death.

Is matcha the ultimate coffee alternative, or just another wellness fad? In this episode, Andrew Kojima - aka Chef Koj - an expert in Japanese cuisine, and Professor Tim Spector, a world-leading scientist in nutrition and gut health, explore whether matcha is truly a healthier choice than coffee.  Chef Koj explains the rich history behind matcha, its role in Japanese culture, and why it has become a global wellness trend. Tim breaks down the latest science on matcha's impact on metabolism, brain function, and gut health, comparing its effects to those of coffee. For listeners curious about incorporating matcha into their daily routine, this episode includes a practical guide on how to prepare matcha properly. Koj demonstrates the traditional method of whisking matcha and shares tips on avoiding common mistakes. For those new to matcha, he also explains how to make a simple and delicious matcha latte for beginners.  The episode concludes with a tasting of Koj's matcha custard dessert, showing how matcha's umami-rich flavor can be used in unexpected ways. Could matcha actually help curb sugar cravings and build a taste for more complex flavors? 

This research article investigated the effects of Brussels chicory on exercise performance and recovery in untrained college students. The study found that consuming Brussels chicory juice daily for 7 days increased time to exhaustion during high-intensity exercise by 8.3% in men and 12.2% in women. This improvement in performance was observed despite no significant changes in maximal oxygen consumption (VO2 max). Additionally, Brussels chicory consumption promoted post-exercise recovery, evidenced by a reduction in blood lactate levels by 14.5% in men and 10.6% in women. The study suggests that these improvements may be due to the promotion of lactate oxidation, a process that helps clear lactate from the muscles and improve acid-base balance Disclaimers: This information is for educational purposes only and should not be interpreted as medical advice. The study discussed was conducted on a specific population (untrained college students). Further research is needed to confirm these findings in other populations. Always consult with a qualified healthcare professional before making any changes to your diet or exercise plan, especially if you have a medical condition or are taking medications. This channel is not monetized and does not provide medical advice. #BrusselsChicory #ExercisePerformance #PostExerciseRecovery #LactateOxidation #SportsScience Mao Y, Huang J, Li S, Chen G, Du Y, Kang M, Zhu S, Zhang W, Xu Q, Wang Y, et al. Brussels Chicory Enhances Exhaustive Aerobic Exercise Performance and Post-Exercise Recovery, Possibly Through Promotion of Lactate Oxidation: A Pilot Randomized, Single-Blind, Placebo-Controlled, Two-Way Crossover Study. Nutrients. 2025; 17(2):365. https://doi.org/10.3390/nu17020365

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses how to be a better trainer. He explores tips for training people, the five levels of training, and sensory overload. Later in the podcast, he further explores the topic of training trainers with Professor Mark Coleman, co-founder of Lapco, an innovative training consultancy focused on safer surgeries. They highlight details of Professor Coleman's courses, the program's learning curve, and how this training could be beneficial for cardiothoracic surgeons worldwide.   Joel also reviews recent JANS articles on clinical outcomes of mitral valve surgery in atrial functional mitral regurgitation in the REVEAL-AFMR registry, risk of transfusion in isolated coronary artery bypass graft, the efficacy of loco-regional ropivacaine analgesia via intercostal catheters after lung resection, and percutaneous transcatheter edge-to-edge repair for functional mitral regurgitation in heart failure.  In addition, Joel explores a case report of coronary stentectomy, principles of complex mitral valve repair with Leonard Lee and Vince Gaudiani, and uniportal robotic-assisted extended thymectomy. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Clinical Outcomes of Mitral Valve Surgery in Atrial Functional Mitral Regurgitation in the REVEAL-AFMR Registry  2.) Risk of Transfusion in Isolated Coronary Artery Bypass Graft: Models Developed From The Society of Thoracic Surgeons Database  3.) The Efficacy of Loco-Regional Ropivacaine Analgesia Via Intercostal Catheters After Lung Resection: A Randomized, Double-Blind, Placebo-Controlled, Superiority Study  4.) Percutaneous Transcatheter Edge-to-Edge Repair for Functional Mitral Regurgitation in Heart Failure: A Meta-Analysis of Three RCTs  CTSNET Content Mentioned  1.) Undressing the “Full Metal Jacket”—A Case Report of Coronary Stentectomy  2.) Principles of Complex Mitral Valve Repair: An Exploration With Leonard Lee and Vince Gaudiani  3.) Uniportal Robotic-Assisted Extended Thymectomy  Other Items Mentioned  CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

En el episodio de hoy, tratamos de responder a la pregunta que formulamos, sobre todo matizando la autonomía o no de esos CPGs en la médula humana. Revisamos los principales autores y estudios sobre el tema y ahondamos en la evidencia más actual sobre el sistema de interneuronas que conforman los CPGs y las implicaciones para la neurorrehabilitación (estimulación epidural y terapia intensiva). Referencias del episodio: 1. Angeli, C. A., Edgerton, V. R., Gerasimenko, Y. P., & Harkema, S. J. (2014). Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans. Brain : a journal of neurology, 137(Pt 5), 1394–1409. https://doi.org/10.1093/brain/awu038 (https://pubmed.ncbi.nlm.nih.gov/24713270/). 2. Barkan, C. L., & Zornik, E. (2019). Feedback to the future: motor neuron contributions to central pattern generator function. The Journal of experimental biology, 222(Pt 16), jeb193318. https://doi.org/10.1242/jeb.193318 (https://pmc.ncbi.nlm.nih.gov/articles/PMC6739810/). 3. Brown, T. G. (1911). The Intrinsic Factors in the Act of Progression in the Mammal. Proceedings of the Royal Society of London. Series B, Containing Papers of a Biological Character, 84(572), 308–319. http://www.jstor.org/stable/80647 (https://www.jstor.org/stable/80647). 4. Cherni, Y., Begon, M., Chababe, H., & Moissenet, F. (2017). Use of electromyography to optimize Lokomat® settings for subject-specific gait rehabilitation in post-stroke hemiparetic patients: A proof-of-concept study. Neurophysiologie clinique = Clinical neurophysiology, 47(4), 293–299. https://doi.org/10.1016/j.neucli.2017.01.008 (https://pubmed.ncbi.nlm.nih.gov/28318816/). 5. Courtine, G., Gerasimenko, Y., van den Brand, R., Yew, A., Musienko, P., Zhong, H., Song, B., Ao, Y., Ichiyama, R. M., Lavrov, I., Roy, R. R., Sofroniew, M. V., & Edgerton, V. R. (2009). Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Nature neuroscience, 12(10), 1333–1342. https://doi.org/10.1038/nn.2401 (https://pubmed.ncbi.nlm.nih.gov/19767747/). 6. Dietz V. (2010). Behavior of spinal neurons deprived of supraspinal input. Nature reviews. Neurology, 6(3), 167–174. https://doi.org/10.1038/nrneurol.2009.227 (https://pubmed.ncbi.nlm.nih.gov/20101254/). 7. Dimitrijevic, M. R., Gerasimenko, Y., & Pinter, M. M. (1998). Evidence for a spinal central pattern generator in humans. Annals of the New York Academy of Sciences, 860, 360–376. https://doi.org/10.1111/j.1749-6632.1998.tb09062.x (https://pubmed.ncbi.nlm.nih.gov/9928325/). 8. Dzeladini, F., van den Kieboom, J., & Ijspeert, A. (2014). The contribution of a central pattern generator in a reflex-based neuromuscular model. Frontiers in human neuroscience, 8, 371. https://doi.org/10.3389/fnhum.2014.00371 (https://pmc.ncbi.nlm.nih.gov/articles/PMC4071613/). 9. Gizzi, L., Nielsen, J. F., Felici, F., Moreno, J. C., Pons, J. L., & Farina, D. (2012). Motor modules in robot-aided walking. Journal of neuroengineering and rehabilitation, 9, 76. https://doi.org/10.1186/1743-0003-9-76 (https://pubmed.ncbi.nlm.nih.gov/23043818/). 10. Gosgnach S. (2022). Synaptic connectivity amongst components of the locomotor central pattern generator. Frontiers in neural circuits, 16, 1076766. https://doi.org/10.3389/fncir.2022.1076766 (https://pmc.ncbi.nlm.nih.gov/articles/PMC9730330/). 11. Grillner, S. (1981). Control of Locomotion in Bipeds, Tetrapods, and Fish. Comprehensive Physiology, 1179-1236 (https://onlinelibrary.wiley.com/doi/10.1002/cphy.cp010226). 12. Guertin P. A. (2014). Preclinical evidence supporting the clinical development of central pattern generator-modulating therapies for chronic spinal cord-injured patients. Frontiers in human neuroscience, 8, 272. https://doi.org/10.3389/fnhum.2014.00272 (https://pubmed.ncbi.nlm.nih.gov/24910602/). 13. Harkema, S., Gerasimenko, Y., Hodes, J., Burdick, J., Angeli, C., Chen, Y., Ferreira, C., Willhite, A., Rejc, E., Grossman, R. G., & Edgerton, V. R. (2011). Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Lancet (London, England), 377(9781), 1938–1947. https://doi.org/10.1016/S0140-6736(11)60547-3 (https://pubmed.ncbi.nlm.nih.gov/21601270/). 14. Kathe, C., Skinnider, M. A., Hutson, T. H., Regazzi, N., Gautier, M., Demesmaeker, R., Komi, S., Ceto, S., James, N. D., Cho, N., Baud, L., Galan, K., Matson, K. J. E., Rowald, A., Kim, K., Wang, R., Minassian, K., Prior, J. O., Asboth, L., Barraud, Q., … Courtine, G. (2022). The neurons that restore walking after paralysis. Nature, 611(7936), 540–547. https://doi.org/10.1038/s41586-022-05385-7 (https://pubmed.ncbi.nlm.nih.gov/36352232/). 15. Minassian, K., Jilge, B., Rattay, F., Pinter, M. M., Binder, H., Gerstenbrand, F., & Dimitrijevic, M. R. (2004). Stepping-like movements in humans with complete spinal cord injury induced by epidural stimulation of the lumbar cord: electromyographic study of compound muscle action potentials. Spinal cord, 42(7), 401–416. https://doi.org/10.1038/sj.sc.3101615 (https://pubmed.ncbi.nlm.nih.gov/15124000/). 16. Minassian, K., Persy, I., Rattay, F., Dimitrijevic, M. R., Hofer, C., & Kern, H. (2007). Posterior root-muscle reflexes elicited by transcutaneous stimulation of the human lumbosacral cord. Muscle & nerve, 35(3), 327–336. https://doi.org/10.1002/mus.20700 (https://pubmed.ncbi.nlm.nih.gov/17117411/). 17. Radhakrishna, M., Steuer, I., Prince, F., Roberts, M., Mongeon, D., Kia, M., Dyck, S., Matte, G., Vaillancourt, M., & Guertin, P. A. (2017). Double-Blind, Placebo-Controlled, Randomized Phase I/IIa Study (Safety and Efficacy) with Buspirone/Levodopa/Carbidopa (SpinalonTM) in Subjects with Complete AIS A or Motor-Complete AIS B Spinal Cord Injury. Current pharmaceutical design, 23(12), 1789–1804. https://doi.org/10.2174/1381612822666161227152200 (https://pubmed.ncbi.nlm.nih.gov/28025945/). 18. Reier, P. J., Howland, D. R., Mitchell, G., Wolpaw, J. R., Hoh, D., & Lane, M. A. (2017). Spinal cord injury: repair, plasticity and rehabilitation. eLS, 1-12 (https://onlinelibrary.wiley.com/doi/abs/10.1002/9780470015902.a0021403.pub2).

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Extended-release ketamine tablets for treatment-resistant depression: a randomized placebo-controlled phase 2 trial  Nature Medicine The safety and tolerability of racemic ketamine may be improved if given orally, as an extended-release tablet (R-107), compared with other routes of administration. In this phase 2 multicenter clinical trial, male and female adult patients with treatment-resistant major depression (TRD) and Montgomery–Asberg Depression Rating Scale (MADRS) scores ≥20 received open-label R-107 tablets 120 mg per day for 5 days and were assessed on day 8 (enrichment phase). On day 8, responders (MADRS scores ≤12 and reduction ≥50%) were randomized to receive double-blind R-107 doses of 30, 60, 120, or 180 mg, or placebo, twice weekly for 12 weeks. Nonresponders on day 8 exited the study. Tolerability was excellent, with no changes in blood pressure, minimal reports of sedation, and minimal dissociation. The most common adverse events were headache, dizziness, and anxiety. R-107 tablets were effective, safe, and well tolerated in patients with TRD, enriched for initial response to R-107 tablets.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief

Coronary Sinus Reducer for the Treatment of Refractory Angina: A Randomized, Placebo-Controlled Trial (ORBITA-COSMIC)

In this episode, we discuss updates in primary myelofibrosis with Dr. Ayalew Tefferi from the Mayo Clinic. The key studies and trials discussed are as follows: ·       GIPSS: Genetically inspired prognostic scoring system that is exclusively based on genetic markers. §  https://www.nature.com/articles/s41375-018-0107-z ·       MIPSS70+ Version 2.0: Mutation and Karyotype-Enhanced International Prognostic Scoring System for Primary Myelofibrosis §  https://ascopubs.org/doi/10.1200/JCO.2018.78.9867?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed ·       TRANSFORM-1: A Randomized, Double-Blind, Placebo-Controlled, Multicenter, International Phase 3 Study of Navitoclax in Combination with Ruxolitinib Versus Ruxolitinib Plus Placebo in Patients with Untreated Myelofibrosis §  https://ashpublications.org/blood/article/142/Supplement%201/620/502738/Transform-1-A-Randomized-Double-Blind-Placebo ·       MANIFEST-2: Pelabresib in Combination with Ruxolitinib for Janus Kinase Inhibitor Treatment-Naïve Patients with Myelofibrosis: Results of the MANIFEST-2 Randomized, Double-Blind, Phase 3 Study §  https://ashpublications.org/blood/article/142/Supplement%201/628/502728/Pelabresib-in-Combination-with-Ruxolitinib-for ·       XPORT-MF-034: Selinexor Plus Ruxolitinib in JAK Inhibitor (JAKi)-Naïve Patients with Myelofibrosis: Long Term Follow up from XPORT-MF-034 Suggestive of Disease Modification 

In this episode, we discuss top abstracts in the myeloid space from the American Society of Hematology 2023 meeting with Dr. Anand Patel. Here are the abstracts that were discussed:1. TRANSFORM-1: A Randomized, Double-Blind, Placebo-Controlled, Multicenter, International Phase 3 Study of Navitoclax in Combination with Ruxolitinib Versus Ruxolitinib Plus Placebo in Patients with Untreated Myelofibrosis https://ash.confex.com/ash/2023/webprogram/Paper173509.html 2. MANIFEST-2: Pelabresib in Combination with Ruxolitinib for Janus Kinase Inhibitor Treatment-Naïve Patients with Myelofibrosis: Results of the MANIFEST-2 Randomized, Double-Blind, Phase 3 Study https://ash.confex.com/ash/2023/webprogram/Paper179141.html 3. Venetoclax + Decitabine vs 7+3 in AML https://ashpublications.org/blood/article/142/Supplement%201/970/503790/Comparing-the-Efficacy-and-Safety-of-Venetoclax 4. FILO study: Acute Myeloid Leukemia Patients Who Stopped Venetoclax or/and Azacytidine for Other Reasons Than Progression Have a Prolonged Treatment Free Remission and Overall Survival. https://ash.confex.com/ash/2023/webprogram/Paper185437.html  5. AUGMENT-101: Revumenib Monotherapy in Patients with Relapsed/Refractory KMT2Ar Acute Leukemia: Topline Efficacy and Safety Results https://ash.confex.com/ash/2023/webprogram/Paper172422.html 6. VEN+HMA in HR MDS: Safety, Efficacy, and Patient-Reported Outcomes of Venetoclax in Combination with Azacitidine for the Treatment of Patients with Higher-Risk Myelodysplastic Syndrome: A Phase 1b Study https://ash.confex.com/ash/2020/webprogram/Paper139492.html

Sometimes, we learn more from what isn't achieved than when we achieve an expected result. Such is the case for our next guest, Dr. David R. Jayne, who is the first author of Clinical and Biomarker Responses to BI 655064, an Antagonistic Anti-CD40 Antibody, in Patients With Active Lupus Nephritis: A Randomized, Double-Blind, Placebo-Controlled, Phase II Trial , a study designed to characterize a dose-response relationship between an anti-CD40 monoclonal antibody known as Bi 655064 and complete renal response (CRR) in patients with active lupus nephritis (LN). Dr. Jayne and his research team's study may not have shown this dose-response relationship, but what was gained along the way surely shows the power of the negative study! 

In discussion with Dr. Uma Borate from the Ohio State University Comprehensive Cancer Center, The James, covering the leukemia, myelofibrosis and myelodysplastic syndrome key practice changing/informing abstracts from American Society of Hematology (ASH) 2023 conference from Community Oncology perspective. We covered 4 important practice informing studies with Dr. Borate: - TRANSFORM-1: Ph III, Randomized, Double-Blind, Placebo-Controlled, Multicenter, International, Study of Navitoclax in Combination with Ruxolitinib vs Ruxolitinib Plus Placebo in Patients with Untreated Myelofibrosis - MANIFEST-2: Ph III, Randomized, Double-Blind Study, Pelabresib in Combination with Ruxolitinib for Janus Kinase Inhibitor Treatment-Naïve Patients with Myelofibrosis - SAVE: Phase I/II, Investigating the All-Oral Combination of the Menin Inhibitor Revumenib (SNDX-5613) with Decitabine/Cedazuridine (ASTX727) and Venetoclax in AML - AUGMENT-101: Ph I/II, Revumenib Monotherapy in Patients with R/R KMT2Ar Acute Leukemias: Efficacy and Safety Results   #ASH #Leukemia #MDS #Myelofibrosis #Blood #Cancer #2023 #oncology #oncbrothers   Website: http://www.oncbrothers.com/ Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

Recent research highlights that probiotics can make a significant impact on a wide range of conditions like immunity, stress, allergies, and even lactose intolerance.  Tune in to hear the latest updates and stay in step with the science.   Read & Watch Next What is Leaky Gut? https://drruscio.com/what-is-leaky-gut/  How to Use Probiotics for Bloating & Constipation Relief: https://drruscio.com/probiotics-for-bloating/   How Long Does it Take for Probiotics to Work? https://drruscio.com/how-long-does-it-take-for-probiotics-to-work/  7 Surprising Things That are Stressing Your Nervous System: https://drruscio.com/things-stressing-your-nervous-system/  The Latest Research Update Episodes: https://drruscio.com/research-updates/   Why You Have Food Intolerances & How to Improve Them: https://www.youtube.com/watch?v=y-LNHKlk5Oc&t=14s    Timestamps 00:00 Intro  00:56 Benefits for white blood cells 04:11 Benefits for diarrhea & sickness duration 08:13 Benefits for the stress response  13:21 Benefits for food allergies  19:22 Research update wrap-up   Featured Studies  Effect of synbiotic supplementation on immune parameters and gut microbiota in healthy adults: a double-blind randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/37614109/ Adjunctive efficacy of Lactis XLTG11 for Acute diarrhea in children: A randomized, blinded, placebo-controlled study: https://pubmed.ncbi.nlm.nih.gov/37172455/ The effect of oral probiotics on CD4 count in patients with HIV infection undergoing treatment with ART who have had an immunological failure: https://pubmed.ncbi.nlm.nih.gov/37382253/ Effects of Heat-Killed Lacticaseibacillus paracasei MCC1849 on the Maintenance of Physical Condition in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study: https://pubmed.ncbi.nlm.nih.gov/37571384/ Potential probiotics for regulation of the gut-lung axis to prevent or alleviate influenza in vulnerable populations: https://pubmed.ncbi.nlm.nih.gov/36970463/ Bifidobacterium longum subsp. longum Reduces Perceived Psychological Stress in Healthy Adults: An Exploratory Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/37513541/ Intake of Lactiplantibacillus plantarum HEAL9 Improves Cognition in Moderately Stressed Subjects: A Randomized Controlled Study: https://pubmed.ncbi.nlm.nih.gov/37571403/ Exaggerated amygdala response to threat and association with immune hyperactivity in depression: https://pubmed.ncbi.nlm.nih.gov/35636614/ Probiotics fortify intestinal barrier function: a systematic review and meta-analysis of randomized trials: https://pubmed.ncbi.nlm.nih.gov/37168869/ The role of probiotic supplementation in inflammatory biomarkers in adults: an umbrella meta-analysis of randomized controlled trials: https://pubmed.ncbi.nlm.nih.gov/37698776/ Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome: https://pubmed.ncbi.nlm.nih.gov/28483500/ Lacticaseibacillus rhamnosus HA-114 improves eating behaviors and mood-related factors in adults with overweight during weight loss: a randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/35714163/ The Effectiveness of Probiotics in Treating Food and Cow's Milk Allergies among Pediatric Age Group: A Meta-analysis of Randomized Controlled Trials: https://pubmed.ncbi.nlm.nih.gov/37496406/ Effects of probiotics administration on lactose intolerance in adulthood: A meta-analysis: https://pubmed.ncbi.nlm.nih.gov/37225575/   Get the Latest Updates Facebook - https://www.facebook.com/DrRusciodc Instagram - https://www.instagram.com/drrusciodc/ Pinterest - https://www.pinterest.com/drmichaelrusciodc  DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g  *Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video.

As many of you know, I have long argued (unsuccessfully until now) for a placebo-controlled trial of AF ablation. One group gets the ablation; the other gets a placebo or sham procedure. This way we can sort out the placebo-resistant effect of the ablation. Finally, here is the first report of one. Dr. Malcolm Finlay is an electrophysiologist at St Bartholomew hospital in London UK and primary investigator of the study. They recently published their feasibility study for AF ablation vs placebo. The American Heart Journal published the pilot study of 20 patients. Finlay and colleagues call it the ORBITA AF trial. But it's important to note that this was done separate from the ORBITA investigators at Imperial College. The larger study will have a different name. Here is a copy and paste:Twenty patients with PersAF (duration

Synbiotic drink result in important Fat Loss Ep. 1167 DEC 2023 This study investigated the effects of consuming a combination of Bifidobacterium animalis subsp. lactis GCL2505 and inulin on abdominal fat reduction. The results showed that participants who consumed the combined beverage had significant reductions in visceral fat area and total fat area compared to the placebo group. Additionally, the intervention increased the total number of bifidobacteria in the gut and affected several lipid markers. The authors suggest that the combined intake of GCL2505 and inulin improves the intestinal environment and reduces abdominal fat through a mechanism involving short-chain fatty acids (SCFAs). Further research is needed to investigate the full mechanisms involved in this effect. Overall, the study suggests that the combined intake of GCL2505 and inulin may be a simple and effective way to reduce abdominal fat and potentially prevent metabolic abnormalities. #probiotics #weightloss #BMI Baba Y, Saito Y, Kadowaki M, Azuma N, Tsuge D. Effect of Continuous Ingestion of Bifidobacteria and Inulin on Reducing Body Fat: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Comparison Study. Nutrients. 2023; 15(24):5025. https://doi.org/10.3390/nu15245025 visceral fat reduction, inulin and bifidobacteria, GCL2505 probiotic, gut health and weight loss, natural ways to reduce abdominal fat, reducing inflammation through diet, probiotics for metabolic health, improving digestion and gut microbiome, "GCL2505 and inulin combined", "Bifidobacterium animalis subsp. lactis GCL2505 study", --- Support this podcast: https://podcasters.spotify.com/pod/show/ralph-turchiano/support

This study investigated the effects of consuming a combination of Bifidobacterium animalis subsp. lactis GCL2505 and inulin on abdominal fat reduction. The results showed that participants who consumed the combined beverage had significant reductions in visceral fat area and total fat area compared to the placebo group. Additionally, the intervention increased the total number of bifidobacteria in the gut and affected several lipid markers. The authors suggest that the combined intake of GCL2505 and inulin improves the intestinal environment and reduces abdominal fat through a mechanism involving short-chain fatty acids (SCFAs). Further research is needed to investigate the full mechanisms involved in this effect. Overall, the study suggests that the combined intake of GCL2505 and inulin may be a simple and effective way to reduce abdominal fat and potentially prevent metabolic abnormalities. #probiotics #weightloss #BMI Baba Y, Saito Y, Kadowaki M, Azuma N, Tsuge D. Effect of Continuous Ingestion of Bifidobacteria and Inulin on Reducing Body Fat: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Comparison Study. Nutrients. 2023; 15(24):5025. https://doi.org/10.3390/nu15245025 visceral fat reduction, inulin and bifidobacteria, GCL2505 probiotic, gut health and weight loss, natural ways to reduce abdominal fat, reducing inflammation through diet, probiotics for metabolic health, improving digestion and gut microbiome, "GCL2505 and inulin combined", "Bifidobacterium animalis subsp. lactis GCL2505 study", --- Support this podcast: https://podcasters.spotify.com/pod/show/ralph-turchiano/support

AHA23 Congress Coverage: PCI for Stable Angina (ORBITA-2 Trial)

Diana and JR discuss how Kratom began their journey into plant medicine, and how it can be an effective alternative to pharmaceutical pain medications. Guest Dr. Grinspoon shares insights on Kratom's potential in treating conditions like anxiety, insomnia, and chronic pain. Key Points of this episode:*The podcast episode focuses on exploring Kratom, a plant native to Southeast Asia, known for its medicinal properties and increasing popularity in the Western world. *Diana and JR share their personal experiences with Kratom, emphasizing how it has helped them manage their chronic pain. *The podcast delves into the history of Kratom, discussing its traditional uses in Southeast Asia and its rise in popularity in the West, despite controversy and regulatory issues with the DEA. *Dr. Grinspoon, a respected physician and author, provides a professional perspective on the potential of Kratom in treating conditions like anxiety, insomnia, and chronic pain. *The importance of further research, regulation, and sourcing Kratom from reliable vendors to ensure its safety and efficacy. *Diana and JR also discuss how Kratom has allowed them and others to successfully wean off scheduled drugs, providing a natural alternative for pain management. *Dr. Grinspoon highlights the need for regulation and better study of Kratom, emphasizing that legal drugs are safer. Timestamps:0:16 - Welcome to Your Highness Podcast 1:41 - What is Kratom 2:19 - History of Kratom 7:59 - Diana's Personal Kratom Story 21:55 - Dr. Grinspoon38:00 - Kratom Science and Legislation 42:56 - Where to buy Kratom Important links:Pain relief Kratom trial at Yale University. Focus: Plant-based Medicine and Pharmacology: Kratom and Pain Tolerance: A Randomized, Placebo-Controlled, Double-Blind Study”American Kratom Association(PDF) Abuse liability and therapeutic potential of the Mitragyna speciosa (kratom) alkaloids mitragynine and 7-hydroxymitragynine (researchgate.net)Kratom: Fear-worthy foliage or beneficial botanical? - Harvard Health  

Listen to our interview with Dr. Oshri Barel, the author of "Addition of Lidocaine to the Distension Medium in Hysteroscopy Decreases Pain during the Procedure –A Randomized Double-blind, Placebo-controlled Trial". In this episode, we discuss the intervention of adding lidocaine to hysteroscopy distention medium and its effect on pain from the procedure. See below for publication details and be sure to join discussion on this topic through our social media platforms.Publication details: VOLUME 28, ISSUE 4, P865-871, APRIL 2021Full text linkConnect with the JMIG Social Media Team!X: @AAGLJMIGInstagram: @AAGLJMIGFacebook: AAGLJMIG

On Episode 32 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the September 2023 issue of Stroke: “Prestroke and Poststroke Sulfonylurea Exposure and Functional Outcomes: A Post Hoc Analysis of the SHINE Trial” and “Sleep Duration Is Associated With Subclinical Carotid Plaque Burden.” She also interviews Dr. Alexandros Polymeris and Prof. Philippe Lyrer about their article “Tranexamic Acid for Intracerebral Hemorrhage in Patients on Non-Vitamin K Antagonist Oral Anticoagulants (TICH-NOAC): A Multicenter, Randomized, Placebo-Controlled, Phase 2 Trial.” For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20230829.123365

Drs Sandhya Srinivas and Heather Cheng discuss PARP inhibitors, clinical trials, and germline vs somatic testing for patients with prostate cancer, as well as the optimal time for this testing. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988734). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Germline Testing in Prostate Cancer: When and Who to Test https://pubmed.ncbi.nlm.nih.gov/34669358/ Germline and Somatic Mutations in Prostate Cancer for the Clinician https://pubmed.ncbi.nlm.nih.gov/31085765/ Genetic and Genomic Testing for Prostate Cancer: Beyond DNA Repair https://pubmed.ncbi.nlm.nih.gov/37207301/ Genome-Wide Association Study of Prostate Cancer-Specific Survival https://pubmed.ncbi.nlm.nih.gov/26307654/ Inherited DNA-Repair Gene Mutations in Men With Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/27433846/ NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Prostate Cancer https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf PARP Inhibitors in Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/37168382/ Rucaparib in Men With Metastatic Castration-Resistant Prostate Cancer Harboring a BRCA1 or BRCA2 Gene Alteration https://pubmed.ncbi.nlm.nih.gov/32795228/ Olaparib for Metastatic Castration-Resistant Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/32343890/ Abiraterone and Olaparib for Metastatic Castration-Resistant Prostate Cancer https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200043 Rucaparib or Physician's Choice in Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/36795891/ FDA Approves Olaparib With Abiraterone and Prednisone (or Prednisolone) for BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-olaparib-abiraterone-and-prednisone-or-prednisolone-brca-mutated-metastatic-castration Niraparib and Abiraterone Acetate for Metastatic Castration-Resistant Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/36952634/ Talazoparib Plus Enzalutamide in Men With First-line Metastatic Castration-Resistant Prostate Cancer (TALAPRO-2): A Randomised, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/37285865/

Commentary by Dr Jian-Jun Li

Drs Sandhya Srinivas and Rana R. McKay discuss bone health and survivorship, including risk factors and potential side effects with androgen deprivation therapy in patients with prostate cancer. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988732). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Metastases in Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/29661810/ Do Dietary Calcium and Vitamin D Matter in Men With Prostate Cancer? https://pubmed.ncbi.nlm.nih.gov/29765146/ Zoledronic Acid: A Review of Its Use in the Management of Bone Metastases and Hypercalcaemia of Malignancy https://pubmed.ncbi.nlm.nih.gov/12558465/ Denosumab in Osteoporosis https://pubmed.ncbi.nlm.nih.gov/24289327/ Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/23863050/ Effect of Longer-Interval vs Standard Dosing of Zoledronic Acid on Skeletal Events in Patients With Bone Metastases: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/28030702/ The Prevention of Fragility Fractures in Patients With Non-Metastatic Prostate Cancer: A Position Statement by the International Osteoporosis Foundation https://pubmed.ncbi.nlm.nih.gov/29088899/ Decreased Fracture Rate by Mandating Bone Protecting Agents in the EORTC 1333/PEACEIII Trial Combining Ra223 With Enzalutamide Versus Enzalutamide Alone: An Updated Safety Analysis. https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.5002 Addition of Radium-223 to Abiraterone Acetate and Prednisone or Prednisolone in Patients With Castration-Resistant Prostate Cancer and Bone Metastases (ERA 223): A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/30738780/

Drs Sapna P. Patel and Kim A. Margolin sift through the data from studies presented at recent conferences, including the KEYNOTE-942 and RP1 IGNYTE studies. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989036). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources An Efficacy Study of Adjuvant Treatment With the Personalized Cancer Vaccine mRNA-4157 and Pembrolizumab in Participants With High-Risk Melanoma (KEYNOTE-942) https://classic.clinicaltrials.gov/ct2/show/NCT03897881?term=Keynote-942&draw=2&rank=1 A Personalized Cancer Vaccine, mRNA-4157, Combined With Pembrolizumab Versus Pembrolizumab in Patients With Resected High-Risk Melanoma: Efficacy and Safety Results From the Randomized, Open-Label Phase 2 mRNA-4157-P201/Keynote-942 Trial https://www.abstractsonline.com/pp8/#!/10828/presentation/10243 Distant Metastasis-Free Survival Results From the Randomized, Phase 2 mRNA-4157-P201/KEYNOTE-942 Trial https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA9503 Neoadjuvant-Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/36856617/ Pembrolizumab Versus Placebo as Adjuvant Therapy in Stage IIB or IIC Melanoma: Final Analysis of Distant Metastasis-Free Survival in the Phase 3 KEYNOTE-716 Study https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA9505 Study of RP1 Monotherapy and RP1 in Combination With Nivolumab (IGNYTE) https://www.clinicaltrials.gov/study/NCT03767348?term=Study%20of%20RP1%20Monotherapy%20and%20RP1%20in%20Combination%20With%20Nivolumab%20(IGNYTE)&rank=1 Talimogene Laherparepvec (T-VEC): An Intralesional Cancer Immunotherapy for Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/33803762/ Randomized, Double-blind, Placebo-Controlled, Global Phase III Trial of Talimogene Laherparepvec Combined With Pembrolizumab for Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/35998300/ Phase I Study of Fianlimab, a Human Lymphocyte Activation Gene-3 (LAG-3) Monoclonal Antibody, in Combination With Cemiplimab in Advanced Melanoma https://oncologypro.esmo.org/meeting-resources/esmo-congress/phase-i-study-of-fianlimab-a-human-lymphocyte-activation-gene-3-lag-3-monoclonal-antibody-in-combination-with-cemiplimab-in-advanced-melanoma Significant Durable Response With Fianlimab (Anti-LAG-3) and Cemiplimab (Anti-PD-1) in Advanced Melanoma: Post Adjuvant PD-1 Analysis https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.9501?af=R Relatlimab and Nivolumab Versus Nivolumab in Untreated Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/34986285/ BRAF and MEK Inhibition in Melanoma https://pubmed.ncbi.nlm.nih.gov/25648338/ Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations https://pubmed.ncbi.nlm.nih.gov/29644214/ Society for Immunotherapy of Cancer (SITC) Consensus Definitions for Resistance to Combinations of Immune Checkpoint Inhibitors https://pubmed.ncbi.nlm.nih.gov/36918224/ RECIST 1.1 – Update and Clarification: From the RECIST Committee https://pubmed.ncbi.nlm.nih.gov/27189322/ Histopathological Features of Complete Pathological Response Predict Recurrence-Free Survival Following Neoadjuvant Targeted Therapy for Metastatic Melanoma https://pubmed.ncbi.nlm.nih.gov/32739408/

Drs Sapna Patel and Yana Najjar analyze the data and share their approach to frontline therapy. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989035). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial-ECOG-ACRIN EA6134 https://pubmed.ncbi.nlm.nih.gov/36166727/ Sequencing of Ipilimumab Plus Nivolumab and Encorafenib Plus Binimetinib for Untreated BRAF-Mutated Metastatic Melanoma (SECOMBIT): A Randomized, Three-Arm, Open-Label Phase II Trial https://pubmed.ncbi.nlm.nih.gov/36049147/ Long-Term Outcomes of Patients With Active Melanoma Brain Metastases Treated With Combination Nivolumab Plus Ipilimumab (CheckMate 204): Final Results of an Open-Label, Multicentre, Phase 2 Study https://pubmed.ncbi.nlm.nih.gov/34774225/ Health-related Quality of Life With Nivolumab Plus Relatlimab Versus Nivolumab Monotherapy in Patients With Previously Untreated Unresectable or Metastatic Melanoma: RELATIVITY-047 Trial https://pubmed.ncbi.nlm.nih.gov/37167764/ Overall Survival With Combined Nivolumab and Ipilimumab in Advanced Melanoma https://pubmed.ncbi.nlm.nih.gov/28889792/ Evaluation of Two Dosing Regimens for Nivolumab in Combination With Ipilimumab in Patients With Advanced Melanoma: Results From the Phase IIIb/IV CheckMate 511 Trial https://pubmed.ncbi.nlm.nih.gov/30811280/ Adjuvant Therapy of Nivolumab Combined With Ipilimumab Versus Nivolumab Alone in Patients With Resected Stage IIIB-D or Stage IV Melanoma (CheckMate 915) https://pubmed.ncbi.nlm.nih.gov/36162037/ Single-Agent PD-1 Blockade Is "Treatment of Choice" for Desmoplastic Melanoma https://pubmed.ncbi.nlm.nih.gov/37071762/ Single-agent Pembrolizumab May Benefit Patients With Rare Type of Skin Cancer https://www.aacr.org/about-the-aacr/newsroom/news-releases/single-agent-pembrolizumab-may-benefit-patients-with-rare-type-of-skin-cancer/ Atezolizumab, Vemurafenib, and Cobimetinib as First-Line Treatment for Unresectable Advanced BRAFV600 Mutation-Positive Melanoma (Imspire150): Primary Analysis of the Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/32534646/ Overall Survival Benefit With Tebentafusp in Metastatic Uveal Melanoma https://pubmed.ncbi.nlm.nih.gov/34551229/ Efficacy and Safety of Nivolumab Alone or in Combination With Ipilimumab in Patients With Mucosal Melanoma: A Pooled Analysis https://pubmed.ncbi.nlm.nih.gov/28056206/ Single-Agent Anti-PD-1 or Combined With Ipilimumab in Patients With Mucosal Melanoma: An International, Retrospective, Cohort Study https://pubmed.ncbi.nlm.nih.gov/35716907/ CheckMate 067: Long-Term Outcomes in Patients With Mucosal Melanoma. https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.10019 A Randomized Phase 2 Trial of Encorafenib + Binimetinib + Nivolumab Vs Ipilimumab + Nivolumab In BRAFV600-Mutant Melanoma Brain Metastases https://www.swog.org/clinical-trials/s2000

Drs Stanley Cohen and Philip Mease review the 2022 ACR meeting topics, including new treatments, trial data, and what they think are the most pressing unmet needs in the field. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984271). The topics and discussions are planned, produced, and reviewed independently of the advertisers. This podcast is intended only for US healthcare professionals. Resources Etanercept in the Treatment of Psoriatic Arthritis and Psoriasis: A Randomised Trial https://pubmed.ncbi.nlm.nih.gov/10972371/ Group for Research and Assessment of Psoriasis and Psoriatic Arthritis https://www.grappanetwork.org/ American College of Rheumatology (ACR) Convergence https://www.rheumatology.org/Annual-Meeting Bimekizumab Treatment in Biologic DMARD-Naïve Patients With Active Psoriatic Arthritis: 52-Week Efficacy and Safety Results From a Phase 3, Randomized, Placebo-Controlled, Active Reference Study https://acrabstracts.org/abstract/bimekizumab-treatment-in-biologic-dmard-naive-patients-with-active-psoriatic-arthritis-52-week-efficacy-and-safety-results-from-a-phase-3-randomized-placebo-controlled-active-reference-study/ Bimekizumab Treatment in Patients With Active Psoriatic Arthritis and Inadequate Response to Tumor Necrosis Factor Inhibitors: 16-Week Efficacy and Safety From a Phase 3, Randomized, Double-Blind, Placebo-Controlled Study https://acrabstracts.org/abstract/bimekizumab-treatment-in-patients-with-active-psoriatic-arthritis-and-inadequate-response-to-tumor-necrosis-factor-inhibitors-16-week-efficacy-and-safety-from-a-phase-3-randomized-double-blind-pla/ Bimekizumab Improvements in Efficacy on Disease Activity Assessed via Composite Endpoints in Biologic DMARD-Naïve and TNFi-IR Patients With Active PsA: Pooled 16-Week Results From Phase 3 Randomized, Placebo-Controlled Studies https://acrabstracts.org/abstract/bimekizumab-improvements-in-efficacy-on-disease-activity-assessed-via-composite-endpoints-in-biologic-dmard-naive-and-tnfi-ir-patients-with-active-psa-pooled-16-week-results-from-phase-3-randomized/ Bimekizumab Versus Adalimumab in Plaque Psoriasis https://pubmed.ncbi.nlm.nih.gov/33891379/ A Head-to-Head Comparison of the Efficacy and Safety of Ixekizumab and Adalimumab in Biological-Naïve Patients With Active Psoriatic Arthritis: 24-Week Results of a Randomised, Open-Label, Blinded-Assessor Trial https://pubmed.ncbi.nlm.nih.gov/31563894/ GRAPPA Treatment Recommendations: 2021 Update https://pubmed.ncbi.nlm.nih.gov/35293339/ Deucravacitinib Prescribing Information https://packageinserts.bms.com/pi/pi_sotyktu.pdf Safety and Efficacy of Deucravacitinib, an Oral, Selective Tyrosine Kinase 2 Inhibitor, in Patients With Psoriatic Arthritis: 52-Week Results From a Randomized Phase 2 Trial https://acrabstracts.org/abstract/safety-and-efficacy-of-deucravacitinib-an-oral-selective-tyrosine-kinase-2-inhibitor-in-patients-with-psoriatic-arthritis-52-week-results-from-a-randomized-phase-2-trial/ Deucravacitinib Reduces Interferons, B Cell Pathways, and Serological Biomarkers of Systemic Lupus Disease Activity: Pharmacodynamic Analysis From the Phase 2 PAISLEY Study https://acrabstracts.org/abstract/deucravacitinib-reduces-interferons-b-cell-pathways-and-serological-biomarkers-of-systemic-lupus-disease-activity-pharmacodynamic-analysis-from-the-phase-2-paisley-study/ Nanobody: A Promising Toolkit for Molecular Imaging and Disease Therapy https://pubmed.ncbi.nlm.nih.gov/33464410/

Os cremes com vitaminas fazem mesmo bem à pele? O colagénio rejuvenesce? O botox não faz mal? Os protetores solares, protegem mesmo? E o solário: faz bem?Pois é, se no episódio anterior lhe trouxemos a composição química de muito daquilo que ingerimos, desta vez vamos fazer uma viagem às profundezas da pele para perceber a química daquilo que colocamos neste que é o maior órgão do nosso corpo e o nosso primeiro (e enorme) escudo protetor. Inês Lopes Gonçalves entusiasmou-se com o tema e literalmente encheu Nuno Maulide com todas aquelas questões que todos nós (sim, mulheres e homens) gostaríamos de saber para ter uma pele mais bonita e, acima de tudo, mais saudável e com aspeto mais jovem. Até parece um anúncio de publicidade, mas não, não é... é Ciência.REFERÊNCIAS E LINKS ÚTEIS A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind StudyCollagen Products: Healthy or Hype?Why Science Says Hyaluronic Acid Is the Holy Grail to Wrinkle-Free, Youthful HydrationSunscreens and PhotoprotectionThe history of Botulinum toxin: from poison to beautyBIOS INÊS LOPES GONÇALVESInês Lopes Gonçalves é uma pessoa, função que acumula com as de radialista, locutora e apresentadora de televisão. Na rádio, é atualmente uma d'As Três da Manhã da Rádio Renascença, na televisão é anfitriã do talk show Traz Pr'a Frente, na RTP e RTP Memória. Fez rádio na Antena 3, foi apresentadora do 5 Para a Meia Noite na RTP, e desde 2017 que é uma das caras do Festival da canção. O seu percurso começou na informação como jornalista da Rádio Renascença, passou pela Sport TV, Canal Q, e colaborou com as revistas Time Out, Sábado e semanário Expresso.NUNO MAULIDENascido em Lisboa em 1979, é professor catedrático premiado e diretor do Instituto de Química Orgânica da Universidade de Viena. Foi eleito Cientista do Ano na Áustria, em 2018. Estudou Piano e Química em Lisboa, tendo realizado estadas de investigação nas Universidade Católica de Louvain, École Polytechnique em Paris e na Universidade de Stanford. Em 2009, assumiu o cargo de chefe de equipa no Instituto Max Planck para a Investigação sobre o Carvão, em Mülheim an der Ruhr (Alemanha).Desde 2013, ocupa a cátedra de Síntese Orgânica na Universidade de Viena. É autor do best-seller “Como se Transforma Ar em Pão” e de “Como Desvendar o Quebra-Cabeças da Origem da Vida?”, livros em que procura desmistificar a Química e explicar que ela – a Química – é omnipresente nas nossas vidas.

JP Sears is selling CBD. His new company, Awaken, recently sent out a marketing email extolling the benefits of CBD. Derek looks at the science behind the claims. Show Notes CBD is everywhere. But is it a scam? Inverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real Life Pioneering UAMS Study Warns of CBD Supplements' Harm to Gut Health Can Cannabis Help Your Gut? The Impact of Cannabidiol on Human Brain Function: A Systematic Review Cannabis, Cannabinoids, and Sleep: a Review of the Literature Does CBD Help With Insomnia? Cannabidiol (CBD): What we know and what we don't Antioxidative and Anti-Inflammatory Properties of Cannabidiol Cannabidiol (CBD): a killer for inflammatory rheumatoid arthritis synovial fibroblasts A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study Immune Responses Regulated by Cannabidiol Can CBD Benefit Your Immune System? CBD and Heart Health Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study Learn more about your ad choices. Visit megaphone.fm/adchoices

CME credits: 1.25 Valid until: 27-03-2024 Claim your CME credit at https://reachmd.com/programs/cme/efficacy-and-safety-of-the-oral-pcsk9-inhibitor-mk-0616-a-macrocyclic-peptide-in-the-treatment-of-hypercholesterolemia-a-phase-2b-randomized-placebo-controlled-clinical-trial/15285/ In this program, expert faculty discuss data presented at the 2023 ACC Congress in a concise, informative, on-demand format. This format extends the congress analysis to a broader audience with greater detail than what is available in abstracts. Rapid advances from the meeting require well-planned educational programming to bridge knowledge, competence, and performance gaps.

Exercise, sudden cardiac death in sports, new TAVI data, behavioral psychology, EHR doing good things, maybe, and coffee are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Fitness and Longevity Even Small Changes in Fitness Tied to Lower Mortality Risk https://www.medscape.com/viewarticle/989906 - Changes in Cardiorespiratory Fitness and Survival in Patients With or Without Cardiovascular Disease https://www.jacc.org/doi/full/10.1016/j.jacc.2023.01.027 II. SCD in Sports Sports-Related Sudden Cardiac Arrest 'Extremely' Rare in Women https://www.medscape.com/viewarticle/990025 - Incidence of Cardiac Arrest During Sports Among Women in the European Union https://www.jacc.org/doi/full/10.1016/j.jacc.2023.01.015 - Sex-Related Differences in Sports-Related Sudden Cardiac Death Should Be Reflected in Guideline Screening Recommendations∗   https://www.jacc.org/doi/full/10.1016/j.jacc.2023.01.014 - Association between physical activity and risk of incident arrhythmias in 402 406 individuals: evidence from the UK Biobank cohort https://doi.org/10.1093/eurheartj/ehz897 III. EVOLUT Three Year Data Encouraging 3-Year Data for TAVR in Low-Risk Patients: EVOLUT https://www.medscape.com/viewarticle/989144 - Three-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis https://www.jacc.org/doi/10.1016/j.jacc.2023.02.017 - Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients https://www.nejm.org/doi/full/10.1056/nejmoa1816885 - Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk https://www.jacc.org/doi/10.1016/j.jacc.2020.12.052 IV. Behavioral Psychology NUDGE-FLU: Electronic 'Nudges' Boost Flu Shot Uptake in Seniors https://www.medscape.com/viewarticle/989108 - The Effect of Electronic Nudges on Influenza Vaccination Rate in Older Adults With Cardiovascular Disease: a Prespecified Analysis of the NUDGE-FLU Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064270 - Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.121.057042 EHR Alerts Boosted MRA Prescribing in HFrEF: BETTER CARE-HF https://www.medscape.com/viewarticle/989110 - Cluster-Randomized Trial Comparing Ambulatory Decision Support Tools to Improve Heart Failure Care https://doi.org/10.1016/j.jacc.2023.02.005 - The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure https://www.nejm.org/doi/full/10.1056/nejm199909023411001 V. Coffee - Acute Effects of Coffee Consumption on Health among Ambulatory Adults https://www.nejm.org/doi/full/10.1056/NEJMoa2204737 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Yesterday's conversation with guest David Meine was so intriguing that Walt decided to bring it into today's conversation with Jodielynn as well. We talk about the interaction between medical / scientific evidence and belief / mindset. Modern medicine is beginning in small ways to embrace mindset and belief in terms of personal preferences, but there's also a lot of room for improvement. Walt ends up proposing a modification to double-blind, placebo controlled studies. He suggests adding four new test schemes. In addition to testing a particular substance and a control group, he also advocates testing both the substance and control group with the test administrator praising the thing being tested as the next great thing. He also suggests two more variants of the substance and control groups where the administrator of the test expresses doubt or concern about the efficacy of the thing tested. The idea is to really explore all of the different ways that our beliefs and preferences impact our medical outcomes in relation to a particular healing modality. And finally, he also proposes medical doctors explaining both the placebo-free likelihood and the placebo-enhanced likely outcomes to the patient, so that the patient understands how important it is to adopt a positive mindset toward the objective of their own healing. Follow LOA Today: https://www.loatoday.net/follow

Efficacy And Safety Of The Oral PCSK9 Inhibitor, MK-0616, A Macrocyclic Peptide, In The Treatment Of Hypercholesterolemia: A Phase 2b Randomized Placebo-Controlled Clinical Trial

https://psychiatry.dev/wp-content/uploads/speaker/post-11939.mp3?cb=1677095420.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: Efficacy and safety of adjunctive therapy with fingolimod in patients with schizophrenia: A randomized, double-blind, placebo-controlled clinical trial – Monire Karbalaee etFull EntryEfficacy and safety of adjunctive therapy with fingolimod in patients with schizophrenia: A randomized, double-blind, placebo-controlled clinical trial –

April Armstrong, MD interviewed by Brad Glick, DO, MPH, FAAD

Trials on heart failure, hypertension and lipid-lowering drugs, and the evolution of antithrombin and antiplatelet therapy are discussed in part 2 of cardiologists Bob Harrington and Mike Gibson's annual review. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Lipid Lowering Safety, Tolerability and Efficacy of Up-Titration of Guideline-Directed Medical Therapies for Acute Heart Failure (STRONG-HF): A Multinational, Open-Label, Randomised, Trial https://doi.org/10.1016/S0140-6736(22)02076-1 Why Combination Lipid-Lowering Therapy Should Be Considered Early in the Treatment of Elevated LDL-C for CV Risk Reduction https://www.acc.org/latest-in-cardiology/articles/2022/06/01/12/11/why-combination-lipid-lowering-therapy-should-be-considered Incidental Coronary Artery Calcium: Opportunistic Screening of Prior Non-gated Chest CTs to Improve Statin Rates (NOTIFY-1 Project) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062746 Equivalent Impact of Elevated Lipoprotein(a) and Familial Hypercholesterolemia in Patients With Atherosclerotic Cardiovascular Disease https://doi.org/10.1016/j.jacc.2022.09.021 Comparative Effects of Low-Dose Rosuvastatin, Placebo and Dietary Supplements on Lipids and Inflammatory Biomarkers https://doi.org/10.1016/j.jacc.2022.10.013 Antihypertensive Drugs No Survival Advantage for Either Torsemide or Furosemide in HF: TRANSFORM-HF https://www.medscape.com/viewarticle/983611 Chlorthalidone vs. Hydrochlorothiazide for Hypertension–Cardiovascular Events www.nejm.org/doi/full/10.1056/NEJMoa2212270 Antiplatelets Duration of Antiplatelet Therapy After Complex Percutaneous Coronary Intervention in Patients at High Bleeding Risk: A MASTER DAPT Trial Sub-analysis https://doi.org/10.1093/eurheartj/ehac284 PANTHER: Should Clopidogrel Become the 'New Aspirin' in CAD? https://www.medscape.com/viewarticle/980117 P2Y12 Inhibitor Versus Aspirin Monotherapy for Secondary Prevention of Cardiovascular Events: Meta-analysis of Randomized Trials https://doi.org/10.1093/ehjopen/oeac019 Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes https://doi.org/10.1056/nejmoa0904327 TCT-320 Pharmacokinetic and Pharmacodynamic Profile of PL-ASA, a Novel Phospholipid-Aspirin Complex Liquid Formulation, Compared to Enteric-Coated Aspirin at an 81-mg Dose – Results From a Prospective, Randomized, Crossover Study https://www.jacc.org/doi/10.1016/j.jacc.2021.09.1173 Pharmacokinetic and Pharmacodynamic Profile of a Novel Phospholipid Aspirin Formulation https://europepmc.org/article/pmc/pmc8773391 Antithrombins/Factor XI Rivaroxaban in Patients With a Recent Acute Coronary Syndrome https://www.nejm.org/doi/full/10.1056/nejmoa1112277 Genetically Determined FXI (Factor XI) Levels and Risk of Stroke https://doi.org/10.1161/strokeaha.118.022792 Factor XIa Inhibition With Asundexian After Acute Non-cardioembolic Ischaemic Stroke (PACIFIC-Stroke): an International, Randomised, Double-Blind, Placebo-Controlled, Phase 2b Trial https://doi.org/10.1016/s0140-6736(22)01588-4 Safety of the Oral Factor Xia Inhibitor Asundexian Compared With Apixaban in Patients With Atrial Fibrillation (PACIFIC-AF): a Multicentre, Randomised, Double-Blind, Double-Dummy, Dose-Finding Phase 2 Study https://doi.org/10.1016/S0140-6736(22)00456-1 A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind, Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute Myocardial Infarction https://doi.org/10.1161/circulationaha.122.061612 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback? Please contact news@medscape.net

Get the Skinny on Bimekizumab in PsA Dr. Janet Pope discusses abstract presented at ACR22 Convergence in Philadelphia, PA. L02: Bimekizumab Treatment in Biologic DMARD-Naïve Patients with Active Psoriatic Arthritis: 52-Week Efficacy and Safety Results from a Phase 3, Randomized, Placebo-Controlled, Active Reference Study Low dose steroids can negatively impact bone healthDr. Janet Pope discusses abstract L01 presented at ACR22 Convergence in Philadelphia, PA.  L01: Impact of Glucocorticoid Dosing and Anti-Osteoporotic Treatment on Bone Health in Patients with Inflammatory Rheumatic Musculoskeletal Diseases: A Longitudinal Cohort Study The First Head to Head trial in Axial Spondyloarthritis Dr. Lianne Gensler discusses abstract L15 presented at ACR22 Convergence in Philadelphia, PA. L15: Effect of Secukinumab versus Adalimumab Biosimilar on Radiographic Progression in Patients with Radiographic Axial Spondyloarthritis: A Randomized Phase IIIb Study Why Clinical Trials? Dr. Guillermo Valenzuela talks about the importance of clinical trials from ACR22 Convergence in Philadelphia, PA.

Join Drs Cohen and Gibofsky as they step through a case of refractory psoriatic arthritis, discuss novel therapeutics, review latest clinical trials, and talk about the future in psoriatic arthritis. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/970786). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals. Resources Psoriatic Arthritis Workup https://emedicine.medscape.com/article/2196539-workup#c6 GRAPPA Treatment Recommendations: 2021 Update https://www.jrheum.org/content/49/6_Suppl_1/52.long Methotrexate in Psoriasis and Psoriatic Arthritis https://www.jrheum.org/content/96/31 Psoriatic Arthritis Medication https://emedicine.medscape.com/article/2196539-medication#4 Effect of Secukinumab on the Different GRAPPA-OMERACT Core Domains in Psoriatic Arthritis: A Pooled Analysis of 2049 Patients https://www.jrheum.org/content/47/6/854 Three JAK Inhibitors Get Boxed Warnings, Modified Indications https://www.medscape.com/viewarticle/958024 Effect of Tofacitinib on Patient-Reported Outcomes in Patients With Active Psoriatic Arthritis and an Inadequate Response to Tumour Necrosis Factor Inhibitors in the Phase III, Randomised Controlled Trial: OPAL Beyond https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340607/ Upadacitinib in Patients With Psoriatic Arthritis and an Inadequate Response to Non-biological Therapy: 56-Week Data From the Phase 3 SELECT-PsA 1 Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524381/ Multicentre, Randomised, Open-Label, Parallel-Group Study Evaluating the Efficacy and Safety of Ixekizumab Versus Adalimumab in Patients With Psoriatic Arthritis Naïve to Biological Disease-Modifying Antirheumatic Drug: Final Results by Week 52 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509529/ Improvement in Patient-Reported Outcomes in Patients With Psoriatic Arthritis Treated With Upadacitinib Versus Placebo or Adalimumab: Results From SELECT-PsA 1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572257/ Bimekizumab in Patients With Active Psoriatic Arthritis: Results From a 48-Week, Randomised, Double-Blind, Placebo-Controlled, Dose-Ranging Phase 2b Trial https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(19)33161-7 A Study to Determine the Efficacy and Safety of Deucravacitinib Compared With Placebo in Participants With Active Psoriatic Arthritis (PsA) Who Are Naïve to Biologic Disease Modifying Anti-rheumatic Drugs or Had Previously Received TNFα Inhibitor Treatment https://clinicaltrials.gov/ct2/show/NCT04908189

Bouncebackability portends increased risk of adverse outcomes in RA Dr. Richard Conway discusses Abstract 2218 at ACR22 Convergence. Abstract 2218: Frailty Is Associated with Serious Infections in Biologic and Targeted-synthetic DMARD Treated Patients with Rheumatoid Arthritis Deucravacitinib in PsA Dr. Arthur Kavanaugh discusses abstract 1598 at ACR22 Convergence in Philadelphia. Abstract 1598: Safety and Efficacy of Deucravacitinib, an Oral, Selective Tyrosine Kinase 2 Inhibitor, in Patients with Psoriatic Arthritis: 52-Week Results from a Randomized Phase 2 Trial Efficacy and Safety Results from BE OPTIMAL in PsA Dr. Arthur Kavanaugh discusses abstract L02 ACR22 Convergence in Philadelphia, PA.  L02: Bimekizumab Treatment in Biologic DMARD-Naïve Patients with Active Psoriatic Arthritis: 52-Week Efficacy and Safety Results from a Phase 3, Randomized, Placebo-Controlled, Active Reference Study Hydroxychloroquine Update from ACR22 Dr. Michelle Petri reviews several abstracts presented at ACR22 Convergence. Abstracts 0343, 0538, 0976, 0983, 0981, 0980 RA: Steroids are bad, again Dr. Richard Conway discusses Abstract 2219 at ACR22 Convergence Abstract 2219: Time-Dependent Evaluation of Glucocorticoid Exposure Duration and Major Adverse Cardiovascular Events in a Cohort of Veterans with Rheumatoid Arthritis Tapering TNFi in nonradiographic AxSpA Dr. Peter Nash at ACR22 Convergence in Philadelphia, PA. Tofacitinib and RA-ILD Dr. Richard Conway discusses Abstract 2251 at ACR22 Convergence.  Abstract 2251: Reduction in Rheumatoid Arthritis-Associated Interstitial Lung Disease Risk in Patients Treated with Tofacitinib Life or Organ Threatening SLE: What To Do? Is There Anything New? Dr. Michelle Petri discusses Abstracts 1651, 1677 at ACR22 Convergence in Philiadelphia, PA.      

Can we alter neonatal gut microbiome to prevent spondyloarthritis? Dr Chao discusses Abstract 0868 at the ACR22 Convergence meeting.  Abstract 0868: Spondyloarthritis and Neonatal Factors Affecting the Gut Microbiome JAK vs TNF inhibitor Infections in RA Dr. David Liew discusses abstract 0302 at ACR22 Convergence. Abstract 0302: Risk of Infections Between JAK Inhibitors and TNF Inhibitors Among Patients with Rheumatoid Arthritis Opioid and Neuropathic Use After Initiating btsDMARDs in RA Dr. Julian Segan discusses Abstract 0925 at the ACR22 Convergence meeting. The Dietary Intervention in PsA (DIPSA) StudyDr. Patricia Harkins talks with Professor Lihi Eder about abstract 1007 at the ACR22 Convergence meeting.  Abstract 1007: Metabolic Disorders and Abnormal Dietary Patterns and Their Association with Psoriatic Arthritis Activity: The Dietary Intervention in PsA (DIPSA) Study Treatment Considerations in Axial Spondyloarthritis Dr. Lianne Gensler discusses treatment considerations in Axial SpA. Abstract 0402: Opioid Use and Healthcare Utilization in Adults with PsA and AS Abstract 0388: Incidence Rate and Factors Associated with Fractures Among Older Adults with Ankylosing Spondylitis in the United States Abstract 0544: Bimekizumab Improves Signs and Symptoms, Including Inflammation, in Patients with Active Non-Radiographic Axial Spondyloarthritis: 24-Week Efficacy & Safety from a Phase 3, Multicenter, Randomized, Placebo Controlled Study Abstract 0545: Continuing (Full or Reduced Treatment) versus Withdrawing from Golimumab Treatment in Patients with Non-radiographic Spondylarthritis Who Achieved Inactive Disease: Efficacy and Safety Results from a Placebo-Controlled, Randomized Withdrawal and Retreatment Study (GO-BACK) What lifestyle factors affect TNF inhibitor efficacy in AxSpA? Dr Chao discusses Abstract 1510 at ACR22 Convergence. Abstract 1510: Modifying Lifestyle Factors May Offer the Potential to Enhance the Outcome of Tumour Necrosis Factor Inhibitors in Axial Spondyloarthritis – Data from 14 European Countries    

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.09.515792v1?rss=1 Authors: Altinok, A., Karabay, A., de Jong, J., Balta, G., Akyurek, E. G. Abstract: {gamma}-aminobutyric acid (GABA) is a primary inhibitory neurotransmitter that plays a significant role in the central nervous system. Studies on both animals and humans show it has the pharmacological potential for reducing the impact of cognitive disorders, as well as enhancing cognitive functions and mood. However, its specific effects on human attention and working memory have not yet been extensively studied. In this randomized, double-blind, placebo-controlled, and crossover trial, we tested whether the administration of 800 mg GABA, dissolved in a drink, acutely affected visual working memory maintenance, as well as temporal and spatial attention in healthy adults. The participants were 32 young adults (16 females and 16 males). Working memory recall precision, spatial attention and temporal attention were measured by a delayed match-to-sample task, a visual search task, and a speeded rapid serial visual presentation task, respectively. Participants completed two experimental sessions (GABA and Placebo) in randomized and counterbalanced order. In each session, forty-five minutes after administration of the drink, they completed the aforementioned cognitive tasks. Linear mixed model analysis results showed that GABA increased visual search time, compared to the placebo, but did not affect visual search accuracy, temporal attention, nor visual working memory precision. The results suggest that GABA increases visual search time but does not affect temporal attention and memory, and that previously reported effects on cognition might rely on other functions. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Contributor: Nick Hatch, MD Educational Pearls: In the setting of traumatic injury, tranexamic acid (TXA) is given to stabilize clots which minimizes bleeding and decreases risk of hemorrhagic shock   Current TXA dose for trauma is 1 g bolus followed by a 1 g infusion; both doses should be given within 3 hours from time of injury  Due to the split dose and narrow window, patients with complicated care, particularly if they require transfer may miss the infusion dose  Various smaller studies have shown that dosing 2 g initially or 2 g followed by a 1 g infusion produces the same patient outcomes and no additional harm  Receiving hospitals should strive to acquire accurate information regarding previous doses of TXA given and confirm timeline of injury    References Roberts I, Shakur H, Coats T, et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013;17(10):1-79. doi:10.3310/hta17100   Ramirez RJ, Spinella PC, Bochicchio GV. Tranexamic Acid Update in Trauma. Crit Care Clin. 2017;33(1):85-99. doi:10.1016/j.ccc.2016.08.004   Spinella PC, Thomas KA, Turnbull IR, et al. The Immunologic Effect of Early Intravenous Two and Four Gram Bolus Dosing of Tranexamic Acid Compared to Placebo in Patients With Severe Traumatic Bleeding (TAMPITI): A Randomized, Double-Blind, Placebo-Controlled, Single-Center Trial. Front Immunol. 2020;11:2085. Published 2020 Sep 8. doi:10.3389/fimmu.2020.02085   Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD   In an effort to promote diversity, equity, and inclusion in Emergency Medicine, The Emergency Medical Minute is proud to present our 2nd annual Diversity and Inclusion Award. We support increasing the representation of underrepresented groups in medicine and extend this award to individuals applying to emergency medicine residencies during the 2022-2023 cycle. For information on award eligibility and the application process, visit https://emergencymedicalminute.com/edi-award/ Donate to EMM today!

This week, please join author Sunil Rao and Guest Editor and Editorialist Gregory Lip as they discuss the article "A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind, Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute Myocardial Infarction" and the editorial "Factor XIa Inhibition: Is It a Novel Alternative Antithrombotic Strategy for High-Risk ACS Patients?" Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, today's feature paper is about the factor XI inhibitor asundexian. It's the trial that we've been waiting for the PACIFIC-AMI trial. You really have to listen to it because these factor XI inhibitors are super interesting. What? We're going to tell you about the other papers in today's issue first. Aren't we, Greg? Do you want to go first? Dr. Greg Hundley: You bet, Carolyn. Thank you so much. Carolyn, did you ever consider the genetic underpinnings of venous thromboembolism? Well, as you know, venous thromboembolism is a complex disease with environmental and genetic determinants. And in this study, this large investigative team represented by Dr. Nicholas Smith from the University of Washington in Seattle, and their colleagues present new cross-ancestry meta-analyzed genome-wide association study results from 30 studies with replication of novel loci and their characterization through in silicone genomic interrogations. Dr. Carolyn Lam: Wow. Sounds like a really large effort, Greg. What did they find? Dr. Greg Hundley: Right, Carolyn. In the author's initial genetic discovery effort that included 55,330 participants with venous thromboembolism: 47,000 were European, 6,000 African, and a little over 1000 Hispanic ancestry. They identified 48 novel associations of which 34 are replicated after correction for multiple testing. In their combined discovery replication analysis, so that's 81,669 venous thromboembolism participants and ancestry stratified meta-analyses from the European, African and Hispanic ethnic groups. They identified another 44 novel associations, which are new candidate venous thromboembolism associated loci requiring replication. And many of the replicated loci were outside of known or currently hypothesized pathways to thrombosis. Carolyn, in summary, these findings from this very large GWAS analysis highlight new pathways to thrombosis and provide novel molecules that may be useful in the development of anti-thrombosis treatments with reducing the risk of bleed. Dr. Carolyn Lam: Wow. Super interesting and very related to that feature paper that we just discuss. But nonetheless, this next paper I love as well, if I may say so myself. It deals with frailty and as we know, frailty is increasing in prevalence. And because frail patients are often perceived to have a less favorable benefit risk profile, they may be less likely to receive new pharmacological treatments. And so, we and led by Professor John McMurray from the University of Glasgow, decided to investigate the efficacy and tolerability of dapagliflozin according to frailty status in the DELIVER trial. Dr. Greg Hundley: The DELIVER trial. Carolyn, tell us about the DELIVER trial? Dr. Carolyn Lam: Sure. In deliver dapagliflozin compared to placebo, reduced the risk of worsening heart failure events or cardiovascular death and improved symptoms in more than 6,000 patients with heart failure and mildly reduced and preserved ejection fraction, so ejection fraction above 40%. Now in this pre-specified analysis, we examine the efficacy and safety of dapagliflozin according to frailty status. That was determined using the Rockwood cumulative deficit approach. And so, what we found was that greater frailty was associated with more impairment of health status and worse clinical outcomes in patients with heart failure and ejection fraction of 40%. The beneficial effects of dapagliflozin compared to placebo on clinical outcomes were consistent regardless of frailty class. But interestingly, the improvement in symptoms, physical function and quality of life were larger in the frailest patients. Adverse events were not more common in individuals randomized to receive dapagliflozin compared to placebo irrespective of frailty class. And so, the take home message is the benefit risk balance related to frailty in patients with heart failure with mildly reduced and preserved ejection fraction is favorable for dapagliflozin. And so, these findings should challenge any clinical reluctance to introduce dapagliflozin in patients perceived to be frail. Dr. Greg Hundley: Wow. Carolyn, really interesting. You could see with the diuretic effect in someone that's frail, the potential hesitancy, but very interesting study results in this world of frailty and the use of dapagliflozin. Well, Carolyn, this next study is very interesting and it comes to us from the world of preclinical science that takes a very interesting approach to a scientific question. Now, as you may know, RNA-binding proteins or RBPs are master orchestrators of genetic expression regulation. They regulate hundreds of transcripts at once by recognizing specific motifs, thus characterizing RBPs targets is critical to harvest their full therapeutic potential. However, such investigation has often been restricted to a few RBP targets, thereby limiting our understanding of their function. Carolyn, these investigators led by Dr. Grégoire Ruffenach from UCLA were interested in assessing pulmonary arterial hypertension and they turned to the world of cancer research. Carolyn, in cancer, the RNA-binding protein hnRNPA2B1, and we're going to abbreviate that as A2B1, promotes a pro proliferative anti-apoptotic phenotype. The same phenotype is present in pulmonary arterial smooth muscle cells and is responsible for the development of pulmonary arterial hypertension. However, the A2B1 function that's never really been investigated in pulmonary arterial hypertension. Dr. Carolyn Lam: Oh, Greg, that's not only fascinating, but so beautifully described. Thank you. What did they find? Dr. Greg Hundley: Right, Carolyn. These authors found that A2B1 expression and it's nuclear localization are increased in human pulmonary arterial hypertension, pulmonary arterial smooth muscle cells. Using bioinformatics, they identified three known motifs of A2B1 and all mRNAs carrying them and demonstrated the complimentary non-redundant function of A2B1 motifs as all motifs are implicated in different aspects of the cell cycle. In addition, they showed that pulmonary arterial smooth muscle cells and A2B1 promote the expression of its targets. Additionally, in vivo A2B1 inhibition in the lungs rescued pulmonary hypertension in rats. And so, Carolyn, through the integration of computational and experimental biology, this team study revealed the role of A2B1 as a master orchestrator of pulmonary arterial smooth muscle cells in pulmonary hypertension and that phenotype and its relevance as a therapeutic target in pulmonary arterial hypertension. Dr. Carolyn Lam: Wow, that's super, Greg. Thanks. Shall we go through what else is in today's issue? Dr. Greg Hundley: You bet, Carolyn. There's a Research Letter from Professor Mustroph entitled, “Empagliflozin Inhibits Cardiac Late Sodium Current versus Calcium Calmodulin‐dependent Kinase II.” Dr. Carolyn Lam: There's also an exchange of letters between Doctors Omarjee and Diederichsen regarding vitamin K2 and D in patients with aortic valve calcification: [an] absence of evidence might not be evidence of absence? And finally, there's an On My Mind paper by me and Scott Solomon and it's entitled, “Delivering Therapeutic Efficacy Across the Ejection Fraction Spectrum of Heart Failure.” But let's go on now to talk about the Factor XI inhibitor, shall we, Greg? Dr. Greg Hundley: You bet. Well, listeners, welcome to this feature discussion on October 18th at a very special article today. And we have with us the lead author, Dr. Sunil Rao from NYU in New York City and also our associate guest editor as well as editorialist, Dr. Gregory Lip from Liverpool. Welcome, gentlemen. Sunil, we'll start with you. Can you describe for us some of the background information that went into the preparation of your study and what was the hypothesis that you wanted to address? Dr. Sunil Rao: Yeah, great. Thanks so much, Greg. It's a real pleasure to be here with you. The background of the PACIFIC-AMI study is really rooted in the fact that patients who have acute myocardial infarction are really at risk for recurrent thrombotic events, even after their event. And this risk continues despite the fact that we have evidence based therapies that are really around targeting the platelet as well as aspects of the coagulation cascade. There have been studies that have looked at the use of dual antiplatelet therapy plus an anticoagulant or single antiplatelet therapy plus an anticoagulant. And those studies have shown a benefit. However, their clinical use is limited because of the bleeding risk. Factor XI is an interesting target, because factor XI is likely involved in the amplification of thrombin generation after plaque rupture. But it really doesn't play much of a role in hemostasis. And so, as a target in reducing events after acute coronary syndrome, activated factor XI is a very attractive one. And so, the hypothesis of this study was that a highly bioavailable oral, direct, selective activated factor XI inhibitor called asundexian would be safe and effective in the treatment of patients who experience acute coronary syndrome at reducing adverse events. Now, this is a phase two study, so it really wasn't powered for clinical events. It was really a dose-finding study, so it was really looking at adverse events and sort of bleeding complications. Dr. Greg Hundley: Very nice. Asundexian, a new factor XI inhibitor. And Sunil, can you describe for us your study design and then maybe a little bit more about the study population, how many subjects? Dr. Sunil Rao: Sure. Again, this is a phase two study. It was a randomized, double-blind, parallel-group design where patients, who were admitted with acute coronary syndrome were randomized to three different doses of asundexian and or placebo in a one-to-one to one-to-one fashion. Patients who met criteria for enrollment were: patients who were admitted with a diagnosis of acute MI; if they were older than or equal to 45 years of age; they were hospitalized in acute coronary syndrome that did not occur in the context of revascularization, so it was not a type 4 event; and they were planned to be treated with dual antiplatelet therapy after hospital discharge. Dr. Greg Hundley: Sunil, thank you for describing this very interesting study design. Now, how many subjects did you include and could you just describe for us the study population? Dr. Sunil Rao: We had a total of 1,601 patients that were randomized at 157 centers in 14 countries between June 2020 and July 2021. And in order to be eligible for enrollment into the study: patients had to be admitted with a diagnosis of acute MI, they had to be greater than or equal to 45 years of age, and be hospitalized with that acute MI that did not occur in the context of revascularization, so type 4 MIs were excluded. The other inclusion criteria was that they had to be planned to be treated with dual antiplatelet therapy after hospital discharge. Now, we allowed randomization up to five days after hospital admission and randomization occurred after patients were clinically stabilized and any planned PCI was performed. We included both patients with STEMI as well as non-ST segmental elevation ACS, but we capped the number of patients with STEMI that were included to no more than 50%. Now, the main exclusion criteria were things that you would expect for a phase two trial. Obviously, hemodynamic instability at the time of randomization, active bleeding or bleeding dialysis, severe renal dysfunction, planned use of full-dose anticoagulation. Dr. Greg Hundley: Very nice. And so, we have several doses of this new factor XI inhibitor. Describe for us your study results? Dr. Sunil Rao: Again, this was a phase two trial that was really looking at safety and adverse events as you would expect. The study groups were pretty balanced across all of the dosing arms. When we looked at the pharmacokinetic and pharmacodynamic data, we found something really interesting, which was that there was a dose relationship between the dose of asundexian and the factor XIa activity. Factor XIa is activated factor XI. The higher the dose, the more suppression of factor XI activity. In fact, the highest dose nearly eliminated factor XI activity. The drug clearly works in the way that it was intended. Now again, the clinical data, it wasn't powered for clinical data. But when we look at the bleeding results, we found that there was in fact an increase in bleeding as the dose of asundexian increased. The overall rate of bleeding in the highest dose of asundexian was in 50 milligrams was 10.5% with type 2 or 3 or 5 BARC bleeding, a placebo is about 9.02%. Again, the efficacy outcomes, very, very low rates of overall events. Again, not powered to show a difference. Essentially, very similar across all the arms. Dr. Greg Hundley: And did you find the same results for the men and the women? And what about older individuals and younger individuals? Dr. Sunil Rao: Yeah. We did look at some subgroups. And you had to be a little bit cautious because again, the trial itself is relatively small. I mean, we didn't notice any significant patterns across these subgroups. And the overall interaction p-values were really non-significant. But I think what this does show is like a phase two trial that the drug works as in the way that it's intended. Overall, safety was as expected. And I think it really sets up data for a larger study. Dr. Greg Hundley: Well, listeners, what a fantastic presentation. And now, we're going to turn to our guest editor and editorialist, Dr. Gregory Lip from Liverpool. Greg, I know working for circulation, you have many papers come across your desk. What attracted you to this particular paper? And then maybe secondly, can you help us put the results of this study in the context of other studies that have been evaluating these factor XI therapies? Dr. Gregory Lip: Thanks, Greg. Well, I think this is an important paper, because it is a phase two trial with a novel, orally bioavailable inhibitor factor XI. And this is intriguing because factor XI efficiency in humans and experimentally in animals is associated with a reduced risk of thrombotic events like stroke or venous thromboembolism. But spontaneous bleeding is rare and also bleeding in response to trauma or surgery is much milder. Really it's the holy grail of trying to get an anticoagulant that reduces thrombosis but doesn't cause an excess of bleeding. Now, this was the quest with different anticoagulants. And I think it was very exciting to see this particular paper in the patients who've had an acute coronary syndrome, because there was a lot of interest in the use of anticoagulants, particularly in combination with antiplatelet therapy from trials such as ATLAS and COMPASS, where there was certainly a reduction in adverse cardiovascular events. But a downside with those drugs and when using combination, was an excess of bleeding by the combination of the available anticoagulants now plus antiplatelets. The factor XIs agents offered the possibilities we might have combination therapy to reduce cardiovascular events but not causing an excess of bleeding. Dr. Greg Hundley: Well, listeners, what a wonderful discussion that we've had here. Let's circle back with both individuals. Sunil, we'll start with you. What do you see as the next study to really be performed in this sphere of research? Dr. Sunil Rao: I think that factor XI is a very attractive target in patients with acute coronary syndrome. Again, the rationale for why we did this phase two trial was to show that inhibition of activated factor XI should result in a low rate of ischemic events without a significant increase in bleeding. This phase two trial was really to try and decide which doses result in potent inhibition of factor XIa and potentially which doses should be carried forward into a larger study. What we found in the PACIFIC-AMI trial was that the doses of asundexian and the factor XIa inhibitor were very, very well tolerated with a low rate of adverse events. It resulted in a dose-dependent near complete inhibition of factor XIa activity without a significant increase in bleeding and a low rate of ischemic events. I think, again, it's a very attractive target in patients with ACS and this really provides support for a larger adequately powered clinical trial in patients with acute coronary syndrome that is really looking at clinical events such as MACE as well as bleeding. Dr. Greg Hundley: And Greg as an editorialist, what did you see with this paper? Maybe some unanswered questions that we'd like to pursue further? Dr. Gregory Lip: Well, I think this does raise a lot of questions in the sense that it'll be interesting because as a phase two trial, it's a relatively moderate sized trial. It's not like a phase three large outcome trial and phase two trials also testing different doses of the novel agent. We need to see the definitive phase three trial and to look at the magnitude of benefit versus potential for bleeding if in the large phase three trial and obviously, the net clinical benefit and importantly are some of the subgroups: ST elevation, myocardial infarction, undergoing primary PCI, for example, those with renal impairment. And I think particularly intriguing would be looking at the patients in this scenario who get the new antiplatelet drugs such as ticagrelor and prasugrel. And the reason I say that is what we have with warfarin or Coumadin and from the current DOACs or NOACs, depending on the risk side upon. We refer to them, that's the direct oral anticoagulants or non-vitamin K antagonist or anticoagulants. Well, if you give a more potent antiplatelet like prasugrel or ticagrelor, the risk of bleeding not surprisingly is higher. Hence, the guidelines recommend that if you use an anticoagulant or a DOAC, you use it with a P2Y 12 inhibitor clopidogrel as opposed to the more potent ones. If this new class of drugs, the factor XI inhibitors can work well in combination with one of the more potent antiplatelets without causing an excessive bleeding, again, this is going to be a substantial advance. Well, with these new class of anticoagulants, will be really interesting to see the phase three trials when applied to other chronic conditions. For example, stroke prevention and atrial fibrillation. And the other category of patients would be those who've had an embolic stroke of uncertain source or ESUS or in old terminology cryptogenic stroke. With the ESUS group of patients, they're currently treated with aspirin because the trials which tried a NOAC or DOAC, they were not showing a positive result. They'll be interesting again with the factor XI inhibitors, whether we are going to see this benefit with the reduction in recurrence stroke with no excessive bleeding. Dr. Greg Hundley: Very nice. Well, listeners, we want to thank Dr. Sunil Rao from NYU in New York City and Dr. Gregory Lip from the University of Liverpool for bringing us this study highlighting that in patients with recent acute myocardial infarction, three doses of asundexian when added to aspirin plus a P2Y 12 inhibitor resulted in dose-dependent near complete inhibition of factor XIa activity without a significant increase in bleeding and a low rate of ischemic events. And certainly, the data from this study support the investigation of asundexian at a dose of 50 milligrams daily in an adequately powered clinical trial of patients following acute myocardial infection. Well, on behalf of Carolyn and myself, we want to wish you a great week and we will catch you next week On the Run. This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Telomere length is a recognized biomarker of aging and it plays an important role in longevity medicine. On today’s episode I have a renowned expert on telomere biology and longevity medicine, Dr. Joseph Raffaele, MD. Dr. Raffaele received his Bachelor of Arts in philosophy from Princeton University and his MD from Hahnemann University Medical School. He did his residency at The New York Hospital-Cornell University Medical Center. Dr. Raffaele is board certified in internal medicine, and is a diplomat of the American Board of Age Management Medicine. Dr. Raffaele is the co-founder and CEO of PhysioAge, a software analytic tool that enables next-generation medical consultations by comparing patient data to populations and optimal values to form a deeper understanding of the patients aging process. Their mission is to enhance the delivery of proactive medicine. Topics covered: What it means to practice longevity medicine Normal vs optimal results and the impact that has on our quality of life Improvement in GylcanAge/PhyscioAge scores when patients optimize their hormones The importance of estradiol for arterial health What is a telomere? How do you test the length of someones telomere? How do you improve the length of your telomere? What is TA-65? CMV virus and herpes virus Rapamycin This podcast is NOT medical advice. To check out Dr. Raffaele's PhysioAge software CLICK HERE To visit Dr. Raffaele's website CLICK HERE To purchase the book Lifespan: Why We Age―and Why We Don't Have To CLICK HERE Dr. Raffaele's INSTAGRAM Dr. Raffaele's TWITTER To reach Amy Stuttle for questions or comments please email podcast@amystuttle.cpm To visit Victory Men's Health webiste CLICK HERE Victory Men's Health INSTAGRAM Dr. Raffael's presentation on telomeres at A4M CLICK HERE Studies: Double-Blind, Placebo-Controlled, Randomized Clinical Trial Demonstrates Telomerase Activator TA-65 Decreases Immunosenescent CD8+CD28- T Cells in Humans What if there’s no such thing as “aging”? Rapamycin for longevity: opinion article Telomerase reactivation reverses tissue degeneration in aged telomerase-deficient mice Corroboration of a Major Role for Herpes Simplex Virus Type 1 in Alzheimer’s Disease A natural product telomerase activator as part of a health maintenance program

Join us after hours at Dr. Bryan A. Cotton's pop-up bourbon bar at the AAST 2022 Meeting in Chicago. In this FANTASTIC & FUN episode, we talk amongst friends about cutting edge research at this year's meeting. To no one's surprise, coagulopathy, damage control resuscitation, whole blood, and factor replacement therapy just happen to be but a few of the topics discussed on Rounds.Time Stamps:00:12 AAST 2022 - Intro00:42 Sex diamoprhisms in coagulation01:52 Hemostatic profiles of female donors02:48 Pediatric whole blood (WB) is safe03:10 WB for TBI03:31 Leukoreduction is unnecessary05:30 TXA, TEG  and trauma06:44 STAAMP trial07:21 TXA: go early, big or go home07:52 Calcium...early!09:33 Canadian perspective on TXA and TEG – Neil Perry from London, ON11:25 Nori Bradley from Edmonton, AB13:53 Jordan Weinberg, not Canadian – Phoenix, AZ16:12 Issues with WB – COMBAT vs PAMPer17:31 Cold stored platelets18:22 Rapid transfusers and whole blood: Only the strong survive!!19:42 How are we doing with our resuscitation? 1:1:1 is just the beginning, not the end!21:44 Timing is everything!23:38 Plasma first resuscitation: “…God damn good!” -BAC24:37 Dr. Joshua B. Brown - Pittsburgh, PA25:31 More Canadian perspectives with Perry and Bradley29:48 Less is best!31:27 Prothrombin complex concentrate: Yay or nay?32:18 More on the endotheliopathy of trauma33:38 Just messing around and having a blast34:22 What was the best bourbon tonight?References:CRASH-2 trial collaborators, Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejía-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14. PMID: 20554319.Gruen DS, Guyette FX, Brown JB, Okonkwo DO, Puccio AM, Campwala IK, Tessmer MT, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Neal MD, Zuckerbraun BS, Yazer MH, Billiar TR, Sperry JL. Association of Prehospital Plasma With Survival in Patients With Traumatic Brain Injury: A Secondary Analysis of the PAMPer Cluster Randomized Clinical Trial. JAMA Netw Open. 2020 Oct 1;3(10):e2016869. doi: 10.1001/jamanetworkopen.2020.16869. PMID: 33057642; PMCID: PMC7563075.Guyette FX, Brown JB, Zenati MS, Early-Young BJ, Adams PW, Eastridge BJ, Nirula R, Vercruysse GA, O'Keeffe T, Joseph B, Alarcon LH, Callaway CW, Zuckerbraun BS, Neal MD, Forsythe RM, Rosengart MR, Billiar TR, Yealy DM, Peitzman AB, Sperry JL; STAAMP Study Group. Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury: A Double-blind, Placebo-Controlled, Randomized Clinical Trial. JAMA Surg. 2020 Oct 5;156(1):11–20. doi: 10.1001/jamasurg.2020.4350. Epub ahead of print. Erratum in: JAMA Surg. 2021 Jan 1;156(1):105. PMID: 33016996; PMCID: PMC7536625.Moore HB, Moore EE, Chapman MP, McVaney K, Bryskiewicz G, Blechar R, Chin T, Burlew CC, Pieracci F, West FB, Fleming CD, Ghasabyan A, Chandler J, Silliman CC, Banerjee A, Sauaia A. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018 Jul 28;392(10144):283-291. doi: 10.1016/S0140-6736(18)31553-8. Epub 2018 Jul 20. PMID: 30032977; PMCID: PMC6284829.Pusateri AE, Moore EE, Moore HB, Le TD, Guyette FX, Chapman MP, Sauaia A, Ghasabyan A, Chandler J, McVaney K, Brown JB, Daley BJ, MSupport the show

Beyond the surface. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trialA modern landmark glaucoma trial and first-of-its-kind that provides surprising and useful outcomes for current practice and research. Can the visual field be preserved with an intraocular-pressure-lowering drug in patients with open-angle glaucoma? Dr Jennifer Fan Gaskin explores Latanoprost for open-angle glaucoma.View article hereJennifer Fan Gaskin is a Consultant Ophthalmologist at the Royal Victorian Eye and Ear Hospital and a Principal Investigator at the Centre for Eye Research Australia where she leads Ocular Fibrosis Research. In 2021 she was named a Superstar of STEM by Science and Technology Australia. She is a Director of Australian Vision Research (formerly known as the Ophthalmic Research Institute of Australia) and a board member of the Australian and New Zealand Glaucoma Society.

How cranberries could improve memory and ward off dementia Researchers have found that eating cranberries could improve memory, ward off dementia, and reduce 'bad' cholesterol. The research team studied the benefits of consuming the equivalent of a cup of cranberries a day among 50 to 80-year-olds. They hope that their findings could have implications for the prevention of neurodegenerative diseases such as dementia. #cranberries #memory #dementia Emma Flanagan, Donnie Cameron, Rashed Sobhan, Chloe Wong, Matthew G. Pontifex, Nicole Tosi, Pedro Mena, Daniele Del Rio, Saber Sami, Arjan Narbad, Michael Müller, Michael Hornberger, David Vauzour. Chronic Consumption of Cranberries (Vaccinium macrocarpon) for 12 Weeks Improves Episodic Memory and Regional Brain Perfusion in Healthy Older Adults: A Randomised, Placebo-Controlled, Parallel-Groups Feasibility Study. Frontiers in Nutrition, 2022; 9 DOI: 10.3389/fnut.2022.849902 Cranberry, cranberries, polyphenols, memory, recall, dementia, ldl, nucleus accumbens, medial temporal, prefrontal, episodic memory, visual episodic memory, ), neural functioning, brain perfusion, oxygen, glucose, brain energy, Vaccinium macrocarpon #cranberries #memory #dementia #recall #polyphenol #perfusion #accumbens #episodic #temporal #Vacciniummacrocarpon #ldl --- Support this podcast: https://anchor.fm/ralph-turchiano/support

Allmennlege Sjur Even Aunmo fikk sparken som fastlegevikar fordi han fortalte pasienter at COVID-19-vaksinen kan gi bivirkninger. Dette er noe han plikter å gjøre ifølge Pasient- og brukerrettighetsloven § 4. Aunmo har satt seg grundig inn i forskningen på disse vaksinene, og påpeker at de for det første er eksperimentelle på dette stadiet. Videre er det Pfizer selv som har finansiert sin studie, en ansatt fikk sparken fordi hun varslet om at blindingen (anonymiseringen) var brutt, personer har blitt tatt ut av studien uten at det er oppgitt noen god grunn og rådataene for studien er ikke offentliggjort. Selv har han sett flere bivirkninger, som kraftige menstruasjonsblødninger, hjerteproblemer og alvorlige nevrologiske bivirkninger. Han frykter at underrapportering kan medføre at bivirkningstallene fra Statens legemiddelverk er for lave. KILDER:› COVID-19 • https://clinicaltrials.gov/ct2/show/NCT04368728 • https://clinicaltrials.gov/ct2/show/NCT04470427 • Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine • Efficacy of the mRNA-1273 SARS-CoV-2 Vaccine at Completion of Blinded Phase • https://covid-nma.com/vaccines/variants/ • https://covid-nma.com/vaccines/index.php?search_by=1&search_input=1273&submit=Validate#moteur_recherche • How significant is the Ventavia scandal? • Covid-19: Researcher blows the whistle on data integrity issues in Pfizer's vaccine trial • CDC-vurdering av Modernas studie • https://www.bmj.com/company/newsroom/editors-call-for-covid-19-vaccine-and-treatment-data-to-be-available-for-public-scrutiny/ • https://www.nrk.no/norge/norges-forste-koronavaksine-settes-1.15304159, lest 20.3.22 • https://tidsskriftet.no/2021/05/originalartikkel/dodsfall-i-sykehjem-etter-covid-19-vaksine ◦ https://www.fhi.no/hn/helseregistre-og-registre/dodsarsaksregisteret/tall-for-covid-19-assosierte-dodsfall-i-dodsarsaksregisteret-i-2020/ ◦ https://legemiddelverket.no/Documents/Bivirkninger%20og%20sikkerhet/Rapporter%20og%20oversikter/Koronavaksiner/20211028%20Rapport%20over%20meldte%20bivirkninger%20av%20koronavaksine.pdf ◦ Surveillance for safety after immunization; vaccine adverse event reporting system (VAERS) - United States 1991-2001 ◦ Mandatory Reporting of Infectious Diseases by Clinicians ◦ Myopericarditis after vaccination, Vaccine Adverse Event Reporting System (VAERS), 1990–2018 ◦ https://www.nrk.no/livsstil/_-en-medisinsk-katastrofe-1.10880384 ◦ https://legemiddelverket.no/nyheter/bivirkninger-av-vaksiner-hva-lerte-vi-av-pandemien-i-2009#ble-det-meldt-noen-d%C3%B8dsfall? ◦ The illusion of evidence based medicine ‧ Amerikanske Centers for Disease Control om underrapportering ‧ Studie fra det medisinske tidsskriftet JAMA om underrapportering ‧ Studie fra det medisinske tidsskriftet Vaccine om underrapportering ‧ Fra det amerikanske registrerings-systemet VAERS om deres system ‧ Randomised Clinical Trials of COVID-19 Vaccines: Do Adenovirus-Vector Vaccines Have Beneficial Non-Specific Effects? ‧ Lancet 2022. Samlestudie RCT. Obs: Preprrint, ikke fagfallevurdert enda. Signifikant og stor forskjell mellom Pfizer/Moderna og svekket-virus-vaksiner.› FETT • Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis • Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73) • Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease • The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials • Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art Review • http://dx.doi.org/10.1136/openhrt-2014-000196 • Fat or fiction: the diet-heart hypothesis | BMJ Evidence-Based Medicine • https://www.mn.uio.no/ibv/tjenester/kunnskap/plantefys/leksikon/h/herdet-fett.html • 4-Hydroxynonenal-Derived Advanced Lipid Peroxidation End Products Are Increased in Alzheimer's Disease • https://doi.org/10.1016/j.freeradbiomed.2006.07.021 ◦ Dietary stearic acid regulates mitochondria in vivo in humans - Nature Communications ◦ 33.9 10.17140/AFTNSOJ-1-123 Oxidation of Polyunsaturated Fatty Acids and its Impact on Food Quality and Human Health ◦ Dietary oxidized n-3 PUFA induce oxidative stress and inflammation: role of intestinal absorption of 4-HHE and reactivity in intestinal cells ◦ Effect of the Type of Frying Culinary Fat on Volatile Compounds Isolated in Fried Pork Loin Chops by Using SPME-GC-MS› STATINER • BMJ RCT sysrew/meta Statins for the primary prevention of cardiovascular disease: an overview of systematic reviews • The effect of statins on average survival in randomised trials, an analysis of end point postponement • JAMA RCT-meta 2010 - Statins and All-Cause Mortality in High-Risk Primary Prevention: A Meta-analysis of 11 Randomized Controlled Trials Involving 65 229 Participants • https://www.felleskatalogen.no/medisin/lipitor-upjohn-eesv-pfizer-560999 • https://www.felleskatalogen.no/medisin/zocor-organon-565655 • https://www.legemiddelhandboka.no/L8.15.1/Statiner • Statins - a call for transparent data - The BMJ • Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women's Health Initiative› KJØTT • Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes A Systematic Review of Randomized Trials • Total red meat intake of ≥0.5 servings/d does not negatively influence cardiovascular disease risk factors: a systemically searched meta-analysis of randomized controlled trials› KOLESTEROL • Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review • Inborn coagulation factors are more important cardiovascular risk factors than high LDL-cholesterol in familial hypercholesterolemia • PMID: 18277343 ApoB/ApoA1 ratio and subclinical atherosclerosis ◦ Cigarette smoking renders LDL susceptible to peroxidative modification and enhanced metabolism by macrophages ◦ Cigarette Smoking Potentiates Endothelial Dysfunction of Forearm Resistance Vessels in Patients With Hypercholesterolemia: Role of Oxidized LDL ◦ Passive Smoking Induces Atherogenic Changes in Low-Density Lipoprotein ◦ Smoking and smoking cessation—The relationship between cardiovascular disease and lipoprotein metabolism: A review ◦ Smoking and Cardiovascular Disease ◦ LDL biochemical modifications: a link between atherosclerosis and aging ◦ Association Between Circulating Oxidized LDL and Atherosclerotic Cardiovascular Disease: A Meta-analysis of Observational Studies› KARBOHYDRAT • https://www.helsedirektoratet.no/rapporter/anbefalinger-om-kosthold-ernaering-og-fysisk-aktivitet/Anbefalinger%20om%20kosthold%20ern%C3%A6ring%20og%20fysisk%20aktivitet.pdf/_/attachment/inline/2f5d80b2-e0f7-4071-a2e5-3b080f99d37d:2aed64b5b986acd14764b3aa7fba3f3c48547d2d/Anbefalinger%20om%20kosthold%20ern%C3%A6ring%20og%20fysisk%20aktivitet.pdf› DIABETES • JAMA WMI 2006Low-Fat Dietary Pattern and Risk of Cardiovascular DiseaseThe Women's Health Initiative Randomized Controlled Dietary Modification Trial – se side 661, økt hjerte/kar-risk sfa. Lavfett-diett • AmJourClinNutr WMI 2011 Effects of a low-fat dietary intervention on glucose, insulin, and insulin resistance in the Women's Health Initiative (WHI) Dietary Modification trial • AOCS Lipids (lavranket journal) Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet • Small Dense Low-Density Lipoprotein-Cholesterol Concentrations Predict Risk for Coronary Heart Disease- ArtThromVas prospektiv kohort • Glycation as an atherogenic modification of LDL : Current Opinion in Lipidology • Glycosylated low density lipoprotein is more sensitive to oxidation: implications for the diabetic patient? • Loss of Endothelial Glycocalyx During Acute Hyperglycemia Coincides With Endothelial Dysfunction and Coagulation Activation In Vivo› DIABETES-DEMENS • AgeingResearchRewiew 2019 sysrew/meta 144 prospektive studier – 58 % økt risiko demens • Int. Med. Journ. 2012 meta-analyse av prospektive kohorter dia-demens-risk 51 % økning demens • Lancet Neurology 2006, sysrew lavere evidensgrad. Risk of dementia in diabetes mellitus: a systematic review • Diabetes mellitus and the risk of dementia - The Rotterdam Study – prospektiv kohort • JDST 2008 Alzheimer's Disease is Type 3 Diabetes—Evidence Reviewed • MDPI 2015 Evaluating the Association between Diabetes, Cognitive Decline and Dementia • Ketone Bodies Promote Amyloid-β1–40 Clearance in a Human in Vitro Blood–Brain Barrier Model - 2020 • Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implication - 2018 • APOE4 leads to blood–brain barrier dysfunction predicting cognitive decline - 2020› HJERTE- OG KAR-SYKDOM • 10.1001/jamacardio.2020.7073 Association of Lipid, Inflammatory, and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women› PLANTE-ANTINÆRINGSSTOFF OG VERN • Food Chemistry 2008 Bioaccessibility of Ca, Mg, Mn and Cu from whole grain tea-biscuits: Impact of proteins, phytic acid and polyphenols • Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. • Oxalate content of foods and its effect on humans • Lectins as plant defense proteins • Effects of wheat germ agglutinin on human gastrointestinal epithelium: Insights from an experimental model of immune/epithelial cell interaction • Ingestion of subthreshold doses of environmental toxins induces ascending Parkinsonism in the rat • Identification of intact peanut lectin in peripheral venous blood • Do dietary lectins cause disease? BMJ • Lectin binding of endometrium in women with unexplained infertility • Changes in organs and tissues induced by feeding of purified kidney bean (Phaseolus vulgaris) lectins • Insecticidal Activity of Plant Lectins and Potential Application in Crop Protection • Bound Lectins that Mimic Insulin Produce Persistent Insulin-Like Activities • Contribution of leptin receptor N-linked glycans to leptin binding • Potato lectin activates basophils and mast cells of atopic subjects by its interaction with core chitobiose of cell-bound non-specific immunoglobulin E • 3.0.CO;2-T Dietary lectins can induce in vitro release of IL-4 and IL-13 from human basophils • Secondary Oxalate Nephropathy: A Systematic Review • The effect of tea on iron absorption • PMID: 1862 Disler PB, Lynch SR, Torrance JD, et al. The mechanism of the inhibition of iron absorption by tea. The South African Journal of Medical Sciences. 1975 ;40(4):109-116. • Effects of saponins and glycoalkaloids on the permeability and viability of mammalian intestinal cells and on the integrity of tissue preparationsin vitro • The biological action of saponins in animal systems: a review • Small Amounts of Gluten in Subjects With Suspected Nonceliac Gluten Sensitivity: A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial ◦ Obs: Kapsler brukt i studien ble supplert av legemiddelfirmaet Giuliani, som lager glutenfritt brød.› LEKK TARM • Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines • Gliadin Induces an Increase in Intestinal Permeability and Zonulin Release by Binding to the Chemokine Receptor CXCR3 • AmJourClinNu 2009 Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) • FODMAP diet modulates visceral nociception by lipopolysaccharide-mediated intestinal inflammation and barrier dysfunction • 73.3 10.12688/f1000research.20510.1 All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases› LAVKARB • Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors • BritJourNutr 2013 RCT-meta Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials • AnnIntMed 2004 A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial • JAMAIntMed A Randomized Trial of a Low-Carbohydrate Diet vs Orlistat Plus a Low-Fat Diet for Weight Loss • NEJM RCT 2006 A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity • Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes—a randomized controlled trial • Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial • Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents • Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal WomenThe A TO Z Weight Loss Study: A Randomized Trial • Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adolescents • Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial› FRUKTOSE • JourHepatology 2021 Fructose- and sucrose- but not glucose-sweetened beverages promote hepatic de novo lipogenesis: A randomized controlled trial • Effects of fructose restriction on liver steatosis (FRUITLESS); a double-blind randomized controlled trial› KETOGENISITET/KREFT • https://oslo-universitetssykehus.no/behandlinger/pet-undersokelse • https://stanfordhealthcare.org/medical-tests/p/pet-scan/what-to-expect.html • https://www.sciencedirect.com/topics/medicine-and-dentistry/warburg-effect • The Warburg Effect: How Does it Benefit Cancer Cells? • NutrCanc 2019 Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study • Dietary Glycemic Load and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings From CALGB 89803 • Ketogenic diet in cancer therapy› IATROGEN SKADE • https://tidsskriftet.no/2000/10/kronikk/uheldige-hendelser-i-helsetjenesten-forebygging-og-handteringDownload this episodeRecorded: 2022-05-02Published: 2022-05-22

Allmennlege Sjur Even Aunmo fikk sparken som fastlegevikar fordi han fortalte pasienter at COVID-19-vaksinen kan gi bivirkninger. Dette er noe han plikter å gjøre ifølge Pasient- og brukerrettighetsloven § 4. Aunmo har satt seg grundig inn i forskningen på disse vaksinene, og påpeker at de for det første er eksperimentelle på dette stadiet. Videre er det Pfizer selv som har finansiert sin studie, en ansatt fikk sparken fordi hun varslet om at blindingen (anonymiseringen) var brutt, personer har blitt tatt ut av studien uten at det er oppgitt noen god grunn og rådataene for studien er ikke offentliggjort. Selv har han sett flere bivirkninger, som kraftige menstruasjonsblødninger, hjerteproblemer og alvorlige nevrologiske bivirkninger. Han frykter at underrapportering kan medføre at bivirkningstallene fra Statens legemiddelverk er for lave. KILDER:› COVID-19 • https://clinicaltrials.gov/ct2/show/NCT04368728 • https://clinicaltrials.gov/ct2/show/NCT04470427 • Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine • Efficacy of the mRNA-1273 SARS-CoV-2 Vaccine at Completion of Blinded Phase • https://covid-nma.com/vaccines/variants/ • https://covid-nma.com/vaccines/index.php?search_by=1&search_input=1273&submit=Validate#moteur_recherche • How significant is the Ventavia scandal? • Covid-19: Researcher blows the whistle on data integrity issues in Pfizer's vaccine trial • CDC-vurdering av Modernas studie • https://www.bmj.com/company/newsroom/editors-call-for-covid-19-vaccine-and-treatment-data-to-be-available-for-public-scrutiny/ • https://www.nrk.no/norge/norges-forste-koronavaksine-settes-1.15304159, lest 20.3.22 • https://tidsskriftet.no/2021/05/originalartikkel/dodsfall-i-sykehjem-etter-covid-19-vaksine ◦ https://www.fhi.no/hn/helseregistre-og-registre/dodsarsaksregisteret/tall-for-covid-19-assosierte-dodsfall-i-dodsarsaksregisteret-i-2020/ ◦ https://legemiddelverket.no/Documents/Bivirkninger%20og%20sikkerhet/Rapporter%20og%20oversikter/Koronavaksiner/20211028%20Rapport%20over%20meldte%20bivirkninger%20av%20koronavaksine.pdf ◦ Surveillance for safety after immunization; vaccine adverse event reporting system (VAERS) - United States 1991-2001 ◦ Mandatory Reporting of Infectious Diseases by Clinicians ◦ Myopericarditis after vaccination, Vaccine Adverse Event Reporting System (VAERS), 1990–2018 ◦ https://www.nrk.no/livsstil/_-en-medisinsk-katastrofe-1.10880384 ◦ https://legemiddelverket.no/nyheter/bivirkninger-av-vaksiner-hva-lerte-vi-av-pandemien-i-2009#ble-det-meldt-noen-d%C3%B8dsfall? ◦ The illusion of evidence based medicine ‧ Amerikanske Centers for Disease Control om underrapportering ‧ Studie fra det medisinske tidsskriftet JAMA om underrapportering ‧ Studie fra det medisinske tidsskriftet Vaccine om underrapportering ‧ Fra det amerikanske registrerings-systemet VAERS om deres system ‧ Randomised Clinical Trials of COVID-19 Vaccines: Do Adenovirus-Vector Vaccines Have Beneficial Non-Specific Effects? ‧ Lancet 2022. Samlestudie RCT. Obs: Preprrint, ikke fagfallevurdert enda. Signifikant og stor forskjell mellom Pfizer/Moderna og svekket-virus-vaksiner.› FETT • Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis • Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73) • Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease • The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials • Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art Review • http://dx.doi.org/10.1136/openhrt-2014-000196 • Fat or fiction: the diet-heart hypothesis | BMJ Evidence-Based Medicine • https://www.mn.uio.no/ibv/tjenester/kunnskap/plantefys/leksikon/h/herdet-fett.html • 4-Hydroxynonenal-Derived Advanced Lipid Peroxidation End Products Are Increased in Alzheimer's Disease • https://doi.org/10.1016/j.freeradbiomed.2006.07.021 ◦ Dietary stearic acid regulates mitochondria in vivo in humans - Nature Communications ◦ 33.9 10.17140/AFTNSOJ-1-123 Oxidation of Polyunsaturated Fatty Acids and its Impact on Food Quality and Human Health ◦ Dietary oxidized n-3 PUFA induce oxidative stress and inflammation: role of intestinal absorption of 4-HHE and reactivity in intestinal cells ◦ Effect of the Type of Frying Culinary Fat on Volatile Compounds Isolated in Fried Pork Loin Chops by Using SPME-GC-MS› STATINER • BMJ RCT sysrew/meta Statins for the primary prevention of cardiovascular disease: an overview of systematic reviews • The effect of statins on average survival in randomised trials, an analysis of end point postponement • JAMA RCT-meta 2010 - Statins and All-Cause Mortality in High-Risk Primary Prevention: A Meta-analysis of 11 Randomized Controlled Trials Involving 65 229 Participants • https://www.felleskatalogen.no/medisin/lipitor-upjohn-eesv-pfizer-560999 • https://www.felleskatalogen.no/medisin/zocor-organon-565655 • https://www.legemiddelhandboka.no/L8.15.1/Statiner • Statins - a call for transparent data - The BMJ • Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women's Health Initiative› KJØTT • Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes A Systematic Review of Randomized Trials • Total red meat intake of ≥0.5 servings/d does not negatively influence cardiovascular disease risk factors: a systemically searched meta-analysis of randomized controlled trials› KOLESTEROL • Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review • Inborn coagulation factors are more important cardiovascular risk factors than high LDL-cholesterol in familial hypercholesterolemia • PMID: 18277343 ApoB/ApoA1 ratio and subclinical atherosclerosis ◦ Cigarette smoking renders LDL susceptible to peroxidative modification and enhanced metabolism by macrophages ◦ Cigarette Smoking Potentiates Endothelial Dysfunction of Forearm Resistance Vessels in Patients With Hypercholesterolemia: Role of Oxidized LDL ◦ Passive Smoking Induces Atherogenic Changes in Low-Density Lipoprotein ◦ Smoking and smoking cessation—The relationship between cardiovascular disease and lipoprotein metabolism: A review ◦ Smoking and Cardiovascular Disease ◦ LDL biochemical modifications: a link between atherosclerosis and aging ◦ Association Between Circulating Oxidized LDL and Atherosclerotic Cardiovascular Disease: A Meta-analysis of Observational Studies› KARBOHYDRAT • https://www.helsedirektoratet.no/rapporter/anbefalinger-om-kosthold-ernaering-og-fysisk-aktivitet/Anbefalinger%20om%20kosthold%20ern%C3%A6ring%20og%20fysisk%20aktivitet.pdf/_/attachment/inline/2f5d80b2-e0f7-4071-a2e5-3b080f99d37d:2aed64b5b986acd14764b3aa7fba3f3c48547d2d/Anbefalinger%20om%20kosthold%20ern%C3%A6ring%20og%20fysisk%20aktivitet.pdf› DIABETES • JAMA WMI 2006Low-Fat Dietary Pattern and Risk of Cardiovascular DiseaseThe Women's Health Initiative Randomized Controlled Dietary Modification Trial – se side 661, økt hjerte/kar-risk sfa. Lavfett-diett • AmJourClinNutr WMI 2011 Effects of a low-fat dietary intervention on glucose, insulin, and insulin resistance in the Women's Health Initiative (WHI) Dietary Modification trial • AOCS Lipids (lavranket journal) Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet • Small Dense Low-Density Lipoprotein-Cholesterol Concentrations Predict Risk for Coronary Heart Disease- ArtThromVas prospektiv kohort • Glycation as an atherogenic modification of LDL : Current Opinion in Lipidology • Glycosylated low density lipoprotein is more sensitive to oxidation: implications for the diabetic patient? • Loss of Endothelial Glycocalyx During Acute Hyperglycemia Coincides With Endothelial Dysfunction and Coagulation Activation In Vivo› DIABETES-DEMENS • AgeingResearchRewiew 2019 sysrew/meta 144 prospektive studier – 58 % økt risiko demens • Int. Med. Journ. 2012 meta-analyse av prospektive kohorter dia-demens-risk 51 % økning demens • Lancet Neurology 2006, sysrew lavere evidensgrad. Risk of dementia in diabetes mellitus: a systematic review • Diabetes mellitus and the risk of dementia - The Rotterdam Study – prospektiv kohort • JDST 2008 Alzheimer's Disease is Type 3 Diabetes—Evidence Reviewed • MDPI 2015 Evaluating the Association between Diabetes, Cognitive Decline and Dementia • Ketone Bodies Promote Amyloid-β1–40 Clearance in a Human in Vitro Blood–Brain Barrier Model - 2020 • Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implication - 2018 • APOE4 leads to blood–brain barrier dysfunction predicting cognitive decline - 2020› HJERTE- OG KAR-SYKDOM • 10.1001/jamacardio.2020.7073 Association of Lipid, Inflammatory, and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women› PLANTE-ANTINÆRINGSSTOFF OG VERN • Food Chemistry 2008 Bioaccessibility of Ca, Mg, Mn and Cu from whole grain tea-biscuits: Impact of proteins, phytic acid and polyphenols • Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. • Oxalate content of foods and its effect on humans • Lectins as plant defense proteins • Effects of wheat germ agglutinin on human gastrointestinal epithelium: Insights from an experimental model of immune/epithelial cell interaction • Ingestion of subthreshold doses of environmental toxins induces ascending Parkinsonism in the rat • Identification of intact peanut lectin in peripheral venous blood • Do dietary lectins cause disease? BMJ • Lectin binding of endometrium in women with unexplained infertility • Changes in organs and tissues induced by feeding of purified kidney bean (Phaseolus vulgaris) lectins • Insecticidal Activity of Plant Lectins and Potential Application in Crop Protection • Bound Lectins that Mimic Insulin Produce Persistent Insulin-Like Activities • Contribution of leptin receptor N-linked glycans to leptin binding • Potato lectin activates basophils and mast cells of atopic subjects by its interaction with core chitobiose of cell-bound non-specific immunoglobulin E • 3.0.CO;2-T Dietary lectins can induce in vitro release of IL-4 and IL-13 from human basophils • Secondary Oxalate Nephropathy: A Systematic Review • The effect of tea on iron absorption • PMID: 1862 Disler PB, Lynch SR, Torrance JD, et al. The mechanism of the inhibition of iron absorption by tea. The South African Journal of Medical Sciences. 1975 ;40(4):109-116. • Effects of saponins and glycoalkaloids on the permeability and viability of mammalian intestinal cells and on the integrity of tissue preparationsin vitro • The biological action of saponins in animal systems: a review • Small Amounts of Gluten in Subjects With Suspected Nonceliac Gluten Sensitivity: A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial ◦ Obs: Kapsler brukt i studien ble supplert av legemiddelfirmaet Giuliani, som lager glutenfritt brød.› LEKK TARM • Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines • Gliadin Induces an Increase in Intestinal Permeability and Zonulin Release by Binding to the Chemokine Receptor CXCR3 • AmJourClinNu 2009 Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) • FODMAP diet modulates visceral nociception by lipopolysaccharide-mediated intestinal inflammation and barrier dysfunction • 73.3 10.12688/f1000research.20510.1 All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases› LAVKARB • Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors • BritJourNutr 2013 RCT-meta Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials • AnnIntMed 2004 A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial • JAMAIntMed A Randomized Trial of a Low-Carbohydrate Diet vs Orlistat Plus a Low-Fat Diet for Weight Loss • NEJM RCT 2006 A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity • Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes—a randomized controlled trial • Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial • Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents • Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal WomenThe A TO Z Weight Loss Study: A Randomized Trial • Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adolescents • Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial› FRUKTOSE • JourHepatology 2021 Fructose- and sucrose- but not glucose-sweetened beverages promote hepatic de novo lipogenesis: A randomized controlled trial • Effects of fructose restriction on liver steatosis (FRUITLESS); a double-blind randomized controlled trial› KETOGENISITET/KREFT • https://oslo-universitetssykehus.no/behandlinger/pet-undersokelse • https://stanfordhealthcare.org/medical-tests/p/pet-scan/what-to-expect.html • https://www.sciencedirect.com/topics/medicine-and-dentistry/warburg-effect • The Warburg Effect: How Does it Benefit Cancer Cells? • NutrCanc 2019 Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study • Dietary Glycemic Load and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings From CALGB 89803 • Ketogenic diet in cancer therapy› IATROGEN SKADE • https://tidsskriftet.no/2000/10/kronikk/uheldige-hendelser-i-helsetjenesten-forebygging-og-handteringOpptaksdato: 2022-05-02Publiseringsdato: 2022-05-22Last ned episoden

If you've had the experience of walking through a meadow or trail in the woods and found yourself with a bristly rash on exposed parts of your limbs, you may have brushed up against some stinging nettle. Nettles are an herbaceous perennial flowering plant, native to Europe, Asia, northern Africa, and North America. Tune in to learn how nettles actually support vibrant health!   What is nettle? Nettle, or stinging nettle, is a shrub that comes from northern Europe and Asia. Its scientific name is Urtica dioica. If you've had the experience of walking through a meadow or trail in the woods and found yourself with a bristly rash on exposed parts of your limbs, you may have brushed up against some stinging nettle. Nettles are an herbaceous perennial flowering plant, native to Europe, Asia, northern Africa, and North America. The plant has many hollow stinging hairs called “trichomes” on its leaves and stems, which act like needles that inject histamine, formic acid and other chemicals that produce a stinging sensation. It's very high nutritional content has made it a popular food source steamed and eaten like spinach (it does loose the “sting” when cooked), taken as a tea made from the dried leaves to assist in the nutrition of expectant or nursing mothers, or for general tonic properties for good health. The leaves, stem, or root from the nettle plant can be crushed and made into powders, tinctures, creams, teas, and more. While people have used it for centuries as an herbal medicine, modern research also supports many of the potential health benefits of nettle and nettle tea. Stinging nettle's leaves and root provide a wide variety of nutrients, including: Vitamins: Vitamins A, C and K, as well as several B vitamins Minerals: Calcium, iron, magnesium, phosphorus, potassium and sodium Fats: Linoleic acid, palmitic acid, stearic acid and oleic acid Amino acids: All of the essential amino acids Polyphenols: Kaempferol, quercetin, caffeic acid, coumarins and other flavonoids Pigments: Beta-carotene, lutein, luteoxanthin and other carotenoids What's more, many of these nutrients act as antioxidants inside your body. Antioxidants are molecules that help defend your cells against damage from free radicals. Damage caused by free radicals is linked to aging, as well as cancer and other harmful diseases. Studies indicate that stinging nettle extract can raise blood antioxidant levels. Top 5 Benefits of Nettles 1. Urinary tract health Nettle may help flush harmful bacteria from the urinary tract. This can benefit people who have urinary conditions, such as benign prostatic hyperplasia (BPH). BPH causes an enlarged prostate gland in men. This can cause pain or other problems urinating. According to one 2013 study men with BPH who took nettle extract had fewer clinical symptoms than those who didn't. Nettle may also help support any medications you're taking for infections or conditions related to the urinary tract. Talk to your doctor first about any possible interactions between herbal remedies and medications you take. 2. Arthritis and pain Nettle has historically been used to treat pain and sore muscles, especially related to arthritis. The Arthritis Foundation suggests that nettle tea may also reduce the inflammation and pain association with osteoarthritis. 3. Blood sugar management Nettle has shown some promising effects on blood glucose levels. It may help the pancreas make or release more insulin, the hormone that lowers blood sugar. In a 2013 study, nettle leaf extract lowered blood glucose and A1C in a group of people with type 2 diabetes who were taking insulin as well as oral diabetes medications. 4. The power of polyphenols Nettle is high in plant chemicals called polyphenols. A review of the research on polyphenols suggests that these powerful compounds may play a role in the prevention and management of chronic diseases related to inflammation, such as diabetes, obesity, cancer, and heart disease. In particular, polyphenols from nettle extract have shown some exciting potential for treating breast cancer and prostate cancer. Plants like nettle also contain potent antioxidants, which are substances that protect the body from aging and cell damage. 5. May Treat Hay Fever Hay fever is an allergy that involves inflammation in the lining of your nose. Stinging nettle is viewed as a promising natural treatment for hay fever. Test-tube research shows that stinging nettle extracts can inhibit inflammation that can trigger seasonal allergies. This includes blocking histamine receptors and stopping immune cells from releasing chemicals that trigger allergy symptoms. However, human studies note that stinging nettle is equal to or only slightly better at treating hay fever than a placebo. While this plant may prove a promising natural remedy for hay fever symptoms, more long-term human studies are needed. How to make nettle tea You can buy nettle tea loose or in teabags, but you can also grow or harvest the leaves yourself. With fresh leaves, experiment with the ratio of nettle to water you prefer, but a general reference is two cups of water for every cup of leaves. Here's how: Add water to the leaves. Bring the water just to a boil. Turn off the stove and let sit for five minutes. Pour the mixture through a small strainer. Add a bit of honey, cinnamon, or stevia, if you like. Start out by only having one cup of nettle tea to make sure you don't have any reactions to it. Warnings Be sure to talk to your doctor before you try any new herb or supplement. Even all-natural foods and drinks like tea can cause allergic reactions or interact with certain medications. Some herbs and supplements can be harmful to people with certain health conditions.   Resources: Stinging nettle Stinging nettles leaf (Urtica dioica L.): Extraordinary vegetable medicine Chronic Inflammation and Oxidative Stress as a Major Cause of Age-Related Diseases and Cancer Effects of Urtica dioica Supplementation on Blood Lipids, Hepatic Enzymes and Nitric Oxide Levels in Type 2 Diabetic Patients: A Double Blind, Randomized Clinical Trial Effects of Urtica dioica Supplementation on Blood Lipids, Hepatic Enzymes and Nitric Oxide Levels in Type 2 Diabetic Patients: A Double Blind, Randomized Clinical Trial Effects of Stinging Nettle (Urtica Dioica L.,) on Antioxidant Enzyme Activities in Rat Model of Mammary Gland Cancer The Efficacy of Stinging Nettle (Urtica Dioica) in Patients with Benign Prostatic Hyperplasia: A Randomized Double-Blind Study in 100 Patients Improved Glycemic Control in Patients With Advanced Type 2 Diabetes Mellitus Taking Urtica Dioica Leaf Extract: A Randomized Double-Blind Placebo-Controlled Clinical Trial Effects of Urtica Dioica Dichloromethane Extract on Cell Apoptosis and Related Gene Expression in Human Breast Cancer Cell Line (MDA-MB-468) Antiproliferative Effect on Human Prostate Cancer Cells by a Stinging Nettle Root (Urtica Dioica) Extract The Immunomodulatory and Anti-Inflammatory Role of Polyphenols Nettle Extract (Urtica Dioica) Affects Key Receptors and Enzymes Associated With Allergic Rhinitis Randomized, Double-Blind Study of Freeze-Dried Urtica Dioica in the Treatment of Allergic Rhinitis Efficacy of Supportive Therapy of Allergic Rhinitis by Stinging Nettle (Urtica dioica) Root Extract: A Randomized, Double-Blind, Placebo- Controlled, Clinical Trial Testosterone Booster Balance for Men

If you've had the experience of walking through a meadow or trail in the woods and found yourself with a bristly rash on exposed parts of your limbs, you may have brushed up against some stinging nettle. Nettles are an herbaceous perennial flowering plant, native to Europe, Asia, northern Africa, and North America. Tune in to learn how nettles actually support vibrant health!   What is nettle? Nettle, or stinging nettle, is a shrub that comes from northern Europe and Asia. Its scientific name is Urtica dioica. If you've had the experience of walking through a meadow or trail in the woods and found yourself with a bristly rash on exposed parts of your limbs, you may have brushed up against some stinging nettle. Nettles are an herbaceous perennial flowering plant, native to Europe, Asia, northern Africa, and North America. The plant has many hollow stinging hairs called “trichomes” on its leaves and stems, which act like needles that inject histamine, formic acid and other chemicals that produce a stinging sensation. It's very high nutritional content has made it a popular food source steamed and eaten like spinach (it does loose the “sting” when cooked), taken as a tea made from the dried leaves to assist in the nutrition of expectant or nursing mothers, or for general tonic properties for good health. The leaves, stem, or root from the nettle plant can be crushed and made into powders, tinctures, creams, teas, and more. While people have used it for centuries as an herbal medicine, modern research also supports many of the potential health benefits of nettle and nettle tea. Stinging nettle's leaves and root provide a wide variety of nutrients, including: Vitamins: Vitamins A, C and K, as well as several B vitamins Minerals: Calcium, iron, magnesium, phosphorus, potassium and sodium Fats: Linoleic acid, palmitic acid, stearic acid and oleic acid Amino acids: All of the essential amino acids Polyphenols: Kaempferol, quercetin, caffeic acid, coumarins and other flavonoids Pigments: Beta-carotene, lutein, luteoxanthin and other carotenoids What's more, many of these nutrients act as antioxidants inside your body. Antioxidants are molecules that help defend your cells against damage from free radicals. Damage caused by free radicals is linked to aging, as well as cancer and other harmful diseases. Studies indicate that stinging nettle extract can raise blood antioxidant levels. Top 5 Benefits of Nettles 1. Urinary tract health Nettle may help flush harmful bacteria from the urinary tract. This can benefit people who have urinary conditions, such as benign prostatic hyperplasia (BPH). BPH causes an enlarged prostate gland in men. This can cause pain or other problems urinating. According to one 2013 study men with BPH who took nettle extract had fewer clinical symptoms than those who didn't. Nettle may also help support any medications you're taking for infections or conditions related to the urinary tract. Talk to your doctor first about any possible interactions between herbal remedies and medications you take. 2. Arthritis and pain Nettle has historically been used to treat pain and sore muscles, especially related to arthritis. The Arthritis Foundation suggests that nettle tea may also reduce the inflammation and pain association with osteoarthritis. 3. Blood sugar management Nettle has shown some promising effects on blood glucose levels. It may help the pancreas make or release more insulin, the hormone that lowers blood sugar. In a 2013 study, nettle leaf extract lowered blood glucose and A1C in a group of people with type 2 diabetes who were taking insulin as well as oral diabetes medications. 4. The power of polyphenols Nettle is high in plant chemicals called polyphenols. A review of the research on polyphenols suggests that these powerful compounds may play a role in the prevention and management of chronic diseases related to inflammation, such as diabetes, obesity, cancer, and heart disease. In particular, polyphenols from nettle extract have shown some exciting potential for treating breast cancer and prostate cancer. Plants like nettle also contain potent antioxidants, which are substances that protect the body from aging and cell damage. 5. May Treat Hay Fever Hay fever is an allergy that involves inflammation in the lining of your nose. Stinging nettle is viewed as a promising natural treatment for hay fever. Test-tube research shows that stinging nettle extracts can inhibit inflammation that can trigger seasonal allergies. This includes blocking histamine receptors and stopping immune cells from releasing chemicals that trigger allergy symptoms. However, human studies note that stinging nettle is equal to or only slightly better at treating hay fever than a placebo. While this plant may prove a promising natural remedy for hay fever symptoms, more long-term human studies are needed. How to make nettle tea You can buy nettle tea loose or in teabags, but you can also grow or harvest the leaves yourself. With fresh leaves, experiment with the ratio of nettle to water you prefer, but a general reference is two cups of water for every cup of leaves. Here's how: Add water to the leaves. Bring the water just to a boil. Turn off the stove and let sit for five minutes. Pour the mixture through a small strainer. Add a bit of honey, cinnamon, or stevia, if you like. Start out by only having one cup of nettle tea to make sure you don't have any reactions to it. Warnings Be sure to talk to your doctor before you try any new herb or supplement. Even all-natural foods and drinks like tea can cause allergic reactions or interact with certain medications. Some herbs and supplements can be harmful to people with certain health conditions.   Resources: Stinging nettle Stinging nettles leaf (Urtica dioica L.): Extraordinary vegetable medicine Chronic Inflammation and Oxidative Stress as a Major Cause of Age-Related Diseases and Cancer Effects of Urtica dioica Supplementation on Blood Lipids, Hepatic Enzymes and Nitric Oxide Levels in Type 2 Diabetic Patients: A Double Blind, Randomized Clinical Trial Effects of Urtica dioica Supplementation on Blood Lipids, Hepatic Enzymes and Nitric Oxide Levels in Type 2 Diabetic Patients: A Double Blind, Randomized Clinical Trial Effects of Stinging Nettle (Urtica Dioica L.,) on Antioxidant Enzyme Activities in Rat Model of Mammary Gland Cancer The Efficacy of Stinging Nettle (Urtica Dioica) in Patients with Benign Prostatic Hyperplasia: A Randomized Double-Blind Study in 100 Patients Improved Glycemic Control in Patients With Advanced Type 2 Diabetes Mellitus Taking Urtica Dioica Leaf Extract: A Randomized Double-Blind Placebo-Controlled Clinical Trial Effects of Urtica Dioica Dichloromethane Extract on Cell Apoptosis and Related Gene Expression in Human Breast Cancer Cell Line (MDA-MB-468) Antiproliferative Effect on Human Prostate Cancer Cells by a Stinging Nettle Root (Urtica Dioica) Extract The Immunomodulatory and Anti-Inflammatory Role of Polyphenols Nettle Extract (Urtica Dioica) Affects Key Receptors and Enzymes Associated With Allergic Rhinitis Randomized, Double-Blind Study of Freeze-Dried Urtica Dioica in the Treatment of Allergic Rhinitis Efficacy of Supportive Therapy of Allergic Rhinitis by Stinging Nettle (Urtica dioica) Root Extract: A Randomized, Double-Blind, Placebo- Controlled, Clinical Trial Testosterone Booster Balance for Men

Elaine Husni, MD, MPH, and Ana-Maria Orbai, MD, MHS, discuss the emerging and novel therapeutics in psoriatic arthritis and the impact that they will have on their patients. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/959157). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis https://www.rheumatology.org/Portals/0/Files/PsA-Guideline-2018.pdf EULAR Recommendations for the Management of Psoriatic Arthritis With Pharmacological Therapies: 2019 Update https://ard.bmj.com/content/79/6/700.1 Treatment Guidelines in Psoriatic Arthritis https://academic.oup.com/rheumatology/article/59/Supplement_1/i37/5802853 Bimekizumab in Patients with Active Psoriatic Arthritis: Results From a 48-Week, Randomised, Double-Blind, Placebo-Controlled, Dose-Ranging Phase 2b Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33161-7/fulltext

Commentary by Dr. Douglas Mann

Drs Laurence Sperling and Neil Stone put key messages from the 2018 cholesterol guidelines into a clear clinical context. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/958747). The topics and discussions are planned, produced, and reviewed independently of our advertiser. This podcast is intended only for US healthcare professionals. Resources 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625 ASCVD Risk Estimator Plus https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/ 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia https://www.jacc.org/doi/10.1016/j.jacc.2021.06.011 What Do US Physicians and Patients Think About Lipid‐Lowering Therapy and Goals of Treatment? Results From the GOULD Registry https://www.ahajournals.org/doi/10.1161/JAHA.120.020893 Statin Treatment and Muscle Symptoms: Series of Randomised, Placebo Controlled n-of-1 Trials https://www.bmj.com/content/372/bmj.n135

Please join author Ole Fröbert and Associate Editor Dharam Kumbhani as they discuss the article "Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast, summary and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center in Duke National University of Singapore. Dr. Greg Hundley: I'm Dr. Greg Hundley, associate editor, director of the Poly Heart Center at VCU health in Richmond, Virginia. Well, listeners, this week we've got a really hot feature topic pertaining to flu vaccines, which are coming in the US, North America, South America, coming up soon, and their relationship to myocardial infarction. But before we get to that feature discussion, let's grab a cup of coffee and jump in to some of the other articles in this issue. Oh, wait a minute. Our first article, we've got a co-author here. Carolyn, something about the VICTORIA trial, which you were a part of. Can you tell us a little bit about this? Dr. Carolyn Lam: I would love to, and first of all, I'm doing this on behalf of a big team, and I want to really, really call up first Dr. Paul Armstrong who's the senior author from University of Alberta. But let me tell you first about the VICTORIA study. VICTORIA evaluated vericiguat, a soluble guanylate cyclase stimulator, compared to placebo, in patients with heart failure with reduced ejection fraction with a recent worsening heart failure event and the primary result was actually a significant reduction in the primary composite outcome of cardiovascular death or heart failure hospitalization with vericiguat compared to placebo. Dr. Carolyn Lam: Now, interestingly though, in VICTORIA, we found that anemia occurred more often in patients treated with vericiguat at a rate of about 7.6% compared to placebo, which was 5.7%. Now, although earlier studies of another soluble guanylate cyclase stimulator like riociguat was found to be associated with anemia. The etiology really remains unknown. In the current paper, we explored the relationship between markers of anemia and vericiguat versus placebo in VICTORIA. We further explored the changes in hemoglobin and hematocrit over the course of the trial and their relationships with the primary composite outcome. Dr. Greg Hundley: Carolyn, this is such an important new study heart failure therapy for those with reduced ejection fraction, and again, an important topic related to anemia. What did they find? Dr. Carolyn Lam: Thanks, Greg. First, approximately a third of patients in VICTORIA had anemia at randomization, and this is using the standard sex-based definitions. With a lower hemoglobin indeed predicting a higher risk for cardiovascular death, heart failure hospitalization, all-cause mortality. As I had already mentioned, we found more anemia with vericiguat than with placebo. The interesting thing though is after 16 weeks, no further decline in hemoglobin occurred over the remaining and over 96 weeks of follow up, and the ratio of hemoglobin to hematocrit remained constant. Now, overall, the adverse event of anemia occurred in 7.1% of the patients. Dr. Carolyn Lam: Importantly, the lower hemoglobin was not related to the beneficial effect of vericiguat over placebo on the primary outcome. Now, I know all of that may be more descriptive and reassuring than really understanding the mechanism by which it occurred. Further mechanistic studies are certainly warranted to better understand the basis of the anemia development, and it's of principle importance because as you said, vericiguat I think it's going to be an important new medication that we can consider in high-risk patients with recent worsening heart failure with reduced ejection fraction. Dr. Greg Hundley: Thanks so much, Carolyn, especially the perspective of being an author on this particular study. Well, Carolyn, my next study is going to come to us from Dr. Zhao Wang from University of Texas Southwestern Medical Center, and it's really about the integrated stress response, and that's an evolutionary conserved process to cope with intracellular and extracellular disturbances. Myocardial infarction is a leading cause of death worldwide. Coronary artery perfusion is the most effective means to mitigate cardiac damage resulting from myocardial infarction. However, that can cause, as we know, additional reperfusion injury. This study aim to investigate the role of the integrated stress response in myocardial ischemia reperfusion injury. Dr. Carolyn Lam: Oh, very interesting. What were the results? Dr. Greg Hundley: Right, Carolyn. The authors found that the integrated stress response is activated by ischemia reperfusion injury in the heart, and the perk branch of the integrated stress response protects the heart from ischemia reperfusion injury through inhibition of protein synthesis. Also, Carolyn, mitochondrial complex proteins are selectively suppressed and oxidative stress is reduced by the integrated stress response. Carolyn, the takeaway is that this integrated stress response is cardioprotective against cardiac ischemia reperfusion injury. Perhaps pharmacological stimulation of the integrated stress response at reperfusion, well, that may reduce heart damage and improve cardiac outcomes after ischemia reperfusion injury. Dr. Carolyn Lam: Cool. Thanks, Greg. Well, I've got one more paper, and this deals with coronary microcircuitry dysfunction and acute rejection after heart transplantation. Co-corresponding authors, Doctors Lee and Choi from Heart Vascular Stroke Institute in Samsung Medical Center sought to evaluate the prognostic implications of coronary microcircuitry dysfunction assessed by the index of microcircuitry resistance or IMR for the risk of acute cellular rejection after heart transplantation. They did this by prospectively enrolling 154 heart transplant recipients who underwent scheduled coronary angiography and invasive coronary physiological assessment one month after transplantation.   Dr. Greg Hundley: Very interesting, Carolyn. What did they find here? Dr. Carolyn Lam: IMR measured early after heart transplantation was significantly associated with the risk of acute cellular rejection, and an IMR above or at 15 was highly predictive for the recurrence of acute cellular rejection during two years of follow up following heart transplantation. Adding IMR to the prediction model with clinical variables significantly increase discriminant and reclassification ability for the risk of acute cellular rejection. In addition to surveillance endomyocardial biopsy, the implications are that early stratification using IMR could be a clinically useful tool to identify patients at higher risk of future acute cellular rejection after heart transplantation, and this is discussed in an editorial by Doctors Fearon and Valentine from Stanford University. Dr. Greg Hundley: Very nice, Carolyn. Dr. Carolyn Lam: Great. Greg, before we go to the exciting feature discussion, let's round it up by just a quick tour of what else there is in today's issue. There is an exchange of letters between Doctors Pappone Leor on atrial fibrillation as a cardiomyopathy, global rounds on United Kingdom by Dr. Cowie, an ECG challenge by Dr. Tsai on grouped beating following acute inferior myocardial infarction, and a research letter by Dr. Salem on electrocardiographic manifestations of immune checkpoint inhibitor myocarditis. Dr. Greg Hundley: Great, Carolyn. Well, I can't wait to get to this next feature discussion and learn a little bit more about the relationship between flu vaccines and future myocardial infarction. Dr. Carolyn Lam: Today's feature discussion was a really hot topic at the ESC 2021, and in fact, a simultaneous publication. It is about influenza vaccination after myocardial infarction, a very important topic and a very novel paper. We are so pleased to have the first and corresponding author, Dr. Ole Fröbert from Orebro University in Sweden to discuss this paper, as well as our associate editor, Dr. Dharam Kumbhani, from UT Southwestern. Welcome, gentlemen. Only if I could start with asking you to describe the rationale for why you did this study, and then perhaps quickly summarize the results. Dr. Ole Fröbert: Yeah, thank you so much, Carolyn. The background of the study was that during influenza epidemics, more people die from cardiovascular causes, and out in the literature, there are numerous observational studies suggesting a protective effect from influenza vaccination on cardiovascular events. There are also three smaller single-center randomized trials supporting these registered findings. Currently influenza vaccination carries a Class I, Level of Evidence B recommendation in both American and European secondary prevention guidelines, but uptake is low and vaccination timing is unclarified. Our aim was to determine whether influenza vaccination improves clinical outcomes in patients with a recent myocardial infarction or with high risk corona artery disease. Dr. Ole Fröbert: The study was international, multi-centers investigator initiated, double-blind randomized control trial, and we enrolled patients at 30 centers across eight countries in both the Northern and the Southern Hemisphere, Sweden, Denmark, Norway, Latvia, Scotland, Czech Republic, Bangladesh and Australia. We enrolled patients between October 2016 and March 2020. We had quite broad inclusion criteria. We included hospitalized patients with STEMI or non-STEMI, or high-risk stable patients over 75 years of age undergoing an angio or PCI. We excluded patients already vaccinated or intending to be vaccinated during the current season. We also included, of course, patients if they had allergy to X or influenza vaccine, if they had infection or if they were immunosuppressed or previously randomized in the trial. Dr. Ole Fröbert: Over these four years of inclusion, we enrolled a total of 2,571 participants. The primary outcome was a composite of all-cause death, MI and stent thrombosis. This outcome occurred in 67 participants assigned influenza vaccine and 91 assigned placebo corresponding to a reduction of the primary endpoint of 28% with a P value of 0.04. Also, rates of all-cause death and of cardiovascular death were reduced and both with a hazard ratio of 0.59 corresponding to a reduction of 41% in all-cause death and cardiovascular death. Based on these results, we think that this trial and what we know from previous smaller trials should be sufficient to establish influenza vaccination as a new standard of care as part of in-hospital treatment after an MI. Dr. Carolyn Lam: Heartfelt congratulations, Ole. What an elegant intervention in a very frankly challenging situation that the trial obviously carried on through COVID as well, multinational. May I just double check? Was it investigator-led? Because- Dr. Ole Fröbert: Yes, this was- Dr. Carolyn Lam: That's amazing. Dr. Ole Fröbert: ... an idea that just popped up, and then yeah, we did it, but it was seven years of work. Dr. Carolyn Lam: Wow. Hard work as I can just imagine. First, heartfelt congratulations. Very impactful results. Dharam, could I invite you to put those results in context and why we single this out? Dr. Dharam Kumbhani: Yeah. No, thank you, Carolyn. Ole, I want to amplify or recapitulate the amazement and wonder that Carolyn just articulated. I think this is a huge endeavor. It's a very important topic. It's "a fairly simple intervention." It's vaccination, and you've just really shown that even in the acute setting, that A, this is as feasible, B, it is safe, and three, it is effective. I think it's potentially ... Given the magnitude of influenza in the world, I think this has tremendous public health ramifications. I really want to congratulate you and your investigators for pursuing this important question and then just executing this, I'm sure despite multiple challenges over a long period of time. Dr. Ole Fröbert: Thank you very much. Dr. Dharam Kumbhani: Yeah, no. I guess you already alluded to the fact that this may influence guidelines. As you mentioned, it's a 1B. Maybe get your thoughts, I suppose this may move the needle towards becoming perhaps a little stronger on the recommendation front, both in the US and the European guidelines? Dr. Ole Fröbert: Yeah. I think what has been the challenge until now is that many places, of course, you commend patients to take a flu jab when treatment is over in the hospital. But then the responsibility is diffused. Who should take care of that? Is that up to the patient or the primary care physician? Who is in charge? One important finding of this study is, as you said, it's safe. There were no differences, adverse events between the two groups. It's safe and it could be given early. I think a take-home factor from the study is that it should be given at the hospital and it's a responsibility of the cardiologist. Dr. Dharam Kumbhani: Yeah, I really like that. Actually, I'm sure this would resonate across the board in the cardiology community. We've taken ownership for starting from statin and now SGLT-2 inhibitors, which kind of ... All of these medications have come from non-cardiology realms, so to say. But now we prescribe those medications. We know they have clear cardiovascular benefits. I suppose you could make a case to say we, the cardiology community, has to adopt this. The implementation gap that exists for a lot of these therapies, that also comes to us and for us to move that forward. It's thought provoking. I certainly felt very strongly after your study. I don't know how you feel about that. We should really be the ones driving this and help with more widespread immunization in these patients. Dr. Ole Fröbert: I think because not just this study, but also the previous studies and what we know from observational findings is that this is safe and it works. What we also saw in our study, and it has been indicated in previous meta analysis, is that the maximum effect is seen in the acute setting. It's the acute coronary syndrome patients, the patients we had in our study, that benefit the most. That's also a case for actually doing this in the hospital and not postponing it. Dr. Carolyn Lam: Wow. That's amazing. Ole, I do have one question. Just for clarification. You were careful to say that you did this during influenza seasons, right? Coming from my part of the world in Singapore where we don't really have influenza seasons, don't have any seasons, frankly, what would you think? What would you advise? Dr. Ole Fröbert: There is influenza seasons in all parts of the world, I'm sorry. Dr. Carolyn Lam: True. Dr. Ole Fröbert: For example, we had Bangladesh on board in our study. It's in the Northern Hemisphere, but influenza-wise, it's in the Southern, and their season is between May and September. But it's not as clearly defined as the Northern Hemisphere season. It's almost always in two waves during that season. One practical challenge with influenza vaccine is that it's produced for the seasons. It's difficult to say, "Yeah, we can just do it all year round," and also we didn't test that. I, of course, feel we should give it all year round, but it's not available, the vaccine. Perhaps it should be tested, but it is probably difficult to find funding for such a study. Dr. Carolyn Lam: Very fair, and thanks for the correction. It's true though. Singapore's on the Equator, so we don't have maybe weather seasons. But yeah, we do get vaccinated for both North and South. It's quite fascinating. But nonetheless, could I now switch topics a little bit and just over the next couple of minutes just ask you, could you please perhaps share with the audience what it was like to work with Circulation, to do this simultaneous publication? You see, our associate editor, Dharam Kumbhani, really leads this effort to get simultaneous a fast-track publication from major conferences, and it means a lot to us that investigators like you chose us. Could you share a bit? Dr. Ole Fröbert: Yeah, thank you very much. Overall, it was a pleasure. Of course, we were ... With every study of this size, you are under stress, you get the results late, and there's a conference coming up, and you would like your paper to come out at the same time across to maximize impact and attention. What I really like with working with Circulation was turnaround time was ultra fast, really extremely fast. Of course, we had a lot of questions to our study, but these were ... Some of them of course were quite difficult, but they were fair. In a way, they were also helpful in a way that made it easier to address the questions in a more, you could say, collaborative way. It was very smooth. No hiccups. Dr. Carolyn Lam: Thank you. Dharam, any final responses to that? Dr. Dharam Kumbhani: No, thank you, Carolyn. Yeah. Well, Ole, it was really a pleasure to work with you on this. I think we all recognize that this was an important study and wanted to make sure that we were able to accomplish the goal of simultaneous publication. Thank you for working with us on that. I just want to put a pitch in, I think this, for Joe, Dr. Hill and the rest of the editorial team, having a robust simultaneous publication program has been very, very important. We are very committed to working with investigators and authors on this. We are really blessed with our team on the backside that works seamlessly with us nights, weekends, just to get these things done. I just want to end with that to say this is very important for us, and we look forward to the opportunity to work with Ole and others on future papers as well.   Dr. Carolyn Lam: I love that. Thank you both for being on this podcast today. Today I want to especially call out David Rivera, a wonderful managing editor who really, really is part of leading this entire group that supports us, but also even this very podcast. You've been listening to Circulation on the Run. Thank you, from both Greg and I, for joining us today, and don't forget to tune in again next week. Thank you. Dr. Greg Hundley: This program is copyright of the American Heart Association 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit ahajournals.org.

Dr. Andrew Bauerschmidt interviews Dr. H. Alex Choi about his presentation, "SAHRANG: Subarachnoid Hemorrhage Recovery and Galantamine- A pilot multicenter randomized placebo controlled trial" from the NCS Annual Meeting. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Tareq Saad Almaghrabi, Andrew Bauerschmidt, Leonid Groysman, Atul Kalanuria, Lauren Koffman, Kassi Kronfeld, Holly Ledyard, Lindsay Marchetti, Alexandra Reynolds, Lucia Rivera Lara, Jon Rosenberg, Jason Siegel, Zachary Threlkeld, Teddy Youn, and Chris Zammit. Our administrative staff includes Bonnie Rossow. Music by Mohan Kottapally.

In this week's episode of the Spine & Nerve podcast Drs. Nicolas Karvelas and Brian Joves take a look back at basic physiology to try to look into the future. An area of research that has really piqued the interest of Dr. Karvelas in recent years has been the discussion/possibility of selective voltage gated sodium channel (NaV) modulators. NaV are transmembrane proteins that are an integral part of the initiation and propagation of action potentials in neurons and other electrically excitable cells. We have seen that small changes in NaV function are biologically relevant because there are several human diseases that are the result of mutations in these channels. This has led to research into selective NaV modulators as a potential target as we continue to search for treatment options with significant analgesic potential and decreased risk of side effects / adverse effects. The medical / research community continues to work to optimize medication options to treat painful disease processes. From an analgesic medication perspective, although there are a variety of different medications available including: topical medications, acetaminophen, non-steroidal anti-inflammatory drugs, gabapentin, pregabalin, serotonin norepinephrine reuptake inhibitors, tricyclic anti-depressant medications, non-selective sodium channel blockers, NMDA receptor modulations (Memantine, Ketamine), alpha-2 agonists, glial cell modulators (Low Dose Naltrexone), Buprenorphine, full mu opioids. These Medications are not without their limitations for multiple reasons including but not limited to side effects, risks, and contraindications depending on patient's age and/or comorbidities. To the best of our knowledge there are 10 different NaV subtypes; and specifically NaV 1.3, 1.7, 1.8, 1.9 have been demonstrated to play a critical role in pain signaling. NaV 1.8 is a sensory neuron specific channel with preferential expression in the dorsal root ganglion and trigeminal ganglion neurons, and it is highly expressed on nociceptors. Similar to the other NaV subtypes that have been identified to play essential roles in pain, mutations in NaV 1.8 have been demonstrated to lead to significant alterations in the nervous system / pain pathways; specifically gain of function NaV 1.8 mutations clinically manifest as painful small fiber peripheral polyneuropathy. NaV 1.8 modulation is being aggressively researched with the goal of positive impact on painful diseases. VX-150 is a oral pro-drug that is a highly selective inhibitor of NaV1.8, and a recent study by Dr. Hijma and colleagues was published evaluating the analgesic potential and safety of VX-150. Listen as the doctors discuss this exciting and important area of research. The discussion includes a detailed review of the fore-mentioned recent research article. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve. References: 1. Hijma HJ, Siebenga PS, de Kam ML, Groeneveld GJ. A Phase 1, Randomized, Double-Blind, Placebo-Controlled, Crossover Study to Evaluate the Pharmacodynamic Effects of VX-150, a Highly Selective NaV1.8 Inhibitor, in Healthy Male Adults. Pain Med. 2021 Aug 6;22(8):1814-1826.

Tracy Beanz from Uncover DC joins this episode of The Jeff Dornik Show to take a deep dive into COVID-19, the vaccines and Joe Biden's insanely unconstitutional vaccine mandates. There are effective treatments and preventative measures that we can take for COVID-19, but the government is ignoring the twenty-six randomized double-blind placebo-controlled studies proving the effectiveness of Ivermectin, and instead push a danger experimental drug with the mRNA injections which are causing severe harm and even death.Sponsors:- Our Gold Guy - Talk to IRA about whether investing in gold is right for you. Let them know Jeff sent you at http://ourgoldguy.com - Tickets for the upcoming Cancel-Proof Christianity Summit are now on sale. This event will take place in Ft Worth, TX, on September 25th, featuring speakers like Jeff Dornik, Dr Bobby Lopez, Jeff Younger, Judd Saul, Dr Mike Spaulding, Dr Paul Church, Pastor Sam Jones and Doni Anthony. Get your tickets at http://cancelproofchristianity.com

ESC Wrap-up Part II: EMPEROR-Preserved, and the STEP, Guide-HF, and IAMI trials, are discussed by John Mandrola, MD, in this week's podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - HFpEF - EMPEROR-Preserved: Empagliflozin Scores HFpEF Breakthrough https://www.medscape.com/viewarticle/957405 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 II - BP Targets - STEP: Lowering Blood Pressure Below 130 mm Hg Shows CV Benefit https://www.medscape.com/viewarticle/957566 - Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension https://www.nejm.org/doi/full/10.1056/NEJMoa2111437 III- PA Catheter Monitoring - GUIDE-HF: CardioMEMS-Guided Meds Fall Short in Mild to Moderate Heart Failure https://www.medscape.com/viewarticle/957390 - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 - Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial https://doi.org/10.1016/S0140-6736(11)60101-3 IV - Influenza Vaccine - Seasonal Flu Vax Cuts Post-MI Mortality in IAMI Trial https://www.medscape.com/viewarticle/957575 - Influenza Vaccination after Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial https://doi.org/10.1161/CIRCULATIONAHA.121.057042 - Stopping randomized trials early for benefit and estimation of treatment effects: systematic review and meta-regression analysis https://pubmed.ncbi.nlm.nih.gov/20332404/ You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine. https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Episódio especial com o LAPLAF (Laboratório de Pesquisa em Lazer e Atividade Física) @fabiodominski @laplaf.cefid Profª Dra. Adriana Guimarães (UDESC/CEFID/LAPLAF) Dra. Leonessa Boing - pesquisas câncer de mama Doutoranda Jéssica Moratelli - pesquisas doença de Parkinson Doutoranda Danielly Fausto - pesquisas menopausa Doutoranda Alice Erwig – USP - pesquisas sobre a deficiência androgência masculina e suplementação Dra. Vanessa Lyra - pesquisas sobre o corpo Artigos LAPLAF: LEONESSA, BOING ; Moratelli, J. ; MELISSA DE CARVALHO SOUZA, VIEIRA ; GUIMARÃES, A. C. A. . Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy - A systematic review and meta-analysis. MATURITAS, v. 141, p. 71-81, 2020. Moratelli, J. ; Boing, L ; HAMES, K. ; CORREA, C. L. ; SWAROWSKY, A. ; ADRIANA COUTINHO DE AZEVEDO GUIMARAES . Dance Rhythms Improve Motor Symptoms in Individuals with Parkinson's Disease: A Randomized Clinical Trial. JOURNAL OF DANCE MEDICINE & SCIENCE, 2021. Moratelli, J. ; CORREA, C. L. ; SWAROWSKY, A. ; ADRIANA COUTINHO DE AZEVEDO, GUIMARAES . Binary dance rhythm or Quaternary dance rhythm which has the greatest effect on non-motor symptoms of individuals with Parkinson?s disease?. Complementary Therapies in Clinical Practice, p. 101348, 2021. LEITÃO, ALICE ERWIG ; GUIMARÃES, ADRIANA . Exercise associated or not to the intake of Eurycoma longifolia improves strength and cardiorespiratory fitness in men with androgen deficiency. Complementary Therapies in Clinical Practice, p. 101301, 2021. LEITÃO, ALICE ERWIG ; VIEIRA, MELISSA ; PELEGRINI, ANDREIA ; DA SILVA, EDSON ; GUIMARÃES, ADRIANA . A 6-Month, Double-Blind, Placebo-Controlled, Randomized Trial to Evaluate the Effect of Eurycoma longifolia (Tongkat Ali) and Concurrent Training on Erectile Function and Testosterone Levels in Androgen Deficiency of Aging Males (ADAM). MATURITAS, v. 145, p. 78-85, 2020. FAUSTO, D. Y. ; KLEN, J. A. ; POGERE, A. ; Sperandio, F.S. ; VIEIRA, M. C. ; GUIMARÃES, A. C. A. . Concurrent training for women in Menopause: protocol of randomized controlled clinical trial. Current Women's Health Reviews (Print), 2021. --- Support this podcast: https://anchor.fm/fabio-dominski/support

JAACAP July 2021: Contributing Editor Dr. Jung W. Kim interviews Drs. L. Eugene Arnold and Roger deBeus on if theta/beta-ratio (TBR) electroencephalographic biofeedback (neurofeedback [NF]) has a specific effect on attention-deficit/hyperactivity disorder (ADHD) beyond nonspecific benefit.

JAACAP July 2021: Contributing Editor Dr. Jung W. Kim interviews Drs. L. Eugene Arnold and Roger deBeus on if theta/beta-ratio (TBR) electroencephalographic biofeedback (neurofeedback [NF]) has a specific effect on attention-deficit/hyperactivity disorder (ADHD) beyond nonspecific benefit.

First join author Marc Dweck and Associate Editor Victoria Delgado as they discuss the article "Effect of Denosumab or Alendronic Acid on the Progression of Aortic Stenosis: A Double-Blind Randomized Controlled Trial." Then, join authors Torbjørn Omland and Geeta Gulati as they discuss the article "Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy (PRADA) Extended Follow-Up of a 2×2 Factorial, Randomized, Placebo-Controlled, Double-Blind Clinical Trial of Candesartan and Metoprolol." Dr. Carolyn Lam: Welcome to Circulation On The Run. Your weekly podcast summary and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center, VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Hooray, it's another double feature week! And guess what, these two papers are two randomized control trials. One looking at progression of aortic stenosis and the other, looking at a prevention of cardiac dysfunction following adjuvant breast cancer therapies. Dr. Carolyn Lam: So, very interesting two papers coming right up. But Greg, why don't you start by highlighting some of your favorite papers from today's issue. Dr. Greg Hundley: You bet Carolyn. Dr. Greg Hundley: So my first study was conducted by Dr. Gabriela Trifan and colleagues from University of Illinois who performed a meta analysis of major studies that compare the efficacy and safety of dual anti-platelet therapy versus monotherapy for secondary prevention of recurrent stroke or transient ischemic attack in those previously experiencing minor non cardioembolic stroke. And their primary outcomes were stroke and the composite of stroke, TIA, acute coronary syndrome and death of all cause. And the safety outcome was major hemorrhage. Dr. Carolyn Lam: Oh, okay. Very important study. What did they find? Dr. Greg Hundley: Right Carolyn. So the analysis included 27,358 patients. And compared with monotherapy, dual anti-platelet therapy reduced the risk of recurrent stroke and the composite outcome, but increased the risk of major bleeding. And in subgroup analysis at less than or equal to 30 days, dual anti-platelet therapy increased the risk of hemorrhage relative to monotherapy. In sensitivity analyses, the risk for hemorrhage with less than or equal to 30 days of dual anti-platelet therapy, after excluding the combination of aspirin plus Ticagrelor, was comparable to monotherapy. However, the risk of stroke recurrence and composite outcomes in the subgroup and sensitivity analyses remained decreased compared to monotherapy. Dr. Greg Hundley: And so Carolyn, the take-home message from this paper is that dual anti-platelet therapy decreases the risk of recurrent stroke and composite events compared with monotherapy. But, dual anti-platelet therapy increases the risk of major hemorrhage, except if the treatment is limited to 30 days and does not include the combination of aspirin plus Ticagrelor. Dr. Carolyn Lam: Ah, thanks for that last take home message. Thank you. Dr. Carolyn Lam: Well, the paper I'm going to tell you about is the first to examine the role of epicardial fat derived extracellular vesicles in the pathogenesis of atrial fibrillation. And this comes from Dr. Leor from Sheba Medical Center, Tel Aviv University in Israel and his colleagues who collected epicardial fat specimens from patients with and without atrial fibrillation during elective heart surgery. Dr. Carolyn Lam: Epicardial fat samples were grown as organ cultures and the culture medium was collected every two days. And the authors then isolated and purify these epicardial fat extracellular vesicles from the culture medium. Dr. Carolyn Lam: They found that epicardial fat extracellular vesicles of patients with atrial fibrillation had unique pro-inflammatory, profibrotic and proarrhythmic properties. Epicardial fat extracellular vesicles could in fact induce cellular, molecular and electrophysiological remodeling that could result in atrial fibrosis, myopathy and the development of atrial fibrillation. Dr. Greg Hundley: Wow Carolyn, so what are the clinical implications of epicardial fat extracellular vesicles? Dr. Carolyn Lam: Hmm, good question. Well, understanding their role in the pathogenesis of atrial fibrillation may for one lead to the discovery of new diagnostic markers or new targets for the prevention and treatment of atrial fibrillation. And that combined pro-inflammatory profibrotic and proarrhythmic effects of these epicardial fat and extracellular vesicles may in fact be relevant to the pathogenesis of other cardiovascular diseases associated with obesity and abnormal adipose tissue deposition. Dr. Greg Hundley: Very nice Carolyn. Dr. Greg Hundley: My next paper comes again to us from the world of preclinical science and these authors led by Dr. Masanori Aikawa from Harvard Medical School applied a systems approach in mouse experiments to discovering therapeutic targets for vein graft failure. They use global proteomics and high dimensional clustering on multiple vein graft tissues to identify potential pathogenic mechanisms. And experiments were conducted in both in vivo mouse models and in vitro human macrophages. Dr. Carolyn Lam: Oh wow. So what did they find? Dr. Greg Hundley: So Carolyn, peroxisomes proliferator activated receptors or PPAR alpha agonism by pemafibrate retarded the development and inflammation of vein graft lesions in mice, while gene silencing worsened plaque formation. Pemafibrate also suppressed arteriovenous fistula lesion development. Dr. Greg Hundley: Now, metabolomics, lipidomics, functional metabolic assays and single cell analysis of cultured human macrophages revealed that PPAR alpha modulates macrophage glycolosis, citrate metabolism, mitochondrial membrane sphingolipid metabolism and heterogeneity. Dr. Carolyn Lam: Okay. So what is the take home message Greg? Dr. Greg Hundley: Right Carolyn, thought you would ask me that. Dr. Greg Hundley: So PPAR alpha activation suppresses the development of vein graft and arterial venous fistula lesions. And PPAR alpha reduces macrophage activation by influencing macrophage heterogeneity, mitochondrial integrity, and the metabolome. So Carolyn, given that peripheral arterial disease and chronic kidney disease prevalences are increasing, warranting needs for more vein grafts and arterial venous fistulas, this target discovery platform is applicable to investigating therapies for these diseases. Dr. Greg Hundley: And a really nice accompanying editorial is provided by doctors Reilly and Bornfeldt. Dr. Greg Hundley: Well Carolyn, how about we turn to look at what is in the mailbag this week? Dr. Carolyn Lam: Well let me tell you about it Greg. We've got a cardiovascular case series by Dr. Borlaug on things are not always as they seem, multimodality exercise assessment and evaluation of dyspnea. In cardiology news by Kuhn there's a discussion of Evinecumab approval adds a new option for homozygous familial hypercholesterolemia with a hefty price tag. A perspective piece by Dr. Watkins on time to think differently about sarcomere negative hypertrophic cardiomyopathy. And finally a research letter by Dr. Ahn on reduction in Kawasaki disease after non-pharmaceutical interventions in the COVID-19 era, a nationwide observational study in Korea. Dr. Carolyn Lam: Wow. That wraps it up for the summaries. Let's go on to the feature discussions shall we, Greg? Dr. Greg Hundley: You bet. Dr. Carolyn Lam: We are about to talk about the extended follow-up results of the PRADA trial. Oh, so interesting. So happy to have with us today, doctors Geeta Gulati and Dr. Torbjørn Omland, both from the Akershus University hospital in Norway, and you would probably recognize that Dr. Torbjørn Omland is also one of our associate editors, but both here are the co-corresponding authors of this beautiful paper. Dr. Carolyn Lam: Thank you so much for coming here today. Torbjørn, maybe you could start with what is the PRADA trial? Why did you decide to do an extended follow-up? Dr. Torbjørn Omland: Yeah so PRADA was a two times two factorial randomized double blind clinical trial that sought to evaluate the effects of intervention with receptor blocker Candesartan. And a beta blocker Metoprolol in patients with early breast cancer who received anthracycline therapy as part of their chemotherapy. And then we wanted to assess the effect of this sort of preventative therapy, left ventricular function and injury. Dr. Torbjørn Omland: So we reported the primary results of the trial a few years ago and showed that intervention with Candesartan most associated with a significant elevation of the reduction in left ventricular ejection fraction that these patients may experience, and also that treatment with the beta blocker Metoprolol was associated with an intimation of the increase in cardio proponents suggesting a beneficial effect on myocardial injury. However, whether these results were or these effects were sustained after termination of the study drugs was unknown. And that was what we really wanted to address with extended follow-up study. Dr. Carolyn Lam: Yeah, makes a lot of sense, especially because these injuries I suppose could still continue. And just to be very clear, the medications though were only taken during the adjuvant chemotherapy and therefore could be a variable duration from what I understand. Right? Great. Dr. Carolyn Lam: So Geeta then, could you tell us what did the extended analysis show? Dr. Geeta Gulati: The extended follow-up was interesting and it was something we really wanted to figure out because there are not many studies who have been done on the extended follow-up and you're not giving these study medications afterwards. Dr. Geeta Gulati: So very interestingly we saw that the decline in the ejection fraction was still there in the whole group. But this time there was no difference in the group who received Candesartan do those who didn't. And we show that there was a different in the primary results, but now in the extended follow-up there was no difference. And then also in the Metoprolol group that had previously shown that there was lesser rise in the troponins. Again, there was no difference in the groups now on the extended follow-up. Dr. Geeta Gulati: So this is very interesting because this shows that there is a small, modest decline in a left ventricular ejection fraction during and after the breast cancer therapy. But what does this really mean? It's a small decline and it's within the normal range and the cardioprotection is not working. So, are we perhaps looking at the wrong group? Perhaps we should look at patients who have the higher cardiovascular risk factors. Perhaps even we should look at more novel heart failure or cardiac drugs that may have a stronger effect on the ejection fraction. Dr. Carolyn Lam: Right. So Geeta though, can we unpack that a little bit? You see, the patients were not on the medication anymore at the time of follow-up. So you're saying that even though they were given adjuvant chemotherapy and covered with the drug, that even not having any more chemotherapy, their ejection fraction still fell. And if I'm not wrong, this was an MRI analysis. And so it was only by an ejection fraction of two percent on mean fall, right? How do we think about that clinically? Dr. Geeta Gulati: And that's the important question, isn't it? Because a decline in the ejection fraction of less than two percent within the normal range, what does it really mean? Well initially we thought that if there was a different in those who had cardioprotective medication compared to those that didn't, it may prevent development of further decline in the cardiac function and then heart failure in the future. But now, there is really no difference between the groups. So perhaps the clinical implication of giving cardio protection to all cancer patients is not really that useful. Perhaps they should look at those who are at higher risk because they would have a greater fall in ejection fraction and then more cardioprotective effect of these drugs. Dr. Carolyn Lam: Yeah, totally. And perhaps the metrics that we're used to seeing in the past with greater falls of ejection fraction, maybe it just doesn't apply currently or perhaps with the specific chemotherapeutic regimens perhaps that you're using now. Because with a very small fall, and I believe you only had one heart failure event, right? If I'm not wrong in this extended follow-up. So, just to let the audience know, it was very small fall, little number of events. It's hard to really tease apart what that clinically means. Now, could I ask though, does it mean we need actually a more sensitive marker? Because there was some interesting stuff about global longitudinal strain. Could you- Dr. Geeta Gulati: I would throw that question back to Torbjørn I think. Dr. Torbjørn Omland: Yes. So that's a very interesting question Carolyn. So we did observe what seemed to be a beneficial, but a sort of minor effect on global longitudinal strain. So we know that that is the more sensitive index of systolic function than left ventricular ejection fraction, that was the pre defined primary outcome. So that's raises of course questions whether a future trial should more focus on these more sensitive indices of cardiac function. Dr. Carolyn Lam: Yeah. Geeta, could I then really put it back to you? And the tough question I always get, how do we apply these results clinically then? I mean, you see these patients right? Now what? Do you give or do you don't give? And which one do you give? And how do you identify high risk patients? I don't know. Dr. Geeta Gulati: Again, I think all the patients are unique aren't they? So that's where we have to start. So in my clinic, if I have a high risk patient with hypertension, diabetes, hypercholesterolemia, yeah perhaps they even have had a cardiovascular disease before something like this. Then I will take more care of these patients and be more careful with the echo measurements I'm doing and if I find that they have a decline in their cardiac function, I may be more eager to start them on cardioprotective medication. Dr. Geeta Gulati: But then in R-Regen we follow all the HER two positive breast cancers with echo. If I don't have echoparamaties that clearly tells me that they have a decline in the cardiac function, then I may wait to start cardio protection because none of the studies has really so far show that all patients should have these cardioprotective medication or prevention. Dr. Carolyn Lam: Nice. Thank you. That was a tough one to get at. And I suppose Torbjørn I have to give you another tough one then. Because how to address the remaining unanswered questions, right? Because one of them on my mind too, is how to identify the high risk, do biomarkers play a role? And then the other is if we then start the preventive therapies like ERBs and beta blockers, should we actually continue it forever? And so on. But anyway Torbjørn please, please, what does the future hold? Dr. Torbjørn Omland: I think it's worthy of a recap or underscoring that these are really good news for many breast cancer patients that actually the risk of an important decline in ventricular function is lower than we thought. So that may be because of several things. I think in general, those whose used these cardiotoxic drugs are lower. And we also, I think that there's increased collaboration between oncologists and cardiologists. Also meaning that we are better to pick up the high-risk patients at an early stage. Dr. Torbjørn Omland: But of course, it's very important questions that you asked regarding how to identify the high risk patients. And I think that's where really future research should focus. So there we know that traditional risk factors are important. We are looking into whether biomarkers can be used, if there's more sensitive imaging in this can be used. But so far we haven't really succeeded in getting the risk model that really identifies it on the patient level. So that's work that remains to be done. Dr. Torbjørn Omland: And then we are also looking for new types of intervention, good exercise, good other drugs. We are doing now a PRADA two study where we look at the effects of Sacubitril Valsartan in this setting. And those are also very exciting, I think, and we look very much forward to present that in the future. Dr. Carolyn Lam: Oh wow thank you so much Torbjørn and Geeta. The PRADA two trial. I've got to ask you, why do you then call it the Chanel trial? But I think I'll save that for another day. So thank you. Thank you once again, this is fabulous and congratulations to you both. Dr. Torbjørn Omland: Thank you. Dr. Geeta Gulati: Thank you. Dr. Greg Hundley: Well listeners, welcome to our second feature discussion today. And we have with us Dr. Marc Dweck from University of Edinburgh in Scotland and our own associate editor, Victoria Delgado from Leiden in the Netherlands. Welcome to both of you. Dr. Greg Hundley: Marc, we're going to get started with you. Could you tell us a little bit about the background for your study and what was the hypothesis that you wanted to test? Dr. Marc Dweck: Thanks very much Greg for the invitation. So I guess aortic stenosis is perhaps the last major cardiovascular condition where we don't have a medical therapy. We're unable to treat these patients. We're unable to prevent progression. We're only left with a valve replacement. And so we, like a lot of groups around the world, want to develop a treatment for aortic stenosis. Our group did the first SALTIRE trial, where we looked at statins seeing if we could slow aortic stenosis progression. And that, like similar trials, was neutral. No effect on the valve progression. Dr. Marc Dweck: And so actually I've spent the last 10 years looking at some of the factors associated with aortic stenosis progression in particular. The answers that we've had from those trials have kind of come back telling us that really it's a process of calcification. If you look at what triggers progressive valve narrowness is this calcific process, that seems to be a self perpetuating disease. Dr. Marc Dweck: So the question is, how do you target this calcification process? How can you interrupt it? And how can you do that without compromising bone health in these elderly patients? So in trying to come up with a solution to that we thought about using osteopetrosis agents, which we hypothesized would maintain both bone health and reduce vascular calcification on the basis of observational data and also animal data suggesting that. And that was really where we came from in the design of the SALTIRE two trial. Dr. Marc Dweck: And doing a big trial with clinical endpoints wasn't felt to be feasible and instead we decided to look at imaging end points and see whether we could slow disease progression using these agents. Dr. Greg Hundley: Very nice Marc. And so you're really leading us into, tell us a little bit more about your study population and your study design. Dr. Marc Dweck: Yeah so we wanted to take patients from our outpatient clinic with mild, moderate and even early severe disease, asymptomatic patients crucially, patients that aren't scheduled for aortic valve replacement and see the effects of these drugs on disease progression. Dr. Marc Dweck: So we did a randomized control trial. There was three arms. Patients were randomized to Alendronate, Denosumab, these are the two osteopetrosis agents, or placebo. We then did a series of baseline imaging tests. So the primary end point was based on CT calcium scoring. So they had a baseline CT calcium score. They also had a baseline echocardiogram and they had a baseline fluoride PET scan. So this measures calcification activity in the valve. And then we essentially repeated those tests after a period of time on the drugs, or on placebo. We repeated the calcium score and the echo after two years and repeated the PET scan after one year. Dr. Greg Hundley: Very nice, and so before you tell us your results, a little bit, how many patients? And maybe their average age and the rough distribution of men versus women. Dr. Marc Dweck: Yeah so study recruited roughly 50 patients in each arm. The average age was 72 and there was 21% females in the study. So, like a lot of studies in aortic stenosis, a low female prevalence. Despite our best efforts, that's something we need to attend to in the future, but otherwise, a representative age group and patients with this disease. Dr. Greg Hundley: And what did you find? Dr. Marc Dweck: Well we found that the drugs didn't have an effect on any of these imaging assessments. So, there was no effect on the progression for CT calcium score at two years, no effects on any of the echocardiographic assessments of hemodynamic severity, and no effect on calcification activity as measured with the fluoride. Dr. Marc Dweck: So a very consistent result using multiple different imaging modalities, which I think gives us confidence that there isn't at least a dramatic effect of these drugs on disease activity or disease progression, in aortic stenosis. Dr. Greg Hundley: Very good. Well listeners, we're now going to turn to one of our associate editors, Dr. Victoria Delgado, and she is really a valvular heart disease expert member of our team. Dr. Greg Hundley: Victoria, I know you see a lot of papers that kind of come across your desk. What attracted you to this manuscript? And then how do you put the results in the context of other research that's going on to halt the progression of aortic stenosis. Dr. Victoria Delgado: Thank you Greg. So first the first thing that attracted my attention for this article is the question. We know that we don't have any medical therapy for halting the progression of aortic stenosis. And even if the previous studies have been negative or neutral, still there is the interest of trying to find a less invasive therapy for these patients, or even prevent that they arrive to surgical or transcatheter aortic valve replacement. Dr. Victoria Delgado: And the second is that these are very strong analysis because it's a randomized clinical trial and using as end points imaging. So that trial also in a way answers the question of which imaging technique we need to use in order to see the effects of specific therapies. Previous studies have used mainly echocardiography, but that only gave us information on the modynamic effects of the aortic stenosis. While in this study, we have the combination of CT and a combination of a PET that he give us also information on how the calcification is happening. So that makes the study very comprehensive and give us more insights into this pathophysiology, to this pathology particularly. Dr. Greg Hundley: Very nice. So it sounds like looking at aortic stenosis from multiple different angles, whether it be echocardiography or perhaps imaging processes that look at the progression of calcification. Dr. Greg Hundley: Well, Marc, I want to come back to you. What do you think is the next, sounds like you've been working in this area for an extended period of time. What do you see as the next research study that you and your group may undertake in this area? Dr. Marc Dweck: I Think we've got the study design about right. I think if in the future studies we want to do, I think we would adopt a similar design using these imaging end points. Dr. Marc Dweck: I have to say I'm very influenced by the recovery trial that has been conducted in the UK with COVID. I mean, here's a disease where we wanted to get a treatment as quickly as we can. And in doing that, developing a platform type trial where you potentially test multiple different promising agents simultaneously across multiple centers across the world or the UK, I think that would be the quickest way to developing a treatment. And so I'm encouraged that there are five or six very good targets where we could, for a new therapy in aortic stenosis. And I think a platform type design where we engage multiple groups using imaging as that initial end point. And then, the drugs that appear to have an effect on these imaging end points we can start to recruit more patients at those sites, into those centers, looking for clinical end points. Dr. Marc Dweck: I think that kind of discussion is happening around the world now between groups that are interested because we want to crack this problem quickly. We don't want to wait and do these different studies sequentially. We want to try and do them simultaneously. And I'm excited about that. I think if we do that, we've got a real shot at developing a treatment over the next five to 10 years say. Dr. Greg Hundley: Fantastic. Dr. Greg Hundley: And Victoria, I know you have interest in this particular area. Do you have anything you'd like to add? Dr. Victoria Delgado: Yeah. I think that those studies that Mark said are really welcome and I hope that they are positive. And give us a little bit of more to treat these patients. My main fear is that these patients are not as frequent, for example, as heart failure patients. Where we have several therapies where we have possibility to enroll patients in trials for new drugs, that we know that probably are going to be effective. But for valvular heart disease it has been always the end point to reach surgery or to reach an aortic valve replacement or indication of the mitral valve and mitral valve repair. So in early phase of the disease, my main concern is that maybe the patient is not going to be well-trained to understand what are the consequences. I want to always wait until maybe when is needed for the surgical or transcatheter procedure. Dr. Victoria Delgado: But I think that increasing the awareness of the prevalence of valvular heart disease and the consequences may help people to understand, to put more attention for an early diagnosis and develop new drugs that can help, like in this case, aortic stenosis one of the most frequent valvular heart disease, to prevent the proliferation and to prevent the replacement of the valve. Dr. Greg Hundley: Very nice. Well listeners, this has been a wonderful discussion and we greatly appreciate the input that we've been able to gather today from Dr. Marc Dweck from Edinburgh in Scotland and our own associate editor, Dr. Victoria Delgado. Bringing this information from a randomized trial, evaluating osteoporosis drugs, and really indicating they did not disrupt the progression of calcification in patients with aortic stenosis. Dr. Greg Hundley: Well, on behalf of Carolyn and myself, we want to wish you a great rest of your week and we will catch you next week on The Run. Dr. Greg Hundley: This program is copyright of the American Heart Association, 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit ahajournals.org.  

This episode is also available as a blog post: https://fierceautie.com/2021/06/17/bogus-studyprobiotic-and-oxytocin-combination-therapy-in-patients-with-autism-spectrum-disorder-a-randomized-double-blind-placebo-controlled-pilot-trial/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Entenda mais sobre as promessas e evidências associadas ao supercoffee Artigos citados:Borba GL, Batista JSF, Novais LMQ, Silva MB, Silva Júnior JBD, Gentil P, Marini ACB, Giglio BM, Pimentel GD. Acute Caffeine and Coconut Oil Intake, Isolated or Combined, Does Not Improve Running Times of Recreational Runners: A Randomized, Placebo-Controlled and Crossover Study. Nutrients. 2019 […]

Collagen is the most abundant protein found in the body and represents about one-third of all protein in the body.  There are over one dozen types of collagen, but type 1, 2, and 3 are the types you'll see in the store in supplement form.  For years, collagen supplements have been used for bone and joint support, as well as skin health. But does it live up to the hype? Subscribe to the Rat Pack NewsletterRate the show on Apple PodcastFollow along on InstagramGet 25% off the most comprehensive blood, DNA, and fitness tracking platform with InsideTrackerTry the cleanest, most effective electrolyte drink on the market: Drink LMNTResourcesA Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind StudyThe effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo‐controlled clinical trials The Effect of Collagen Supplementation from Pork Skin on Serum Collagen, Serum Sex Steroid Hormone, Serum Lipid and Skin Crack in Korean Middle-aged WomenOral intake of specific bioactive collagen peptides reduces skin wrinkles and increases dermal matrix synthesisEnhancing Skin Health: By Oral Administration of Natural Compounds and Minerals with Implications to the Dermal Microbiome A double-blind, placebo-controlled, randomised, clinical study on the effectiveness of collagen peptide on osteoarthritis24-Week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint painDaily oral consumption of hydrolyzed type 1 collagen is chondroprotective and anti-inflammatory in murine posttraumatic osteoarthritis Collagen hydrolysate for the treatment of osteoarthritis and other joint disorders: a review of the literature DisclaimerThis podcast is not intended to provide medical advice, diagnosis, or treatment. The products, information, services, and other content provided on and through this podcast, including information that may be provided in the show notes (directly or via linking to third-party sites), are provided for informational purposes only. Please consult with your physician or other healthcare professionals regarding any medical or health-related diagnosis or treatment options.

If you’ve had the experience of walking through a meadow or trail in the woods and found yourself with a bristly rash on exposed parts of your limbs, you may have brushed up against some stinging nettle. Nettles are an herbaceous perennial flowering plant, native to Europe, Asia, northern Africa, and North America. Tune in to learn how nettles actually support vibrant health!   What is nettle?  Nettle, or stinging nettle, is a shrub that comes from northern Europe and Asia. Its scientific name is Urtica dioica.   If you’ve had the experience of walking through a meadow or trail in the woods and found yourself with a bristly rash on exposed parts of your limbs, you may have brushed up against some stinging nettle. Nettles are an herbaceous perennial flowering plant, native to Europe, Asia, northern Africa, and North America.   The plant has many hollow stinging hairs called "trichomes" on its leaves and stems, which act like needles that inject histamine, formic acid and other chemicals that produce a stinging sensation. It’s very high nutritional content has made it a popular food source steamed and eaten like spinach (it does loose the “sting” when cooked), taken as a tea made from the dried leaves to assist in the nutrition of expectant or nursing mothers, or for general tonic properties for good health.  The leaves, stem, or root from the nettle plant can be crushed and made into powders, tinctures, creams, teas, and more. While people have used it for centuries as an herbal medicine, modern research also supports many of the potential health benefits of nettle and nettle tea.  Stinging nettle’s leaves and root provide a wide variety of nutrients, including:  Vitamins: Vitamins A, C and K, as well as several B vitamins  Minerals: Calcium, iron, magnesium, phosphorus, potassium and sodium  Fats: Linoleic acid, palmitic acid, stearic acid and oleic acid  Amino acids: All of the essential amino acids  Polyphenols: Kaempferol, quercetin, caffeic acid, coumarins and other flavonoids  Pigments: Beta-carotene, lutein, luteoxanthin and other carotenoids  What’s more, many of these nutrients act as antioxidants inside your body.  Antioxidants are molecules that help defend your cells against damage from free radicals. Damage caused by free radicals is linked to aging, as well as cancer and other harmful diseases.  Studies indicate that stinging nettle extract can raise blood antioxidant levels.  Top 5 Benefits of Nettles  1. Urinary tract health  Nettle may help flush harmful bacteria from the urinary tract. This can benefit people who have urinary conditions, such as benign prostatic hyperplasia (BPH). BPH causes an enlarged prostate gland in men. This can cause pain or other problems urinating.  According to one 2013 study men with BPH who took nettle extract had fewer clinical symptoms than those who didn’t.  Nettle may also help support any medications you’re taking for infections or conditions related to the urinary tract. Talk to your doctor first about any possible interactions between herbal remedies and medications you take.  2. Arthritis and pain  Nettle has historically been used to treat pain and sore muscles, especially related to arthritis. The Arthritis Foundation suggests that nettle tea may also reduce the inflammation and pain association with osteoarthritis.  3. Blood sugar management  Nettle has shown some promising effects on blood glucose levels. It may help the pancreas make or release more insulin, the hormone that lowers blood sugar.  In a 2013 study, nettle leaf extract lowered blood glucose and A1C in a group of people with type 2 diabetes who were taking insulin as well as oral diabetes medications.  4. The power of polyphenols  Nettle is high in plant chemicals called polyphenols. A review of the research on polyphenols suggests that these powerful compounds may play a role in the prevention and management of chronic diseases related to inflammation, such as diabetes, obesity, cancer, and heart disease.  In particular, polyphenols from nettle extract have shown some exciting potential for treating breast cancer and prostate cancer. Plants like nettle also contain potent antioxidants, which are substances that protect the body from aging and cell damage.  5. May Treat Hay Fever  Hay fever is an allergy that involves inflammation in the lining of your nose.  Stinging nettle is viewed as a promising natural treatment for hay fever.  Test-tube research shows that stinging nettle extracts can inhibit inflammation that can trigger seasonal allergies.  This includes blocking histamine receptors and stopping immune cells from releasing chemicals that trigger allergy symptoms.  However, human studies note that stinging nettle is equal to or only slightly better at treating hay fever than a placebo.   While this plant may prove a promising natural remedy for hay fever symptoms, more long-term human studies are needed.  How to make nettle tea  You can buy nettle tea loose or in teabags, but you can also grow or harvest the leaves yourself. With fresh leaves, experiment with the ratio of nettle to water you prefer, but a general reference is two cups of water for every cup of leaves. Here’s how:  Add water to the leaves.  Bring the water just to a boil.  Turn off the stove and let sit for five minutes.  Pour the mixture through a small strainer.  Add a bit of honey, cinnamon, or stevia, if you like.  Start out by only having one cup of nettle tea to make sure you don’t have any reactions to it.  Warnings  Be sure to talk to your doctor before you try any new herb or supplement. Even all-natural foods and drinks like tea can cause allergic reactions or interact with certain medications. Some herbs and supplements can be harmful to people with certain health conditions.  RESOURCES  Stinging nettle  http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000275    Stinging nettles leaf (Urtica dioica L.): Extraordinary vegetable medicine  https://www.sciencedirect.com/science/article/abs/pii/S2210803312000978    Chronic Inflammation and Oxidative Stress as a Major Cause of Age-Related Diseases and Cancer  https://pubmed.ncbi.nlm.nih.gov/19149749/    Effects of Urtica dioica Supplementation on Blood Lipids, Hepatic Enzymes and Nitric Oxide Levels in Type 2 Diabetic Patients: A Double Blind, Randomized Clinical Trial  https://pubmed.ncbi.nlm.nih.gov/28078249/    Effects of Urtica dioica Supplementation on Blood Lipids, Hepatic Enzymes and Nitric Oxide Levels in Type 2 Diabetic Patients: A Double Blind, Randomized Clinical Trial  https://pubmed.ncbi.nlm.nih.gov/28078249/    Effects of Stinging Nettle (Urtica Dioica L.,) on Antioxidant Enzyme Activities in Rat Model of Mammary Gland Cancer  https://pubmed.ncbi.nlm.nih.gov/29844787/    The Efficacy of Stinging Nettle (Urtica Dioica) in Patients with Benign Prostatic Hyperplasia: A Randomized Double-Blind Study in 100 Patients  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589769/    Improved Glycemic Control in Patients With Advanced Type 2 Diabetes Mellitus Taking Urtica Dioica Leaf Extract: A Randomized Double-Blind Placebo-Controlled Clinical Trial  https://pubmed.ncbi.nlm.nih.gov/24273930/      Effects of Urtica Dioica Dichloromethane Extract on Cell Apoptosis and Related Gene Expression in Human Breast Cancer Cell Line (MDA-MB-468)  https://pubmed.ncbi.nlm.nih.gov/26950453/    Antiproliferative Effect on Human Prostate Cancer Cells by a Stinging Nettle Root (Urtica Dioica) Extract  https://pubmed.ncbi.nlm.nih.gov/10705733/    The Immunomodulatory and Anti-Inflammatory Role of Polyphenols  https://www.mdpi.com/2072-6643/10/11/1618    Nettle Extract (Urtica Dioica) Affects Key Receptors and Enzymes Associated With Allergic Rhinitis  https://pubmed.ncbi.nlm.nih.gov/19140159/    Randomized, Double-Blind Study of Freeze-Dried Urtica Dioica in the Treatment of Allergic Rhinitis  https://pubmed.ncbi.nlm.nih.gov/2192379/    Efficacy of Supportive Therapy of Allergic Rhinitis by Stinging Nettle (Urtica dioica) Root Extract: A Randomized, Double-Blind, Placebo- Controlled, Clinical Trial  https://pubmed.ncbi.nlm.nih.gov/29844782/       

As a follow-up to our 3 part series on "addictions", we wanted to provide constructive ways to manage stress. Stress is a normal part of life; tthere is no way to completely avoid the stressors we face daily. However, what we can control is how we respond to that stress. In this episode, we share our 9 favorite ways to naturally manage stress:SleepSupplementsExerciseBreathworkMindsetNatureLaughterSaying "no"RelationshipsSubscribe to the Rat Pack NewsletterRate the show on Apple PodcastFollow along on InstagramGet 25% off the most comprehensive blood, DNA, and fitness tracking platform with InsideTrackerTry the cleanest, most effective electrolyte drink on the market: Drink LMNTResourcesA prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adultsAn investigation into the stress-relieving actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled studyAnti-Stress, Behavioural and Magnetoencephalography Effects of an L-Theanine-Based Nutrient Drink: A Randomised, Double-Blind, Placebo-Controlled, Crossover TrialMulticenter, open-label, exploratory clinical trial with Rhodiola rosea extractStress management and the role of Rhodiola rosea: a reviewThe Effects of Rhodiola rosea L. Extract on Anxiety, Stress, Cognition and Other Mood SymptomsRhodiola rosea in Subjects with Prolonged or Chronic Fatigue SymptomsHerbal Medicine for Depression and Anxiety: A Systematic ReviewThe Effect of Valeric on Anxiety Severity in Women Undergoing HysterosalpingographyKavain, the Major Constituent of the Anxiolytic Kava Extract, Potentiates GABAA ReceptorsThe Role of Nature in Coping with Psycho-Physiological Stress: A Literature Review on RestorativenessMinimum Time Dose in Nature to Positively Impact the Mental Health of College-Aged Students, and How to Measure It: A Scoping ReviewDisclaimerThis podcast is not intended to provide medical advice, diagnosis, or treatment. The products, information, services, and other content provided on and through this podcast, including information that may be provided in the show notes (directly or via linking to third-party sites), are provided for informational purposes only. Please consult with your physician or other healthcare professionals regarding any medical or health-related diagnosis or treatment options.

Have you ever heard about Positive Thinking or Positive Psychology and thought "Sure, but what does that really look like?"  Or "How could I even use that in a way that makes sense for me?"  If you have, or if you've ever wondered if there is an evidence-based way to make positive thinking work for you, this is the episode for you.  In this episode we explore one way, taking just ten minutes per day, that you can employ the principles of Positive Psychology outlined by Martin Seligmann in his latest book, Flourish.  We'll look at the structure of a Randomized, Placebo-Controlled study that found significant evidence that folks who intentionally paid attention to, and wrote about, the principles of Pleasure, Engagement, Positive Relationships, Meaning and Accomplishment (PERMA) for just ten minutes each night reported higher happiness scores and much lower rates of depression.  Best of all, we can do this ourselves with a pen, a notebook and just ten minutes each night.  Want to learn more?  Tune in!Want to read more about the theory and science?  See below:Original research article:Gander, F., Proyer, R., & Ruch, W. (2016) Positive Psychology Interventions Addressing Pleasure, Engagement, Meaning, Positive Relationships, and Accomplishment Increase Well-Being and Ameliorate Depressive Symptoms: A Randomized, Placebo-Controlled Online Study. Frontiers in Psychology, 7, 2016, Article: 686  Retrieved from:  https://www.frontiersin.org/article/10.3389/fpsyg.2016.00686More on Seligman's Positive Psychology:Seligman, M. (2011).  Flourish: A visionary new understanding of Happiness and Well-being.  New York, Atria Paperback.

JAACAP March 2020: Contributing Editor Dr. John Erik Leikauf interviews Dr. Kenneth Towbin on the effects of adding citalopram to methylphenidate in the treatment of chronic severe irritability in youth using a double-blind randomized placebo-controlled design.

In this episode, Sal, Adam & Justin discuss the five kinds of supplements many people need to take if nutrients are lacking in their whole food diet.  What are supplements? (4:24) Why do certain segments of the population NEED supplements? (6:43) The importance of testing to track the changing of your nutrient demands. (15:15) Why whole foods are the ideal source. (18:40) The 5 Most Important Supplements to Take.  (24:00) Vitamins and minerals to fill nutrient deficiencies. (26:41) Protein. (41:19) Creatine. (47:11) Caffeine. (53:15) Adaptogens. (1:00:46) Related Links/Products Mentioned February Promotion: MAPS Split ½ off! **Code “SPLIT50” at checkout** Visit Four Sigmatic for an exclusive offer for Mind Pump listeners! **Code “mindpump” at checkout** Folate deficiency Health effects of vegan diets Visit Everly Well for an exclusive offer for Mind Pump listeners! **Code “mindpump” at checkout** Visit Joovv for an exclusive offer for Mind Pump listeners! Mind Pump 1125: Dr. Jolene Brighten- What You Need to Know About the Menstrual Cycle Low Vitamin D Levels Associated with Colds and Flu Visit Organifi for the exclusive offer for Mind Pump listeners! **Code “mindpump” at checkout** Visit Legion Athletics for the exclusive offer for Mind Pump listeners! **Code “mindpump” at checkout** Mind Pump 1220: The 4 Best Sources of Protein Your Brain on Creatine | Psychology Today The Benefits Of Caffeine Cycling A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide Mind Pump Free Resources People Mentioned Dr. Jolene Brighten (@drjolenebrighten)  Instagram Jessica Di Stefano (@thetraininghour)  Instagram    

Video Podcast (CC)Aired date: 10/30/2013 8:30:00 AM Eastern Time

Methotrexate in psoriatic arthritis - does it really work or are we just giving a placebo? Listen to Professor Robert Moots and Dr Robert Thompson, University of Liverpool discuss the management psoriatic arthritis and analyse a major new randomized

Methotrexate in psoriatic arthritis - does it really work or are we just giving a placebo? Listen to Professor Robert Moots and Dr Robert Thompson, University of Liverpool discuss the management psoriatic arthritis and analyse a major new randomized

Methotrexate in psoriatic arthritis - does it really work or are we just giving a placebo? Listen to Professor Robert Moots and Dr Robert Thompson, University of Liverpool discuss the management psoriatic arthritis and analyse a major new randomized