Podcasts about randomized

Why are we still treating acute uncomplicated diverticulitis with antibiotics? There is plenty of evidence from several randomized controlled trials demonstrating that symptomatic management alone yields similar results. If we should continue prescribing antibiotics for acute uncomplicated diverticulitis, which patients should undergo treatment and when? Join Drs. Jared Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss the management of uncomplicated diverticulitis while reviewing groundbreaking literature. Hosts: -Jared Hendren, MD Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio - Elissa Dabaghi, MD Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio - Joseph Trunzo, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter @joseph_trunzo - Ajaratu Keshinro, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter- @AJKesh - David Rosen, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter- @davidrrosenmd Learning Objectives: By the end of this episode, listeners will be able to: 1.     Identify criteria for managing acute uncomplicated diverticulitis without antibiotics based on recent literature 2.     Define uncomplicated and complicated diverticulitis 3.     Discuss nuanced management decisions of patients with uncomplicated diverticulitis to determine when antibiotics may be appropriate for management References: 1.     Azhar, N., Aref, H., Brorsson, A., Lydrup, M.‑L., Jörgren, F., Schultz, J. K., & Buchwald, P. (2022). Management of acute uncomplicated diverticulitis without antibiotics: Compliance and outcomes – a retrospective cohort study. BMC Emergency Medicine, 22(1), Article 28. https://doi.org/10.1186/s12873‑022‑00584‑X  2.     Mora‑López, L., Ruiz‑Edo, N., Estrada‑Ferrer, O., Piñana‑Campón, M. L., Labró‑Ciurans, M., Escuder‑Perez, J., Sales‑Mallafré, R., Rebasa‑Cladera, P., Navarro‑Soto, S., Serra‑Aracil, X., & DINAMO‑study Group. (2021). Efficacy and safety of nonantibiotic outpatient treatment in mild acute diverticulitis (DINAMO‑study): A multicentre, randomised, open‑label, noninferiority trial. Annals of Surgery, 274(5), e435–e442. https://doi.org/10.1097/SLA.0000000000005031 3.     Daniels, L., Ünlü, Ç., de Korte, N., van Dieren, S., Stockmann, H. B., Vrouenraets, B. C., Consten, E. C., van der Hoeven, J. A., Eijsbouts, Q. A., Faneyte, I. F., Bemelman, W. A., Dijkgraaf, M. G., & Boermeester, M. A. (2017). Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT‑proven uncomplicated acute diverticulitis. British Journal of Surgery, 104(1), 52‑61. https://doi.org/10.1002/bjs.10309 4.     Chabok, A., Påhlman, L., Hjern, F., Haapaniemi, S., & Smedh, K.; AVOD Study Group. (2012). Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. British Journal of Surgery, 99(4), 532–539. https://doi.org/10.1002/bjs.8688 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Molly Jacobson speaks with Dr. Erica Ancier about Pulsed Electromagnetic Field (PEMF) therapy and its applications for dogs with cancer, chronic pain, arthritis, and more. They discuss the safety of PEMF therapy, how it works, its benefits, and how to use it at home to improve your dog's quality of life. Topics Covered: • What is PEMF therapy? • How PEMF therapy helps with pain relief, inflammation, and healing. • The debate about PEMF therapy and cancer safety. • Combining PEMF therapy with chemotherapy for better results. • Practical tips for using PEMF devices at home. • Dr. Ancier's personal experience using PEMF therapy for her dog. Key Takeaway: PEMF therapy is a safe, affordable, and effective tool to improve your dog's quality of life, especially when managing pain and inflammation. Your Voice Matters! If you have a question for our team, or if you want to share your own hopeful dog cancer story, we want to hear from you! Go to https://www.dogcancer.com/ask to submit your question or story, or call our Listener Line at +1 808-868-3200 to leave a question. Related Videos: https://www.youtube.com/watch?v=ZvA7W9XlciM https://www.youtube.com/watch?v=s2w5AyaLqrw Related Links: Assisi Animal Health/Zomedica https://assisianimalhealth.com/ Respond Systems https://respondsystems.com/pemf/ BEMER https://life.bemergroup.com/pemf-pulse-electro-magnetic-field/ Effect of Targeted Pulsed Electromagnetic Field Therapy on Canine Postoperative Hemilaminectomy: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial: https://meridian.allenpress.com/jaaha/article-abstract/55/2/83/184239/Effect-of-Targeted-Pulsed-Electromagnetic-Field?redirectedFrom=fulltext Chapters: 00:00 Introduction 00:30 - Dr. Ancier's Experience with PEMF Therapy 01:15 - What is PEMF Therapy? How It Works 03:00 - Benefits of PEMF: Pain Relief and Inflammation Reduction 04:45 - Controversy Around PEMF Therapy and Cancer Safety 06:30 - FDA-Approved Uses for PEMF in Humans and Dogs 08:15 - Situations to Avoid PEMF Therapy (Contraindications) 10:00 - Using PEMF Devices at Home: Tips and Safety 13:00 - Combining PEMF Therapy with Chemotherapy 16:00 - Practical Uses for PEMF: Arthritis, Recovery, and Anxiety 22:00 - Device Options: Loops, Mats, and Costs 25:30 - Longevity of Devices and Maintenance Tips 27:15 - Enhancing Quality of Life for Dogs with PEMF Therapy 30:00 - Closing Thoughts and Life Quality vs. Quantity Get to know Dr. Erica Ancier: https://www.dogcancer.com/people/erica-ancier-dvm-cva-ccrp/ For more details, articles, podcast episodes, and quality education, go to the episode page: https://www.dogcancer.com/podcast/ Learn more about your ad choices. Visit megaphone.fm/adchoices

I sat down with Dr. Layne Norton, PhD, one of the most respected names in evidence-based fitness and nutrition, to cut through the noise that dominates our feeds. If you've ever been confused by conflicting advice from influencers, or wondered how to separate hype from science, this conversation is for you.Layne walks us through how to actually read research, spot red flags, and apply the right evidence to your own health and performance. We talk about adherence, why consistency beats hacks, how to think about n=1 experimentation, and why muscle is way more than just something that moves your body—it's one of the most powerful protectors of long-term health.If you want to stop guessing and start making decisions that are backed by data (and not just feelings), you'll love this episode. Listen in, and you'll walk away with a practical blueprint for training smarter, fueling better, and staying resilient—without falling for the myths.Timeline Mitopure Gummies: GET 20% Off Now!

Los artículos que se tratan en el episodio de hoy están listados aquí: Legge, N., Schneuer, F. J., Shand, A. W., Fitzgerald, D., Popat, H., & Nassar, N. (2025). Educational Performance of Extremely Preterm Infants in Primary School. Pediatrics, 156(1), e2024069425. https://doi.org/10.1542/peds.2024-069425Dudeja, S., Saini, S. S., Sundaram, V., Dutta, S., Sachdeva, N., & Kumar, P. (2025). Early hydrocortisone versus placebo in neonatal shock- a double blind Randomized controlled trial. Journal of perinatology : official journal of the California Perinatal Association, 45(3), 342–349. https://doi.org/10.1038/s41372-025-02222-3Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal.Soy tu host, Maria Flores Cordova, MD.Este podcast está presentado por los médicos neonatólogos Dani de Luis Rosell, Elena Itriago, Carolina Michel y Juliana Castellanos.No dudes en enviarnos preguntas, comentarios o sugerencias a nuestro correo electrónico: nicupodcast@gmail.comSíguenos en nuestras redes:Twitter: @incubadorapodInstagram: @laincubadorapodcastCreado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org  Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal. Soy tu host, Maria Flores Cordova, MD. Este podcast está presentado por los médicos neonatólogos Dani de Luis Rosell, Elena Itriago, Carolina Michel y Juliana Castellanos. No dudes en enviarnos preguntas, comentarios o sugerencias a nuestro correo electrónico: nicupodcast@gmail.comSíguenos en nuestras redes:Twitter: @incubadorapodInstagram: @laincubadorapodcast Creado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org

Send us a textBom-vindos ao episódio 61 do Podcast A Incubadora. Esse é o nosso Journal Club 40 – Especial Agosto Dourado. A cada quinze dias, trazemos uma seleção de artigos recentes em neonatologia para discussão em português, com o objetivo de tornar a literatura científica mais acessível para profissionais da área.Neste episódio, vamos conversar sobre quatro estudos que exploram diferentes dimensões do leite humano no cuidado neonatal:Potential Epigenetic Effects of Human Milk on Infants' Neurodevelopment - https://www.mdpi.com/2072-6643/15/16/3614Effect of Neonatal Unit Interventions Designed to Increase Breastfeeding in Preterm Infants: An Overview of Systematic Reviews - https://karger.com/neo/article/121/4/411/896932/Effect-of-Neonatal-Unit-Interventions-Designed-toSeverity of Bronchopulmonary Dysplasia in Infants Born Extremely Preterm and Randomized to Early Human Milk Fortification with a Donor Milk-Derived Fortifier for Two Weeks - https://www.jpeds.com/article/S0022-3476(25)00291-4/abstractNon-nutritional Use of Human Milk as a Therapeutic Agent in Neonates: Brain, Gut, and Immunologic Targets - https://pubmed.ncbi.nlm.nih.gov/39348773/ Não esqueça: você pode ter acesso aos artigos do nosso Journal Club no nosso site: https://www.the-incubator.org/podcast-1 Lembrando que o Podcast está no Instagram, @incubadora.podcast, onde a gente posta as figuras e tabelas de alguns artigos. Se estiver gostando do nosso Podcast, por favor dedique um pouquinho do seu tempo para deixar sua avaliação no seu aplicativo favorito e compartilhe com seus colegas. Isso é importante para a gente poder continuar produzindo os episódios. O nosso objetivo é democratizar a informação. Se quiser entrar em contato, nos mandar sugestões, comentários, críticas e elogios, manda um e-mail pra gente: incubadora@the-incubator.org

We recently hosted a session on the DHS's proposed rule to replace the current H-1B lottery with a weighted-based selection system. Although the rule has not yet been made public, there is speculation that it could prioritize H-1B cap registrations for occupations offering higher wages, potentially impacting future cap seasons starting in FY 2027.Partner and Attorney ⁠Min Kim⁠ and Client Services Manager ⁠Arianna Gonzalez, MBA⁠ explained what is known so far, how it compares to the 2021 proposal, and what employers should expect as the rule moves through the required notice and comment federal review process.Listen in to know more!

Program notes:0:40 Alteplase after stroke1:40 Expand time window2:40 Imaging crucial in use3:20 Use of health care and mortality in those with dementia4:20 Women used much less healthcare5:20 Focus on prevention in women5:50 IVF outcomes and weight loss6:50 Did not appear to increase success with IVF7:45 Ultraprocessed foods versus minimally processed foods8:45 Randomized to one diet or the other for 8 weeks9:45 Minimally processed foods improved risk factors10:45 Short period of study11:42 End

In this episode, Mo and Marc are joined by special guest Professor Ted Miclau (Orthopaedic Trauma Institute International Chair, UCSF Department of Orthopaedic Surgery) in a discussion focusing on innovations and recent work in fracture-healing.    Link  Gouhari F, Shariatpanahi ZV, Talebi S, Mehrvar A, Momeny M, Ehsani A, Ahmadi-Abdashti A, Zandi R. Therapeutic Effects of Bovine Colostrum on Bone Healing, Rehabilitation, and Postoperative Complications: A Prospective, Randomized, Double-Blinded Comparative Trial. J Bone Joint Surg Am. 2025 Apr 18;107(12):1307-1315. doi: 10.2106/JBJS.24.00542. PMID: 40249794. https://www.jbjs.org/reader.php?rsuite_id=bf628643-fcfe-4fc5-9f9e-b46db1bd70d2&source=The_Journal_of_Bone_and_Joint_Surgery/107/12/1307&topics=hp+ta#info    Subspecialties:  Basic Science  Hip  Orthopaedic Essentials  Trauma  Chapters (00:00:03) - Orthojoe Podcast(00:00:49) - Bovine Colostrum and Bone Healing(00:03:23) - Mental Fitness: Ted McLow(00:03:52) - Osteomyelitis and fracture healing(00:09:48) - Breastfeeding and hip fracture(00:11:20) - Hip Fracture and the International RCT

Oral methadone versus sublingual buprenorphine for the treatment of acute opioid withdrawal: A triple-blind, double-dummy, randomized control trial  Drug and Alcohol Dependence Researchers compared oral methadone to sublingual buprenorphine for the management of acute opioid withdrawal. Patients at an inpatient drug treatment center in India were randomly assigned to receive either methadone or buprenorphine titrated over days 1-3 to control opioid withdrawal symptoms. Over days 4-10 medications were tapered and stopped by day 11. Completion of treatment was similar in both groups (83% methadone, 82% buprenorphine). Both subjective (SOWS) and objective (COWS) withdrawal symptoms decreased during the treatment, however the buprenorphine group had significantly greater withdrawal symptoms than the methadone group (p=0.009) at the end of treatment (day 10). Opioid craving also decreased in both groups with no significant difference between groups. Authors conclude that methadone is a safe and effective alternative to buprenorphine for management of opioid withdrawal.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM  

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Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPSES conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.    

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPS  conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.  

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPSES conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.    

Divaka Perera, MD and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the SERIAL study, the first randomized comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in serial coronary artery disease.

In this conversation, Dr. Elizabeth Klodas, a preventive cardiologist and founder of Step One Foods, discusses the critical role of nutrition in managing heart disease and the challenges faced in integrating dietary changes into medical practice. She shares her journey from traditional medicine to creating a food company aimed at reducing reliance on medications through nutrition. The discussion highlights the importance of randomized controlled trials in validating the effectiveness of food-based interventions, the impact of pharmaceuticals on healthcare, and the need for a shift in consumer perceptions towards whole food ingredients. Dr. Klodas emphasizes the potential for a healthier future where cardiologists are less needed due to preventive measures and lifestyle changes.Takeaways:Nutrition is often overlooked in favor of pharmaceuticals in healthcare.Patients are rarely asked about their diet by healthcare providers.Changing dietary habits can lead to significant health improvements.Pharmaceuticals are easier to prescribe than dietary changes.There is a lack of nutrition education in medical training.Step One Foods aims to fill nutritional gaps in patients' diets.Randomized controlled trials can validate the effectiveness of food products.Consumer perceptions of health foods can be influenced by marketing.The food industry often prioritizes cost over nutrition.A better world would mean fewer cardiologists needed due to preventive health measures.Sound bites:“There is very little to no nutrition education for physicians. As I look back on this I consider this educational malpractice.”“All the medical evidence of what we should be doing is very heavily pharma biased, because guidelines are based on randomized control clinical trials.”“So there's loads of reasons why nutrition is not used in clinical care the way it should be. None of that is an excuse though, because it works and it's so vital.”“What if I asked you to like eat this food twice a day and I otherwise left you alone? What started happening is people calling and saying, hey, my cholesterol dropped 39 points. Then I'm like, okay, we're gonna subject our products to a randomized control trial. Let's see. Let's prove it. Does this actually work?”“If I reduce, LDL, the bad cholesterol across the US population by an average of 9%, I will finally dethrone heart disease as our number one killer.”“In that trial, we replicated what people were calling in with our highest LDL reduction was close to 40 % in 30 days. That's a medication level cholesterol reduction. And we did that with food, without turning people's lives upside down.”“It's not just the nutrient of interest that's important. It's the delivery vehicle. You can stuff a bunch of fiber into a Twinkie. But in the end, you're still eating a Twinkie, right? Food and nutrition is complex.”“At Step One Foods I take the complexity out for people. I take whole food ingredients, each and every single one that has data behind it in terms health benefits, and put them in my foods.”“We are probably the most overfed and undernourished society in the history of our species.”“If you truly believe in your mission, you have to ignore all the no's.”Promo Offer:Code: BETTERWORLDLink: https://www.steponefoods.com/discount/BETTERWORLDOffer: 10% off first order for both one time and subscription orders. Offer can be stacked with the subscription discount to save 30% on their first order. Exclusions: Limited to one use per customer. Limited to a customer's first order and only applies to the first recurring order. Code must be entered at checkout for the discount to be applied. Links:Dr Elizabeth Klodas on LinkedIn - https://www.linkedin.com/in/eklodas/Step One Foods- https://www.steponefoods.com/Step One Foods on LinkedIn - https://www.linkedin.com/company/steponefoods/Step One Foods on Facebook - https://www.facebook.com/StepOneFoodsStep One Foods on Instagram - https://www.instagram.com/steponefoods/Step One Foods on YouTube - https://www.youtube.com/StepOneFoods…“Slay the Giant: The Power of Prevention in Defeating Heart Disease” book - https://www.steponefoods.com/products/slay-the-giant…Brands for a Better World Episode Archive - http://brandsforabetterworld.com/Brands for a Better World on LinkedIn - https://www.linkedin.com/company/brand-for-a-better-world/Modern Species - https://modernspecies.com/Modern Species on LinkedIn - https://www.linkedin.com/company/modern-species/Gage Mitchell on LinkedIn - https://www.linkedin.com/in/gagemitchell/…Print Magazine Design Podcasts - https://www.printmag.com/categories/printcast/…Heritage Radio Network - https://heritageradionetwork.org/Heritage Radio Network on LinkedIn - https://www.linkedin.com/company/heritage-radio-network/posts/Heritage Radio Network on Facebook - https://www.facebook.com/HeritageRadioNetworkHeritage Radio Network on X - https://x.com/Heritage_RadioHeritage Radio Network on Instagram - https://www.instagram.com/heritage_radio/Heritage Radio Network on Youtube - https://www.youtube.com/@heritage_radioChapters:03:00 Introduction to Preventive Cardiology and Nutrition05:58 The Shift from Nutrition to Medication in Healthcare08:45 The Role of Pharmaceuticals in Patient Care11:41 The Challenges of Nutrition Education in Medicine14:41 The Complexity of Food and Nutrition Science17:59 Step One Foods: A New Approach to Nutrition20:57 The Impact of Randomized Controlled Trials on Nutrition23:59 The Importance of Ingredient Quality in Food Products26:49 Pushback from the Medical and Food Industries29:52 The Insurance Industry's Role in Healthcare Costs32:52 Step One Foods: Product Overview and Benefits38:43 Introduction to Whole Foods and Health Claims40:56 The Importance of Real Ingredients42:56 Navigating Organic Ingredients and Supply Chain Challenges44:59 Stepwise Approach to Health and Nutrition48:58 Challenges in Scaling Food Production51:49 Milestones and Industry Changes56:55 Advice for Aspiring Food Entrepreneurs59:50 Personal Indulgences and Food Preferences01:03:00 Innovative Thinkers in Nutrition01:05:50 Vision for a Healthier WorldSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

What's best for skin closure at C-Section? Staples or suture? This debate has raged for over 20 years. Past data has shown greater odds of wound complications with metal staples compared to suture. But new a meta-analysis from June 2025 is challenging the prior results. In this episode, we will explore the data from 2010 to present day. PLUS, we will summarize a separate meta-analysis examining if wound dressing removal is tied to any wound complication. This was just published July 15, 2025 in the “Pink” journal. Listen in for details. 1. 2010: Basha SL, Rochon ML, Quiñones JN, Coassolo KM, Rust OA, Smulian JC. Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery. Am J Obstet Gynecol. 2010 Sep;203(3):285.e1-8. doi: 10.1016/j.ajog.2010.07.011. PMID: 20816153.2. 2015: Mackeen AD, Schuster M, Berghella V. Suture versus staples for skin closure after cesarean: a metaanalysis. Am J Obstet Gynecol. 2015 May;212(5):621.e1-10. doi: 10.1016/j.ajog.2014.12.020. Epub 2014 Dec 19. PMID: 25530592.3. Jan 2025: Gabbai D, Jacoby C, Gilboa I, Maslovitz S, Yogev Y, Attali E. Comparison of complications and surgery outcomes in skin closure methods following cesarean sections. Arch Gynecol Obstet. 2025 Jul;312(1):125-129. doi: 10.1007/s00404-024-07911-6. Epub 2025 Jan 25. PMID: 39862268; PMCID: PMC12176926.4. June 2025: Post-cesarean skin closure with metal staples versus subcuticular suture in obese patients: A systematic review and meta-analysis of randomized controlled trials. Luis Sanchez-Ramos et al (Univ Florida). https://onlinelibrary.wiley.com/doi/pdf/10.1002/pmf2.700615. DRESSING REMOVAL: July 15, 2025: Leshae A Cenac, Serena Guerra, Alicia Huckaby, Gabriele Saccone, Vincenzo Berghella. Early Wound Dressing (soft gauze/tape dressing) Removal after Cesarean Delivery: A Meta-Analysis of Randomized Trials: Short title: early wound dressing removal after cesarean, American Journal of Obstetrics & Gynecology MFM, 2025; https://doi.org/10.1016/j.ajogmf.2025.101739.6. https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf

Vous êtes toujours parmi nous? La fin approche! Dans ce 47ème épisode du Pharmascope et dernier de la série sur le TDAH, Nicolas, Isabelle et leur invitée discutent entre autres des options de traitement pharmacologiques autres que les psychostimulants. Les objectifs pour cet épisode sont : Comprendre les risques et les bénéfices associés à la prise de l'atomoxetine et de la guanfacine Évaluer la place de l'atomoxetine et la guanfacine dans l'algorithme de traitement du TDAH Adapter le traitement pharmacologique du TDAH en fonction du patient   Ressources pertinentes en lien avec l'épisode Lignes directrices canadiennes CADDRA – Canadian ADHD Ressource Alliance : Lignes directrices canadiennes pour le TDAH, quatrième édition, Toronto (Ontario); CADDRA 2018. Lignes directrices américaines Wolraich ML et coll. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Subcommittee on children and adolescents with attention-deficit / hyperactive disorder. Pediatrics 2019. 144(4). pii:e20192528. Revues du TDAH Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet. 2016;387(10024):1240-50. Auclair M, Elalami M. Traitement du TDAH chez l'enfant. Québec Pharmacie. Septembre 2018. 28p. Revue systématique globale  Stuhec M, Lukic P, Locatelli I. Efficacy, Acceptability, and Tolerability of Lisdexamfetamine, Mixed Amphetamine Salts, Methylphenidate, and Modafinil in the Treatment of Attention-Deficit Hyperactivity Disorder in Adults: A Systematic Review and Meta-analysis. Ann Pharmacother. 2019; 2:121-133. Liens utiles pour ressources Canadian ADHD Ressource Alliance (CADDRA). 2020. Centre for ADHD awareness, Canada (CADDAC). 2017. Clinique FOCUS. 2020. Annick Vincent. TDAH, informations, trucs et astuces. 2020. Méta-analyse comparant l'atomoxétine aux psychostimulants en TDAH Liu Q, Zhang H, Fang Q, et coll. Comparative Efficacy and Safety of Methylphenidate and Atomoxetine for Attention-Deficit Hyperactivity Disorder in Children and Adolescents: Meta-analysis Based on Head-To-Head Trials. J Clin Exp Neuropsychol. 2017; 39(9): 854-65. Évaluation de la guanfacine en TDAH par l'INESSS Institut national d'excellence en santé et services sociaux. INTUNIV XRMC – Trouble du déficit de l'attention avec ou sans hyperactivité. Février 2014. Étude portant sur des doses de 1 à 7mg de guanfacine en TDAH chez l'adolescent Wilens TE, Robertson B, Sikirica V, et coll. A Randomized, Placebo-Controlled Trial of Guanfacine Extended Release in Adolescents With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2015;54(11):916–925.

Dr. John Fleetham chats with Dr. Jaclyn Smith and Dr. Imran Satia about their articles, "Camlipixant in Refractory Chronic Cough: A Phase 2b, Randomized, Placebo-controlled Trial (SOOTHE)" and "Camlipixant: A New Hope for Refractory Chronic Cough?"

FACT (fentanyl And Crushed Ticagrelor) PCI: A Randomized Control Trial of Patients Undergoing Percutaneous Coronary Intervention Who Receive Ticagrelor and Fentanyl

En lo último en salud y fitness edición de junio 2025, damos un paseo por las últimas tendencias, investigaciones y noticias en el mundo de la salud y el fitness.En este episodio de junio 2025, vamos a explorar varios temas que han estado dando de qué hablar. Hablaremos sobre algo que muchos se preguntan: ¿realmente sirven los baños fríos o calientes después de entrenar? También veremos cómo el entrenamiento de fuerza y el yoga están mostrando resultados prometedores para combatir el cansancio relacionado con el cáncer.Para los padres que nos escuchan, tenemos datos importantes sobre el impacto real de las pantallas en niños pequeños. Y para quienes están pendientes de su alimentación, analizaremos si realmente importa comer 3 o 6 veces al día, además de comparar estrategias de ayuno intermitente para bajar de peso.02:20 - Baños fríos o calientes post-ejercicio: La ciencia dice que da igual 105:03 - Entrenamiento de fuerza y yoga para mejorar el cansancio por cáncer207:25 - El verdadero costo del tiempo frente a la pantalla en preescolares310:28 - ¿Comer 3 o 6 veces al día? Spoiler: ni tu hambre ni tu cuerpo parecen notarlo mucho413:25 - ¿El ayuno intermitente 4:3 es la mejor forma de ayunar para perder peso?5Referencias:1.      Wellauer, V., Clijsen, R., Bianchi, G. & Riggi…, E. No acceleration of recovery from exercise-induced muscle damage after cold or hot water immersion in women: A randomised controlled trial. PloS one (2025).2.      Zhou, S., Chen, G., Xu, X., Zhang, C. & Chen…, G. Comparative Efficacy of Various Exercise Types on Cancer‐Related Fatigue for Cancer Survivors: A Systematic Review and Network Meta‐Analysis of Randomized …. Cancer … (2025).3.      Ahmer, A., Raza, M., Azhar, M., Rahman, A. & Das…, J. K. A Systematic Review and Meta-Analysis on the Impact of Screen-Time on the Social-Emotional Development of Children Under Five Years. Journal of the College of … (2025).4.      Zhang, X., Perrigue, M., Schenk, J. M. & Drewnowski…, A. Objective and subjective appetite measures: high versus low eating frequency in a randomized crossover clinical trial. … (2025).5.      Catenacci, V. A., Ostendorf, D. M. & Pan…, Z. The effect of 4: 3 intermittent fasting on weight loss at 12 months: A randomized clinical trial. Annals of Internal … (2025).

In the wake of the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork® put together an X Spaces discussion hosted by Stephen Liu, MD, and Joshua Sabari, MD, to highlight the most intriguing and practice-changing lung cancer abstracts. Discussed topics ranged from long-term follow-up with commonplace therapies to an analysis of what time of day is the best to administer immunochemotherapy.  Liu, an associate professor of Medicine at Georgetown University, and the director of Thoracic Oncology and head of Developmental Therapeutics at the Georgetown Lombardi Comprehensive Cancer Center, and Sabari, an assistant professor in the Department of Medicine at the NYU Grossman School of Medicine, and the director of High Reliability Organization Initiatives at the Perlmutter Cancer Center, shared expert insights on the latest non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) breakthroughs. Trials of note that they discussed included: The phase 3 DeLLphi-304 trial (NCT05740566) - Tarlatamab (Imdelltra) versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of Ph3 DeLLphi-304.1 The phase 3 IMforte trial (NCT05091567) - Lurbinectedin (Zepzelca; lurbi) + atezolizumab (Tecentriq; atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial.2 The phase 3 CheckMate 816 trial (NCT02998528) - Overall survival with neoadjuvant nivolumab (Opdivo; NIVO) + chemotherapy (chemo) in patients with resectable NSCLC in CheckMate 816.3 The phase 3 PACIFIC15 trial (NCT05549037) - Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non–small cell lung cancer.4 The phase 3 Beamion LUNG-1 trial (NCT04886804) - Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non–small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial.5 The phase 3 ARTEMIA trial (NCT06472245) - Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non–small cell lung cancer and secondary resistance to immunotherapy. References Rudin C, Mountzios G, Sun L, et al. Tarlatamab versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of Ph3 DeLLphi-304. J Clin Oncol. 2025;43(suppl 17):LBA8008. doi:10.1200/JCO.2025.43.17_suppl.LBA8008 Paz-Ares L, Borghaei H, Liu SV, et al. Lurbinectedin (lurbi) + atezolizumab (atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial. J Clin Oncol. 2025;43(suppl 16):8006. doi:10.1200/JCO.2025.43.16_suppl.8006 Forde PM, Spicer JD, Provencio M, et al. Overall survival with neoadjuvant nivolumab + chemotherapy in patients with resectable NSCLC in CheckMate 816. J Clin Oncol. 2025;43(suppl 17):LBA8000. doi:10.1200/JCO.2025.43.17_suppl.LBA8000 Zhang Y, Huang Z, Zeng L, et al. Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non-small cell lung cancer. J Clin Oncol. 2025;43(suppl 16):8516. doi:10.1200/JCO.2025.43.16_suppl.8516 Sabari JK, Nadal E, Hendriks L, et al. Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non-small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial. J Clin Oncol. 2025;43(suppl 16):8620. doi:10.1200/JCO.2025.43.16_suppl.8620 Liu SV, Guibert C, Tostivint EP, et al. Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non-small cell lung cancer and secondary resistance to immunotherapy. J Clin Oncol. 2025;43(suppl 16):TPS8651. doi:10.1200/JCO.2025.43.16_suppl.TPS8651

For full review of the trials, please visit https://cardiologytrials.substack.com/ Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Efficacy And Safety of AZD0780, An Oral Small Molecule PCSK9 Inhibitor For Treatment Of Hypercholesterolemia: Results From A Ph2b Randomized Placebo-controlled Clinical Trial

The Effect of Once-weekly Subcutaneous Semaglutide on Functional Capacity in People with Type 2 Diabetes and Peripheral Artery Disease: Primary Results from the Phase 3b, Randomized, Placebo...

Outline00:00 - Intro00:42 - “Research should be fun”02:02 - Early steps in research09:00 - Book writing and meeting C. Desoer18:33 - Control synthesis via the factorization approach25:46 - The graph metric 29:27 - Robotics and CAIR36:00 - Randomized algorithms40:41 - On learning44:05 - Neural networks48:40 - Tata, hidden Markov models, and large deviations theory55:48 - Picking problems and role of luck58:07 - Compressed sensing and non-convex optimization01:02:17 - Interplay between control and machine learning01:09:10 - Advice to future students01:13:29 - Future of controlLinksSagar's website: https://tinyurl.com/4hwruajsHilbert: https://tinyurl.com/ykpdh929Feedback Systems: https://tinyurl.com/2k3jsdatHow to Write Mathematics: https://tinyurl.com/35794bv9Nonlinear systems: https://tinyurl.com/2fdtnjcmC. Desoer: https://tinyurl.com/svhknrenControl Systems Synthesis — A Factorization Approach: https://tinyurl.com/59wdc4svAryabhata: https://tinyurl.com/43x6hfhpA Brief History of the Graph Topology: https://tinyurl.com/49uftzdkRobot Dynamics and Control: https://tinyurl.com/5b4cmt7mCAIR: https://tinyurl.com/rajdtxaxRandomized algorithms for robust controller synthesis using statistical learning theory: https://tinyurl.com/wanpyeucR. Tempo: https://tinyurl.com/jkufdwarVC dimension: https://tinyurl.com/mvwk8afmLearning and Generalisation: https://tinyurl.com/2s3mzh8hAre Analog Neural Networks Better Than Binary Neural Networks? https://tinyurl.com/3fnk27xcHidden Markov Processes: https://tinyurl.com/t5frrvfzAn Introduction to Compressed Sensing: https://tinyurl.com/fc6a8eerSupport the showPodcast infoPodcast website: https://www.incontrolpodcast.com/Apple Podcasts: https://tinyurl.com/5n84j85jSpotify: https://tinyurl.com/4rwztj3cRSS: https://tinyurl.com/yc2fcv4yYoutube: https://tinyurl.com/bdbvhsj6Facebook: https://tinyurl.com/3z24yr43Twitter: https://twitter.com/IncontrolPInstagram: https://tinyurl.com/35cu4kr4Acknowledgments and sponsorsThis episode was supported by the National Centre of Competence in Research on «Dependable, ubiquitous automation» and the IFAC Activity fund. The podcast benefits from the help of an incredibly talented and passionate team. Special thanks to L. Seward, E. Cahard, F. Banis, F. Dörfler, J. Lygeros, ETH studio and mirrorlake . Music was composed by A New Element.

In this keynote episode, Professor Sebastian Schneeweiss from Harvard Medical School shares groundbreaking insights from his extensive research into emulating randomized controlled trials (RCTs) using real-world data (RWD). Recorded live at The Effective Statistician Conference 2024, this talk explores whether non-randomized studies based on electronic health records and claims data can reach conclusions as reliable as those from traditional RCTs. Prof. Schneeweiss, also Chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital, walks us through the RCT DUPLICATE project, a major FDA-funded initiative that evaluated whether regulatory decisions could be replicated through high-quality real-world evidence (RWE). From the successes to the limitations—and everything in between—this episode is packed with lessons for statisticians, regulators, and pharmaceutical leaders interested in the future of data-driven healthcare decisions.

Bacterial vaginosis (BV) was long considered not to be a sexually transmitted infection (STI), and treatment was only for women to bear. That was the convention at least until Catriona Bradshaw and her team at the Melbourne Sexual Health Centre published their groundbreaking clinical trial results earlier this year, demonstrating that treating male partners of women with BV prevented recurrence in those women. In this episode of Communicable, hosts Angela Huttner and Annie Joseph welcome back Bradshaw to discuss her trial's design, results, and clinical implications—with some guidelines already updated to include male partners in BV treatment regimens. The conversation also explores the complexities of BV diagnosis, the challenges of trial execution in general, and future research directions.This episode was edited by Kathryn Hostettler and peer reviewed by Arjana Zerja (Mother Theresa University Hospital Centre, Tirana, Albania)ReferencesVodstricil LA, et al. Male-partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med 2025. DOI: 10.1056/NEJMoa2405404Bacterial vaginosis in focus. Melbourne Sexual Health Centre (MSHC). https://www.mshc.org.au/sexual-health/bacterial-vaginosisFurther readingAuvert B, et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med 2005. DOI: 10.1371/journal.pmed.0020298Bailey RC, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 2007. DOI: 10.1016/S0140-6736(07)60312-2Bukusi E, et al. Topical penile microbicide use by men to prevent recurrent bacterial vaginosis in sex partners: A randomized clinical trial, Sex Transmi Dis 2011. DOI: 10.1097/OLQ.0b013e318214b82dCohen CR, et al. Randomized trial of Lactin-V to prevent recurrence of bacterial vaginosis. N Engl J Med 2020. DOI: 10.1056/NEJMoa1915254Gray RH, et al. The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda, Am J Obstet Gynecol 2009. DOI: 10.1016/j.ajog.2008.07.069King AJ, et al. Getting Everyone on Board to Break the Cycle of Bacterial Vaginosis (BV) Recurrence: A Qualitative Study of Partner Treatment for BV. Patient 2025. DOI: 10.1007/s40271-025-00731-zMehta S, et al. The microbiome composition of a man's penis predicts incident bacterial vaginosis in his female sex partner with high accuracy, Front Cell Infect Microbiol 2020. DOI: 10.3389/fcimb.2020.00433Muzny CA, et al. An Updated Conceptual Model on the Pathogenesis of Bacterial Vaginosis. J Infect Dis 2019 DOI: 10.1093/infdis/jiz342Mitchell CM, et al. Screening and characterization of vaginal fluid donations for vaginal microbiota transplantation, Sci Rep 2022. DOI: 10.1038/s41598-022-22873-yPlummer EL, et al. A Prospective, Open-Label Pilot Study of Concurrent Male Partner Treatment for Bacterial Vaginosis. mBio 2021. DOI: 10.1128/mBio.02323-21Plummer EL, et al. Combined oral and topical antimicrobial therapy for male partners of women with bacterial vaginosis: Acceptability, tolerability and impact on the genital microbiota of couples - A pilot study. PLoS One 2018. DOI: 10.1371/journal.pone.0190199Vodstrcil LA, et al. Bacterial vaginosis: drivers of recurrence and challenges and opportunities in partner treatment. BMC Med 2021. DOI: 10.1186/s12916-021-02077-3Wawer MJ, et al. Wawer MJ, et al. Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: A randomised controlled trial. Lancet 2009. DOI: 10.1016/S0140-6736(09)60998-3

Host Dr. Ben Young invites Drs. Roni Levin and Evan Silverstein to review the current state of amblyopia treatment, ranging from the mainstays of patching and atropine drops to novel advances such as dichoptic therapy. Below are some references regarding dichoptic therapy that were discussed in this episode: Xiao S, Angjeli E, Wu HC, Gaier ED, et al. Luminopia Pivotal Trial Group. Randomized controlled trial of a dichoptic digital therapeutic for amblyopia. Ophthalmology. 2022 Jan;129(1):77-85. Wygnanski-Jaffe T, Kushner BJ, Moshkovitz A, Belkin M, Yehezkel O. CureSight Pivotal Trial Group. An eye-tracking-based dichoptic home treatment for amblyopia: A multicenter randomized clinical trial. Ophthalmology. 2023 Mar;130(3):274-285. Koc I, Bagheri S, Chau RK, Hoyek S, et al. Cost-effectiveness analysis of digital therapeutics for amblyopia. Ophthalmology. 2025 Jun;132(6):654-660. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Comparison Of Stent Geometry Achieved By Different Side-branch Ballooning Techniques For Bifurcation Provisional Scenting: The Randomized Crabbis Trial

N Engl J Med 2001;344:1651-1658Background: The MERIT-HF trial demonstrated the efficacy of the selective beta blocker metoprolol CR/XL for well selected patients with chronic systolic heart failure who were on optimal therapy with an ACEi and diuretic. The trial randomized nearly 4,000 patients and was stopped early due to the benefit of the drug on all-cause mortality but it also reduced major morbidity as indicated by significant reductions in hospitalization. It represented the first large scale trial to show a morbidity and mortality benefit for beta blockers in patients with chronic systolic heart failure. Prior to MERIT-HF, the nonselective beta blocker carvedilol reduced morbidity and mortality in a smaller trial of patients with chronic stable heart failure. Limitations of the trial included its size and the fact that it was not originally designed to test mortality. Furthermore, it was stopped early without clearly prespecified stopping rules and 8% of total patients selected for participation in the trial were excluded prior to randomization after a 2 week, open-label run-in phase with the study drug. During the run-in period, 24 patients (2%) experienced worsening heart failure or death and were excluded from participation in the trial - the difference in total deaths between groups was 9 when the trial was stopped. In our opinion, the results of this trial were far from definitive and there are theoretical reasons why selective and nonselective beta blockers could have different effects on cardiac outcomes.The primary difference between selective and nonselective beta blockers lies in their specificity of action; while both types block adrenaline from binding to beta receptors on nerves, selective beta blockers primarily affect those found in the heart whereas nonselective ones also impact those located in the lungs and blood vessels. In the lungs, adrenaline causes bronchodilation and in the blood vessels, vasoconstriction. Thus, nonselective beta blockers also reduce afterload, which can improve cardiac hemodynamics in the failing heart.The Carvedilol Prospective Randomized Cumulative Survival Study was a large-scale trial that sought to test the hypothesis that the nonselective beta blocker carvedilol reduces mortality in patients with chronic stable heart failure who are on optimal treatment.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients: Patients with “severe chronic heart failure” were recruited from 334 sites in 21 countries. Severe chronic heart failure was defined by the presence of dyspnea or fatigue at rest or on minimal exertion for at least 2 months and a LVEF of

In the ruins of a fallen tower, the crew of the Little Snail found themselves (and their egos) battered and bruised. Worse, Elena, Veile, and Nicky found themselves missing one ingredient to the special stew that was their group: Jonathan! Where had he been taken? And could it, perhaps, lead them towards the eternal flame which they were sent to retrieve?  This week on Perpetua: The Shadow of the Dragon Tower Pt. 4 Perpetua Guide [In Progress v.01] - Some Feedback [Page 01 of 03] Alukard83 Hey, this FAQ rules! Normally I buy the official guide but they want FIFTY dollars for this one, and I just don't have that sorta cash right now, so this is a lifesaver.  HOWEVER, your map on the final puzzle area in the Dragon Tower isn't right at ALL. Not sure what you were on when you made it, but it's totally wrong. Otherwise, keep up the good work XD TheUnforgivenIII Yeah I was coming here to post the same thing. This guide sucks bigtime. In my opinion, it's PROOF you should not be releasing this guide without finishing the full game first, because you're going to be in such a hurry that you're going to make stupid mistakes like this (or maybe even make things up entirely, which is my guess.) Take the FAQ down because it doesn't have any REAL answers in it. CarlsSr That's not what OP said, Unforgiveniii. Your bias is showing. FriendOfNei Thanks for the kudos Alukard, but listen, I loaded the save FIVE TIMES and checked it again and again and it's right. I don't know what YOU'RE on but maybe you're the one who is mistaken. As for you, Unforgiven, you're not even worth my keystrokes. XxZelgadyskXx I'm not OP or the FAQ writer but we did some testing over in the IRC channel it turns out that the bomb placement is RANDOMIZED for every player. So the FAQ isn't *wrong* it's just not right for anyone except for Nei. n.n;;;;   Hosted by Austin Walker (austinwalker.bsky.social) Featuring Ali Acampora (ali-online.bsky.social), Art Martinez-Tebbel (amtebbel.bsky.social), Jack de Quidt (notquitereal.bsky.social), and Andrew Lee Swan (swandre3000.bsky.social) Produced by Ali Acampora Music by Jack de Quidt (available on bandcamp) Cover Art by Ben McEntee (https://linktr.ee/benmce.art) With thanks to Amelia Renee, Arthur B., Aster Maragos, Bill Kaszubski, Cassie Jones, Clark, DB, Daniel Laloggia, Diana Crowley, Edwin Adelsberger, Emrys, Greg Cobb, Ian O'Dea, Ian Urbina, Irina A., Jack Shirai, Jake Strang, Katie Diekhaus, Ken George, Konisforce, Kristina Harris Esq, L Tantivy, Lawson Coleman, Mark Conner, Mike & Ruby, Muna A, Nat Knight, Olive Perry, Quinn Pollock, Robert Lasica, Shawn Drape, Shawn Hall, Summer Rose, TeganEden, Thomas Whitney, Voi, chocoube, deepFlaw, fen, & weakmint This episode was made with support from listeners like you! To support us, you can go to friendsatthetable.cash.

Drs. Amy Crockett (@amyhcrockett), Ben Ereshefsky (@brainofbpharm), and Pamela Bailey (@pamipenem) join Dr. Julie Ann Justo (@julie_justo) to discuss new treatment strategies for management of intraamniotic infections, also known as chorioamnionitis. They discuss whether it is time to move away from the combination of ampicillin, gentamicin, and/or clindamycin, alternative antibiotic regimens to consider, and stewardship strategies to approach this practice change at a local level. References: Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593 Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.

"This composition is built entirely from a field recording of an electrical storm, whose raw energy and unpredictable structure inspired the form of the piece. I preserved the full length of the original audio, allowing its natural rise and fall to guide the listening experience.  "Through heavy processing, the storm's dynamics are brought into sharper focus — from piercing, harsh bursts of energy to more subdued, crackling textures. Randomized sound transformations reflect the storm's inherent volatility, creating a sonic environment that is both violent and delicate, chaotic and contemplative." Electrical storm in Perth reimagined by Stefan Strasser.

The FiltrateJoel TopfAC GomezSophia AmbrusoNayan AroraSpecial Guest Charles Edelstein, MD, PhD Professor, Medicine-Renal Med Diseases/HypertensionExtra-Special GuestMichelle Rheault, MD Professor of Pediatrics, University of MinnesotaEditing bySimon and Joel TopfThe Kidney Connection written and performed by by Tim YauShow NotesKDIGO ADPKD Guidelines:WebsiteGuideline PDFExecutive Summary PDFNephJC coverageConsortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP)Hy's Law (Wikipedia) has three components:ALT or AST by 3-fold or greater above the upper limit of normalAnd total serum bilirubin of greater than 2× the upper limit of normal, without findings of cholestasis (defined as serum alkaline phosphatase activity less than 2× the upper limit of normal)And no other reason can be found to explain the combination of increased aminotransferase and serum total bilirubin, such as viral hepatitis, alcohol abuse, ischemia, preexisting liver disease, or another drug capable of causing the observed injuryMeeting this definition yields a very high risk of fulminant kidney failure (76% in one series)Clinical Pattern of Tolvaptan-Associated Liver Injury in Subjects with Autosomal Dominant Polycystic Kidney Disease: Analysis of Clinical Trials Database (PubMed) Two of 957 patients on tolvaptan met Hy's law criteria. None had fulminant kidney failure.Effects of Hydrochlorothiazide and Metformin on Aquaresis and Nephroprotection by a Vasopressin V2 Receptor Antagonist in ADPKD: A Randomized Crossover Trial (PubMed) Patients had a baseline urine volume on tolvaptan of 6.9 L/24 h. Urine volume decreased to 5.1 L/24 h with hydrochlorothiazide and to 5.4 L/24 h on metformin.TEMPO 3:4 Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney Disease (NEJM)Reprise Trial Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease ( NEJM | NephJC )Unified ultrasonographic diagnostic criteria for polycystic kidney disease by Edelstein in JASN (PubMed)Tolvaptan and Kidney Function Decline in Older Individuals With Autosomal Dominant Polycystic Kidney Disease: A Pooled Analysis of Randomized Clinical Trials and Observational Studies (PubMed)Charles' draft choice Recommendation 4.1.1.1: We recommend initiating tolvaptan treatment in adults with ADPKD with an estimated glomerular filtration rate (eGFR) ‡25 ml/min per 1.73 m2 who are at risk for rapidly progressive disease (1B).Sophia's draft choice Recommendation 1.4.2.1: We recommend employing the Mayo Imaging Classi cation (MIC) to predict future decline in kidney function and the timing of kidney failure (1B).Progression to kidney failure in ADPKD: the PROPKD score underestimates the risk assessed by the Mayo imaging classification (Frontiers of Science)AC's draft choice Recommendation 9.2.1: We recommend targeting BP to ≤ 50th percentile for age, sex, and height or ≤ 110/70 mm Hg in adolescents in the setting of ADPKD and high BP (1D).HALT-PKD Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease (NEJM)Nayan's draft choice Recommendation 6.1.2: We recommend screening for ICA in people with ADPKD and a personal history of SAH or a positive family history of ICA, SAH, or unexplained sudden death in those eligible for treatment and who have a reasonable life expectancy (1D).Screening for Intracranial Aneurysms in Patients with Autosomal Dominant Polycystic Kidney Disease (CJASN)Surgical Clipping Versus Endovascular Coiling in the Management of Intracranial Aneurysms (PubMed) Clipping is associated with a higher rate of occlusion of the aneurysm and lower rates of residual and recurrent aneurysms, whereas coiling is associated with lower morbidity and mortality and a better postoperative course.Joel's editorial pick Recommendation 6.1.1: We recommend informing adults with ADPKD about the increased risk for intracranial aneurysms (ICAs) and subarachnoid hemorrhage (1C).Joel's first draft pick The bring out your dead pick:Recommendation 4.3.1: We recommend not using mammalian target of rapamycin (mTOR) inhibitors to slow kidney disease progression in people with ADPKD (1C).Recommendation 4.4.1: We suggest not using statins specfiically to slow kidney disease progression in people with ADPKD (2D).Recommendation 4.5.1: We recommend not using metformin specifically to slow the rate of disease progression in people with ADPKD who do not have diabetes (1B).Recommendation 4.6.1: We suggest that somatostatin analogues should not be prescribed for the sole purpose of decreasing eGFR decline in people with ADPKD (2B).Perfect match: mTOR inhibitors and tuberous sclerosis complex (Orphanet Journal of Rare Diseases)Navitor Pharmaceuticals Announces Janssen Has Acquired Anakuria Therapeutics, Inc. (BioSpace) This is press release about acquiring the mTor1 inhibitor.Joel's second draft pick Recommendation 4.2.1.1: We suggest adapting water intake, spread throughout the day, to achieve at least 2–3 liters of water intake per day in people with ADPKD and an eGFR ≥ 30 ml/min per 1.73 m2 without contraindications to excreting a solute load (2D).Nayan's bonus draft Practice Point 4.7.1: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) should not be used to slow eGFR decline in people with ADPKD.Open-Label, Randomized, Controlled, Crossover Trial on the Effect of Dapagliflozin in Patients With ADPKD Receiving Tolvaptan (KIReports)SMART Trial of GLP-1ra in non-diabetics: Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial (PubMed)Tubular SecretionsNayan: Landman on Paramount Plus (IMDB)Sophia: PassNayan: steps in with The Pitt on HBO (Wikipedia)Charles: The White Lotus, Yellowstone 1923, Poirot (IMDB)AC: The PittMichael Crichton's Estate Sends The Pitt to the Courtroom (Vulture)Joel: I Must Betray you by Ruta Sepetys (Amazon)

Take a sneak peak at this month's Fertility & Sterility! Articles discussed this month are:   4:08 Classification system of human ovarian follicle morphology: recommendations of the National Institute of Child Health and Human Development - sponsored ovarian nomenclature workshop  12:32 Impact of Prednisone on Vasectomy Reversal Outcomes (iPRED Study): Results from a Randomized, Controlled Clinical Trial 21:38 Triggering oocyte maturation in IVF treatment in normal responders: a systematic review and network meta-analysis 33:57 Parental Balanced Translocation Carriers do not have Decreased Usable Blastulation Rates or Live Birth Rates Compared to Infertile Controls  45:28 A re-look at the relevance of TSH and thyroid autoimmunity for pregnancy outcomes: Analyses of RCT data from PPCOS II and AMIGOS View Fertility and Sterility May 2025, Volume 123, Issue 5:  https://www.fertstert.org/issue/S0015-0282(25)X0004-2 View Fertility and Sterility at https://www.fertstert.org/

The Only Anime Podcast drops nothing but uncommons this episode, covering 5 more premieres in their leisurely scramble to close out the season.Anne ShirleyTeogoniaThe Dinner Table DetectiveCan a Boy/Girl Friendship Survive? No, Of Course Not!#Compass 2.0: Animation Project

This interview with Walter Lawrence Jr. was conducted in 2020, when Lawrence was 95 years old and director emeritus of VCU Massey Cancer Center. Lawrence died one year later, on Nov. 9, 2021.Lawrence was one of the founders of the field of surgical oncology, setting up the first-ever university-based division of surgical oncology at what later became VCU Massey Comprehensive Cancer Center, in Richmond, Virginia. He served as director of VCU Massey from 1975 to 1988, during which time the cancer center earned NCI designation.Lawrence spoke with Paul Goldberg, editor and publisher of The Cancer Letter, and Robert Winn, director of VCU. “The thing that was exciting about the National Cancer Act, which I think was one of the best things President Nixon did, among things that weren't so good, was that it did bring the federal government into the funding of various kinds of research,” Lawrence said.Lawrence saw promise in the National Cancer Act, and earning the Cancer Center designation from NCI in 1975 allowed VCU, then called the Medical College of Virginia, to become systematically involved in clinical trials.“Randomized clinical trials were the only way we had of really improving patient cancer care—things like the one that Bernie Fisher in Pittsburgh started, the National Surgical Adjuvant Breast and Bowel Project,” Lawrence said.Read more and explore related archives at https://cancerhistoryproject.com/article/walter-lawrence-podcast/

Host Roz is joined by Timucin Taner, MD, PhD and Dami Ko, PhD to discuss the key articles of the May issue of the American Journal of Transplantation. Dr. Timucin Taner is a professor of surgery at Mayo Clinic, Rochester, MN. Dr. Dami Ko is an assistant professor at the School of Nursing at Northeastern University. [02:51] Development and validation of the Neuro-Score: a specific scale to detect and monitor cognitive impairment in kidney or liver transplant recipients Editorial: Cognitive impairment after liver and kidney transplant: An easy way to check [14:16] Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression [20:46] Donor-specific immune senescence as a candidate biomarker of operational tolerance following liver transplantation in adults: Results of a prospective, multicenter cohort study Editorial: Acquired immune tolerance 2.0 [29:10] Major histocompatibility complex and peptide specificity underpin CD8+ T cell direct alloresponse Editorial: Direct and indirect allorecognition—not so different after all?

Send us a textShort Summary: The flaws of nutrition epidemiology with Dr. John SpeakmanAbout the guest: John Speakman, PhD is a professor at the University of Aberdeen and runs a lab in Shenzhen, China, focusing on energy balance, obesity, and aging. Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.Episode Summary: Dr. John Speakman explores the pitfalls of nutrition epidemiology, a field that links diet to health outcomes like cancer and obesity but often produces contradictory results. They discuss flawed methods like 24-hour recalls and food frequency questionnaires, which rely on memory and are prone to bias, and introduce Speakman's new tool using doubly labeled water to screen implausible dietary data. The conversation highlights systematic biases, such as under-reporting by heavier individuals, and emerging technologies like photo diaries and AI for better dietary tracking.Key Takeaways:Nutrition epidemiology studies often contradict each other due to unreliable methods.Common techniques like 24-hour recalls & food frequency questionnaires suffer from memory issues, portion size issues, and systematic biases, often underestimating food intake.Heavier individuals (higher BMI) under-report food intake more, skewing associations between diet & obesity.Speakman's tool, based on 6,500 doubly labeled water measurements, predicts energy expenditure to flag implausible dietary survey data.Emerging technologies, like smartphone photo diaries and AI food identification, promise more accurate dietary tracking than traditional surveys.Randomized controlled trials, not surveys, provide the most reliable dietary insights; single-day intake surveys linked to outcomes years later are dubious.Speakman advises ignoring most nutrition epidemiology headlines due to their inconsistency and lack of prognostic value for behavior change.Related episode:Support the showAll episodes, show notes, transcripts, etc. at the M&M Substack Affiliates: Lumen device to optimize your metabolism for weight loss or athletic performance. Use code MIND for 10% off. Readwise: Organize and share what you read. Athletic Greens: Comprehensive & convenient daily nutrition. Free 1-year supply of vitamin D with purchase. KetoCitra—Ketone body BHB + potassium, calcium & magnesium, formulated with kidney health in mind. Use code MIND20 for 20% off any subscription. MASA Chips—delicious tortilla chips made from organic corn and grass-fed beef tallow. No seed oils or artificial ingredients. Use code MIND for 20% off. For all the ways you can support my efforts

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.

Dr. Judith Cook (University of Illinois Chicago) joins Dr. Dixon and Dr. Berezin to discuss an intervention designed to help improve financial literacy and competency and reduce economic strain for people receiving services for psychiatric disorders. Transcript 00:57     Psychiatric services research 02:05     Clinical work and Thresholds 03:46     Current role 04:23     Why does financial wellness matter for this population? 06:43     Psych rehab 08:05     Spending triggers 10:59     A psych rehab framework 12:53     Financial wellness 14:10     Beyond trans-diagnostic 16:24     The curriculum 20:10     Receiving a good financial education 21:32     Top line findings of the trial 25:07     The emotional context of financial wellness 25:55     Trained peer instructors 27:34     Policymaker takeaways 30:30     Financial literacy does not imply financial wellness 32:07     Small goals towards financial wellness  Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Send us a textWelcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Dr. John Fralick and guest host Dr. Chunpeng Nie discuss two recent papers: resmetirom for the treatment of Nonalcoholic Steatohepatitis (NASH)—now known as Metabolic Dysfunction-Associated Steatohepatitis (MASH)—with liver fibrosis, and the effect of a Mediterranean diet on disease activity, inflammation, and the gut microbiome in patients with ulcerative colitis. Two papers, here we go!A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis (0:00 – 10:17)A Mediterranean Diet Pattern Improves Intestinal Inflammation Concomitant with Reshaping of the Bacteriome in Ulcerative Colitis: A Randomised Controlled Trial (10:18– 15:45)And for the Good Stuff:Shoutout to all the MTU teams supporting their R1's! (15:46 – 16:20).For the 1st time in Canada, surgeons put teeth in patients' eyes to restore sight (16:21 – 17:56)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

In this episode, Dr. Valentin Fuster summarizes the March 25, 2025, issue of the JACC, which focuses on advancements in electrophysiology. Highlights include groundbreaking studies on leadless pacemakers, atrial fibrillation treatments, and appropriate use criteria for cardiac devices, with key papers exploring the safety of pacemaker retrieval, the role of electrograms in ablation procedures, and long-term outcomes for left atrial appendage occlusion devices.

In this episode, Dr. Valentin Fuster summarizes the March 25, 2025, issue of the JACC, which focuses on advancements in electrophysiology. Highlights include groundbreaking studies on leadless pacemakers, atrial fibrillation treatments, and appropriate use criteria for cardiac devices, with key papers exploring the safety of pacemaker retrieval, the role of electrograms in ablation procedures, and long-term outcomes for left atrial appendage occlusion devices.

This week we're doing something very different!  By Patron request, we're playing a classic SNES game, The Legend of Zelda : A Link to the Past, but we're playing it with a randomizer.  Items are moved around, meaning you'll tackle this game in a different order, with different weapons and items than you're used to, and it's a very different experience. Here's the directions we had : https://www.youtube.com/watch?v=82dogTS1KT4 (Not our video!) and then create your file over here : https://alttpr.com/en We discuss the game itself first, and then our experience with the randomizer, and then of course take on some listener mail. Join us over on our Discord to discuss games, food, or really anything over at https://discord.gg/pb76x32uWY __________________________ If you would like additional bonus episodes of Retrovaniacs or to request a game we must cover, our Patreon is located here : https://www.patreon.com/user?u=21041333 If you enjoy this podcast, why not write a review wherever you download it from? It's easy, and helps people find us by accident. Find everything Retrovaniacs at http://www.retrovania.net Intro song is "8-Bitter" by Subtastics, and is used with permission, mainly because Jeremy P is in that band.  

Send us a textEarly hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial.Dudeja S, Saini SS, Sundaram V, Dutta S, Sachdeva N, Kumar P.J Perinatol. 2025 Feb 13. doi: 10.1038/s41372-025-02222-3. Online ahead of print.PMID: 39948354As 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!

In this episode of Audible Bleeding, Jamila, Anh, and Naveed discuss the LifeBTK Trial with Principal Investigator Dr. Brian DeRubertis, where we discuss the new Abbott Esprit everolimus-eluting resorbable scaffold for the below-knee popliteal space. Guest: Dr. DeRubertis, is the Principal Investigator of the LIFE-BTK trial. He is the Chief of the Division of Vascular & Endovascular Surgery at New York-Presbyterian and Weill Cornell Medicine in New York City. Audible Bleeding Team Dr. Jamila Hedhliis a general surgery resident at the University of Illinois. Anh Dang, (@QuynhAnh_Dang), is a fourth year medical student at the University of Pennsylvania.  Dr. Naveed A. Rahman, (@naveedrahmanmd), is a Vascular Surgery Fellow at the University of Maryland.    References: Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease (LIFE-BTK). Advances in Endovascular Treatment of CLTI: Insights From the LIFE-BTK Trial. Diversity, Equity, and Inclusion in the LIFE-BTK Trial Evaluating the Esprit™ BTK Drug-Eluting Resorbable Scaffold for the Treatment of Infrapopliteal Lesions in Patients with Chronic Limb-Threatening Ischemia, VIVA 2024. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial (YUKON). Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease (DESTINY).  A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease (ACHILLES). Sex Differences in Outcomes Following Endovascular Treatment for Symptomatic Peripheral Artery Disease: An Analysis From the K- VIS ELLA Registry. Drug-Coated vs Uncoated Percutaneous Transluminal Angioplasty in Infrapopliteal Arteries: Six-Month Results of the Lutonix BTK Trial.  Paclitaxel-Coated Balloon in Infrapopliteal Arteries: 12-Month Results From the BIOLUX P-II Randomized Trial (BIOTRONIK'S-First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries).  The IN.PACT DEEP Clinical Drug-Coated Balloon Trial: 5-Year Outcomes.     Follow us @audiblebleeding Learn more about us at  https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM). --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Alzate starts by sharing his early influences, including his time with interventional radiology giant Dr. Harold Coons. The doctors also cover the importance of proper vessel access techniques, innovative approaches to limb salvage, and how to address complex chronic total occlusions (CTOs). Dr. Alzate then goes on to give us a thorough walkthrough of the A-RAM. The episode concludes with Dr. Alzate's closing thoughts on being open to adopt new techniques, the impact of strong mentorship, and importance for consuming and sharing knowledge. --- TIMESTAMPS 00:00 - Introduction 03:05 - Dr. Alzate's Journey 25:52 - A-RAM Technique 34:26 - CTO's and Heavy Calcium 40:16 - Moral Injury in Medical Practice 43:35 - Honoring Dr. Harold Coons 46:23 - Closing Thoughts and Reflections --- RESOURCES Ohki, Takao et al. “Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.” Journal of vascular surgery vol. 74,6 (2021): 1958-1967.e2. https://www.jvascsurg.org/article/S0741-5214(21)01011-9/fulltext Kedora, John et al. “Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.” Journal of vascular surgeryvol. 45,1 (2007): 10-6; discussion 16. https://www.jvascsurg.org/article/S0741-5214(06)01612-0/fulltext

Get 20% off the New 2nd Generation Tone Device HERE with the code VANESSA In this groundbreaking episode of The Optimal Protein Podcast, we dive into a fascinating new randomized controlled trial published in Obesity (link to study) that explores the impact of carbohydrate consumption on ketosis and hunger regulation. Key Topics Discussed: • Study Overview: The methodology and key findings of this recent trial, which evaluates how carbohydrates affect ketone production and appetite. • Carbs and Ketosis: Why carbohydrates are inherently “anti-ketogenic” and how they disrupt the metabolic state of ketosis. • Hunger Regulation: Evidence from the study that links higher carbohydrate intake to increased hunger levels and how this impacts weight management strategies. • Practical Implications: What these findings mean for those pursuing ketogenic or low-carb diets for fat loss, body recomposition, and improved metabolic health. • Satiety and Protein: How prioritizing protein can help counteract the hunger-inducing effects of carbs while supporting sustainable fat loss. Why This Episode Matters: This study provides compelling evidence that supports the ketogenic approach to nutrition by highlighting the direct relationship between carbohydrate intake and hunger signaling. Whether you're a seasoned low-carb enthusiast or someone curious about the benefits of keto, this episode offers valuable insights and actionable takeaways. Links and Resources: • Full Study: Carbs Are Anti-Ketogenic • Follow @ketogenicgirl for updates on the latest studies and strategies to optimize protein intake and metabolic health.  Follow @optimalproteinpodcast on Instagram to see visuals and posts mentioned on this podcast. Link to join the facebook group for the podcast: https://www.facebook.com/groups/2017506024952802/   Thank you to our sponsor:   Bioptimizers Magnesium Breakthrough is one of the only supplements I take with me when I travel as it is so important to me! Save 10% OFF with the code VANESSA at bioptimizers.com/vanessa - This podcast content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and personal health questions. Prior to beginning a new diet you should undergo a health screening with your physician to confirm that a new diet is suitable for you and to out any conditions and contraindications that may pose risks or are incompatible with a new diet, including by way of example: conditions affecting the kidneys, liver or pancreas; muscular dystrophy; pregnancy; breast-feeding; being underweight; eating disorders; any health condition that requires a special diet [other conditions or contraindications]; hypoglycemia; or type 1 diabetes. A new diet may or may not be appropriate if you have type 2 diabetes, so you must consult with your physician if you have this condition. Anyone under the age of 18 should consult with their physician and their parents or legal guardian before beginning such a diet. Use of Ketogenic Girl podcasts & videos are subject to the Ketogenicgirl.com Terms of Use and Medical Disclaimer. All rights reserved. If you do not agree with these terms, do not listen to, or view any Ketogenic Girl podcasts or videos.