Podcasts about randomized

It's the end of another busy week in May of 2023, and Matt is in studio to hang out and do a little of this and that. Randomized media on Russia, Biden, funny shorts, and more. Open lines for Weird Local History, Obscure Languages people in the audience may speak, and whatever else is on people's minds. Reminder: We are getting closer to our June 2023 Book Club sessions! Sign up as a monthly sponsor (Pledge Here: https://bit.ly/3MF6z9Q) at any level and get exclusive access to the live streams. Watch the full episode on Rumble: https://rumble.com/v2oq5bw-friday-jambalaya-news-and-shenanigans-ft-matt-51923.html Support Our Proud Sponsors: Blue Monster Prep: An Online Superstore for Emergency Preparedness Gear (Storable Food, Water, Filters, Radios, MEDICAL SUPPLIES, and so much more). Use code 'FRANKLY' for Free Shipping on every purchase you make @ https://bluemonsterprep.com/ SUPPORT the Show and New Media: Sponsor through QFTV: https://www.quitefrankly.tv/sponsor SubscribeStar: https://www.subscribestar.com/quitefrankly One-Time Gift: http://www.paypal.me/QuiteFranklyLive Official QF Merch: https://bit.ly/3tOgRsV Sign up for the Free Mailing List: https://bit.ly/3frUdOj Send Crypto: BTC: 1EafWUDPHY6y6HQNBjZ4kLWzQJFnE5k9PK LTC: LRs6my7scMxpTD5j7i8WkgBgxpbjXABYXX ETH: 0x80cd26f708815003F11Bd99310a47069320641fC FULL Episodes On Demand: Spotify: https://spoti.fi/301gcES iTunes: http://apple.co/2dMURMq Amazon: https://amzn.to/3afgEXZ SoundCloud: http://bit.ly/2dTMD13 Google Play: https://bit.ly/2SMi1SF Stitcher: https://bit.ly/2tI5THI BitChute: https://bit.ly/2vNSMFq Rumble: https://bit.ly/31h2HUg Watch Live On: QuiteFrankly.tv (Powered by Foxhole) DLive: https://bit.ly/2In9ipw Rokfin: https://bit.ly/3rjrh4q Twitch: https://bit.ly/2TGAeB6 YouTube: https://bit.ly/2exPzj4 CloutHub: https://bit.ly/37uzr0o Theta: https://bit.ly/3v62oIw Rumble: https://bit.ly/31h2HUg How Else to Find Us: Official WebSite: http://www.QuiteFrankly.tv Official Forum: https://bit.ly/3SToJFJ Official Telegram: https://t.me/quitefranklytv GUILDED Hangout: https://bit.ly/3SmpV4G Twitter: @PoliticalOrgy Gab: @QuiteFrankly Truth Social: @QuiteFrankly GETTR: @QuiteFrankly

Dr Pavlos Msaouel: https://faculty.mdanderson.org/profiles/pavlos_msaouel.html 0:00 Pretext and context MD Anderson Cancer Center 1:42 The Early Experiences That Shaped Dr Msaouel 3:39 The System of Cancer Research In the United States 5:25 FDA Drug Approvals and Special Designations For Oncology 11:09 A trade-off in our current system 12:35 Whoops

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice. In this episode, we spoke with a variety of specialists in neurology who presented research and gave talks at the 75th American Academy of Neurology Annual Meeting, held April 22-27, 2023, in Boston, Massachusetts. Those included in this week's episode, in order of appearance, are: Michael H. Barnett, MBBS, PhD, FRACP, a consultant neurologist at Royal Prince Alfred Hospital (RPAH) Sydney, director of the RPAH MS Clinic and the MS Clinical Trials Unit at the Brain and Mind Centre; codirector of the MS Research Australia Brain Bank; and a senior professor at the University of Sydney. Nancy R. Foldvary-Schaefer, DO, FAAN, the director of the Sleep Disorders Center and staff in the Epilepsy Center at Cleveland Clinic, and a professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Sean J. Pittock, MD, the director of the Center for Multiple Sclerosis and Autoimmune Neurology and director of the Neuroimmunology Research Laboratory at Mayo Clinic. Katherine W. Turk, MD, a neurologist at Boston VA Memory Disorders Clinic, principal investigator and codirector of the Center for Translational Cognitive Neuroscience lab (CTCN) at VA Boston; and assistant professor of neurology and coleader of the Outreach, Recruitment and Engagement core of the Alzheimer's Disease Research Center at Boston University. Erika U. Augustine, MD, MS, the associate chief science officer and director of the Clinical Trials Unit at the Kennedy Krieger Institute. Jeffrey M. Statland, MD, a neuromuscular disease specialist and professor of neurology at the University of Kansas Medical Center. Chian-Chun Chiang, MD, a stroke and migraine specialist and assistant professor of neurology at Mayo Clinic. Want more from the 75th American Academy of Neurology Annual Meeting? Click here for all of NeurologyLive®'s coverage of AAN 2023. Episode Breakdown: 1:10 – Barnett on the topline findings for CNM-Au8 from the VISIONARY-MS clinical trial. 8:35 – Foldvary-Schaefer on the understanding of the relationship between epilepsy and sleep. 13:25 – Pittock on the latest data on ravulizumab from the CHAMPION-NMOSD trial. 19:00 – Turk on the landscape of diagnosis and treatment for mild cognitive impairment, and how to improve the process. 22:00 – Augustine on Dr. Sidney Carter and the current paradigm of care in child neurology. 27:15 – Statland on the findings for ataluren in nonsense mutation Duchenne muscular dystrophy from Study 041. 34:05 – Chiang on the takeaways from a big data analysis of 25 therapies for acute migraine management. This episode is brought to you by Medical World News, a streaming channel from MJH Life Sciences®. Check out new content and shows every day, only at medicalworldnews.com. Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com. REFERENCES 1. Barnett MH. VISIONARY-MS Top-line Results: A Phase 2, Randomized, Double-Blind, Parallel Group, Placebo-controlled Study to Assess the Safety and Efficacy of CNM-Au8, a Catalytically Active Gold Nanocrystal Suspension in Relapsing Multiple Sclerosis. Presented at: AAN Annual Meeting; April 22-27, 2023; Boston, MA. 2. Foldvary-Schaefer NR. Diagnostic Testing: Beyond the MSLT. Presented at: AAN Annual Meeting; April 22-27, 2023; Boston, MA. 3. Pittock SJ. Efficacy and safety of ravulizumab in adults with anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder: outcomes from the phase 3 CHAMPION-NMOSD trial. Presented at: AAN Annual Meeting; April 22-27, 2023; Boston, MA. 4. Statland JM. Safety and Efficacy of Ataluren in nmDMD Patients from Study 041, a Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial. Presented at: AAN Annual Meeting; April 22-27, 2023; Boston, MA. 5. Chiang CC. Simultaneous Comparisons of 25 Acute Migraine Medications: A Big Data Analysis of 10 Million Patient Self-Reported Treatment Records From A Migraine Smartphone Application. Presented at: AAN Annual Meeting; April 22-27, 2023; Boston, MA.

Lindholt JS, Søgaard R, Rasmussen LM, et al. Five-year outcomes of the Danish cardiovascular screening (DANCAVAS) trial. N Engl J Med 2022;387(15):1385-1394.     Study design: Randomized controlled trial (nonblinded) Looking to see if intensive screening protocol for cardiovascular disease reduce cardiovascular events or mortality in older men? Danish study, 46,611 men aged 65 to 74 years were randomly assigned to receive an invitation to screening or usual careThe screening program included non-contrast electrocardiographically gated CT to measure coronary artery calcium, look for aneurysms, and detect atrial fibrillation; ankle-brachial index measurements for peripheral arterial disease (PAD) and hypertension; and blood tests for diabetes and hyperlipidemiaThose who accepted screening were more educated, more likely to be employed, and had a somewhat lower rate of hospitalization for cardiovascular events in the previous 5 years. (the rich white gullible ceo male)The screened group was more likely to be given lipid-lowering drugs and antithrombotics, and they were more likely to have repair of an aortic aneurysm.In the entire population, stroke was less likely (HR 0.93; 0.86 - 0.99) but there were no significant differences in myocardial infarction, aortic dissection, or aortic rupture. The authors estimated that 97.4% of men who received preventive therapy of some kind as a result of screening experienced no mortality benefit after almost 6 yrs of follow up. This is basically a really small absolute benefit which we could also see in just placing a pt on a statin. We don't need vip medicine we need pcp that have time to calculate risk and place pt on statin when indicated.     Goldberg RB, Orchard TJ, Crandall JP, et al, for the Diabetes Prevention Program Research Group. Effects of long-term metformin and lifestyle interventions on cardiovascular events in the diabetes prevention program and its outcome study. Circulation 2022;145(22):1632-1641. Study design: Randomized controlled trial (nonblinded) What is the long-term impact of treating prediabetes on mortality and cardiovascular outcomes? Go way back original Diabetes Prevention Program study randomized 3234 overweight or obese adults with impaired glucose tolerance ("prediabetes") to receive metformin 850 mg twice daily, an intensive exercise program, or placebo and followed them for 3 years Patients were invited to participate in a long-term open-label follow-up study This article reports long-term cardiovascular and mortality outcomes for each group. Patients in the intervention groups were less likely to have been given a diagnosis of T2DM (55% for metformin and 53% for lifestyle vs 60% for placebo; P = .001; number needed to treat [NNT] = 17) There was no difference between either intervention group and placebo with regard to the risk of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. There was also no significant difference in the composite of all 3 outcomes for the original metformin group versus the placebo group (hazard ratio [HR] 1.03; 95% CI 0.78 - 1.37) or for those in the original lifestyle group versus the placebo group (HR 1.14; 0.87 - 1.50). More is less or rather more meds is less diagnosis but no difference in things we actually care about     Skjerven HO, Lie A, Vettukattil R, et al. Early food intervention and skin emollients to prevent food allergy in young children (PreventADALL): a factorial, multicentre, cluster-randomised trial. Lancet 2022;399(10344):2398-2411. Study design: Randomized controlled trial (single-blinded) Does the early introduction of allergenic foods prevent the development of food allergy? investigators randomized healthy newborns, singletons or twins, with at least 35 weeks' gestational age (concealed allocation) to receive no intervention (n = 597), a skin intervention (n = 575), a food intervention (n = 642), or a combined intervention (n = 583). The skin intervention consisted of 5- to 10-minute baths with added petrolatum-based emulsified oil followed by topical cetirizine cream applied to the face. This intervention was to occur at least 4 days per week from age 2 weeks to 8 months, The food allergy intervention consisted of sequentially adding allergenic foods (peanuts, cow's milk, wheat, then eggs) to the infants' regular diet at weekly intervals starting at age 3 months. Overall, 95% of the infants in each group were breastfed at 3 months The researchers had final data on 99.9% of the participants!   based on structured parental interviews, skin testing, and oral challenges  The researchers classified the development of food allergy at 36 months as probable, none, or unclear.  There was no significant difference, however, between the infants who were exposed to skin interventions and those who were not exposed (2.1% vs 1.6%). BUT BUT BUT Food allergy occurred in 1.1% of infants in the interventions using food (food intervention and combination intervention) compared with 2.6% in not using food (no intervention and skin intervention; number needed to treat = 63; 95% CI 37-196).   Lewis E, Merghani K, Robertson I, et al. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint J 2022;104-B(6):663-671. Study design: Randomized controlled trial (double-blinded) Allocation: Concealed recruited adults with at least 4 months of knee pain (with or without swelling) who had mild degeneration on their x-rays (if plain x-rays found no signs of degeneration, they used magnetic resonance imaging to confirm the diagnosis). The participants were randomized to receive 3 weekly saline injections (n = 28), or a single PRP injection followed by 2 weekly saline injections (n = 47), or 3 weekly PRP injections (n = 27). . The clinician performing the injections was unmasked but had no other involvement in the study procedures. the participants were evaluated at 6 weeks, 12 weeks, 6 months, and 12 months after enrollment Using intention-to-treat analysis looking at pain, function, and quality of life, at no point in the study were PRP injections, singly or serially, superior to saline injections.

Drs Stanley Cohen and Christopher Ritchlin discuss advances in basic research for psoriatic arthritis, including new research using a humanized mouse model, combination therapy trials, and more. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984269). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Psoriatic Arthritis https://emedicine.medscape.com/article/2196539-overview Transcriptional Signature Associated With Early Rheumatoid Arthritis and Healthy Individuals at High Risk to Develop the Disease https://pubmed.ncbi.nlm.nih.gov/29584756/ DC-STAMP: A Key Regulator in Osteoclast Differentiation https://pubmed.ncbi.nlm.nih.gov/27018136/ Psoriatic Dactylitis: Current Perspectives and New Insights in Ultrasonography and Magnetic Resonance Imaging https://pubmed.ncbi.nlm.nih.gov/34204773/ Transcriptome Fact Sheet https://www.genome.gov/about-genomics/fact-sheets/Transcriptome-Fact-Sheet Tumor Necrosis Factor Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK482425/ Inverse Psoriasis https://www.psoriasis.org/inverse-psoriasis/ Prediction of Psoriatic Arthritis Tool (PRESTO): Development and Performance of a New Scoring System for Psoriatic Arthritis Risk https://acrabstracts.org/abstract/prediction-of-psoriatic-arthritis-tool-presto-development-and-performance-of-a-new-scoring-system-for-psoriatic-arthritis-risk/ Efficacy of Guselkumab, a Selective IL-23 Inhibitor, in Preventing Arthritis in a Multicentre Psoriasis At-Risk Cohort (PAMPA): Protocol of a Randomised, Double-Blind, Placebo Controlled Multicentre Trial https://pubmed.ncbi.nlm.nih.gov/36564123/ Use of IL-23 Inhibitors for the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review https://pubmed.ncbi.nlm.nih.gov/33301128/ Association Between Biological Immunotherapy for Psoriasis and Time to Incident Inflammatory Arthritis: A Retrospective Cohort Study https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00034-6/fulltext Prevention of Psoriatic Arthritis: The Next Frontier https://www.thelancet.com/pdfs/journals/lanrhe/PIIS2665-9913(23)00055-3.pdf Ultrasound Power Doppler and Gray Scale Joint Inflammation: What They Reveal in Rheumatoid Arthritis https://pubmed.ncbi.nlm.nih.gov/31304659/ Consensus Terminology for Preclinical Phases of Psoriatic Arthritis for Use in Research Studies: Results From a Delphi Consensus Study https://pubmed.ncbi.nlm.nih.gov/33589818/ Rheumatoid Arthritis Pathogenesis, Prediction, and Prevention: An Emerging Paradigm Shift https://pubmed.ncbi.nlm.nih.gov/32602263/ Abatacept Reverses Subclinical Arthritis in Patients With High-Risk to Develop Rheumatoid Arthritis -- Results From the Randomized, Placebo-Controlled ARIAA Study in RA-at risk Patients https://acrabstracts.org/abstract/abatacept-reverses-subclinical-arthritis-in-patients-with-high-risk-to-develop-rheumatoid-arthritis-results-from-the-randomized-placebo-controlled-ariaa-study-in-ra-at-risk-patients/ Etanercept in the Treatment of Psoriatic Arthritis and Psoriasis: A Randomised Trial https://pubmed.ncbi.nlm.nih.gov/10972371/ Arthritis Mutilans https://pubmed.ncbi.nlm.nih.gov/23430715/ Usage of C-Reactive Protein Testing in the Diagnosis and Monitoring of Psoriatic Arthritis (PsA): Results From a Real-World Survey in the USA and Europe https://pubmed.ncbi.nlm.nih.gov/35032324/ Disease Modifying Anti-Rheumatic Drugs (DMARD) https://pubmed.ncbi.nlm.nih.gov/29939640/ Combination Therapy of Apremilast and Biologic Agent as a Safe Option of Psoriatic Arthritis and Psoriasis https://pubmed.ncbi.nlm.nih.gov/30499418/

There's nothing more frustrating than wanting to lose weight and not being able to, which is why today, I'm going to teach you about the real cause of weight loss resistance and HOW TO FIX IT! Being able to LOSE 15 LBS IN 21 DAYS without having to count a single calorie may sound too good to be true but it's possible! Today's video isn't about changing how much you eat or about learning how to exercise, or exercising more. It's about your hormones and understanding how your metabolism works on a cellular level. There's a lot of things in our diets that have been marketed as being “good” for you that really aren't. I'll expose those things today and present you with dietary exchanges; what you can eat and cook with instead of what you've been using. You'll be surprised at how simple it really is to switch out one thing for another and.. you'll see that you even feel better! Perhaps not your goal at first but these dietary swaps will help you reduce inflammation and optimize your hormones and WEIGHT LOSS will be the natural side effect of those changes. You're about to make your cells very happy. Are you up for the 21 day challenge?

Joshua Klatt of The University of Utah joins the show to discuss his recent randomized prospective trial on casting material in pediatric forearm fractures. He will then enlighten the audience with the "one right way" to approach a variety of controversial spine, hip, and trauma conditions. Host Joshua Holt from University of Iowa leads the session with co-hosts Carter Clement (Children's Hospital of New Orleans) and Julia Sanders (Children's Hospital Colorado). Plaster Versus Ortho-Glass®: Does Initial Splint Material Matter in Pediatric Forearm Fracture Outcomes? A Randomized, Prospective Trial. Ludwig et al. JPOSNA 2023. https://doi.org/10.55275/JPOSNA-2023-597   Does Transitioning to a Brace Improve HRQoL After Casting for Early Onset Scoliosis? Henstenburg et al and the PSSG. JPO Epub 2023. PMID: 36728464   Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children. Chen et al. JBJS Am Epub 2023. PMID: 36727888.   Imposter Syndrome Among Surgeons Is Associated With Intolerance of Uncertainty and Lower Confidence in Problem Solving. Lin et al. and The Science of Variation Group. CORR Epub 2022. PMID: 36073997.   A Practical Guide for Improving Orthopaedic Care in Children with Autism Spectrum Disorder. Maloy et al. JPOSNA 2023. https://doi.org/10.55275/JPOSNA-2023-640

Dr. Jill Sylvester reviews the article, “Subacromial Decompression Versus Diagnostic Arthroscopy for Shoulder Impingement: A 5-year Follow-up of a Randomized, Placebo Surgery Controlled Clinical Trial,” which was originally published in the British Journal of Sports Medicine in January 2021. Dr. Jeremy Schroeder serves as moderator. Dr. Sylvester is a member of the AMSSM Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2021, as selected for the 2022 AMSSM Annual Meeting in Austin, TX. Subacromial Decompression Versus Diagnostic Arthroscopy for Shoulder Impingement: A 5-year Follow-up of a Randomized, Placebo Surgery Controlled Clinical Trial DOI: 10.1136/bjsports-2020-102216

Thanks for listening!

The Prospective Randomized Data Says That It's Just As Dangerous To Eat Fish As Red Meat Kim Williams, MD •Book Foreword - Healthy at Last T. Colin Campbell, PhD • https://nutritionstudies.org/ • Book - China Study Caldwell B. Esselstyn Jr. MD • http://www.drEsselstyn.com• Book - Prevent and Reverse Heart Disease Dr. Heather Shenkman • http://www. drheathershenkman.com • Book – The Vegan Heart Doctor's Guide #PlantBased#Doctors  #HeartDisease  #Cancer Dr Kim Williams Sr. is an American cardiologist, professor and author. He has been vegan since 2003;His enthusiasm for plant-based diets is based on his interpretation of medical literature and his own experience lowering his own cholesterol by removing dairy and animal protein. He has board certifications in internal medicine, cardiovascular diseases, nuclear medicine, nuclear cardiology, and cardiovascular computed tomography. He has served on the faculty of the Pritzker School of Medicine, the Wayne State University School of Medicine in Detroit, Michigan, and at Rush University Medical Center in Chicago, where he is the head of the cardiology department. To Contact Dr Williams go to doctors.rush.edu/details/1728/kim-williams-sr-cardiovascular_disease-chicago-oak_park Dr. T. Colin Campbell, PhD has been dedicated to the science of human health for more than 60 years. His primary focus is on the association between diet and disease, particularly cancer. Although largely known for the China Study — one of the most comprehensive studies of health and nutrition ever conducted and recognized by The New York Times as the “Grand Prix of epidemiology” — Dr. Campbell's profound impact also includes extensive involvement in education, public policy, and laboratory research. He has delivered hundreds of lectures around the world, and he is the founder of the T. Colin Campbell Center for Nutrition Studies and the online Plant-Based Nutrition Certificate in partnership with eCornell. To Contact Dr. T. Colin Campbell, Ph.D.  go to nutritionstudies.org Dr. Caldwell Esselstyn Jr. is a world-renowned surgeon and the acclaimed author of the game-changing book, Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure.This Book outlines a groundbreaking program backed by the irrefutable results from Dr. Esselstyn's 20-year study proving changes in diet and nutrition can cure heart disease. He's been featured on many television programs and in very popular documentaries on health and nutrition. Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet since 1984. Dr. Esselstyn presently directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute. To Contact Dr. Esselstyn Jr go to DrEsselstyn.com Dr. Heather Shenkman is an author of her book The Vegan Heart Doctor's Guide to reversing heart disease, losing weight, and reclaiming your life. If you suffer from heart disease, you are all too familiar with the standard treatment plan of pills, doctor s appointments, and tests. But interventional cardiologist Heather Shenkman, MD, says what happens inside medical offices and hospitals is only a tiny part of what it really takes to heal heart disease. Most conventional doctors barely mention lifestyle. And yet, what you eat and how much you move are central to attaining optimal health. Shenkman says a plant-based diet, plenty of exercise, and a whole-hearted approach to living make up the best prescription of all. And in The Vegan Heart Doctor s Guide to Reversing Heart Disease, Losing Weight, and Reclaiming Your Life, she lays out a simple, manageable protocol for transitioning to a vegan diet and safely leaving your former, sedentary self in the dust. Dr Shenkman is an interventional cardiologist in practice in Tarzana, California. To Contact Dr Heather Shenkman drheathershenkman.com Disclaimer:Medical and Health information changes constantly. Therefore, the information provided in this podcast should not be considered current, complete, or exhaustive. Reliance on any information provided in this podcast is solely at your own risk. The Real Truth About Health does not recommend or endorse any specific tests, products, procedures, or opinions referenced in the following podcasts, nor does it exercise any authority or editorial control over that material. The Real Truth About Health provides a forum for discussion of public health issues. The views and opinions of our panelists do not necessarily reflect those of The Real Truth About Health and are provided by those panelists in their individual capacities. The Real Truth About Health has not reviewed or evaluated those statements or claims. 

Tune in to hear Drs Stanley Cohen and Alexis Ogdie dive into new research on switching vs cycling medications in caring for patients with psoriatic arthritis, tight control in axSpA, and more. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984265). The topics and discussions are planned, produced, and reviewed independently of the advertisers. This podcast is intended only for US healthcare professionals. Resources 1600: The Impact of Second-Line Therapeutic on Disease Control After Discontinuation of First Line TNF Inhibitor in Patients With PsA: Analysis From the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry https://www.eventscribe.net/2022/ACRConvergence/index.asp?presTarget=2189995 Cycling or Swap Biologics and Small Molecules in Psoriatic Arthritis: Observations From a Real-life Single Center Cohort https://pubmed.ncbi.nlm.nih.gov/33879661/ Baseline Disease Activity Predicts Achievement of cDAPSA Treatment Targets With Apremilast: Phase III Results in DMARD-naïve Patients With Psoriatic Arthritis https://pubmed.ncbi.nlm.nih.gov/35428720/ Etanercept and Methotrexate as Monotherapy or in Combination for Psoriatic Arthritis: Primary Results From a Randomized, Controlled Phase III Trial https://pubmed.ncbi.nlm.nih.gov/30747501/ EULAR 2023. European Congress of Rheumatology https://congress.eular.org/ GRAPPA Treatment Recommendations: 2021 Update https://pubmed.ncbi.nlm.nih.gov/35293339/ Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis https://pubmed.ncbi.nlm.nih.gov/30499246/ Effect of a Treatment Strategy of Tight Control for Rheumatoid Arthritis (the TICORA Study): A Single-blind Randomised Controlled Trial https://pubmed.ncbi.nlm.nih.gov/15262104/ Aiming at Low Disease Activity in Rheumatoid Arthritis With Initial Combination Therapy or Initial Monotherapy Strategies: The BeSt Study https://pubmed.ncbi.nlm.nih.gov/17083767/ Long-term Follow-up of Patients in the TIght COntrol of Inflammation in Early Psoriatic Arthritis (TICOPA) Trial https://pubmed.ncbi.nlm.nih.gov/31504996/ Efficacy of a Tight-control and Treat-to-target Strategy in Axial Spondyloarthritis: Results of the Open-label, Pragmatic, Cluster-randomised TICOSPA Trial https://pubmed.ncbi.nlm.nih.gov/33958325/ ASAS Health Index: The "All in One" for Spondyloarthritis Evaluation? https://pubmed.ncbi.nlm.nih.gov/33004479/ Central Sensitization Has Major Impact on Quality of Life in Patients With Axial Spondyloarthritis https://pubmed.ncbi.nlm.nih.gov/35033996/ ASAS-EULAR Recommendations for the Management of Axial Spondyloarthritis: 2022 Update https://pubmed.ncbi.nlm.nih.gov/36270658/ Treatment of Ankylosing Spondylitis by Primary Care Physicians and Rheumatologists: A Retrospective Study in Three Health Systems https://acrabstracts.org/abstract/treatment-of-ankylosing-spondylitis-by-primary-care-physicians-and-rheumatologists-a-retrospective-study-in-three-health-systems/ Multimorbidity in Psoriasis as a Risk Factor for Psoriatic Arthritis: A Population-Based Study https://acrabstracts.org/abstract/multimorbidity-in-psoriasis-as-a-risk-factor-for-psoriatic-arthritis-a-population-based-study/ Comorbidities, Pain and Fatigue in Psoriatic Arthritis, Psoriasis and Healthy Controls: A Clinical Cohort Study https://pubmed.ncbi.nlm.nih.gov/33325531/

In this episode, we are joined by Dr. Beth Livingston to take a critical look at a recent paper that criticized "woke" DEI efforts. Waldman & Sparr - Rethinking Diversity Strategies: An Application of Paradox and Positive Organization Behavior Theories Thomason, Opie, Livingston & Sitzmann: “Woke” Diversity Strategies: Science or Sensationalism? Woke (Dictionary.com) Stop WOKE act was deemed unconstitutional Amy Wax says white culture is superior Chris Rufo's work is misleading and dishonest Manhattan institute Discovery institute Some substantive critiques of diversity trainings:  ‘Diversity Training' Doesn't Work. This Might.  Rethinking Diversity Training  African American Museum site removes ‘whiteness' chart after criticism from Trump Jr. and conservative media  Randomized placebo-controlled RCT on outcomes for diversity training

This week, please join author Mikael Dellborg and Associate Editor Gerald Greil as they discuss the article "Adults With Congenital Heart Disease: Trends in Event-Free Survival Past Middle Age." Dr. Greg Hundley: Welcome listeners to this March 21st issue. And I am one of your co-hosts, Dr. Greg Hundley, Associate Editor Director of the Pauley Heart Center at VSU Health in Richmond, Virginia. Dr. Peder Myhre: And I am the other co-host, Dr. Peder Myhre, from Akershus University Hospital and University of Oslo in Norway. Dr. Greg Hundley: Well, Peder, we have a very interesting feature discussion this week. It focuses on adults with congenital heart disease. And as you are aware, over the last 25 to 30 years the survival rate of individuals with congenital heart disease has really improved. And this group, led by Professor Dellborg, will discuss with us more on results from a Swedish registry examining patients after the age of 18 with adult congenital heart disease. But before we get to that, how about we grab a cup of coffee and jump into some of the other articles in the issue? Would you like to go first? Dr. Peder Myhre: I would love it to, Greg, thank you. So Greg, the first paper is about aortic stenosis and the genome-wide association study looking at aortic stenosis in patients from the Million Veteran Program. And as you know, Greg, calcific aortic stenosis is the most common valve of heart disease in older adults and has no effective preventive therapies. Genome-wide Association studies, GWAS, can identify genes influencing disease and may help prioritize therapeutic targets for aortic stenosis. And in this study, which comes to us from co-corresponding authors, O'Donnell from VA Boston Health System and Dr. Natarajan from Massachusetts General Hospital, both in Boston Massachusetts, performed genetic analysis in 14,451 cases with aortic stenosis and almost 400,000 controls in the Multiancestry Million Veteran Program. And replication for these results was performed in five other cohorts. Dr. Greg Hundley: Wow, Peder, so a very large gene-wide association study. So what did they find? Dr. Peder Myhre: So Greg, the authors found 23 lead variants representing 17 unique genomic regions. And of the 23 lead variants, 14 were significant in replication, representing 11 unique genomic regions. And five replicated genomic regions were previously known risk loci for aortic stenosis, while six were novel. And of the 14 replicated lead variants, only two of these were also significant in atherosclerotic cardiovascular disease GWAS. And in Mendelian randomization, lipoprotein a and LDL cholesterol were both associated with aortic stenosis, but the association between LDL cholesterol and aortic stenosis was attenuated when adjusting for LP a. So Greg, in conclusion this study identified six novel genomic regions for aortic stenosis, and secondary analysis highlighted roles of lipid metabolism, inflammation, cellular senescence and adiposity in the pathobiology of or stenosis, and also clarified the shared and differential genetic architectures of aortic stenosis with atherosclerotic cardiovascular disease. Dr. Greg Hundley: Wow, Peder, what a beautiful description. Very comprehensive study. Well, my study comes to us from the world of preclinical science and, Peder, it involves embryonic heart development. So Peder, placental and embryonic heart development occur in parallel, and these organs have been proposed to exert reciprocal regulation during gestation. Poor presentation has been associated with congenital heart disease, an important cause of infant mortality. However, the mechanisms by which altered placental development can lead to congenital heart disease remain really unresolved. So in this study, led by Dr. Suchita Nadkarni from Queen Mary University of London and colleagues, the team used an in vivo neutrophil-driven placental inflammation model via antibody depletion of maternal circulating neutrophils at key stages during time-mated murine pregnancy, embryonic day 4.5, 7.5, and then the animals were culled at embryonic day 14.5 to assess placental and embryonic heart development. Dr. Peder Myhre: Oh, wow. Very interesting design. And, Greg, I'm curious to know what did they find? Dr. Greg Hundley: Right, Peder. So they found that neutrophil-driven placental inflammation leads to inadequate placental development and loss of barrier function. And consequently, placental inflammatory monocytes of maternal origin become capable of then migrating to the embryonic heart and alter the normal composition of resonant cardiac macrophages and cardiac tissue structure. This cardiac impairment continues into postnatal life, hindering normal tissue architecture and function. Also, they found that tempering placental inflammation can prevent this fetal cardiac defect and is sufficient to promote normal cardiac function in postnatal life. So in conclusion, Peder, these observations provide a mechanistic paradigm whereby neutrophil-driven inflammation in pregnancy can preclude normal embryonic heart development as a direct consequence of poor placental development. And this in turn certainly has major implications on cardiac function into the adult life of these animals. And this really warrants further study in larger animal models and perhaps human subjects. Dr. Peder Myhre: Very interesting, Greg. Thank you for summarizing that. And we also have some other articles in the mail bag today. Do you mind going first? Dr. Greg Hundley: Sure, Peder. So what I've got is a very nice exchange of letters from Doctors Deng, Schmidt, and Tabák regarding a prior paper entitled, "Risk of Macrovascular and Microvascular Disease in Diabetes Diagnosed Using Oral Glucose Tolerance Test With and Without Confirmation by Hemoglobin A1c: The Whitehall II Cohort Study." Dr. Peder Myhre: And Greg, we also have a Research Letter from Dr. Niklas Bergh entitled, "Risk of Heart Failure in Congenital Heart Disease: A Nationwide Register-based Cohort Study." And then there is an article summarizing Highlights from the Circulation Family written by Molly Robbins [and Dr. Parag Joshi] where she summarizes, first the characteristics of pleomorphic ventricular tachycardia described in Circulation: A and E, then racial inequities in assessing advanced heart failure therapies reported in Circulation: Heart Failure. Outpatient clinic-based vascular procedure outcomes are compared with those done in a hospital setting in Circulation: Cardiovascular Quality and Outcomes. Then there's a paper about immune cell imaging using nuclear methods from Circulation: Cardiovascular Imaging. And finally, temporal trends in left main PCI from the UK described in Circulation: Cardiovascular Interventions. And then Greg, we have one final very interesting paper, which is a joint opinion from the European Society of Cardiology, American Heart Association, and American College of Cardiology, in addition to the World Heart Federation and it's entitled, "Randomized Trials Fit for the 21st Century." And I'm going to read you a quote from the beginning of this article, Greg. It is, "Randomized controlled trials are the cornerstones for reliably validating therapeutic strategies. However, during the past 25 years, the rules and regulations governing randomized trials and their interpretation have become increasingly burdensome, and the cost and complexity of trials has become prohibitive. The present model is unsustainable, and the development of potentially effective treatments is often stopped prematurely on financial grounds, while existing drug treatments or non-drug interventions, such as screening strategies or management tools, may not be assessed reliably." What do you think about that? Dr. Greg Hundley: Oh, wow, Peder. Very provocative. So it'd be interesting for our listeners to take a gander at that particular paper. Well, what a great issue and how about we get on to that feature discussion? Dr. Peder Myhre: Let's go. Dr. Mercedes Carnethon: Thank you for joining us on this episode of Circulation on the Run Podcast. My name is Mercedes Carnethon. I'm an Associate Editor at the journal Circulation and Professor and Vice Chair of Preventive Medicine at the Northwestern University, Feinberg School of Medicine. I'm thrilled today to be able to host this podcast alongside my colleague at Circulation, Gerald Greil, and with our special guest today, Dr. Mikael Dellborg from the Sahlgrenska Academy at the University of Gothenburg and Sahlgrenska University Hospital. Welcome this morning, Mikael, to our podcast. We're really excited that you shared this important work to us about adults with congenital heart disease, particularly given the burden of the condition and how many more individuals are living to adulthood with congenital heart disease. So I'd love to really just open with asking you to tell us a little bit about your study and what you found. Professor Mikael Dellborg: Well, first thank you for inviting me to talk about these issues. I very much appreciate the opportunity and I appreciate having the paper published by Circulation, which of course is a great honor. Our study included 37,278 patients with congenital heart disease born between 1950 and 1999, and alive at 18 years of age. Follow-up was started in 1968 and at 18 years of age, and went on until the end of 2017 or death. So the mean follow-up was 19.2 years. And for every patient with CHD, we had 10 randomly chosen controls from the general population registry, matched for year of birth and sex and, of course, without CHD, so 37,000 patients and 412,000 controls. During the follow-up, 1,937 patients with CHD died or 5.2%, as compared to 1.6% of controls, a mortality three to four times higher among patients with CHD. Still, at 50 years of follow-up, i.e. at age 68, more than 75% of all patients with CHD were still alive, and I think that is the positive news of this paper. Mortality wise, this could be expected highest among those with the most severe defects, the conotruncal defects, i.e., the transposition of the great arteries, the tetrology patients, double out ventricles and so on. And there the hazard ratio for death was 10.1 times that of controls. But also, for non-com complex conditions such as that we consider very malignant such as atrial septal defect, the ASD, there was a slight but significant increase in risk with the hazard ratio 1.4 times that of controls. We also looked at how the increased risk of mortality changed over time. And when comparing birth year by birth year, we could see that things started to really change in the mid 1970s, where the hazard ratio began to decline. So if you were born around 1950, '60 or '70, once you reached 18 years of age, your risk of dying had not really changed over the years. But once you were born '75, '80, '85 and on, your risk past 18 years of age declined and was lower as compared to those born before that, although still higher than the risk for controls. This decline was dramatic and significant for all patients with complex CHD. For patients with less complex conditions, it was smaller and not statistically significant. Although it trended in the same direction. The excess risk also declined with age. Typically, it declined from 20 to 100 times the risk of controls in the first years after turning 18, to seven to eight times after 30 years of follow-up. In other words, when you were in your fifties the difference between CHD and controls was much smaller, although still existed. Dr. Mercedes Carnethon: Oh, wow. So that really seems to shift over time and that gap got a little smaller with aging. What about these findings surprised you? Professor Mikael Dellborg: What surprised us was to see that there is a... For the CHD population as a group, we can see that the changes in operative techniques, the possibility to operate on much earlier time that became used in the '70s, mid-late '70s, early '80s, that has really changed life for so many patients. When we started the Adult Congenital Heart Unit at our hospital in 1996, there was a belief that either you were cured or you are a sad person to follow. You will only have trouble and you will die in your thirties or you'll get a transplant. That was the three conditions that we could see coming, but that's not true. I mean, again, once you turn 18, once you come to the adult cardiologist, you will most likely be 68, 70 years, 75 years of age. Dr. Mercedes Carnethon: Now, that is fantastic. I want to turn to you, Gerald, because you were obviously the handling editor of this piece and saw a lot of strengths. Can you tell us a little bit about why you wanted this piece for Circulation? Dr. Gerald Greil: Mikael, thank you so much for submitting to Circulation. The numbers of the patients you had for this study, including the controls, is impressive and we all think that it's one of the largest patients areas we looked at. Mikael, obviously this is all exceptional, but can you line out to us what are the strengths and limitations of your study? And how you think the results of your investigations are going to impact patient care in the future? Professor Mikael Dellborg: Thank you, Gerald. I think that the strengths are obviously, like you pointed out, there's 37,000 patients. There is 50 years of patients, there's 20 years of follow-up on average and that's clearly a strength. Also, that we have virtually no patients lost to follow-up. We have many controls and the registers we used are public, mandatory and have been fully operational for CHD care and CHD hospitals and including the death registry since 1968, which is when we really started the follow-up. So it's a broad and complete spectrum of patients with congenital heart disease, excluding none, and I think it's fair to say that our data reflect what you can expect from a population of eight to 10 million people, which is the Swedish population during these years. The weaknesses are clearly, as with any data of this sort, i.e. Large public registers, you will always lack the granularity. The clinical data, the blood pressure, weight, ECG, the echocardiogram, the cath data, et cetera. And also the lifestyle information, smoking, exercise, diet. It's also important to realize that Sweden was, particularly at this time before 2000, it was a fairly homogenous society in terms of ethnicity. One feature, which I'm not sure if it's a strength or a limitation, is that we group patients with CHD into one or sometimes two complex non-complex or at the most six groups. And since CHD consists of about 400 different diagnosis and entities, we paint a broader general picture. But if you want to know more about specific conditions such as say, hypoplastic left heart syndrome, you need to look for other and more specific papers. We're currently working on several more analysis based on this material for more narrow patient groups where we can take into consideration also things such as type of surgery or intervention, timing of intervention, medication and so on. We have a lot of data on this, but it was simply not possible to put everything into one paper. Dr. Gerald Greil: Yeah, I mean speaking about getting more specific, we were fortunate enough having one of your colleagues publishing about patients with congenital heart disease. They looked at the time period from 1930 to 2017 using the same database. And they focused specifically on heart failure in this group of patient describing it in a research letter, actually in the same volume your paper's published. How does this study relate to your work? And how do you think are their results impacting the care of these patients? Professor Mikael Dellborg: I think they relate to our paper in a nice way, because one of the things we also could show was that the morbidities of patients with adult congenital heart disease are significant. The risk of heart failure, atrial fibrillation, stroke, nonfatal MI, diabetes, and so on, is much larger in that group. And the cumulative risk of having any such adverse event is about 75% at age 68 after 50 years of follow-up. The letter by Bergh et al. focuses on, as you say, heart failure. And during a follow-up or 25 years, there was an overall, like you said, 8.7 times higher risk for patients with CHD to develop heart failure. The most, I think, important factor from this is not only that the risk is increased, it has been described before and it's obvious and quite intuitive, but there was a dramatic difference in the age of onset of heart failure, which was about 40 years in patients with CHD compared to 66 years of age for the controls who developed heart failure. And again, it was obvious that it was highest among the most complex CHD. The risk was 20 to 40 times higher. But also among non-complex CHD, the atrial receptor defects, the ventricular receptor defects, the risk was significantly higher, five to 10 times. One thing we saw there was that... That could be seen there was that the risk was particularly high in the youngest age group, the youngest patients, as compared to controls. And not so much, although still significant, it increased also in the higher age groups. We could also see that the risk of heart failure seemed to increase. It was higher among those born after 1970 as compared to those before 1930 to '69. And I have two explanations for that. One is that a lot of patients born in 1930 and so on were not captured by our registers, because they have died before that. But it also reflects that the most complex patients, the most likely to develop heart failure, they survive these days. They did not survive in their thirties, forties, fifties, sixties and early seventies and so on, so that's why. So things haven't been worse, but we do have a much sicker group of patients with congenital heart disease that are alive today. Dr. Mercedes Carnethon: That's very hopeful. When I hear that and I think about the impact that treatment and therapy has had on these improvements in survival, it's really exciting to hear. We were really enthusiastic because our colleagues, Dr. Rosenthal and Qureshi from London, submitted an editorial to discuss your piece as well as Dr. Bergh's piece. And they're discussing in it some of the complexity in providing this care and what it has taken to get us to this point where survival is better. Can you tell us a little bit based on the findings from your study and what you know of the field, how do you envision the future care of adults with congenital heart disease? Professor Mikael Dellborg: Yes, Mercedes, thank you. I think this is a very nice editorial. It summarizes very well where we are today, and I think they see the future very much along the same lines as I do and as we do. But the large number of patients with CHD living into their sixties, seventies, and eighties, they will not only live longer, they will also have more comorbidities. And I think that's what our data shown and what the editorial is discussing. This will require some changes to be made to the care of adults with congenital heart disease. We will clearly, as pointed out, need large, highly specialized, very competent ACHD centers located close to, or at least in close corporation with pediatric centers. There's no doubt about that building such centers need to continue and you need roughly one large complete such center with outpatient clinic, surgical interventions, structured transfer, specialized physicians, physiotherapists, nurses, education research, et cetera. You need about one such center per 5 million people. But over time the need of ACHD patients will also change and this will have impact also on the large specialized centers. For instance, if you have an adult patient with say, tetrology of Fallot, fairly common disease in this setting, well operated on a early childhood, well-functioning, modest right ventricular dysfunction, modest pulmonary valve insufficiency, and it's followed by a large centralized ACHD unit. You will keep track of the right ventricle size waiting for the proper time to intervene and replace the right ventricular outflow tract by surgery or catheter. This waiting is probably 10, 15, maybe 20 years before anything needs to be done. But during that time the patient develops hypertension, type 2 diabetes, AFib, and the chances of this happening at some time are fairly substantial. So either the ACHD unit needs to take care of also these comorbidities and that's not always the case today. And I think it's unrealistic to expect primary care GPs to do this. I mean, would you as primary... As a GP start the SGLT2 treatment? Is that okay for a patient with Fallot? Or the indications for anticoagulation the same as... And that's not easy patients to handle. So on the other hand, if the ACHD unit will take care also of all these comorbidities, they will, I think, have too much to do and I think they will find it difficult to completely cope with this. So as in increasing role for cardiologists who are knowledgeable on ACHD care, but who perhaps spend most of the time caring for the usual patients with heart failure and AFib, post-MI, type 2 diabetes and who are confident in using novel anti-diabetic medications, but at the same time they know about Fallot. They know enough to understand the do's and don'ts, and they can interact on a regular basis with the local ACHD units. So patients will see their general cardiologist twice a year perhaps, and the ACHD center every two years, something like that. I think there's a great need for that. Dr. Mercedes Carnethon: I really appreciate having your insights on that. Do you have anything, Gerald, that you'd like to follow up with? I think the feedback that you've shared with us, Mikael, about where you see the treatment field going for adults has been very comprehensive and it's fantastic to be able to have these conversations with you, because obviously these discussions go beyond what you can share in the original research article, which is why we really enjoy this opportunity with the podcast. So Gerald, I'd really like to turn it to you for a final wrap up, given your expertise in this area. Dr. Gerald Greil: Yeah, I mean, Mikael, thank you so much to you and your colleagues just giving us this great overview, and even more importantly giving us the perspective how this field is going. I think we are getting more and more aware that there are more patients with and adults with congenital heart disease we need to take care of. We need to find new strategies, as you correctly pointed out, to cope with the enormous burden of disease and providing these patients good quality of life and excellent outcome after sometimes a very difficult start in their lives. And we need to be aware of the pediatricians and adult cardiologists and other subspecialties are forming a team and working together and not working as separate entities. So thank you so much for giving us this perspective. And I would hand over to Mercedes to wrap up the whole discussion please. Dr. Mercedes Carnethon: Well, yes, I just really want to thank our listeners for tuning in with us today. It was such a delight to have you here with us, Dr. Dellborg, and thank you as well for sharing your insights. Thank you for joining us again for this episode of Circulation on the Run Podcast. It's meant to whet your appetite and turn you towards the journal so that you can read more. So thank you very much. Dr. Greg Hundley: This program is copyright of the American Heart Association 2023. The opinions expressed by speakers in this podcast are their own, and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Brought to you by Wealthfront high-yield savings account, Helix Sleep premium mattresses, and Shopify global commerce platform providing tools to start, grow, market, and manage a retail business. Peter Attia, MD (@PeterAttiaMD), is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. He is the host of The Drive, one of the most popular podcasts covering the topics of health and medicine. Dr. Attia received his medical degree from the Stanford University School of Medicine and trained for five years at the Johns Hopkins Hospital in general surgery, where he was the recipient of several prestigious awards, including Resident of the Year. He spent two years at the National Institutes of Health as a surgical oncology fellow at the National Cancer Institute, where his research focused on immune-based therapies for melanoma.His new book is Outlive: The Science and Art of Longevity (3/28).Please enjoy!This episode is brought to you by Shopify! Shopify is one of my favorite platforms and one of my favorite companies. Shopify is designed for anyone to sell anywhere, giving entrepreneurs the resources once reserved for big business. In no time flat, you can have a great-looking online store that brings your ideas to life, and you can have the tools to manage your day-to-day and drive sales. No coding or design experience required.Go to shopify.com/Tim to sign up for a one-dollar-per-month trial period. It's a great deal for a great service, so I encourage you to check it out. Take your business to the next level today by visiting shopify.com/Tim.*This episode is also brought to you by Helix Sleep! Helix was selected as the #1 overall mattress of 2020 by GQ magazine, Wired, Apartment Therapy, and many others. With Helix, there's a specific mattress to meet each and every body's unique comfort needs. Just take their quiz—only two minutes to complete—that matches your body type and sleep preferences to the perfect mattress for you. They have a 10-year warranty, and you get to try it out for a hundred nights, risk-free. They'll even pick it up from you if you don't love it. And now, Helix is offering 20% off all mattress orders plus two free pillows at HelixSleep.com/Tim.*This episode is also brought to you by Wealthfront! Wealthfront is an app that helps you save and invest your money. Right now, you can earn 4.05% APY—that's the Annual Percentage Yield—with the Wealthfront Cash Account. That's more than twelve times more interest than if you left your money in a savings account at the average bank, according to FDIC.gov. It takes just a few minutes to sign up, and then you'll immediately start earning 3.8% interest on your savings. And when you open an account today, you'll get an extra fifty-dollar bonus with a deposit of five hundred dollars or more. Visit Wealthfront.com/Tim to get started.*[07:00] How and why Peter's muscle mass has increased significantly.[18:48] Why the long wait for Outlive: The Science and Art of Longevity?[23:19] Objective, strategy, and tactics.[28:50] From Medicine 1.0 to Medicine 3.0.[39:04] Randomized control trial results: guidelines, not gospel.[43:21] Revisiting why and how one should increase their medical literacy.[52:44] Avoiding scientific method misconceptions.[55:43] Austin Bradford Hill.[56:22] Observational study versus randomized control trial.[1:00:09] Are sleep trackers downgrading the quality of our sleep?[1:02:53] Under what conditions does Peter feel alcohol might be worth its downsides?[1:06:47] Continuous glucose monitors (CGMs).[1:18:24] Underutilized metrics and tools for expanding health and lifespan.[1:25:01] Strength.[1:33:11] Rucking around and finding out about VO2 max.[1:38:32] Finding the zone two sweet spot.[1:41:10] How skinning and rucking have upped my endurance.[1:42:24] Rucking vs. weighted vests.[1:46:39] Are neurodegenerative diseases preventable?[1:51:47] Helping your doctor understand and embrace Medicine 3.0.[1:53:47] How much is an ounce of prevention worth to you?[1:58:23] Early cancer screening.[2:06:33] Outlive chapters.[2:08:46] The chapter on emotional health that almost didn't make the book.[2:10:16] Peter's 47 affirmations.[2:14:18] Parting thoughts.*For show notes and past guests on The Tim Ferriss Show, please visit tim.blog/podcast.For deals from sponsors of The Tim Ferriss Show, please visit tim.blog/podcast-sponsorsSign up for Tim's email newsletter (5-Bullet Friday) at tim.blog/friday.For transcripts of episodes, go to tim.blog/transcripts.Discover Tim's books: tim.blog/books.Follow Tim:Twitter: twitter.com/tferriss Instagram: instagram.com/timferrissYouTube: youtube.com/timferrissFacebook: facebook.com/timferriss LinkedIn: linkedin.com/in/timferrissPast guests on The Tim Ferriss Show include Jerry Seinfeld, Hugh Jackman, Dr. Jane Goodall, LeBron James, Kevin Hart, Doris Kearns Goodwin, Jamie Foxx, Matthew McConaughey, Esther Perel, Elizabeth Gilbert, Terry Crews, Sia, Yuval Noah Harari, Malcolm Gladwell, Madeleine Albright, Cheryl Strayed, Jim Collins, Mary Karr, Maria Popova, Sam Harris, Michael Phelps, Bob Iger, Edward Norton, Arnold Schwarzenegger, Neil Strauss, Ken Burns, Maria Sharapova, Marc Andreessen, Neil Gaiman, Neil de Grasse Tyson, Jocko Willink, Daniel Ek, Kelly Slater, Dr. Peter Attia, Seth Godin, Howard Marks, Dr. Brené Brown, Eric Schmidt, Michael Lewis, Joe Gebbia, Michael Pollan, Dr. Jordan Peterson, Vince Vaughn, Brian Koppelman, Ramit Sethi, Dax Shepard, Tony Robbins, Jim Dethmer, Dan Harris, Ray Dalio, Naval Ravikant, Vitalik Buterin, Elizabeth Lesser, Amanda Palmer, Katie Haun, Sir Richard Branson, Chuck Palahniuk, Arianna Huffington, Reid Hoffman, Bill Burr, Whitney Cummings, Rick Rubin, Dr. Vivek Murthy, Darren Aronofsky, Margaret Atwood, Mark Zuckerberg, Peter Thiel, Dr. Gabor Maté, Anne Lamott, Sarah Silverman, Dr. Andrew Huberman, and many more.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Drs. Rachel Patzer and Stephen Pastan discuss the results of their study "The ASCENT Intervention to Improve Access and Reduce Racial Inequalities in Kidney Waitlisting," on behalf of their colleagues.

A lot of therapies address the context in which nonsuicidal self-injury (NSSI) and self-harm may occur, but only a few treatments have been designed to address NSSI specifically. In this episode, we dive into one of these treatments: Emotion Regulation Group Therapy (ERGT). Drs. Kim Gratz and Matthew Tull from the University of Toledo in Ohio walk us through in significant detail each of the 90-minute 14 sessions of ERGT.Learn more about Dr. Gratz here and reach her at klgratz28@gmail.com. Learn more about Dr. Tull here and follow him on Twitter @MTTull. Learn more about the Personality and Emotion Research and Treatment (PERT) Laboratory within the Department of Psychology at the University of Toledo here, and follow the PERT Lab on Twitter @LabPert. Below are links to their research on ERGT referenced in this episode:Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with Borderline Personality Disorder. Behavior Therapy, 37(1), 25-35.Gratz, K. L., & Tull, M. T. (2011). Extending research on the utility of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology. Personality Disorders: Theory, Research, and Treatment, 2(4), 316–326.Gratz, K. L., Tull, M. T., & Levy, R. (2014). Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Psychological Medicine, 44, 2099–2112.Gratz, K. L., Bardeen, J. R., Levy, R., Dixon-Gordon, K., L., & Tull, M. T. (2015). Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Behaviour Research and Therapy, 65, 29-35.Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman, E., Bjarehed, J., Jokinen, J., Lundh, L., Ljotsson, B., & Hellner, C. (2017). Emotion regulation group therapy for deliberate self-harm: A multi-site evaluation in routine care using an uncontrolled open trial design. BMJ Open, 7(10), e016220.Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

“Izzy’s Quest for the Olympic Rings”, said the Randomizer, cold and indifferent as always. “Would you punish us so harshly for playing Dungeons & Dragons sometimes?” Ian snarked. The Randomized smiled it’s blackened grin in return. “Go and embrace the controversial torch mascot from the 1996 games in Atlanta, my friends. May its slippery and … Continue reading → The post Ep. 703 – Izzy’s Quest for the Olympic Rings appeared first on TADPOG: Tyler and Dave Play Old Games.

Dr. Sue Yom, our Editor-in-Chief, hosts Dr. Meredith Giuliani, Thoracic Section Editor, Associate Professor of Radiation Oncology, and Associate Dean of Postgraduate Medical Education at the University of Toronto, practicing at the Princess Margaret Cancer Center; Dr. Sung-Ja Ahn, Professor in the Department of Radiation Oncology of Chonnam National University Medical School and corresponding author for our new publication this month, "Randomized, Multicenter, Phase 3 Study of Accelerated Fraction Radiation Therapy With Concomitant Boost to the Gross Tumor Volume Compared With Conventional Fractionation in Concurrent Chemoradiation in Patients With Unresectable Stage III Non-Small Cell Lung Cancer: The Korean Radiation Oncology Group 09-03 Trial"; and Dr. Megan Daly, Professor in the Department of Radiation Oncology at the University of California Davis, Associate Section Editor at our Journal, and supervising author of an article publishing next month, "Four-Dimensional Computed Tomography Ventilation Image Guided Lung Functional Avoidance Radiation Therapy: A Single-Arm Prospective Pilot Clinical Trial". We also discuss another trial published this month, "STereotactic Ablative RadioTherapy in NEWly Diagnosed and Recurrent Locally Advanced Non-Small Cell Lung Cancer Patients Unfit for ConcurrEnt RAdio-Chemotherapy: Early Analysis of the START-NEW-ERA Non-Randomised Phase II Trial".

This podcast, Dr. Lucas Dingman and Dr. Cady Welch, emergency medicine physicians with EMPAC and Ridgeview, discuss six articles on various topics related to emergency medicine, as part of this first ED journal review. Enjoy the podcast. Objectives:Upon completion of this podcast, participants should be able to: Identify emergency medicine journal articles that may be potentially practice-changing Describe how to rule out a pulmonary embolism (PE) in the emergency department using the YEARS criteria and age adjusted d-dimer. Differentiate when antibiotics for treating diverticulitis is warranted. Describe the benefits of using a small percutaneous catheter chest tube for treating a traumatic hemothorax. CME credit is only offered to Ridgeview Providers & Allied Health staff for this podcast activity. After listening to the podcast, complete and submit the online evaluation form.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at Education@ridgeviewmedical.org. Click the link below, to complete the activity's evaluation. CME Evaluation (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  DISCLOSURE ANNOUNCEMENT  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws.  It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. Thank-you for listening to the podcast. SHOW NOTES:  *See the attachment for additional information.  Study #1: Efficacy and Safety of Nonantibiotic Outpatient Treatment in Mild Acute Diverticulitis (DINAMO-study) A Multicentre, Randomised, Open-label, Noninferiority Trial - DINAMO study & diverticulitis - Multicenter, randomized, open label, non-inferiority trial (Nov.2016 - Jan.2020) - 480 randomized participants  and put into two groups - Results: admission to hospitals, ED revisits, no complications, no major significant findings - Nonantibiotic outpatient treatment of mild acute diverticulitis is safe and effective and is not inferior to current standard treatment. Study #2: Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation - EPIC Atrial Fibrilation ( EPIC AF) - Two positions for pad placement for cardioverting patients - Multicenter, randomized, open label trial - 467 randomized patients, scheduled for elective cardioversion - Results: 50% successful conversion to normal sinus rhythm after one biphasic shock, many patients needed multiple shocks to cardioconvert (4-5 shocks). - AHA Guidelines: pad placement for AF and VF, treatment recommendations - Anterior-lateral electrode positioning was more effective than anterior-posterior electrode positioning for biphasic cardioversion of atrial fibrillation. There were no significant differences in any safety outcome. Study #3: The small (14 Fr) percutaneous catheter (P-CAT) versus large (28–32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial - Poiseuille's law and chest tubes - and involves components of rate of flow, radius of the tube, change in pressure and viscosity. - 120 participants - 8 years and older, traumatic hemothorax or pneumothorax, hemodynamically stable patient only - Treatment arm: 14 Fr cook catheter used (seldinger techique, anterior axillary or midaxillary line) - Control arm: 28-32 Fr. chest tube placed (standard way - 4th-5th intercostal, midaxillary line) - Results: Failure rate of the tube, repeat hemothorax requiring intervention, drainage outputs at different designated times, total chest tube days, insertion complications, ventilator days, ICU length of days, hospital length of stay - Patients had better experience with percutaneous catheter - Hemlich valve - Study discussed looks specifically at hemothoraces which require drainage of blood and chest tubes connected to traditional pleuro vac chamber - Small caliber 14 Fr PCs are equally as effective as 28- to 32-Fr chest tubes in their ability to drain traumatic HTX with no difference in complications. Patients reported better IPE scores with PCs over chest tubes, suggesting that PCs are better tolerated. Study #4: Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial - ScienceDirect - Single center, placebo controlled, blinded, randomized trial - Sample: 120 healthy adults, median age 40 years old presenting to ED with chief complaint of nausea/vomiting -  Change in nausea score at 30 min. (drop in mm on VAS) - Mean nausea baseline = 50 - Limitations: fairly young healthy participants, difficult to blind (can smell difference) - Among ED patients with acute nausea and not requiring immediate IV access, aromatherapy with or without ondansetron provides greater nausea relief than oral ondansetron alone. Study #5: Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism: A Randomized Clinical Trial - YEARS criteria with age adjusted vs only age adjusted - Cluster, randomized, crossover, non-inferiority trial to determine if YEARS plus age-adjusted could be used to rule out PE, age 18 or older, not pregnant - Sample size: 1414 patients within 18 EDs, PERC positive - Outcome: PE diagnosed in 100 patients, no missed PEs with patients with YEARS score of "0", - Among ED patients with suspected PE, the use of the YEARS rule combined with the age-adjusted D-dimer threshold in PERC-positive patients, compared with a concential diagnostic strategy, did not result in an inferior rate of thromboembolic events. Study #6: Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial - Randomized, single masked study (providers were masked), controlled clinical trial, non-inferiority study design, single center study - Participants: children - aged 8 weeks to 3 years, moderately dehydrated (dehydration score greater than 3, but less than 7) - Outcomes: Successful rehydration at 4 hours, hospitalization rate, time to initiation of treatment, repeat ED visits within 72 hrs -Results: no difference between the groups with succesful rehydration at 4 hours - Limitations: small sample size - Oral rehydration therapy (ORT) is as good as intravenous fluid therapy (IVF) in rehydration of moderately dehydration children due to gastroenteritis. In addition, the study found that less time was required to intiate ORT when compared with IVF in the ED. Patients treated with ORT had fewerer hospitalizations. Results of the study suggested that ORT be the initial treatment of choice for moderately dehydrated children less than three years old with gastroeneritis. Thanks to Dr. Lucas Dingman and Dr. Cady Welch for their knowledge and contribution to this podcast. Please check out the additional show notes for more information/resources.

In this special edition of the Award-winning PRS Journal Club Podcast, Dr. Summer E. Hanson discusses a prospective, randomized comparison of different autologous fat graft processing techniques. The episode was recorded LIVE at PSTM 2022 in Boston, Massachusetts with a live audience. Moderated by 2022 PRS Resident Ambassadors Said Azoury, MD, Emily Long, MD, and Ronnie Shammas, MD. READ the articles discussed in this podcast as well as free related content from the archives: https://bit.ly/PRSJC_LivePSTM22 #PRSJournalClub

In this special edition of the Award-winning PRS Journal Club Podcast, Dr. Summer E. Hanson discusses a prospective, randomized comparison of different autologous fat graft processing techniques. The episode was recorded LIVE at PSTM 2022 in Boston, Massachusetts with a live audience. Moderated by 2022 PRS Resident Ambassadors Said Azoury, MD, Emily Long, MD, and Ronnie Shammas, MD. READ the articles discussed in this podcast as well as free related content from the archives: https://bit.ly/PRSJC_LivePSTM22 #PRSJournalClub

Yale School of Medicine physician and researcher F. Perry Wilson, MD, MSCE, chats with Trey Elling about HOW MEDICINE WORKS AND WHEN IT DOESN'T: LEARNING WHO TO TRUST TO GET AND STAY HEALTHY. Topics include: Goal with the book (0:00) Pharma's role with patient mistrust (1:57) Pharma's influence on doctors (6:49) Generic drugs not such an easy fix (10:22) How medical errors commonly lead to death (12:34) Surrogate outcomes (15:50) Getting patients to change their minds for GOOD reasons (17:44) Combatting motivated reasoning (20:44) The “biggest secret in medicine” (26:22) Factoring in side effects when considering a drug (29:32) Doctors' responsibility to help patients with despair (31:28) Randomized controlled trials, aka RCTs (37:48) How RCTs go wrong (44:19) The difficulty with replication (47:29) Why “open data” isn't already the standard with RCTs (50:35) The problem with the “middle man” in patient care (53:39) An alternative to the current US healthcare system (57:06) How patients can move closer to doctors by embracing uncertainty (1:00:15)

In this episode, Andrew, Azoka, Devin, and Ian talk about randomized events in Infinity. Some (real and joke) events were announced, such as the Salem Sh!tshow and Interplanetario 2023 where random lists would be used. While some of these would be difficult to implement, the cast discusses how it might impact play and how other forms could be used to add interest to events while staying competitive. While you're listening, jump on our Discord server, to talk more Infinity. (https://discord.gg/4WJtJXcYjP) And if you want access some cool benefits while helping us keep the show going, check out our Patreon. (https://www.patreon.com/MetaChemistry)

New food? Randomized books?? A NECROMANCER??? Links Email: digstraightdowncast@gmail.com Twitter: https://twitter.com/RebelJC_92 YouTube: https://www.youtube.com/channel/RebelJC Music: Blue Wednesday, Magnus Klausen - Runaway https://chll.to/2b4ce5ef The Ripple Effect: http://rippleeffectsmp.com/

Acute Care for Elders (ACE Units) have been around for over a quarter of a century. Randomized trials of ACE units date back to 1996 when Seth Landefeld and colleagues published a study in NEJM showing that they improve basic activities of daily living at discharge and can reduce the frequency of discharge to long-term care institutions.  But if ACE units are so great, why do so few hospitals have them? On today's podcast we talk about ACE units with geriatricians Kellie Flood and Stephanie Rogers.  They recently published a paper in JAGS looking at the current landscape of ACE units in the US. In the podcast we go over these issues and more: What are ACE units and what structural elements go into them (see the picture below for a nice summary)?  Which patients are eligible to go to an ACE unit? What are the benefits of an ACE unit? If ACE units are so great, why are they not so common?  What does the future look like for ACE units and how does it differ (if at all) from Age Friendly Health Systems? If you want to do a deeper dive in ACE units, check out some of the following articles: The original NEJM paper on ACE units from 1996 Kellie Flood's paper in JAMA IM showing that not only ACE units deliver better care, but also help with the hospitals bottom line

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

Amidst the battle of the mental health crisis, major depressive disorder stands out as an all-too-common reality for many children and adolescents, but the forces of science and medicine can stand against this foe. Dr. Christopher Drescher, a clinical child psychologist, joins pediatric resident Dr. Daniel Allen and medical student Vuk Lacmanovic to remove the cape from this increasingly common condition and discuss its symptoms, diagnosis, and treatment. Specifically, they will: Define major depressive disorder (MDD) and recognize the common symptoms in both children and adolescents. Formulate a differential diagnosis for patients presenting with depressive symptoms. Recognize validated screening tools for depression in both children and adolescents. Review cognitive behavioral therapy and pharmacotherapy as treatment options. Review appropriate referral to a mental health specialist. Free CME Credit (requires sign-in): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=12493  References: Bhatia SK, Bhatia SC. Childhood and adolescent depression. Am Fam Physician. 2007 Jan 1;75(1):73-80. PMID: 17225707. Brent DA, Maalouf F. Depressive Disorders (in Childhood and Adolescence). In: Ebert MH, Leckman JF, Petrakis IL. eds. Current Diagnosis & Treatment: Psychiatry, 3e. McGraw-Hill; Accessed November 17, 2020. https://accessmedicine.mhmedical.com/content.aspx?bookid=2509§ionid=200807606 Clark MS, Jansen KL, Cloy JA. Treatment of childhood and adolescent depression. Am Fam Physician. 2012 Sep 1;86(5):442-8. PMID: 22963063. Fendrich M, Weissman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990 Mar;131(3):538-51. doi: 10.1093/oxfordjournals.aje.a115529. PMID: 2301363. (PDF of CES-DC here) Forman-Hoffman V, McClure E, McKeeman J, Wood CT, Middleton JC, Skinner AC, Perrin EM, Viswanathan M. Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016 Mar 1;164(5):342-9. doi: 10.7326/M15-2259. Epub 2016 Feb 9. PMID: 26857836. Hathaway EE, Walkup JT, Strawn JR. Antidepressant Treatment Duration in Pediatric Depressive and Anxiety Disorders: How Long is Long Enough? Curr Probl Pediatr Adolesc Health Care. 2018 Feb;48(2):31-39. doi: 10.1016/j.cppeds.2017.12.002. Epub 2018 Jan 12. PMID: 29337001; PMCID: PMC5828899. March JS, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J. The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes. Arch Gen Psychiatry. 2007 Oct;64(10):1132-43. doi: 10.1001/archpsyc.64.10.1132. Erratum in: Arch Gen Psychiatry. 2008 Jan;65(1):101. PMID: 17909125. Meister R, Abbas M, Antel J, Peters T, Pan Y, Bingel U, Nestoriuc Y, Hebebrand J. Placebo response rates and potential modifiers in double-blind randomized controlled trials of second and newer generation antidepressants for major depressive disorder in children and adolescents: a systematic review and meta-regression analysis. Eur Child Adolesc Psychiatry. 2020 Mar;29(3):253-273. doi: 10.1007/s00787-018-1244-7. Epub 2018 Dec 8. PMID: 30535589; PMCID: PMC7056684. Rachel A. Zuckerbrot, Amy Cheung, Peter S. Jensen, Ruth E.K. Stein, Danielle Laraque and GLAD-PC STEERING GROUP. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics March 2018, 141 (3) e20174081; DOI: https://doi.org/10.1542/peds.2017-4081 Scott K, Lewis CC, Marti CN. Trajectories of Symptom Change in the Treatment for Adolescents With Depression Study. J Am Acad Child Adolesc Psychiatry. 2019 Mar;58(3):319-328. doi: 10.1016/j.jaac.2018.07.908. Epub 2019 Jan 8. PMID: 30768414; PMCID: PMC6557284. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ. 2016 Jan 27;352:i65. doi: 10.1136/bmj.i65. PMID: 26819231; PMCID: PMC4729837. Siu AL; US Preventive Services Task Force. Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2016 Mar;137(3):e20154467. doi: 10.1542/peds.2015-4467. Epub 2016 Feb 8. PMID: 26908686. Weersing VR, Brent DA, Rozenman MS, Gonzalez A, Jeffreys M, Dickerson JF, Lynch FL, Porta G, Iyengar S. Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care: A Randomized Clinical Trial. JAMA Psychiatry. 2017 Jun 1;74(6):571-578. doi: 10.1001/jamapsychiatry.2017.0429. PMID: 28423145; PMCID: PMC5539834. Weersing VR, Shamseddeen W, Garber J, Hollon SD, Clarke GN, Beardslee WR, Gladstone TR, Lynch FL, Porta G, Iyengar S, Brent DA. Prevention of Depression in At-Risk Adolescents: Predictors and Moderators of Acute Effects. J Am Acad Child Adolesc Psychiatry. 2016 Mar;55(3):219-26. doi: 10.1016/j.jaac.2015.12.015. Epub 2016 Jan 18. PMID: 26903255; PMCID: PMC4783159. Xu Y, Bai SJ, Lan XH, Qin B, Huang T, Xie P. Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability. Braz J Med Biol Res. 2016 May 24;49(6):e4806. doi: 10.1590/1414-431X20164806. PMID: 27240293; PMCID: PMC4897997. Zhou X, Cipriani A, Zhang Y, Cuijpers P, Hetrick SE, Weisz JR, Pu J, Giovane CD, Furukawa TA, Barth J, Coghill D, Leucht S, Yang L, Ravindran AV, Xie P. Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents: protocol for a network meta-analysis. BMJ Open. 2017 Aug 11;7(8):e016608. doi: 10.1136/bmjopen-2017-016608. PMID: 28801423; PMCID: PMC5629731. Zhou X, Teng T, Zhang Y, Del Giovane C, Furukawa TA, Weisz JR, Li X, Cuijpers P, Coghill D, Xiang Y, Hetrick SE, Leucht S, Qin M, Barth J, Ravindran AV, Yang L, Curry J, Fan L, Silva SG, Cipriani A, Xie P. Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. Lancet Psychiatry. 2020 Jul;7(7):581-601. doi: 10.1016/S2215-0366(20)30137-1. PMID: 32563306; PMCID: PMC7303954.

Roger Seheult, MD of MedCram examines an exciting randomized control trial demonstrating the effects of near infrared light on COVID-19. See all Dr. Seheult's videos at: https://www.medcram.com (This video was recorded on January 2, 2022) Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT: Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-contact Video Produced by Kyle Allred FOLLOW US ON SOCIAL MEDIA: https://www.facebook.com/MedCram https://twitter.com/MedCramVideos https://www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor.

On this episode of the Psychedelic Therapy Frontiers podcast, Dr. Joe Flanders interviews Dr. Anthony Back, M.D. Dr. Back is a co-founder of VitalTalk, a national nonprofit that provides innovative, interactive clinician and faculty development courses to improve communication skills on an individual and institutional level. Dr. Back is a professor of medicine at the University of Washington in Seattle, and the Fred Hutchinson Cancer Research Center. Dr. Back earned his MD at Harvard University. He is triple-board certified in hospice and palliative medicine, medical oncology, and general internal medicine. In his role as a medical communication educator and a VitalTalk co-founder, Dr. Back was the principal investigator for Oncotalk, co-wrote Mastering Communication with Seriously Ill Patients, released the first iPhone app for clinician communication skills, and authored the online communication skills curriculum offered by the Center to Advance Palliative Care.(3:00) Dr. Back introduces himself(6:55) What is palliative care?(9:06) Improving quality of life and having a good death(15:30) The applications of psychedelics for end-of-life care(17:35) Dr. Back's article, "What psilocybin taught me about dying"(21:00) Materialist vs spiritualist views of life and death(29:14) Roland Griffiths' cancer diagnosis (34:07) Gratitude for cancer(38:22) How psychedelics might help people at end-of-life(55:23) Randomized trial of psilocybin for health care practitioners with depression(01:01:07) How do you train a health care practitioner in good palliative care?(01:07:51) How do we scale psychedelic-assisted therapy?Learn more about our podcast at https://numinus.com/podcast/Learn more about Numinus at https://numinus.com/Follow us on Instagram: https://www.instagram.com/drstevethayer/https://www.instagram.com/innerspacedoctor/https://www.instagram.com/joeflanders/https://www.instagram.com/numinushealth/Disclaimer: The content of this podcast does not constitute medical advice or mental health treatment. Consult with a medical/mental health professional if you believe you are in need of mental health treatment.

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

VIDEOS: CRY FOR FREEDOM – Why cyborgs won't save the world (FILM) Gravitas: Did the US help China cover-up Covid-19 outbreak? (10:57) MEP Clare Daly   Drinking hot tea every day linked to lower glaucoma risk Brown University and UCLA, December 14, 2022 Drinking a cup of hot tea at least once a day may be linked to a significantly lower risk of developing the serious eye condition, glaucoma, finds a small study published online in the British Journal of Ophthalmology. The researchers looked at data from the National Health and Nutrition Examination Survey (NHANES) in the US. This is a nationally representative annual survey of around 10, 000 people that includes interviews, physical examinations, and blood samples, designed to gauge the health and nutritional status of US adults and children. In this particular year, it also included eye tests for glaucoma. Among the 1678 participants who had full eye test results, including photos, 84 (5%) adults had developed the condition. They were asked how often and how much they had drunk of caffeinated and decaffeinated drinks, including soft drinks and iced tea, over the preceding 12 months, using a validated questionnaire (Food Frequency). Compared with those who didn't drink hot tea every day, those who did, had a lower glaucoma risk, the data showed. After taking account of potentially influential factors, such as diabetes and smoking, hot tea-drinkers were 74 per cent less likely to have glaucoma. But no such associations were found for coffee—caffeinated or decaffeinated—decaffeinated tea, iced tea or soft drinks. This is an observational study so no firm conclusions can be drawn about cause and effect, and the absolute numbers of those with glaucoma were small. Information on when glaucoma had been diagnosed was also unavailable. But tea contains antioxidants and anti-inflammatory and neuroprotective chemicals, which have been associated with a lowered risk of serious conditions, including heart disease, cancer, and diabetes, say the researchers. (NEXT) Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial. Poznan University of Medical Sciences (Poland), November 29, 2022 Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age. Hyperandrogenism is the central feature of PCOS. Studies on isolated ovarian theca-interstitial cells suggest that resveratrol, a natural polyphenol, reduces androgen production. This study was designed to evaluate endocrine and metabolic effects of resveratrol on PCOS. This was a randomized (1:1) double-blind, placebo-controlled trial that evaluated the effects of resveratrol over a period of 3 months in an academic hospital. Resveratrol (1,500 mg p.o.) or placebo were administered daily. Primary outcome was the change in the serum total T. Resveratrol treatment led to a significant decrease of total T by 23.1% . In parallel, resveratrol induced a 22.2% decrease of dehydroepiandrosterone sulfate, a decrease of fasting insulin level by 31.8% and an increase of the Insulin Sensitivity Index (Matsuda and DeFronzo) by 66.3%. Levels of gonadotropins, the lipid profile as well as markers of inflammation and endothelial function were not significantly altered. Resveratrol significantly reduced ovarian and adrenal androgens. This effect may be, at least in part, related to an improvement of insulin sensitivity and a decline of insulin level. (NEXT) Encouraging risk-taking in children may reduce the prevalence of childhood anxiety Macquarie University's Centre for Emotional Health (Netherlands), December 13, 2022 A new international study suggests that parents who employ challenging parent behavioural (CPB) methods – active physical and verbal behaviours that encourage children to push their limits – are likely protecting their children from developing childhood anxiety disorders. Researchers from Macquarie University's Centre for Emotional Health, along with partners from the University of Amsterdam and the University of Reading, surveyed 312 families with preschool-aged children across the Netherlands and Australia. Results showed that the parents who scored higher in their CPB methods, thereby encouraging their kids to push their limits to a greater extent, had children who were less at risk of exhibiting anxiety disorder symptoms, demonstrating that CPB was related to significantly less anxiety in children. CPB encourages safe risk-taking in children such as giving them a fright, engaging in rough-and-tumble play or letting them lose a game, as well as encouraging them to practice social assertion and confidently enter into unfamiliar situations. This study aimed to build upon existing research that establishes a relationship between parenting behaviours – particularly overinvolvement and overcontrol – and the development and maintenance of childhood anxiety disorders. To determine the effects of CPB on preschool-aged children, parents' CPB was assessed via a questionnaire assessing how much the parents encourage the exhibition of risky behaviour in their children, as well as the extent to which they encourage their children to venture beyond their comfort zones. “While Dutch and Australian mothers showed no differences in CPB towards their sons or daughters, both Dutch and Australian fathers of sons demonstrated more competition towards their sons than fathers of daughters. Dutch fathers in particular reported more rough-and-tumble play than the other groups of parents,” says Rebecca Lazarus from Macquarie University, another co-author of the study. The results are promising in raising the clinical relevance of CPB methods, which could potentially be used to aid parents in helping their children's wellbeing. (NEXT) Music therapy reduces pain and anxiety for patients with cancer and sickle cell disease University Hospitals Cleveland Medical Center, December 19, 2022 A new study found patients with cancer and patients with sickle cell disease (SCD) treated at an academic cancer center reported clinically significant reductions in pain and anxiety in response to music therapy. Furthermore, patients with SCD who received music therapy reported significantly higher pain and anxiety at baseline than patients with hematologic and/or oncologic conditions excluding SCD. The findings from this study were recently published in the journal, Integrative Cancer Therapies, a leading journal focusing on understanding the science of integrative cancer treatments. In this retrospective study conducted between January 2017 and July 202, music therapists at UH Connor Whole Health provided 4,002 music therapy sessions to 1,152 patients across 2,400 encounters at UH Seidman Cancer Center, making this the largest investigation of the real-world effectiveness of music therapy within hematology and oncology to date. This study builds upon a history of seminal music therapy studies funded by the Kulas Foundation, the country's leading foundation for funding scientific research in music therapy, that have investigated the efficacy of music therapy in palliative care, surgery, and sickle cell disease at UH. Music therapists provided interventions including live music listening, active music making, and songwriting to address patients' needs including coping, pain management, anxiety reduction, and self-expression. As part of clinical care, the music therapists assessed patients' self-reported pain, anxiety, and fatigue on a 0 to 10 scale at the beginning and end of each session and documented their sessions in the electronic health record. “This research highlights the increased symptom burden that adults with SCD face in the hospital and the significant impact that a single session of music therapy can have on their pain and anxiety.” These studies support the benefits of music therapy for managing acute pain, improving self-efficacy and quality of life, and improving sickle cell disease knowledge in adolescents and young adults transitioning from pediatric to adult care. Music therapy sessions differed between the two groups, with interventions including active music making, songwriting, and song recording being much more prevalent in the SCD group than the HemOnc group. Furthermore, in an analysis of patients' comments about music therapy, patients expressed themes including enjoyment, gratitude, and improvements in mood, pain, and anxiety. “Integrative Oncology utilizes complementary therapies, such as music therapy discussed in this study, to improve well-being for those affected by cancer. Using an evidence-based approach and building off research allows us to confidently build a program around supporting patients with integrative modalities as part of a strategy to manage symptoms that they may encounter through therapies or from cancer,” explained Santosh Rao, MD, a board-certified medical oncologist and integrative medicine provider and Medical Director of Integrative Oncology at UH Connor Whole Health. (NEXT) Study links health risks to electromagnetic field exposure Kaiser Permanente Division of Research, December 16, 2022 A study of real-world exposure to non-ionizing radiation from magnetic fields in pregnant women found a significantly higher rate of miscarriage, providing new evidence regarding their potential health risks. The Kaiser Permanente study was published in the journal Scientific Reports. Non-ionizing radiation from magnetic fields is produced when electric devices are in use and electricity is flowing. It can be generated by a number of environmental sources, including electric appliances, power lines and transformers, wireless devices and wireless networks. Humans are exposed to magnetic fields via close proximity to these sources while they are in use. While the health hazards from ionizing radiation are well-established and include radiation sickness, cancer and genetic damage, the evidence of health risks to humans from non-ionizing radiation remains limited, said De-Kun Li, MD, PhD, principal investigator of the study and a reproductive and perinatal epidemiologist at the Kaiser Permanente Division of Research in Oakland, California. In a new study funded by the National Institute of Environmental Health Sciences, researchers asked women over age 18 with confirmed pregnancies to wear a small (a bit larger than a deck of cards) magnetic-field monitoring device for 24 hours. Participants also kept a diary of their activities on that day, and were interviewed in person to better control for possible confounding factors, as well as how typical their activities were on the monitoring day. Researchers controlled for multiple variables known to influence the risk of miscarriage, including nausea/vomiting, past history of miscarriage, alcohol use, caffeine intake, and maternal fever and infections. Objective magnetic field measurements and pregnancy outcomes were obtained for 913 pregnant women, all members of Kaiser Permanente Northern California. Miscarriage occurred in 10.4 percent of the women with the lowest measured exposure level (1st quartile) of magnetic field non-ionizing radiation on a typical day, and in 24.2 percent of the women with the higher measured exposure level (2nd, 3rd and 4th quartiles), a nearly three times higher relative risk. The rate of miscarriage reported in the general population is between 10 and 15 percent, Dr. Li said. “This study provides evidence from a human population that magnetic field non-ionizing radiation could have adverse biological impacts on human health,” he said. (NEXT) Common food dye can trigger inflammatory bowel diseases, say researchers McMaster University (Ontario), December 20 2022 Long-term consumption of Allura Red food dye can be a potential trigger of inflammatory bowel diseases (IBDs), Crohn's disease and ulcerative colitis, says McMaster University's Waliul Khan. Researchers using experimental animal models of IBD found that continual exposure to Allura Red AC harms gut health and promotes inflammation. The dye directly disrupts gut barrier function and increases the production of serotonin, a hormone/neurotransmitter found in the gut, which subsequently alters gut microbiota composition leading to increased susceptibility to colitis. Khan said Allura Red (also called FD&C Red 40 and Food Red 17), is a common ingredient in candies, soft drinks, dairy products and some cereals. The dye is used to add color and texture to foodstuffs, often to attract children. The use of synthetic food dyes such as Allura Red has increased significantly over the last several decades, but there has been little earlier study of these dyes' effects on gut health. Khan and his team published their findings in Nature Communications. Yun Han (Eric) Kwon, who recently completed Ph.D. in Khan's laboratory, is first author. “This study demonstrates significant harmful effects of Allura Red on gut health and identifies gut serotonin as a critical factor mediating these effects. These findings have important implication in the prevention and management of gut inflammation,” said Khan, the study's senior author, a professor of the Department of Pathology and Molecular Medicine and a principal investigator of Farncombe Family Digestive Health Research Institute.”What we have found is striking and alarming, as this common synthetic food dye is a possible dietary trigger for IBDs. This research is a significant advance in alerting the public on the potential harms of food dyes that we consume daily,” he said. “The literature suggests that the consumption of Allura Red also affects certain allergies, immune disorders and behavioral problems in children, such as attention deficit hyperactivity disorder.”

Paper discussed in today's episode:Assessing Pretomanid for Tuberculosis (APT), a Randomized Phase 2 Trial of Pretomanid-containing Regimens for Drug-sensitive TB: 12-Week Results

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-306 Overview: In 2015, a landmark study, LEAP (Learning Early About Peanut Allergy), found that early introduction to peanuts, at 4 to 6 months, significantly reduced the incidence of peanut allergies in all children but especially in those at high risk for allergies. A recent survey of pediatric residents and attendings in a large academic center regarding knowledge and implementation of the guidelines uncovered a significant knowledge gap impacting the health of children. Join us as we discuss this gap and review the guidelines for preventing peanut allergies in infants and children.   Episode resource links: Sandhu S, Hanono M, Nagarajan S, Vastardi MA. Knowledge assessment of early peanut introduction in a New York City population [published online ahead of print, 2022 Jun 18]. Ann Allergy Asthma Immunol. 2022;S1081-1206(22)00534-8. doi:10.1016/j.anai.2022.06.013 Greer FR, Sicherer SH, Burks AW, AAP COMMITTEE ON NUTRITION, AAP SECTION ON ALLERGY AND IMMUNOLOGY. The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Pediatrics. 2019;143(4): e20190281 Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Ann Allergy Asthma Immunol. 2017;118(2):166-173.e7. doi:10.1016/j.anai.2016.10.004 Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus Communication on Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants. Pediatr Dermatol. 2016;33(1):103-106. doi:10.1111/pde.12685 Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., Brough, H. A., Phippard, D., Basting, M., Feeney, M., Turcanu, V., Sever, M. L., Gomez Lorenzo, M., Plaut, M., Lack, G., & LEAP Study Team (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England journal of medicine, 372(9), 803–813. https://doi.org/10.1056/NEJMoa1414850 Koplin JJ, Soriano VX, Peters RL. Real-World LEAP Implementation. Curr Allergy Asthma Rep. 2021;22(6):61-66. doi:10.1007/s11882-022-01032-3 https://www.fda.gov/food/cfsan-constituent-updates/fda-completes-review-notification-regarding-health-claim-related-peanut-allergies Guest: Susan Feeney, DNP, FNP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-306 Overview: In 2015, a landmark study, LEAP (Learning Early About Peanut Allergy), found that early introduction to peanuts, at 4 to 6 months, significantly reduced the incidence of peanut allergies in all children but especially in those at high risk for allergies. A recent survey of pediatric residents and attendings in a large academic center regarding knowledge and implementation of the guidelines uncovered a significant knowledge gap impacting the health of children. Join us as we discuss this gap and review the guidelines for preventing peanut allergies in infants and children.   Episode resource links: Sandhu S, Hanono M, Nagarajan S, Vastardi MA. Knowledge assessment of early peanut introduction in a New York City population [published online ahead of print, 2022 Jun 18]. Ann Allergy Asthma Immunol. 2022;S1081-1206(22)00534-8. doi:10.1016/j.anai.2022.06.013 Greer FR, Sicherer SH, Burks AW, AAP COMMITTEE ON NUTRITION, AAP SECTION ON ALLERGY AND IMMUNOLOGY. The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Pediatrics. 2019;143(4): e20190281 Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Ann Allergy Asthma Immunol. 2017;118(2):166-173.e7. doi:10.1016/j.anai.2016.10.004 Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus Communication on Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants. Pediatr Dermatol. 2016;33(1):103-106. doi:10.1111/pde.12685 Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., Brough, H. A., Phippard, D., Basting, M., Feeney, M., Turcanu, V., Sever, M. L., Gomez Lorenzo, M., Plaut, M., Lack, G., & LEAP Study Team (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England journal of medicine, 372(9), 803–813. https://doi.org/10.1056/NEJMoa1414850 Koplin JJ, Soriano VX, Peters RL. Real-World LEAP Implementation. Curr Allergy Asthma Rep. 2021;22(6):61-66. doi:10.1007/s11882-022-01032-3 https://www.fda.gov/food/cfsan-constituent-updates/fda-completes-review-notification-regarding-health-claim-related-peanut-allergies Guest: Susan Feeney, DNP, FNP   Music Credit: Richard Onorato

The acceptance and growth of the Health Coach industry is credited to the influx of research. The value is clear when you provide impact evidence supporting the effectiveness of coaching intervention. But, how do you know which study or journal is a trusted resource? Listen as Dr. Sandi, FMCA Founder and CEO, provides insight into evaluating reports and why it's significant. Randomized controlled trials (RCT) are considered the gold standard because they deliver the highest level of evidence, due to their potential to limit bias and subjective influence. References 1. Effectiveness of Short-Term Health Coaching on Diabetes Control and Self-Management Efficacy: A Quasi-Experimental Trial https://www.frontiersin.org/articles/10.3389/fpubh.2019.00314/full 2. A personalized multi-interventional approach focusing on customized nutrition, progressive fitness, and lifestyle modification resulted in the reduction of HbA1c, fasting blood sugar and weight in type 2 diabetes: a retrospective study https://pubmed.ncbi.nlm.nih.gov/36419152/ 3. Effectiveness of a Health Coaching Intervention for Patient-Family Dyads to Improve Outcomes Among Adults With Diabetes: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/36374502/ Supported by data-driven, science-based research, and published studies.

In a special RANDOMIZED version of our Mock Draft, all the WWE Superstars who competed in a Survivor Series elimination match are up for grabs in a blind pick lottery. Which wrestlers do we end up with on our rosters when we can't willingly choose?! --- Support this podcast: https://anchor.fm/smarkoutmoment/support

Ask Dr Jessica Episode 65 discussing the use of ketamine for treatment of depression, under the care of a psychiatrist.  In recent years, there has been an increase in the number of teenagers who are experiencing major depression.  Randomized trials have demonstrated that  ketamine (given through the IV) and  esketamine (the nasal form) can rapidly improve treatment-resistant depression, including suicidal ideation.   I think it is important to stay up to date on available therapy, because with this knowledge, you never know whose life you may impact for the better.Dr Erin Amato is a practicing psychiatrist in Montana, and she has double board certification in general psychiatry and child  & adolescent psychiatry.  Passionate about holistic and integrative ways to treat mental health disorders,  she is  a fellow of the integrative psychiatry institute, and she has spoken on many media platforms, including many morning television shows.  She has been providing IV ketamine therapy for treatment of depression since 2016.  To learn more about Dr Amato, please look at her website or follow her on Instagram @erinamatomd.Also, to find a nearby  doctor who incorporates use of ketamine into their practice check out:  www.ASKP.orgDr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children.  Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. Do you have a future topic you'd like Dr Jessica Hochman to discuss?  Email your suggestion to: askdrjessicamd@gmail.com. Dr Jessica Hochman is also on social media:Follow her on Instagram: @AskDrJessicaSubscribe to her YouTube channel! Ask Dr JessicaSubscribe to this podcast: Ask Dr JessicaSubscribe to her mailing list: www.askdrjessicamd.comThe information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.