Podcasts about randomized controlled trials

Limited efficacy of platelet-rich plasma intramatricial injections for idiopathic brittle nail treatment: A pilot intrasubject randomized controlled trial.Ricardo JW, Grover C, Iorizzo M, Piraccini BM, Qiu Y, Lipner SR. Journal of the American Academy of Dermatology. 2025Diagnosis and Management of Subungual and Periungual Verruca: A Clinical Review. Curtis KL, Davis JC, Di Chiacchio N, Di Chiacchio NG, Grover C, Iorizzo M, Piraccini BM, Starace M, Tosti A, Lipner SR. Journal of the American Academy of Dermatology. 2024 Nov 15.

PRP in the Epidural Space for Radiculopathy Brooklyn Based Pain Physician, David Rosenblum, MD known for his work publishing and teaching Regenerative Pain Medicine and Ultrasound Guided Pain Procedures hosts this podcast covering the latest and most advanced concepts in Pain Medicine. Summary Dr. David Rosenblum delivered a comprehensive lecture covering several key topics in pain management. He discussed his upcoming speaking engagements at PainWeek, ASPN and great upcoming meetings like the Latin American Pain Society, and other conferences. Dr. Rosenblum shared his extensive experience with PRP (Platelet-Rich Plasma) epidural injections, reviewing multiple research studies that support their efficacy. He highlighted three significant studies: a randomized control trial comparing PRP epidural injections to traditional treatments, a CT-guided epidural PRP study, and a 2025 meta-analysis comparing PRP to steroids. Dr. Rosenblum emphasized that PRP treatments are showing comparable or better results than traditional steroid injections, with potentially fewer required treatments and longer-lasting relief. He noted that while PRP is currently not covered by insurance, it represents a growing trend in 'natural' treatment approaches that patients increasingly prefer. Chapters Introduction and Upcoming Events Dr. Rosenblum announced his upcoming lectures at Pain Week focusing on ultrasound and regenerative medicine, followed by presentations at the Latin American Pain Society in Chile and the New York, New Jersey Pain Conference. He mentioned the SoMeDocs online pain conference accessible through nrappain.org, and upcoming ultrasound training sessions in New York City. PRP Epidural Research Review Dr. Rosenblum discussed a randomized control trial involving 30 patients receiving transforaminal epidural injections. The study showed that PRP patients demonstrated significant improvements in leg pain scores at 6, 12, and 24 weeks. He noted that while the study didn't use contrast, he personally prefers using contrast diluted with saline for better visualization. CT-Guided Epidural Study Analysis Dr. Rosenblum reviewed a study comparing CT-guided epidural PRP versus steroid injections, questioning the necessity of CT guidance. The study included 60 patients and showed similar results between PRP and steroid groups at six weeks, though he criticized the short follow-up period, noting that PRP typically takes months to show full effects. Meta-Analysis Discussion Dr. Rosenblum presented a 2025 meta-analysis comparing PRP to steroids in epidural injections. The analysis included 310 patients across five RCTs, demonstrating comparable efficacy between PRP and steroid injections without increased adverse events. He emphasized that his clinical experience shows patients typically require fewer PRP injections compared to steroid treatments.         Register for Next Weeks SoMeDocs Pain Conference References Wongjarupong, Asarn, et al. "“Platelet-Rich Plasma” epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial." BMC Musculoskeletal Disorders 24.1 (2023): 335. Bise, Sylvain, et al. "Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain." European radiology 30 (2020): 3152-3160. Muthu S, Viswanathan VK, Gangadaran P. Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials. Exp Biol Med (Maywood). 2025 Feb 4;250:10390. doi: 10.3389/ebm.2025.10390. PMID: 39968415; PMCID: PMC11832311.

PRP in the Epidural Space for Radiculopathy Brooklyn Based Pain Physician, David Rosenblum, MD known for his work publishing and teaching Regenerative Pain Medicine and Ultrasound Guided Pain Procedures hosts this podcast covering the latest and most advanced concepts in Pain Medicine. Summary Dr. David Rosenblum delivered a comprehensive lecture covering several key topics in pain management. He discussed his upcoming speaking engagements at PainWeek, ASPN and great upcoming meetings like the Latin American Pain Society, and other conferences. Dr. Rosenblum shared his extensive experience with PRP (Platelet-Rich Plasma) epidural injections, reviewing multiple research studies that support their efficacy. He highlighted three significant studies: a randomized control trial comparing PRP epidural injections to traditional treatments, a CT-guided epidural PRP study, and a 2025 meta-analysis comparing PRP to steroids. Dr. Rosenblum emphasized that PRP treatments are showing comparable or better results than traditional steroid injections, with potentially fewer required treatments and longer-lasting relief. He noted that while PRP is currently not covered by insurance, it represents a growing trend in 'natural' treatment approaches that patients increasingly prefer. Chapters Introduction and Upcoming Events Dr. Rosenblum announced his upcoming lectures at Pain Week focusing on ultrasound and regenerative medicine, followed by presentations at the Latin American Pain Society in Chile and the New York, New Jersey Pain Conference. He mentioned the SoMeDocs online pain conference accessible through nrappain.org, and upcoming ultrasound training sessions in New York City. PRP Epidural Research Review Dr. Rosenblum discussed a randomized control trial involving 30 patients receiving transforaminal epidural injections. The study showed that PRP patients demonstrated significant improvements in leg pain scores at 6, 12, and 24 weeks. He noted that while the study didn't use contrast, he personally prefers using contrast diluted with saline for better visualization. CT-Guided Epidural Study Analysis Dr. Rosenblum reviewed a study comparing CT-guided epidural PRP versus steroid injections, questioning the necessity of CT guidance. The study included 60 patients and showed similar results between PRP and steroid groups at six weeks, though he criticized the short follow-up period, noting that PRP typically takes months to show full effects. Meta-Analysis Discussion Dr. Rosenblum presented a 2025 meta-analysis comparing PRP to steroids in epidural injections. The analysis included 310 patients across five RCTs, demonstrating comparable efficacy between PRP and steroid injections without increased adverse events. He emphasized that his clinical experience shows patients typically require fewer PRP injections compared to steroid treatments.         Register for Next Weeks SoMeDocs Pain Conference References Wongjarupong, Asarn, et al. "“Platelet-Rich Plasma” epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial." BMC Musculoskeletal Disorders 24.1 (2023): 335. Bise, Sylvain, et al. "Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain." European radiology 30 (2020): 3152-3160. Muthu S, Viswanathan VK, Gangadaran P. Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials. Exp Biol Med (Maywood). 2025 Feb 4;250:10390. doi: 10.3389/ebm.2025.10390. PMID: 39968415; PMCID: PMC11832311.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Targeting Investigation and Treatment in Type 2 Myocardial Infarction: A Pilot Randomized Controlled Trial.

PRP in the Epidural Space for Radiculopathy Brooklyn Based Pain Physician, David Rosenblum, MD known for his work publishing and teaching Regenerative Pain Medicine and Ultrasound Guided Pain Procedures hosts this podcast covering the latest and most advanced concepts in Pain Medicine. Summary Dr. David Rosenblum delivered a comprehensive lecture covering several key topics in pain management. He discussed his upcoming speaking engagements at PainWeek, ASPN and great upcoming meetings like the Latin American Pain Society, and other conferences. Dr. Rosenblum shared his extensive experience with PRP (Platelet-Rich Plasma) epidural injections, reviewing multiple research studies that support their efficacy. He highlighted three significant studies: a randomized control trial comparing PRP epidural injections to traditional treatments, a CT-guided epidural PRP study, and a 2025 meta-analysis comparing PRP to steroids. Dr. Rosenblum emphasized that PRP treatments are showing comparable or better results than traditional steroid injections, with potentially fewer required treatments and longer-lasting relief. He noted that while PRP is currently not covered by insurance, it represents a growing trend in 'natural' treatment approaches that patients increasingly prefer. Chapters Introduction and Upcoming Events Dr. Rosenblum announced his upcoming lectures at Pain Week focusing on ultrasound and regenerative medicine, followed by presentations at the Latin American Pain Society in Chile and the New York, New Jersey Pain Conference. He mentioned the SoMeDocs online pain conference accessible through nrappain.org, and upcoming ultrasound training sessions in New York City. PRP Epidural Research Review Dr. Rosenblum discussed a randomized control trial involving 30 patients receiving transforaminal epidural injections. The study showed that PRP patients demonstrated significant improvements in leg pain scores at 6, 12, and 24 weeks. He noted that while the study didn't use contrast, he personally prefers using contrast diluted with saline for better visualization. CT-Guided Epidural Study Analysis Dr. Rosenblum reviewed a study comparing CT-guided epidural PRP versus steroid injections, questioning the necessity of CT guidance. The study included 60 patients and showed similar results between PRP and steroid groups at six weeks, though he criticized the short follow-up period, noting that PRP typically takes months to show full effects. Meta-Analysis Discussion Dr. Rosenblum presented a 2025 meta-analysis comparing PRP to steroids in epidural injections. The analysis included 310 patients across five RCTs, demonstrating comparable efficacy between PRP and steroid injections without increased adverse events. He emphasized that his clinical experience shows patients typically require fewer PRP injections compared to steroid treatments.         Register for Next Weeks SoMeDocs Pain Conference References Wongjarupong, Asarn, et al. "“Platelet-Rich Plasma” epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial." BMC Musculoskeletal Disorders 24.1 (2023): 335. Bise, Sylvain, et al. "Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain." European radiology 30 (2020): 3152-3160. Muthu S, Viswanathan VK, Gangadaran P. Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials. Exp Biol Med (Maywood). 2025 Feb 4;250:10390. doi: 10.3389/ebm.2025.10390. PMID: 39968415; PMCID: PMC11832311.

Kann vegane Ernährung (im Ayurveda) langfristig wirklich funktionieren? Oder wird sie am Ende mehr schaden als helfen? In dieser Folge erwarten dich echte Antworten und 3 grundlegende Vegan-Hacks für jeden Dosha-Typ. Für bessere Verdauung und Nährstoffversorgung – evidenzbasiert und ayurvedisch fundiert.Was dich in dieser Folge erwartet: (Wie) funktioniert vegane Ernährung im Ayurveda? Warum die Antwort so individuell ist, wie dein du. Proteinzufuhr und typgerechte Auswahl und Kombination pflanzlicher Proteinquellen Kritische Nährstoffe, typgerechte Lebensmittel und wann und ob Nahrungsergänzungsmittel erforderlich sind Ghee, Honig & Co: Tierische Ayurveda-Lebensmittel und typgerechte Alternativen Die ethische Perspektive & Qualität tierischer LebensmittelKonntest du etwas für dich mitnehmen? Dann würde ich mich riesig über deinen Like freuen.

Join our scientific team in the discussion of the 3 most clinically impactful papers of the month, the crème de la crème of our weekly top picks.This month we're discussing:A Randomized Controlled Trial of Thoracentesis in Acute Heart FailureDoi: https://doi.org/10.1161/CIRCULATIONAHA.124.07352Metformin for Knee Osteoarthritis in Patients With Overweight or Obesity: A Randomized Clinical TrialDoi: https://doi.org/10.1001/jama.2025.3471Diagnostic accuracy of late gadolinium enhancement cardiac MRI for coronary artery disease in patients with reduced left ventricular ejection fractionDoi: https://doi.org/10.1136/heartjnl-2024-325419Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve ImplantationDoi: https://doi.org/10.1056/NEJMoa2500366Scientific team:Ricardo Ladeiras Lopes, Mário Santos and João Sérgio NevesDiscover Medical Portfolio App weekly top picks - the latest and most relevant papers, curated by our team of experts! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://linktr.ee/medicalportfolioapp⁠

Monk Fruit Extract: Zero-Calorie Sweetener, Surprising Benefits? Ep. 1241 MAY 2025A recent PRISMA-guided systematic review published in Nutrients synthesized findings from randomized controlled trials (RCTs) to assess the impact of monk fruit extract (MFE) on metabolic health, lipid profiles, inflammation, and regulatory considerations. The review included a number of RCTs (note: while some search results indicated 10, others mentioned 5 included studies; refer to the final published article for the definitive number). The findings indicate that MFE may help reduce postprandial glucose levels (by 10–18% in included studies) and insulin responses (by 12–22%). Some studies also reported reductions in inflammatory markers such as IL-6 and TNF-α. No severe adverse effects were observed in the reviewed trials. The review also notes that MFE is approved for use in the United States and China, with its status under review in the European Union. The authors suggest MFE shows potential as a functional food ingredient for metabolic health, though they highlight the need for long-term clinical trials and a harmonized regulatory framework to confirm its long-term safety and efficacy within sustainable health strategies. Disclaimers:"This information is for educational purposes only and should not be interpreted as medical advice.""This video discusses a systematic review of randomized controlled trials. While this represents a high level of evidence, individual results may vary, and further research is always ongoing.""Always consult with a qualified healthcare professional before making any changes to your diet, supplement regimen, or treatment plan, especially if you have a medical condition or are taking medications.""This channel does not provide medical advice."#MonkFruitExtract #MetabolicHealth #SystematicReview #RandomizedControlledTrials #SustainableHealthKaim U, Labus K. Monk Fruit Extract and Sustainable Health: A PRISMA-Guided Systematic Review of Randomized Controlled Trials. Nutrients. 2025; 17(9):1433. https://doi.org/10.3390/nu17091433Alchepharma,Ralph Turchiano,citation,research,study,Monk fruit extract,Siraitia grosvenorii,mogrosides,metabolic health,glycemic control,insulin response,inflammation,blood glucose,type 2 diabetes,natural sweeteners,low-calorie sweeteners,functional foods,dietary supplements,clinical trials,systematic review,PRISMA,nutritional science,dietary interventions,sugar substitutes,glucose metabolism,insulin sensitivity,inflammatory markers,regulatory status

The best management of irreparable rotator cuff tears remains uncertain, with multiple new techniques introduced over the past 2 decades. Two options for treatment are arthroscopic debridement and biceps tenotomy, or the subacromial balloon spacer. Early trial results favored the former option, but the 2-year results have not yet been reported.   In conclusion, participants continued to show better results in the debridement-only group compared with the group who had debridement with the InSpace balloon. Therefore, we do not recommend the subacromial balloon spacer for the treatment of irreparable rotator cuff tears.     Click here to read the article.

Dr. Kenneth Ruggiero (Medical University of South Carolina, Charleston) joins AJP Audio to discuss the the effectiveness of an app-based intervention at reducing the symptoms of sleeplessness and posttraumatic stress in a broad cohort in the wake of a natural disaster.  Afterwards, AJP Editor-in-Chief Dr. Ned Kalin puts the rest of the May issue into context. 00:38     Ruggiero interview 03:13     Bounce Back Now app 05:03     Natural disasters and other sources of trauma 07:31     Low cost and broad-based intervention 08:49     Limitations 10:19     Changes in how the intervention was designed 11:17     Uptake and interactions with the app 13:15     Future directions 14:36     Kalin interview 14:50     Ruggiero et al. 19:26     Norman et al. 23:29     Conrod et al. 27:53     Olfson et al. 31:44     Olfson et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

This week please join author Signe Glargaard and Associate Editor Justin Ezekowitz as they discuss the article "A Randomized Controlled Trial of Thoracentesis in Acute Heart Failure." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20250421.239148

Spring is the perfect time to shake up your routine. In this episode, Professor Tim Spector and Dr. Federica Amati reveal seven delicious, science-backed foods that help cool the flame of chronic inflammation. Whether you're dealing with bloating, aching joints, or low energy, this episode is packed with easy, gut-friendly tips to help you feel your best this season. Tim and Federica begin by explaining what inflammation really is and when it becomes a problem. Then, they'll introduce seven anti-inflammatory foods that are as powerful as they are delicious. From cruciferous vegetables to fermented surprises, these everyday ingredients can help you build a more resilient, healing diet.  Finally, they offer a roadmap for long-term change. Tim and Fed each share one small but powerful shift to reduce inflammation over four timelines - what you can do today, this week, this month, and throughout the year - to create habits that truly stick.

150 - What If Your Brain Fog Isn't All In Your Head? 7 Fixes You've Never TriedIf you've ever walked into a room and immediately forgotten why you're there, you'll want to hear this. What if your brain fog isn't just a coffee shortage… but a mitochondrial meltdown? In this episode of the Pretty Well Podcast, we're digging into the real root of brain health—your mitochondria. Yep, those tiny powerhouses are pulling more weight than you think. You'll learn 7 simple, science-backed ways to boost your brain clarity, energy, and focus (without adding 42 more supplements to your cart). If you're dealing with forgetfulness, low energy, or feeling like your brain's operating on dial-up, this one's for you. We're talking longevity, cognitive vitality, and how to keep your brain as sharp as your wit. Think of it as a tune-up for your brain; real ways to support long-term cognitive health so you can stay sharp, focused, and actually remember where you put your keys.Links & Resources:Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke; Arch Neurol. 2004;61(6):889-892. doi:10.1001/archneur.61.6.889https://jamanetwork.com/journals/jamaneurology/fullarticle/786017#google_vignetteEffects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials; Journal of the American Heart AssociationVolume 7, Number 19 https://doi.org/10.1161/JAHA.118.009835 Amazon Links: *As An Amazon Associate I Earn A Small Commission From Qualifying Purchases At No Extra Cost To You*Pure Encapsulations Brand Mitochondria-Supporting Supplements:Magnesium Glycinate https://amzn.to/4iWlvhx Magnesium Citrate https://amzn.to/4ldRPy1 B complex Plus https://amzn.to/4lj1yTD B complex with PQQ and ALA https://amzn.to/4i3Kv54 CoQ 10 (active form Ubiquinol) https://amzn.to/4lisnHA Saccharomyces boulardii (probiotic) https://amzn.to/3DXc4zg Bellway Super Fiber: https://amzn.to/4i7Ud6B Nature's Sunshine Liquid Chlorophyll ES: https://amzn.to/42xQEly Epic Water Filter Products: https://amzn.to/42wOKSe Join the conversation: Share your thoughts with us on social media or in the comments!Subscribe, Share & Review: Remember to subscribe, share this episode, and leave a review. Your support helps us reach more women looking for answers.Disclaimer: Nothing in this podcast is to be taken as medical advice, please take informed accountability and speak to your provider before making changes to your health routine.The primary purpose of The Pretty Well Podcast being to educate. This content is for informational and educational purposes only. It is not intended to provide medical advice nor to take the place of such advice or treatment from a personal physician. By listening to this content, you agree to consult your own physician or qualified health professional regarding specific health questions. Neither Lisa Smith, The Pretty Well Podcast, nor any guest takes responsibility for possible health consequences of any person or persons following the information in this educational content. All listeners of this content, especially those who are pregnant or taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, or lifestyle program. The Pretty Well Podcast is for private non-commercial use and our guests do not necessarily reflect any agency, organization, or company that they work for. In addition, opinions of interview guests do not necessarily reflect the opinions of Lisa Smith and/or The Pretty Well Podcast. This content is not guaranteed to be correct, complete, or up to date.If you tune into any of the following shows, you'll like ours too! The Dr. Josh Axe Show, Wellness Mama, Be Well By Kelly Leveque, The Freely Rooted Podcast with Kori Meloy, The Dr. Mark Hyman Show, Dr. Jockers Functional Nutrition

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Effect of Sacubitril/Valsartan or Enalapril on Left Ventricular Function in Patients With Hematologic Malignancies Treated With Bone Marrow Transplantation: A Randomized Controlled Trial

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Sodium-Glucose Cotransporter-2 Inhibitors and Arrhythmias: A Meta-Analysis of 38 Randomized Controlled Trials

Dr. Jeff Musgrave // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, join Older Adult Division faculty member Jeff Musgrave discusses a recent randomized control trial, comparing aerobic & cognitive outcomes for high intensity interval training (HIIT) compared to moderate intensity interval training (MIIT) for older adult adults with no training history. Aerobic outcomes were similar measured by peak VO2 max, however working memory & peak knee extensor strength was slightly better for HIIT group & they achieved this in 1/2 the training time! Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.

Limited efficacy of platelet-rich plasma intramatricial injections for idiopathic brittle nail treatment: A pilot intrasubject randomized controlled trial. Ricardo JW, Grover C, Iorizzo M, Piraccini BM, Qiu Y, Lipner SR.JAAD. 2025 Jan 3Concealing Meets Healing in the Treatment of Toenail Onychomycosis: A Review of Concurrent Nail Polish Use With Topical Efinaconazole 10% Solution.Pandit B, Elewski B, Vlahovic TC. The Journal of Clinical and Aesthetic Dermatology. 2024Sep;17(9):38.

Dr. Kenneth Ellenbogen, MD, Deputy Editor of JACC Clinical Electrophysiology, discusses Optimizing CRT Lead Placement Accuracy with MRI-Guided On-Screen Targeting: a Randomized Controlled Trial (ADVISE-CRT III)

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

Five articles from the March 2025 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are, “PRP Injections for the Treatment of Knee Osteoarthritis: The Improvement Is Clinically Significant and Influenced by Platelet Concentration: A Meta-analysis of Randomized Controlled Trials,” “Patients With a Quadriceps Tendon Autograft Demonstrate Greater Asymmetry in Landing Kinetics Than Patients With a Bone–Patellar Tendon–Bone Autograft 6 Months After Anterior Cruciate Ligament Reconstruction,” “Comparison of Interportal and Periportal Capsulotomies and Axial Distraction Resistance During Hip Arthroscopy: An In Vivo Propensity-Matched Cohort Study,” “Trochlear Morphological Changes in Skeletally Immature Patients Across Consecutive MRI Studies,” and “Long-term Recurrence Rates After Isolated Arthroscopic Bankart Repair in Selected Patients Without Preoperative Bone Loss Versus Open Latarjet Procedure: A Matched-Pair Analysis.” Click here to read the articles.

Dr. John Fleetham chats with Dr. Hedner and Dr. Schmickl about their articles “A Randomized Controlled Trial Exploring Safety and Tolerability of Sulthiame in Sleep Apnea" and  “Drug Therapy for Obstructive Sleep Apnea: Are We There Yet?” 

I had thought that in-person therapy was going out of style. But after doing a little research, it looks like it's coming back into fashion.But given that there's evidence showing that virtual therapy is just as effective as in-person therapy, plus the convenience and cost-effectiveness of being remote, why the movement back to meeting in person?We dig into this question a little more in this episode. I turn to research, your responses to my Instagram poll and yes, Reddit, to try to understand a little better.Just one extended version this week. My of my short and snappy episides again next time :)FREE Guide: Start a Private Practice in Counseling:https://tinyurl.com/y9ek9en8Links Mentioned:Link to Poll responses:https://docs.google.com/spreadsheets/d/1MBlDAo78t0yFHoB-rKCD1K3tRR-TqPKHnaBZQ-TRLlg/edit?usp=sharingPsychology Today Article: "The Data Are In: Telehealth Is Here to Stay”https://www.psychologytoday.com/us/blog/psychoanalytic-exploration/202111/the-data-are-in-telehealth-is-here-stayVogue Article Referencing 2024 data: "How to Find a Therapist Online—And Make Sure They're Good"https://www.vogue.com/article/how-to-find-a-virtual-therapistReddit Post: “Why do you in-person?”https://www.reddit.com/r/therapists/comments/15he3xv/why_do_you_inperson/Reddit Post: “Are clients still interested in in-person sessions?”https://www.reddit.com/r/therapists/comments/1g6gajj/are_clients_still_interested_in_inperson_sessions/National Library of Medicine Article: "Evaluation of Online Counseling through the Working Experiences of Mental Health Therapists Amidst the COVID-19 Pandemic”https://pmc.ncbi.nlm.nih.gov/articles/PMC10888081/Yahoo! Article: "The in-person preference: Why traditional therapy still rules over online counseling alternatives”https://www.yahoo.com/lifestyle/online-therapy-not-as-popular-as-in-person-mental-healthcare-232912199.htmlNational Library of Medicine Article: "Therapeutic Alliance in Online and Face-to-face Psychological Treatment: Comparative Study”https://pmc.ncbi.nlm.nih.gov/articles/PMC9112077/National Library of Medicine Article: "Telehealth Versus Face-to-face Psychotherapy for Less Common Mental Health Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials”https://pmc.ncbi.nlm.nih.gov/articles/PMC8956990/LINKS*Some links are affiliate links. A percentage of purchases come back to me and help my channel immensely!

Dr. Annu Navani is one of the research leaders in the field of orthobiologics, and is the Chief Medical Officer for Boomerang Healthcare, with 20+ years of experience in the medical industry. Dr. Navani completed her Anesthesiology residency at the Medical College of Wisconsin, Milwaukee and a fellowship in Pain Medicine from the University of California, Davis. Over the last decade and a half, she has served as Founder and CEO of Comprehensive Spine and Sports Center and is an Adjunct Clinical Associate Professor at the Division of Pain at Stanford University. During this podcast episode, we discuss her journey to pain medicine and her specific interest in orthobiologics. Most importantly, we delve into her groundbreaking research, "The Safety and Effectiveness of Ortho-biologic Injections for Discogenic Chronic Low Back Pain: A Multicenter Prospective, Crossover, Randomized Controlled Trial with 12 Months Follow-up," and discuss the future of orthobiologics in clinical practice.

Commentary by Dr.  Jian'an Wang

In this episode, Dr. Valentin Fuster summarizes the March 11, 2025 issue of the JACC, which features groundbreaking research on transcatheter aortic valve replacement (TAVR) and its expanding applications. The podcast delves into the latest studies on TAVR's impact on heart failure patients, the need for better patient selection, and how new findings are shaping the future of aortic stenosis treatment.

Send us a textEarly hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial.Dudeja S, Saini SS, Sundaram V, Dutta S, Sachdeva N, Kumar P.J Perinatol. 2025 Feb 13. doi: 10.1038/s41372-025-02222-3. Online ahead of print.PMID: 39948354As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Brief Mindfulness-Based Cognitive Therapy in Women With Myocardial Infarction: Results of a Multicenter Randomized Controlled Trial

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a): A Meta-Analysis and Meta-Regression of Randomized Controlled Trials

This special issue of JACC is dedicated to the essential role of cardiovascular surgery in advancing modern cardiology.

In Episode 93 of Trail Society, Corrine, Keely, and Hillary discuss the latest athlete contract news as the new year continues, touching on Keely's decision to forgo a formal sponsorship, Hillary's experience renegotiating with Brooks, and Corrine's new role with HOKA. The episode also celebrates National Girls and Women in Sport Day, highlighting key updates in women's sports, including exciting new sponsorships and efforts toward greater parity in gravel cycling. With upcoming races like Black Canyon 100km and Tarawera, the ladies dive into the growing excitement in the endurance sports world. The episode also takes a deep dive into iron deficiency and supplementation, exploring its critical role in endurance and athletic performance, particularly for female athletes. With insights into how iron impacts energy levels, aerobic capacity, and recovery, the trio breaks down key metrics like hemoglobin, ferritin, and transferrin saturation, emphasizing the importance of a balanced approach to iron supplementation. Additionally, the team tackles creatine supplementation and its potential benefits for female endurance athletes, discussing its impact on muscle function and performance during key hormonal life stages. Keep sliding into our DMs with your messages, they mean so much to us!  FOLLOW US on Instagram: @trail.society And go follow our NEW youtube channel @trailsociety_podcast This episode is brought to you by Freetrail @runfreetrail NEW SPONSOR ALERT: We are so excited to be partnering with Rabbit as our primary apparel sponsor this year! Send us some DMS about your favorite apparel and what you would like to see built for the trail running space!   Articles Effects of Oral Iron Supplementation on Blood Iron Status in Athletes: A Systematic Review, Meta-Analysis and Meta-Regression of Randomized Controlled Trials  https://www.researchgate.net/publication/378488071_Effects_of_Oral_Iron_Supplementation_on_Blood_Iron_Status_in_Athletes_A_Systematic_Review_Meta-Analysis_and_Meta-Regression_of_Randomized_Controlled_Trials The Global Prevalence of Iron Deficiency in Collegiate Athletes: A Systematic Review and Meta-Analysis https://www.sciencedirect.com/science/article/pii/S2095254624001674 Does Creatine Supplementation Enhance Performance in Active Females? A Systematic Review  https://www.mdpi.com/2072-6643/17/2/238#:~:text=5.-,Conclusions,no%20benefit%20compared%20to%20placebo.

The CLEAR SYNERGY (OASIS 9) Trial: A 2x2 Factorial Randomized Controlled Trial of Colchicine versus placebo and Spironolactone versus placebo in Patients with Myocardial Infarction.

Today, we're talking about the use of tranexamic acid or “TXA” for rotator cuff repair surgery. First, what is TXA? If you're not an arthroplasty surgeon or a traumatologist, you may not be as familiar with this medication. TXA is drug that inhibits the enzymatic breakdown of fibrin blood clots, also known as fibrinolysis. By doing this, TXA stabilizes the thrombi, or blood clots, and thus decreases bleeding. TXA was originally developed to treat postpartum hemorrhage but its use has evolved over the years. It is now often used perioperatively in the setting of elective surgery to reduce blood loss, blood transfusions, ecchymosis, and hematoma formation.In the field of orthopedics, use of TXA has traditionally been limited to big open surgeries where large volume blood loss is a concern, such as total joint replacement, fracture fixation and spine procedures. However, sports medicine procedures that rely extensively on visual clarity of the surgical field, such as knee and shoulder arthroscopy, can also greatly benefit from the use of TXA. By lessening intraoperative bleeding, TXA may result in better visualization of the surgical field, potentially decreasing operative time and subsequent postoperative swelling and pain. That is the clinical question that our paper today aimed to investigate. The article that we are reviewing is titled “Tranexamic Acid for Rotator Cuff Repair: A Systematic Review and Meta-analysis of Randomized Controlled Trials.” 

CLEAR SYNERGY (OASIS 9): A 2x2 Factorial Randomized Controlled Trial of Colchicine Versus Placebo and Spironolactone Versus Placebo in Patients with Myocardial Infarction

US dementia cases set to double by 2060; Study claims red meat a culprit in cognitive decline—but a close read reveals it's a lot of baloney; Aerobic exercise is best hedge against Alzheimer's; Prevagen ordered to drop memory claims; When a blood pressure cuff is too tight, can it throw off readings? An 80-year-old who takes DHEA wants to add pregnenolone; Oregon hospital patient awarded $900,000 after face catches fire during surgery; LA residents may suffer health consequences of pollutants long after wildfires quenched. 

Low-dose ketamine as an adjunct to morphine: A randomized controlled trial among patients with and without current opioid use by SAEM

Low-dose ketamine as an adjunct to morphine: A randomized controlled trial among patients with and without current opioid use by SAEM

References:Weight loss on GLP-1 receptor agonistsMoiz A, Levett JY, Filion KB, et al. Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients Without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Cardiol 2024, 222:121-130.Highlights: On average, weight loss on semaglutide (Ozempic) is approximately 15% of body weight.Gastrointestinal adverse effects of GLP-1 receptor agonistsSodhi M, Rezaeianzadeh R, Kezouh A, Etminan M. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA 2023.Nutrient Density and Satiety:Drewnowski, A.. Concept of a nutritious food: toward a nutrient density score. The American Journal of Clinical Nutrition 2005. Nutrient-dense foods like greens and beans have been shown to promote satiety, support weight loss, and provide essential micronutrients.Highlights: Nutrient-dense foods can naturally regulate appetite and reduce caloric intake without sacrificing nutrition.Anti-Angiogenic Effects of Vegetables and Mushrooms:Li WW, Li VW, Hutnik M, Chiou AS. Tumor angiogenesis as a target for dietary cancer prevention. J Oncol 2012, 2012:879623. Certain foods, like cruciferous vegetables and green tea, have anti-angiogenic properties that not only combat tumor growth.Corvera S, Solivan-Rivera J, Yang Loureiro Z. Angiogenesis in adipose tissue and obesity. Angiogenesis 2022, 25:439-453.Cao QZ, Lin ZB. Antitumor and anti-angiogenic activity of Ganoderma lucidum polysaccharides peptide. Acta pharmacologica Sinica 2004, 25:833-838.Highlights: Anti-angiogenic foods limit blood vessel growth in fat cells, aiding in long-term weight management.Role of Fiber in Appetite Suppression:Slavin, JL. Dietary fiber and body weight. Nutrition. 2005. High-fiber foods, such as beans and greens, slow digestion, lower postprandial glucose levels, and enhance satiety, contributing to sustainable weight loss.McRorie JW, Jr., McKeown NM. Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber. J Acad Nutr Diet 2017, 117:251-264.Highlights: Fiber promotes healthy gut microbiota, which indirectly regulates appetite, and viscous fiber directly regulates appetite by slowing breakdown of macronutrients.Green Tea and Weight Regulation:Neyestani TR, Nikooyeh B. A comprehensive overview on the effects of green tea on anthropometric measures, blood pressure, glycemic and lipidemic status: An umbrella review and meta meta-analysis study. Nutr Metab Cardiovasc Dis 2022, 32:2026-2040. Green tea's catechins and mild caffeine content have been shown to modestly increase fat oxidation and support metabolic health.Highlights: Green tea is a natural complement to weight-loss strategies.Nut Consumption and Caloric Absorption:Tindall AM, Petersen KS, Lamendella R, et al. Tree Nut Consumption and Adipose Tissue Mass: Mechanisms of Action. Curr Dev Nutr 2018, 2:nzy069.Highlights: Whole nuts, not oils, reduce caloric intake without compromising satisfaction.

Dr. Emily Eshleman discusses the #1 article of 2023, “Efficacy of Platelet-Rich Plasma Versus Placebo in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Trials,” which was originally published in the Clinical Journal of Sport Medicine in January 2023. Dr. Jeremy Schroeder serves as the series host. Dr. Eshleman 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 2023, as selected for the 2024 AMSSM Annual Meeting. Efficacy of Platelet-Rich Plasma Versus Placebo in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Trials https://journals.lww.com/cjsportsmed/abstract/2023/01000/efficacy_of_platelet_rich_plasma_versus_placebo_in.10.aspx

Co-STAR: Colchicine in Patients with Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Double-Blind Randomized Controlled Trial

If you would like to read a transcript of this episode along with some additional information, head on over to my substack- substack.com/@DrStreicher Chances are you have heard at least one expert say that systemic hormone therapy will prevent heart disease. But you also may have heard other experts say, No- if you don't have hot flashes or low bone mass, it is not recommended to take hormone therapy to prevent heart disease down the road. So, who is right? Why is this controversial?  Isn't the data, the data?  In this episode, I explain why experts are not all on the same page when it comes to the long-term cardiovascular benefits of hormone therapy.  ·      The Difference between a Randomized Controlled Trial and an Observational Trial ·      Why the WHI was an excellent study- and why it was problematic ·      What we learned From the WHI about Hormones and Cardiovascular Health ·      The Study of Women Across the Nation (SWAN)  ·      What we learned From the SWAN about Hormones and Cardiovascular Health ·      What we learned From the SWAN about Hormone therapy and Cardiovascular Risk ·      What we learned From the SWAN about Hormone therapy and Risk of Cardiovascular Disease ·      If hormone therapy should be prescribed for primary prevention of cardiovascular disease-  the view of the two opposing sides  Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine, and the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She is the Medical Director of Community Education and Outreach for Midi Health.  Dr. Streicher is the medical correspondent for Chicago's top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.  Substack/cm/@DrStreicher  DrStreicher.com Instagram @DrStreich Facebook @DrStreicher YouTube @DrStreicherTV LinkedIn @DrStreicher                   Sign up to receive DR. STREICHER'S FREE NEWSLETTER   Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist's guide to eliminating post-menopause dryness and pain   Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy                                      To Find a Menopause Clinician Midi Health   www.Joinmidi.com Midi Health is a telehealth company that provides high-level menopause care and takes insurance in all 50 states. Dr. Streicher is Midi's Medical Director of Education and Community Outreach and is familiar with their medical protocols, which are all regularly updated and set by the top academic menopause experts in the country.      The Menopause Society- Certified Menopause Practitioner List Menopause.org To find a menopause practitioner: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx Put in your zip code and designate NCMP or CMSP to get a certified menopause practitioner. While all people on this list have passed a competency examination, Dr. Streicher does not vouch for every one of these clinicians. Most are excellent.     Major Medical Centers It also may be helpful to check with major medical centers in your area. Many have menopause clinics or lists of doctors who have an interest and expertise in menopause.      If you are in the Chicago area, the center founded by Dr. Streicher:  The Northwestern Medicine Center for Sexual Medicine and Menopause Sexmedmenopause.nm.org        Dr. Streicher's Inside Information podcast is not intended to replace medical advice and should be used to supplement, not replace, care by your personal healthcare clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.

In this episode, Dr. Valentin Fuster delves into the latest research surrounding the use of the mitral clip for patients with severe functional mitral regurgitation, comparing the results of three major trials: the French MITRA-FR trial, the American COAPT trial, and the Reshape HF 2 trial. While the COAPT and Reshape HF 2 trials show positive outcomes, especially in reducing hospitalizations and improving heart failure symptoms, the French trial saw no benefit, prompting debate over the influence of left ventricular volume and disease severity on treatment success, with expert opinions calling for further studies and individualized meta-analyses.

Dr. Graham interviews Dr. Sara Chevalley about her paper "Passive Mobilization With Place-and-Hold Versus Active Mobilization Therapy After Flexor Tendon Repair: 5-Year Minimum Follow-Up of a Randomized Controlled Trial" that is the lead article in the December 2024 issue of The Journal of Hand Surgery.

JACC Deputy Editor Erica S. Spatz, MD, FACC, joins author Rishi Wadhera, MD, to discuss his paper on rural and urban differences in cardiovascular mortality in the United States, and the impact of the COVID-19 pandemic.

In this World Shared Practice Forum podcast, Dr. Mark Peters discusses the Oxy-PICU trial, published in The Lancet in January 2024, which compared conservative to liberal oxygenation targets in critically ill children. The study highlighted the importance of pragmatic trial design and the need for larger trials to confirm these findings. LEARNING OBJECTIVES -Discuss the background driving the investigation of oxygenation in critically ill children -Summarize the study design of the Oxy-PICU Trial -Present the outcomes and challenges of the Oxy-PICU Trial -Identify the key characteristics of pragmatic trial design and the implication of pragmatic trial results AUTHORS Mark Peters, MBChB, MRCP, FFICM, FRCPCH, PhD Professor of Paediatric Intensive Care NIHR Senior Investigator UCL Great Ormond St Institute of Child Health Hon. Consultant Paediatric Intensivist Paediatric Intensive Care Unit and Children's Acute Transport Service Great Ormond St Hospital Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: November 26, 2024. ARTICLES REFERENCED AND ADDITIONAL RESOURCES Peters MJ, Gould DW, Ray S, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial [published correction appears in Lancet. 2024 Jan 27;403(10424):354. doi: 10.1016/S0140-6736(24)00100-4]. Lancet. 2024;403(10424):355-364. https://pubmed.ncbi.nlm.nih.gov/38048787/ Fan E, Del Sorbo L, Goligher EC, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome [published correction appears in Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum]. Am J Respir Crit Care Med. 2017;195(9):1253-1263. https://pubmed.ncbi.nlm.nih.gov/28459336/ Peters MJ, Ramnarayan P. Randomized Trials to Reduce Clinical Uncertainty: Gold Standard or Fool's Gold? Pediatr Crit Care Med. 2024;25(8):775-777. https://pubmed.ncbi.nlm.nih.gov/39101806/ Darnell R, Brown A, Laing E, et al. Protocol for a Randomized Controlled Trial to Evaluate a Permissive Blood Pressure Target Versus Usual Care in Critically Ill Children with Hypotension (PRESSURE). Pediatr Crit Care Med. 2024;25(7):629-637. https://pubmed.ncbi.nlm.nih.gov/38629915/ Taccone FS, Rynkowski Bittencourt C, Møller K, et al. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. JAMA.Published online October 09, 2024. https://pubmed.ncbi.nlm.nih.gov/39382241/ Jones GAL, Eaton S, Orford M, et al. Randomization to a Liberal Versus Conservative Oxygenation Target: Redox Responses in Critically Ill Children. Pediatr Crit Care Med. 2023;24(3):e137-e146. https://pubmed.ncbi.nlm.nih.gov/36728001/ UK-ROX: https://www.icnarc.org/research-studies/uk-rox/ MegaROX: https://www.anzics.org/current-active-endorsed-research/mega-rox/ ICU-ROX: https://www.thebottomline.org.uk/summaries/icm/icu-rox/ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/rq7kgwqkh4hk4nk67584pfj/202411_-_WSP_-_Less_is_more_Oxygenation_Targets_in_Critically_Ill_Children_-_Transcript?position=2 CITATION Peters MJ, Burns JP. Less is More: Oxygenation Targets in Critically Ill Children. 11/2024. OPENPediatrics. https://soundcloud.com/openpediatrics/less-is-more-oxygenation-targets-in-critically-ill-children-by-m-peters-openpediatrics.

Episode 179: Impact of intermittent fasting Impact on T2DMFuture Dr. Carlisle explains the physiology of fasting and how it can help revert type 2 diabetes. Dr. Arreaza adds details on how to do intermittent fasting. Written by Cameron Carlisle, MSIV, Ross University School of Medicine. Comments and edits by Hector Arreaza, MD, FAAFP.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.What is type 2 Diabetes Mellitus (T2DM)?-Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder characterized by insulin resistance and impaired glucose regulation. -This impaired regulation can lead to hyperglycemia, contributing to complications in a myriad of organs: heart, kidneys, eyes, nerves, etc. (target organs). According to the CDC, more than 38 million Americans have T2DM (about 1/10 people). -Multiple mechanisms are believed to contribute to insulin resistance in obese patients with T2DM, such as increased lipid deposition throughout the body and systemic inflammation.What is Intermittent Fasting (IF)? Intermittent fasting (IF) has recently gained popularity as a dietary approach for health benefits, but it has been around for thousands of years. IF is an eating pattern that alternates between eating and fasting (no calories consumed) over a specific period of time. When you are fasting, you are allowed and encouraged to keep drinking water and non-caloric drinks, like coffee, tea, and even homemade bone broth.-According to the International Food Information Council Foundation (IFIC), 10% of Americans engage in IF daily. -According to Mark Mattson, a neuroscientist and IF expert for over 25 years, a mechanism called “metabolic switching” is seen with IF. This is when your body runs out of glucose and starts burning fat (i.e., fatty oxidation). These metabolic changes can help protect your organs and reduce the risk of chronic conditions, like T2DM. Common IF methods: Time-restricted eating: Most common method, involves eating within a specific time frame (e.g., the 16:8, 18:6, 12:12 method is also common.  [16:8 means you have 16 hours of fasting and 8 hours of eating.]Alternate-day fasting: Alternating between fasting days and normal eating days.  [Find more info in The Complete Guide to Fasting, by Jason Fung, who is a nephrologist, he explains that alternate-day is basically eating every other day, which would give 36 hours of fasting, but if you are a beginner you can try a 24 hours fasting, in short, not eating breakfast any day of the week and having lunch 4 days a week, and dinner every night.]5:2 diet (aka periodic fasting): Maintaining a normal diet for 5 days, with 2 days (usually non-consecutive) of caloric restriction (25% of normal caloric intake; e.g., 500 calorie meal). IF is strongly believed to improve metabolic health in individuals with T2DM by reducing insulin resistance via increasing insulin sensitivity, promoting weight loss (patients with obesity and DM… AKA patients with diabesity), and enhancing lipolysis via fat oxidation.While fasting, the body goes through several phases that affect how energy is metabolized. Between 0 and 4 hours after eating, the body enters a feeding state, using glucose as its main energy source. After fasting for 12-16 hours, the body enters ketosis and starts to use fat for energy. Within 24-36 hours, autophagy begins, a process that recycles damaged cells and allows for cellular repair. This process can have great benefits for people with T2DM, such as improved insulin sensitivity and glucose regulation. Pathophysiology of Implementing IF in T2DM. -IF is thought to increase insulin sensitivity by decreasing fatty tissue in the body (i.e., visceral adipose tissue), which is correlated to insulin resistance. Insulin resistance is defined as higher than normal circulating insulin levels needed for a glucose lower response, which is thought to be the culprit for the generation of T2DM. It means you need high levels of insulin to keep glucose normal. -Obesity is an important risk factor for T2DM. Visceral adipose tissue functions as an organ via the secretion of adipokines (cytokines or cellular messengers produced by adipose tissue): leptin and adiponectin. Leptin: proinflammatory, leading to chronic inflammation. Patients with higher BMI levels and increased insulin resistance were found to have increased leptin levels.[Leptin is a good hormone at normal levels, but there is leptin resistance] Adiponectin: anti-inflammatory and antidiabetic effects. Higher adiponectin levels result in decreased hepatic gluconeogenesis, enhanced glucose absorption, and enhanced skeletal muscle and hepatic fatty acid oxidation. Levels drop as visceral fat increases. -Dr. López-Jaramillo, a Colombian endocrinologist and researcher, and colleagues published a review in 2014 examining the imbalance in the levels of leptin and adiponectin in individuals with metabolic syndrome. This imbalance (increase in leptin and decrease in adiponectin) is linked to obesity and insulin resistance, which has been shown to increase the risk of T2DM. It has been shown that IF has resulted in the reduction of leptin levels and increased levels of adiponectin, which leads to decreased insulin resistance and increased insulin sensitivity. -IF allows pancreatic beta-cells to rest by not having to secrete insulin constantly. This allows the beta-cells of the pancreas to improve in function over time. In addition, IF has been shown to lead to noticeable weight loss and loss in body fat, both of which play an important contribution in managing T2DM. Research demonstrates that this weight loss increases insulin sensitivity and decreases the need for insulin therapy, making IF a powerful approach for improving metabolic health. AMP-Activated Protein Kinase (AMPK) and Its Role in IF and T2DM Recent research has highlighted an important enzyme seen in IF, AMP-activated protein kinase (AMPK), which plays a vital role as an important energy sensor in cells. It is activated when cellular energy levels are low, such as during IF. A 2020 research study in Nature Reviews Endocrinology explains that activation of AMPK aids in suppressing gluconeogenesis and stimulates fatty acid oxidation, leading to optimal energy balance and reduction of visceral adipose tissue accumulation, a major contributor to insulin resistance and T2DM progression. AMPK is upregulated during fasting, which enhances glucose metabolism and reduces insulin resistance. This is imperative in managing T2DM, as it counters the effects of insulin resistance associated with T2DM.Exercise, which also promotes AMPK activation, complements IF and can promote a synergistic effect in improving insulin sensitivity and promoting fat burning, New Research Findings on IF and T2DM -The EARLY (Exploration of Treatment of Newly Diagnosed Overweight/Obese Type 2 Diabetes Mellitus) study is a randomized clinical trial published in JAMA Network Open (2024). Findings In this randomized clinical trial study found that a time-restricted eating window significantly improved fasting glucose levels and HbA1c levels in individuals with T2DM. The study examined the effect of a 16-week 5:2 meal replacement (5:2 MR) fasting plan that consisted of five days of normal eating and 2 days, nonconsecutive of restricted diet (500-600 calories). This group was examined alongside a group of patients who took metformin 0.5 g BID and empagliflozin 10 mg QD. The study wanted to investigate the changes in HbA1c in Chinese adults with early T2DM.-The study was a randomized clinical trial of 405 adults, and a study showed that the 5:2 MR approach led to better glycemic control at 16 weeks compared to the counter treatments with metformin and empagliflozin. The 5:2 MR group had the greatest reduction in HbA1c (-1.9%), followed by metformin (-1.6%), and empagliflozin (-1.5%). The 5:2 MR plan also revealed the greatest weight loss (-9.7 kg), followed by empagliflozin (-5.8 kg), and metformin (-5.5 kg). -This research suggests IF, such as 5:2 MR, can be a powerful tool in the management of T2DM and improving metabolic health. This study can potentially open doors for healthcare providers to provide the 5:2 MR approach for individuals as an effective initial lifestyle intervention. However, follow-up studies are needed to assess the effectiveness and durability of the 5:2 MR.Safety and Risks of IF in T2DM. -IF when combined with glucose-lowering medications (e.g., insulin, sulfonylureas, GLP-1 agonists) can increase the risk of hypoglycemia. Also, prolonged fasting can lead to nutrient deficiencies if not planned carefully. Patients should be counseled on maintaining a balanced, nutritious diet during non-fasting days. -IF is not suitable for everyone. Children under the age of 18 should not try IF due to needing proper calories for adequate development and proper growth. Also, it is recommended that pregnant or breastfeeding women do not undergo IF. It is advised that people with eating disorders should not try IF. -Individuals with certain medical conditions, such as kidney stones or gastroesophageal disease should speak with their doctor before trying IF. Also, patients on insulin or other glucose-lowering medications should adjust their dose and talk with their healthcare providers to prevent hypoglycemia during fasting. It is recommended that each person speak with their doctor to discuss the safety and risks of IF and see if it would benefit the individual before starting IF. -Many studies have explored the benefits of IF at the micro level revealing its cellular benefits and on a macro level of the body as a whole. However, more research is needed to confirm the long-term effects of IF on glycemic control and its sustainability as a therapeutic approach for T2DM. Conclusion:-IF shows potential for improving glycemic control, promoting weight loss, and enhancing metabolic health in individuals with T2DM. Despite its benefits, IF may present with risks, such as hypoglycemia, nutrition deficiencies, or dehydration in certain patients. Therefore, it may not be suitable for all individuals. It's important to monitor patients who engage in IF, especially for patients with T2DM. Patients should follow up with their doctor for individualized IF plans in patients with T2DM. ______________This week we thank Hector Arreaza and Cameron Carlisle. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Albosta, Michael, and Jesse Bakke. “Intermittent Fasting: Is There a Role in the Treatment of Diabetes? A Review of the Literature and Guide for Primary Care Physicians - Clinical Diabetes and Endocrinology.” BioMed Central, BioMed Central, 3 Feb. 2021, doi.org/10.1186/s40842-020-00116-1.Blumberg, Jack, et al. “Intermittent Fasting: Consider the Risks of Disordered Eating for Your Patient - Clinical Diabetes and Endocrinology.” BioMed Central, BioMed Central, 21 Oct. 2023, https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-023-00152-7.De Cabo, Rafael, and Mark P. Mattson. “Effects of intermittent fasting on health, aging, and disease.” New England Journal of Medicine, vol. 381, no. 26, 26 Dec. 2019, pp. 2541–2551, https://doi.org/10.1056/nejmra1905136.Guo, Lixin, et al. “A 5:2 intermittent fasting meal replacement diet and glycemic control for adults with diabetes.” JAMA Network Open, vol. 7, no. 6, 21 June 2024, https://doi.org/10.1001/jamanetworkopen.2024.16786.Herz, Daniel, et al. “Efficacy of Fasting in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review.” Nutrients, U.S. National Library of Medicine, 10 Aug. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10459496/. Herzig, S., & Shaw, R. J. (2018). AMPK: Guardian of metabolism and mitochondrial homeostasis. Nature Reviews Molecular Cell Biology, 19(2), 121-135.Longo, V. D., & Mattson, M. P. (2014). Fasting: Molecular mechanisms and clinical applications. Cell Metabolism, 19(2), 181-192. https://doi.org/10.1016/j.cmet.2013.12.008López-Jaramillo P, Gómez-Arbeláez D, López-López J, et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Hormone Molecular Biology and Clinical Investigation. 2014;18(1):37–45.Mattson, Mark P., et al. “Impact of intermittent fasting on health and disease processes.” Ageing Research Reviews, vol. 39, Oct. 2017, pp. 46–58, https://doi.org/10.1016/j.arr.2016.10.005. Patikorn, Chanthawat, et al. “Intermittent fasting and obesity-related health outcomes.” JAMA Network Open, vol. 4, no. 12, 17 Dec. 2021, https://doi.org/10.1001/jamanetworkopen.2021.39558.Sharma, Suresh K, et al. “Effect of Intermittent Fasting on Glycaemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” TouchREVIEWS in Endocrinology, U.S. National Library of Medicine, May 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10258621/#:~:text=In%20IF%2C%20eating%20habits%20are,the%20risk%20of%20developing%20T2DM.Xiaoyu, Wen, et al. “The effects of different intermittent fasting regimens in people with type 2 diabetes: A network meta-analysis.” Frontiers in Nutrition, vol. 11, 25 Jan. 2024, https://doi.org/10.3389/fnut.2024.1325894. Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Protein — how much do we need? What's the healthiest way to consume it? Can we get enough from plant-based diets? Until recent decades, protein hasn't been quite as prominent in public health discussions as sugar and fats.  However, with longer lifespans emphasizing the importance of protein for long-term health, and growing confusion around the quality and quantity of protein needed, it has become a highly debated macronutrient. In ‘Your Brain On… Protein', we explore: • The brain health benefits (and general health benefits) of protein • Plant-based protein vs. meat protein, and supplements like protein powders • How much protein we really need to eat every day • Ways we can all introduce more protein into our diets • Why ‘health' influencers are suddenly recommending unusually  high levels of protein consumption • How we measure the quality of proteins, including digestibility and absorption In this episode, we're joined by two fantastic nutrition experts: DR. MATTHEW NAGRA, nutritionist and science communicator. DR. ALAN FLANAGAN, esteemed nutrition scientist (previously featured in ‘Your Brain On… Sugar' and ‘Your Brain On… Fats' ‘Your Brain On' is hosted by neurologists, scientists and public health advocates Ayesha and Dean Sherzai. Drs. Ayesha and Dean are now welcoming patients via the Brain Health Institute: https://brainhealthinstitute.com/ ‘Your Brain On... Protein' • SEASON 3 • EPISODE 10 (SEASON 3 FINALE!) ——— LINKS: Dr. Matt Nagra Instagram: https://www.instagram.com/dr.matthewnagra Website: https://drmatthewnagra.com/  Dr. Alan Flanagan Alan on Instagram: https://www.instagram.com/thenutritionaladvocate Alinea Nutrition: https://www.alineanutrition.com/ ——— REFERENCES: Dietary Patterns and Risk of Dementia: a Systematic Review and Meta-Analysis of Cohort Studies. https://doi.org/10.1007/s12035-015-9516-4 Dietary fat composition and dementia risk. https://doi.org/10.1016/j.neurobiolaging.2014.03.038 Dietary Protein and Amino Acids in Vegetarian Diets—A Review. https://pmc.ncbi.nlm.nih.gov/articles/PMC6893534/ Animal vs Plant-Based Meat: A Hearty Debate. https://pubmed.ncbi.nlm.nih.gov/38934982/ High-Protein Plant-Based Diet Versus a Protein-Matched Omnivorous Diet to Support Resistance Training Adaptations: A Comparison Between Habitual Vegans and Omnivores. https://pubmed.ncbi.nlm.nih.gov/33599941/ Vegan and Omnivorous High Protein Diets Support Comparable Daily Myofibrillar Protein Synthesis Rates and Skeletal Muscle Hypertrophy in Young Adults. https://pubmed.ncbi.nlm.nih.gov/36822394/ Digestibility issues of vegetable versus animal proteins: protein and amino acid requirements--functional aspects. https://pubmed.ncbi.nlm.nih.gov/23964409/ Soy and Isoflavone Consumption and Multiple Health Outcomes: Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies and Randomized Trials in Humans. https://doi.org/10.1002/mnfr.201900751 No Difference Between the Effects of Supplementing With Soy Protein Versus Animal Protein on Gains in Muscle Mass and Strength in Response to Resistance Exercise. https://pubmed.ncbi.nlm.nih.gov/29722584/ Neither soy nor isoflavone intake affects male reproductive hormones: An expanded and updated meta-analysis of clinical studies. https://pubmed.ncbi.nlm.nih.gov/33383165/ The health effects of soy: A reference guide for health professionals. https://pmc.ncbi.nlm.nih.gov/articles/PMC9410752/ The Effect of Plant-Based Protein Ingestion on Athletic Ability in Healthy People—A Bayesian Meta-Analysis with Systematic Review of Randomized Controlled Trials. https://www.mdpi.com/2072-6643/16/16/2748 Effects of high-quality protein supplementation on cardiovascular risk factors in individuals with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials. https://doi.org/10.1016/j.clnu.2024.06.013 Vegan and Omnivorous High Protein Diets Support Comparable Daily Myofibrillar Protein Synthesis Rates and Skeletal Muscle Hypertrophy in Young Adults. https://pubmed.ncbi.nlm.nih.gov/36822394/

In this episode of Breakpoints' Dosing Consult series, Drs. Chuck Peloquin and Gerry Davies join Dr. Megan Klatt to discuss rifampin dosing for mycobacterial infections. Hear from the experts on if higher doses are really better, toxicity thresholds, and the role of alternative rifamycins for patients with MTB and NTMs. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp References: Efficacy and Safety of High-Dose Rifampin in Pulmonary Tuberculosis. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2018 Sep 1;198(5):657-666. doi: 10.1164/rccm.201712-2524OC. Rifampin vs. rifapentine: what is the preferred rifamycin for tuberculosis? Expert Rev Clin Pharmacol. 2017 Oct;10(10):1027-1036. doi: 10.1080/17512433.2017.1366311. Rifabutin for treating pulmonary tuberculosis. Cochrane Database Syst Rev. 2007 Oct; 2007(4): CD005159. doi: 10.1002/14651858.CD005159.pub2. Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease. Clin Infect Dis. 2023 Oct 5;77(7):1053-1062. doi: 10.1093/cid/ciad312. This podcast is powered by Pinecast.

The internet is panicking that seed oils cause inflammation and disease. Yet, they're everywhere. Canola, sunflower, safflower oil - these are all seed oils. So why is there so much fear? And are any of the accusations true? In this episode, we unpack the science of seed oils. With Professor Sarah Berry's expertise, we simplify what seed oils are, what the latest science says and why countless videos online say they're toxic.  Sarah Berry is a professor in the Department of Nutritional Sciences at King's College London and Chief Scientist at ZOE. She reveals the surprising truth about seed oils and tips to navigate a world full of them.

In this episode, my guest is Dr. Layne Norton, Ph.D., one of the world's top experts in nutrition and training for physical fitness. We discuss how to evaluate scientific evidence and the validity of different practices aimed at achieving fat loss, muscle strength and hypertrophy, microbiome health, vitality, and longevity. We explore many hotly debated topics, including fasting, seed oils, saturated fats, sugar, red meat, artificial/low-calorie sweeteners, and GLP-1 agonists (e.g., Ozempic). Additionally, we delve into the timing of protein and carbohydrate intake relative to fasting and exercise, fat loss and sleep, and the benefits of dietary protein and fiber on overall health. We also discuss how to accelerate hypertrophy and fat loss, improve strength, whether we need to train to “failure,” how to enhance exercise recovery, and how to manage pain. We cover training before versus after age 50, whether metabolism changes with age, and the connection between muscle health and longevity. We also address why certain behaviors and supplements might work for some people but not others. Listeners to this episode will benefit greatly from Layne's science-based expertise on a wide range of topics, including health, nutrition, and fitness. Access the full show notes for this episode at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Mateina: https://drinkmateina.com/huberman Eight Sleep: https://www.eightsleep.com/huberman Maui Nui: https://mauinuivenison.com/huberman LMNT: https://drinklmnt.com/huberman Timestamps 00:00:00 Dr. Layne Norton 00:01:49 Sponsors: Mateina, Eight Sleep, Maui Nui 00:06:39 Science-Based Evidence, Mechanism vs. Outcome 00:14:31 Meta-analysis, Methods, Evidence Quality 00:22:45 Evidence Hierarchy, Randomized Controlled Trials, Cohort Data 00:33:53 Sponsor: AG1 00:35:05 “Don't Turn Your Brain Off”; Protein Synthesis 00:42:01 Protein Synthesis, Refractory Response; Resistance Training   00:46:05 Protein Intake, Intermittent Fasting & Training 00:54:52 Tool: Total Protein Intake, Distribution & Protein Synthesis 01:00:25 Muscle Quality, Protein Remodeling, Muscle Growth 01:05:34 Sponsor: LMNT 01:06:46 Early vs. Late Time-Restricted Eating; Fasting Blood Glucose & HbA1c 01:10:30 Carbohydrate Timing, Individual Response, Placebo; Tool: Tracking Diet 01:19:50 “The Norton Method”; Tool: Consistency 01:25:16 Resistance & Cardiovascular Training; Competition; Immune System & Rest 01:33:50 Mind & Body Effects, Stress; Belief Effects 01:41:30 Training to Failure, Reps in Reserve, Hypertrophy & Strength Training 01:50:24 Fatigue & Training to Failure, Speed, Strength Training 01:59:06 Tool: Training After 50, Consistency 02:09:12 Fat Cells, Diabetes, Exercise 02:16:50 Metabolism & Age-Related Changes?, Appetite 02:23:17 Ozempic, Mounjaro, GLP-1 Agonists, Lean Mass, “Food Noise” 02:33:42 GLP-1 Agonists, Judgement & Obesity 02:40:19 Sugar, Excess Calories, Body Weight 02:49:16 Satiety, Sugar & Calorie Budget 02:54:56 Tool: Individualization, Context & Diet Psychology 02:57:22 Seed Oils, Butter, Olive Oil 03:06:56 Red Meat, Carcinogenic?; Simple Diet; Fiber Benefits 03:13:43 Saturated Fat, Cholesterol; Seed Oils 03:18:41 Artificial & Low-Calorie Sweeteners, Insulin, Appetite 03:29:06 Artificial & Low-Calorie Sweeteners, Gut Microbiome; Cancer 03:37:58 Tools: Training Recovery, Glycogen Replenishment; Stress & Activity 03:45:56 Collagen Supplementation, Skin & Nails, Whey Protein 03:57:00 Evidence-Based Approach 04:01:41 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures