Podcasts about recurrent

In this episode of Optimal Metabolism, I sit down with Dr. Michael Biamonte, founder of the Biamonte Center for Clinical Nutrition and author of The Candida Chronicles, to unpack the surprising connection between Candida overgrowth and metabolic dysfunction. Candida is often reduced to "just a yeast infection," but Dr. Biamonte explains why chronic fungal overgrowth can disrupt insulin signaling, impair liver detoxification, drive inflammation, weaken immunity, and create the perfect storm for weight gain, fatigue, high cholesterol, and blood pressure issues. If you've ever felt like your body is working against you, this conversation may connect the dots. You may want to explore this deeper if you experience: Stubborn weight loss resistance Blood sugar swings or insulin resistance Chronic fatigue or brain fog Recurrent infections Bloating, digestive complaints, or food sensitivities Hormonal imbalances that don't improve with diet alone

With over a billion creators projected to be active in the next decade, is the traditional distinction between a brand, a publisher, and a creator in need of an updated definition? Agility requires not just reacting to new platforms, but fundamentally rethinking who creates your content and how you build an authentic community around it. It's about moving from a campaign mindset to an ecosystem mindset. Today, we're going to talk about the seismic shift in the media landscape, driven by the explosive growth of the creator economy. We'll explore how the very definition of a creator is evolving from a short-term influencer to a long-term brand builder, and what opportunities and challenges this presents for established brands that are trying to earn and keep their audience's attention. To help me discuss this topic, I'd like to welcome, Andrew Perlman, Co-Founder and CEO at Recurrent. About Andrew Perlman Andrew Perlman is the Co-Founder and Chief Executive Officer of Recurrent. Perlman co-founded the company in 2018 with the acquisition of The Drive. Over a span of three years, he oversaw the acquisition of nearly 25 noteworthy brands, including Task & Purpose, Popular Science, Dwell, and Donut, and in the process, introduced Recurrent as the new parent company for the digital media portfolio. In 2022, Perlman rejoined the organization from his role on the board as the Head of M&A and Corporate Development before he assumed the role of CEO in 2023. Previously, Andrew spent over six years as the Chief Executive Officer of XpresSpa, FORM Holdings, and its predecessor company, Vringo, where he led the overall business operations and strategy as well as capital raising. During his tenure, he also oversaw five acquisitions and the NASDAQ listing of the company. Andrew has also served as Vice President of Business Development at EMI Music, SVP of Music and Digital at Classic Media, and held roles at early mobile content companies. Andrew Perlman on LinkedIn: https://www.linkedin.com/in/adperlman/ Resources Recurrent: https://recurrent.io/ Take your personal data back with Incogni! Use code AGILE at the link below and get 60% off an annual plan: https://aglbrnd.co/r/c43e68ce5cfb321e The Agile Brand podcast is brought to you by TEKsystems. Learn more here: https://aglbrnd.co/r/2868abd8085a9703 Drive your customers to new horizons at the premier retail event of the year for Retail and Brand marketers. Learn more at CRMC 2026, June 1-3. https://aglbrnd.co/r/d15ec37a537c0d74 Enjoyed the show? Tell us more at and give us a rating so others can find the show at: https://aglbrnd.co/r/faaed112fc9887f3 Connect with Greg on LinkedIn: https://www.linkedin.com/in/gregkihlstromDon't miss a thing: get the latest episodes, sign up for our newsletter and more: https://aglbrnd.co/r/35ded3ccfb6716ba Check out The Agile Brand Guide website with articles, insights, and Martechipedia, the wiki for marketing technology: https://www.agilebrandguide.com The Agile Brand is produced by Missing Link—a Latina-owned strategy-driven, creatively fueled production co-op. From ideation to creation, they craft human connections through intelligent, engaging and informative content. https://www.missinglink.company

Trigger Warning - Pregnancy after loss. In this episode, Alex returns to the podcast (last seen S8 E16) to talk openly about life after loss. She shares her experience of recurrent miscarriages and what it was really like to step back into pregnancy carrying grief, fear, and hope all at the same time.Alex reflects on the emotional toll of trying again - the constant worry, the anxiety that never quite switches off, and the careful ways she learned to protect herself while still allowing room for hope. She speaks honestly about the coping strategies that helped her get through the hardest moments, and how vital support from others was when everything felt overwhelming.This conversation is a reminder that pregnancy after loss is rarely straightforward. It's about finding balance, holding onto small positives, and allowing yourself to feel everything - without guilt or expectation.

In this episode of JCO Article Insights, host Dr. Melis Canturk summarizes the article, "Phase 2 Trial of Ribociclib plus Letrozole in Women with Recurrent Low-Grade Serous Cancer of the Ovary, Fallopian Tube, or Peritoneum: A GOG Partners Trial," by Slomovitz et al.  TRANSCRIPT Melis Canturk: Hello, and welcome to JCO Article Insights. I'm your host, Melis Canturk, and today we will be discussing the JCO article, "Phase 2 Trial of Ribociclib plus Letrozole in Women with Recurrent Low-Grade Serous Cancer of the Ovary, Fallopian Tube, or Peritoneum: A GOG Partners Trial." Building on the fact that more than 95% of low-grade serous carcinoma are estrogen receptor positive and often exhibit abnormalities in the CDK4/6 signaling pathway, researchers launched the GOG 3026 trial. This study investigated the effectiveness of pairing the CDK4/6 inhibitor ribociclib with letrozole, an aromatase inhibitor, adapting a therapeutic approach that has already transformed the treatment landscape for hormone receptor-positive metastatic breast cancer. Low-grade serous ovarian cancer is a rare malignancy characterized by its hormonally driven nature and relative resistance to traditional platinum-based chemotherapy. While it's associated with longer survival than high-grade serous carcinoma, recurrent disease presents a significant clinical challenge due to low response rates to standard treatments. The GOG 3026 trial was an open-label, single-arm, multicenter, phase 2 study that enrolled 51 women with measurable, recurrent, low-grade serous ovarian cancer. To ensure diagnostic accuracy, all cases underwent central pathology review. Participants were required to be at least 18 years old with an ECOG performance status of 0 to 2. While there was no limit on the number of prior therapies, patients were excluded if they had previously used CDK4/6 inhibitors. Prior endocrine therapy was permitted only if the patient had discontinued it at least 6 months before the study and had not experienced disease progression while on that specific therapy. Additionally, women with intact ovarian function were required to undergo ovarian suppression. The treatment regimen consisted of 600 mg of oral ribociclib daily for the first 21 days of a 28-day cycle, paired with a continuous daily dose of 2.5 mg of letrozole. The trial's primary endpoint was the investigator-assessed objective response rate. The results were clinically meaningful. The confirmed overall response rate was 30.6%, which included one complete response and 14 partial responses. The clinical benefit rate, which includes stable disease, reached 84%. These outcomes are particularly notable given the heavily pretreated study population, where nearly 40% of patients had received three or more prior lines of systemic therapy. Durability and survival data further underscored the potential of this combination. Among those who responded to treatment, the median duration of response was 21.2 months. The median progression-free survival was 14.5 months, and the median overall survival reached 44.5 months. In terms of safety, the profile was consistent with previous CDK4/6 inhibitor studies. The most common grade 3 and 4 adverse event was neutropenia, occurring in 47% of patients. However, it was asymptomatic and managed through dose modification. Only 4% of patients discontinued the trial due to adverse events, and no dose-limiting toxicities were observed. When comparing these results to other therapeutic benchmarks, the ribociclib-letrozole combination demonstrated more favorable outcomes than historical endocrine monotherapy. It yields response rates of only 13% to 14%. Furthermore, while MEK inhibitors like trametinib or the combination of avutometinib defactinib show similar response rates, the ribociclib-letrozole regimen displayed significantly better tolerability. Specifically, only 4% of patients in this trial discontinued the therapy due to adverse events, compared to much higher discontinuation rates seen with MEK inhibitor strategies. In conclusion, the GOG 3026 trial successfully establishes ribociclib plus letrozole as a clinically active and well-tolerated regimen for recurrent low-grade serous ovarian cancer. By achieving durable disease control in a heavily pretreated, relatively chemoresistant population, this combination may redefine the therapeutic paradigm for this rare cancer. These findings support the continued evaluation of CDK4/6 endocrine strategies as a preferred chemotherapy-sparing option that prioritizes both disease control and patients' quality of life. Thank you for tuning into JCO Article Insights. Don't forget to subscribe and join us next time as we explore more groundbreaking research shaping the future of oncology. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Host Dr. Davide Soldato and guests Dr. David Einstein and Dr. Ravi Madan discuss JCO article, "National Cancer Institute's Working Group on Biochemically Recurrent Prostate Cancer: Clinical Trial Design Considerations," underscoring the need for a consensus on clinical trial designs implementing novel endpoints in this population, the importance of PSA doubling time as a prognostic factor and with an emphasis on treatment de-escalation to limit toxicity and improve patient outcomes. TRANSCRIPT The disclosures for guests on this podcast can be found in the show notes. Davide Soldato: Hello and welcome to JCO After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, medical oncologist at Ospedale San Martino in Genoa, Italy. Today, we are joined by JCO authors Dr. David Einstein and Dr. Ravi Madan. Dr. Einstein is a medical oncologist specializing in genitourinary malignancy working at Beth Israel Deaconess Medical Center, part of the DFCI Cancer Center, and an assistant professor at Harvard Medical School. Dr. Madan is a senior clinician at the National Cancer Institute (NCI), where he focuses on conducting clinical research in prostate cancer, particularly in the field of immunotherapy. Today, we will be discussing the article titled, "National Cancer Institute's Working Group on Biochemically Recurrent Prostate Cancer: Clinical Trial Design Considerations." So, thank you for speaking with us, Dr. Einstein and Dr. Madan. David Einstein: Thanks for having us. This is a great pleasure. Ravi Madan: Appreciate being here. Davide Soldato: So, I just want to start from a very wide angle. And the main question is why did you feel that there was the need to convey a consensus and a working group to talk about this specific topic: biochemically recurrent prostate cancer? What has been the change in current clinical practice and in the trial design that we are seeing nowadays? And so, why was it necessary to convey such a consensus and provide considerations on novel clinical trials? David Einstein: Yeah, so I think it's very interesting, this disease state of biochemically recurrent prostate cancer. It's very different from other disease states in prostate cancer, and we felt that there was a real need to define those differences in clinical trials. Years ago, metastatic castration-resistant prostate cancer was the primary disease state that was explored, and over time, a lot of things shifted earlier to metastatic disease defined on a CAT scan and bone scan to an earlier disease state of metastatic castration-sensitive prostate cancer. And the clinical trial principles from late-stage could be applied to MCSPC as well. However, BCR is very different because the patients are very different. And for those reasons, there are unique considerations, especially in terms of toxicity and treatment intensity, that should be applied to biochemically recurrent prostate cancer as opposed to just using the principles that are used in other disease states. And for that reason, we thought it was very important to delineate some of these considerations in this paper with a group of experts. Davide Soldato: Thanks so much. So, one of the main changes that have been applied in recent years in clinical practice when looking at biochemically recurrent prostate cancer is the use of molecular imaging and particularly of PSMA PET. So, first of all, just a quick question: was the topic of the consensus related on which threshold of PSA to use to order a PET scan to evaluate this kind of patient? David Einstein: Yeah, thanks for that question. It's a super important one. The brief answer is that no, we did not address questions about exactly when clinicians would decide to order scans. We were more concerned with the results of those scans in how you define different disease states. But I think as a broader question, I think a lot of folks feel that finding things on a scan equates that with what we used to find on conventional scans. And fundamentally, we actually sought to redefine that disease space as something that's not equivalent to metastatic disease, and rather coined the term "PSMA-positive BCR" to indicate that traditional BCR prognostic criteria and factors still apply, and that these patients have a distinct natural history from those with more advanced metastatic disease. Ravi Madan: And if I may just add that the National Cancer Institute is running a trial where we're prospectively monitoring PSMA-positive BCR patients. And that data is clearly showing that, much like what we knew about BCR a decade ago, PSMA findings in BCR patients do not change the fact that overall, BCR is an indolent disease state. And the findings, which are usually comprised of five- to seven-millimeter lymph nodes, do not endanger patients or require immediate therapy. And so, while PSMA is a tool that we can be using in this disease state, it doesn't really change the principal approach to how we should manage these patients. And as Dr. Einstein alluded to, there is a drive to create a false equivalency between PSMA-positive BCR and metastatic castration-sensitive prostate cancer, but that is not supported by the data we're accumulating or any of the clinical data as it exists. Davide Soldato: One thing that it's very important and you mentioned in your answer to my question was actually the role of PET scan and conventional imaging, so CAT scan and bone scan that we have used for years to stage patients with metastatic prostate cancer. And you mentioned that there is a distinction among patients who have a positive PET scan and a BCR, and patients who have a positive conventional imaging. And yet, we know that sometimes the findings of the PET scan are not always so clear to interpret. So, I just wanted to understand if the consensus reached an agreement as to when to use conventional imaging to potentially resolve some findings that we have on PET scan among thess patients with BCR? David Einstein: Yeah, I think there's a number of questions actually buried within that question. One of which is: does PSMA PET result in false positives? And the answer has definitely been yes. There's a known issue with false-positive rib lesions. And so, first and foremost, we need to be very careful in calling what truly is suspicious disease and what might actually not be cancer or might be something that is totally separate. So I think that's the first part of the answer to that question. The second is to what extent do we need to use paired PET and conventional imaging to define this disease state? In other words, do you have to have positive findings on one and negative findings on the other in order to enter this definition? The challenge there, as we discussed, is that logistically, oftentimes it's hard to get patients to do multiple sets of scans to actually create that definition. Sometimes it's difficult to get insurers to pay for such scans. And finally, it's hard to sometimes blind radiologists to the results of one scan in reading the other. So, we did have some deliberations about to what extent you could use some of the CAT scan portion of a PSMA PET in order to at least partially define that. We also talked about using bone scans to confirm any bone findings seen on PET. But I think another important part of this is not just the baseline imaging, but also what's going to be done serially on a study in order to define responses and progression. And that's sort of a whole separate conversation about to what extent you can interpret changes in serial PET. Ravi Madan: And just to pick up on the key factor here, I think that the PSMA PET in BCR is pretty good at defining lymph node disease, and that's actually predominantly 80 to 90 percent of the disease seen on these findings. It might be pretty good at also defining other soft tissue findings. The real issues come to bone findings. And one thing the group did not feel was appropriate was to just define only PSMA-positive bone findings confirmed on a CT bone window. There's not really great data on that, but the working group felt that, when in the rare situation, because it is relatively rare, a PSMA-positive finding is in a bone, a bone scan should be done. And it's worth noting that Phu Tran, who is a co-author and a co-leader of this working group, his group has already defined that underlying genomics of conventionally based lesions, such as bone scan, are more aggressive than findings on next-gen imaging, such as PSMA. So, there is also a genomic underlying rationale for defining the difference between what is seen on a PET scan in a bone and what is seen on a bone scan. Davide Soldato: Coming back to this issue of PET PSMA sometimes identifying very small lesions where we don't see any kind of correlates on conventional imaging or where we see only very little alteration on the bone scan or in the CT scan, was there any role that was imagined, for example, for MRI to distinguish this type of findings on the PET scan? Ravi Madan: So, I think that, again, what can be identified on a PSMA frequently cannot be seen on conventional imaging. We didn't feel that it was a requirement to get an MRI or a CT to necessarily confirm the PSMA findings. I think that generally, we have to realize that in this disease state, that questionable lesions are going to be seen on any imaging, including PSMA. We've actually probably put way too much faith in PSMA findings thus far, as Dr. Einstein alluded to with some of the false positives we're seeing. So, I think that these false positives are going to have to be baked into trials. And in terms of clinical practice, it highlights the need to again, not overreact to everything we see and not necessarily need to biopsy everything and put patients' health in jeopardy to delineate a disease that's indolent anyway. Davide Soldato: Thanks so much. That was very clear. So, basically, the main driver was really also the data showing that if we have a BCR, so a patient with a biochemically recurrent disease that is positive on the conventional imaging, this is usually associated with a different aggressiveness of the disease. But coming back to a comment that you made before, Dr. Madan, you said that even if we talk about PSMA-positive BCR, we are still talking about BCR and the same criteria should apply. So, what we have used for years in this space to actually try to stratify the prognosis of patients is the PSA doubling time, so how quickly the PSA rises over time. So, coming back to that comment, was the consensus on the PSA doubling time basically retained as what we were using before, so defining patients with a doubling time less than 12 months, 10 months, 9 months, as patients with a higher risk of progressing in terms of developing metastatic disease? Ravi Madan: Yes, so that's a very important point. And the working group defined high-risk BCR as a PSA doubling time less than six months. And this really comes from Johns Hopkins historical data, which shows that if your doubling time is three months or less, there's about a 67 percent chance of metastasis at five years. If it's between three and six months, it's 50 percent. And if it's over six months, if it's between six and nine months, it's roughly only 27 percent. There are trials that are accruing with eligibility criteria that they may describe as high-risk that are beyond six months, but the data as really it's been defined in the literature highlights that truly high-risk BCR is less than six months. And the working group had a consensus on that opinion, and that was our recommendation. David Einstein: And I think an important follow-on to that is that's regardless of PET findings, right? And so, we present a couple of case studies of patients with positive PET findings who have a long doubling time, in whom the disease is in fact indolent, as you would have expected from a traditional BCR prognostic standpoint. Obviously, there are patients in whom they have fast doubling times, and even if they do not have PET findings, that doesn't make them not high-risk. Ravi Madan: And just to follow up that point, I will let you know a little bit of a free preview that my colleague Melissa Abel from the NCI will be presenting PSMA findings in the context of PSA doubling time at ASCO GU if that data is accepted. Davide Soldato: Looking forward for those data because I think that they're going to clarify a lot of the findings that we have in this specific population. And coming back to one of the points that we made before, so PET PSMA has a very high ability to discriminate also a very low burden of disease, which we currently refer to as oligometastatic biochemically recurrent prostate cancer, which is not entirely defined as an entity. But what we are seeing both in some clinical trials, which use mainly conventional imaging, but also what we're starting to see in clinical practice, is that frequently we use the metastasis-directed therapy to treat these patients. So, just a little bit of a comment on the use of this type of strategy in clinical practice and if the panel thought of including this as, for example, a stratification criteria or mandated in the design of novel clinical trials in the field of BCR? David Einstein: Yeah, I think that's an incredibly important point. You know, fundamentally, there's a lot of heterogeneity in practice where some folks are using local salvage approaches, some are using systemic therapies, in some cases surveillance may be reasonable, or some combination of these different strategies. We certainly have phase two data from multiple trials suggesting that met-directed therapy may help buy patients time off of treatment until subsequent treatments are started. And that in and of itself may be an important goal that we can come back to in discussing novel endpoints. I think what our panel acknowledged was that, in some sense, the clinical practice has gotten even farther ahead than where the data are, and this is being offered pretty routinely to patients in practice. And so, what became clear was that we, in developing clinical trials, cannot forbid investigators from doing something that would be within their usual standard of care, even if it might not be supported by the most robust data. But at minimum, it definitely should be used as a stratification factor, or in some trial designs, you can do met-directed therapy after a primary endpoint is assessed. And that offers a compromise between testing, say, the effect of a systemic therapy but also not excluding patients and investigators from doing what they would have done had they not been on a study. Ravi Madan: And I would just like to follow up your phrasing in the question of "oligometastatic prostate cancer." We have a figure in the paper and it highlights the fact that, unfortunately, that term in prostate cancer is imaging agnostic. And we've already discussed in this podcast, as well as in the paper, that imaging used to define a metastatic lesion, whether it's PSMA or conventional imaging, carries with it a different clinical weight and a different prognosis. So, we feel in the working group, that the correct term for this disease state of PSMA-positive BCR is just that: PSMA-positive BCR. We also have to realize that when we talk about oligometastatic disease, while it's imaging agnostic, it seems to be numerically based, whether it's five or three or 10 depending on the trial. But PSMA-positive BCR does not have a limit in terms of the number of lesions. And so again, we just feel that there is an important need to delineate what we're seeing in this disease state, which again is PSMA-positive BCR, and that should be differentiated frankly from oligometastatic disease defined on other imaging platforms. David Einstein: Right, and that also makes clear that patients can have polyfocal disease on PET that still is not what we would consider metastatic, but goes beyond the traditional definition of oligometastatic. So, in other words, just because someone has PET-detected disease only, that does not automatically equate with oligometastatic. Davide Soldato: Thanks so much. So, you were speaking a little bit, Dr. Einstein, about the different types of treatment that we can propose or not propose to this patient because you mentioned, for example, that in clinical practice MDT, so metastasis-directed therapy, is becoming more and more used. For these patients, we can potentially use systemic treatments, which include androgen deprivation therapy, which can be given continuously or in an intermittent fashion. And recently, we can also use novel systemic therapies, for example, enzalutamide, to treat this type of patient. So, given that the point of the consensus was really to provide consideration for novel clinical trials in this space, what was the opinion on the panel regarding the control arm? So, if we're looking at a novel therapy in the BCR space, does the control arm need to include a therapy or not? And if so, which therapy? David Einstein: Yeah, this is a super important question and one that's subject to a lot of discussion, especially in light of recent data from EMBARK. What we came to a consensus around was the fact that neither MDT nor systemic therapy should be required as a control arm on BCR trials. And we can talk about a number of reasons for that. There's also the pragmatics of what investigators might actually accrue patients to and what they would consider their standard of care, and that's important to factor in, too. I think that one of the major goals of our working group was outlining what kinds of trials we would like to see in the future and where the limitations of the current data stand. For example, EMBARK proposes a strategy of a single treatment discontinuation and resumption at a predefined threshold indefinitely. That's probably not how most people are practicing. Most folks are probably using some version of intermittent therapy as they would have before this trial, but we actually don't have any data supporting that. Moreover, we don't have data comparing different intermittent strategies to one another. We don't know what the right thresholds are, we don't know how much time we buy patients off treatment, and we don't know to what extent MDT modifies that. And so, those are all really important questions to be asking in future versions of these trials. I'd say my second point would be that a lot of drug development is happening with novel therapies that are not hormonal, trying to bring them into this space. And when you think about trying to compare one of those types of therapies to a hormonal therapy on short-term endpoints, the hormonal therapy is always going to win. Hormonal therapy is almost universally effective, it will bring down PSAs, and it will prolong, quote-unquote, "progression." The downside of that is that hormonal therapy doesn't actually modify the disease, it suppresses it, and it tends to have fairly transient effects once you remove it. And so, part of our goal was in trying to figure out some novel endpoints that would allow these novel types of therapies to be examined head-to-head against a more traditional type of hormonal therapy and have some measurement of some of the more long-term impacts. Davide Soldato: So, jumping right into the endpoints, because this is a very relevant and I think very well-constructed part of the paper that you published. Because in the past we have used some of these endpoints, for example, metastasis-free survival, as potentially a proxy for long-term outcomes. But is this the right endpoint to be using right now, especially considering that frequently this outcome is measured using conventional imaging, but we are including in these trials patients who are actually negative on conventional imaging but have a positive PSMA when they enter this type of trial? David Einstein: Yeah, there's a number of challenges with those types of endpoints. One of which is, as you say, we're changing the goalposts a little bit on how we're calling progression. We still don't exactly understand what progression on PET means, and so that's something that is challenging. That said, we're also cognizant of the fact that many times investigators are likely to get PET scans in the setting of rising PSA, and that's going to affect any endpoint that relies purely on conventional imaging. So, there's some tension there between these two different sets of goalposts. One thing that we emphasize is that not only are there some challenges in defining those, but also there're challenges in what matters to a patient. So, if a progression event occurs in the form of a single lesion on a PET scan or even a conventional image, that might be relevant for a clinical trial but might be less relevant for a patient. In other words, that's something that, in the real world, an investigator might use serial rounds of metastasis-directed therapy or intermittent therapy to treat in a way that doesn't have any clinical consequences for the patient necessarily. In other words, they're asymptomatic, it's not the equivalent of a metastatic castration-resistant disease progressing. And so, we also need to be cognizant of the fact that if we choose a single endpoint like PFS, that there's going to be many different versions of progression, some of which probably matter clinically more than others, and some of which are more salvageable by local therapies than others. Ravi Madan: So I think the working group really thoughtfully looked at the different options and underscored perhaps strengths and weaknesses, and I think that's presented as you mentioned in the paper. But I think it's also going to depend on the modality, the approach of the therapeutic intervention. In some cases if it's hormone-based, then maybe PSA is providing some early metrics, maybe metastasis-free survival is more relevant in a continuous therapy, but intermittent therapies might have a different approach. There's emerging immunotherapy strategies, radiopharmaceutical strategies, they might have some more novel strategies as well. I think we have to be open-minded here, but we also have to be very clear: we do not know what progression is on a PSMA scan. Just new lesions may not carry the clinical significance that we think, and we may not know what threshold that ultimately becomes clinically relevant is. So, I do think that there was some caution issued by the working group about using PSMA as an endpoint because we still do not have the data to understand what that modality is telling us. Again, I'm optimistic that the National Cancer Institute's prospective data set that we've been collecting, which has over 130 patients now, will provide some insights in the months and years ahead. Davide Soldato: So, just to ask the question very abruptly, what would you feel like the best endpoint for this type of trials is? I understand that is a little bit related to the type of treatments that we're going to use, whether it's intermittent, whether it's continuous, but do we have something that can encapsulate all of the discussion that we have up until this point? David Einstein: Yeah, so that's a perfect segue to the idea of novel endpoints, which we feel are very important to develop in these novel disease spaces. So, one thing that we discussed was an endpoint called treatment-free survival, which conceptually you can think of as exactly what it sounds like, but statistically you actually have to do some work to get there. And so essentially, you imagine a series of Kaplan-Meier curves overlaid: one about overall survival, one time to next therapy, one time on initial therapy. You can actually then take the area under those curves or between those curves and essentially sum it up using restricted mean survival time analysis. And that can give you a guide about the longitudinal experience of a patient: time spent on treatment versus off treatment; time spent with toxicity versus without toxicity. And importantly, each one of those time-to-event metrics can be adjusted depending on exactly what the protocol is and what is allowed or not allowed and what's prespecified as far as initiation of subsequent therapies. So, we felt that this was a really important endpoint to develop in this disease space because it can really capture that longitudinal aspect. It can really reward treatments that are effective in getting durable responses and getting patients off of therapy, because unfortunately, PFS-based endpoints generally reward more or longer systemic therapy versus shorter or no systemic therapy, and that's sort of an artificial bias in the way those endpoints are constructed. So, I think that there are challenges of course in implementing any new endpoint, and some of the things that are really critical are collecting data about toxicity and about subsequent therapies beyond what a typical trial might collect. But I think in this kind of disease space, that longitudinal aspect is critical because these are really patients who are going to be going through multiple rounds of therapy, going to be going on and off treatments, they're going to be using combinations of local and systemic therapies. And so, any one single endpoint is going to be limited, but I think that really highlights the limitations of using PFS-based endpoints in this space. Ravi Madan: I also think that in the concept of treatment-free survival lies one of the more powerful and, honestly, I was surprised by this, that it was so universally accepted, recommendations from the committee. And that was that the general approach to trials in this space should be a de-escalation of the EMBARK strategy as it's laid out with relatively continuous therapy with one pause. And so, I think again, buried in all of this highlights the need for novel endpoints like treatment-free survival. We get to the fact that these are patients who are not at near-term clinical risk from symptoms of their disease, so de-escalating therapies does not put them at risk. And if you look at, for example, lower-volume metastatic castration-sensitive prostate cancer, it's become realized that we need to de-escalate, and there are now trials being done to look at that. Historically, we know that BCR is an indolent disease process for the vast majority of patients who are not at near-term risk from clinical deterioration. So, therefore, we shouldn't wait a decade into abundant BCR trials to de-escalate. The de-escalation strategy should be from the outset. And that was something the committee really actually universally agreed on. David Einstein: And that de-escalation can really take multiple forms. That could be different strategies for intermittent therapy, different start-stop strategies. It could also mean actually intensifying in the short-term with the goal long-term de-intensification, kind of analogous to kidney cancer where we might use dual checkpoint inhibitors up front with some higher upfront toxicity but with the hope of actually long-term benefit and actually being able to come off treatment and stay in remission. Those kinds of trade-offs are the types of things that are challenging to talk about. There's not a one-size-fits-all answer for every patient. And so, that's why some of these endpoints like treatment-free survival would be really helpful in actually quantifying those trade-offs and allowing each patient to make decisions that are concordant with their own wishes. Davide Soldato: Thanks so much. That was very clear, especially on the part of de-escalation, because, as you were mentioning, I think that we are globally talking about a situation, a clinical situation, where the prognosis can be very good and patients can stay off treatment for a very long period of time without compromising long-term outcomes. And I think that well-constructed de-escalation trials, as you were mentioning and as the consensus endorsed, are really needed in this space also to limit toxicity. This brings us to the end of this episode. So, I would like to thank again Dr. Einstein and Dr. Madan for joining us today. David Einstein: We really appreciate the time and the thought, and I think that even starting these types of discussions is critical. Even just recognizing that this is a unique space is the beginning of the conversation. Ravi Madan: Yeah, and I want to thank JCO for giving us this forum and the opportunity to publish these results and all the expert prostate cancer investigators who were part of this committee. We produced some good thoughts for the future. Davide Soldato: We appreciate you sharing more on your JCO article titled, "National Cancer Institute's Working Group on Biochemically Recurrent Prostate Cancer: Clinical Trial Design Considerations." If you enjoy our show, please leave us a rating and review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinion of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

343: Today I'm joined by Dr. Albert Chung, who is a certified colon and rectal surgeon specializing in hemorrhoids, colorectal cancer, Crohn's Disease, Ulcerative Colitis, Diverticulitis, Anal Fissures and more. In our interview, we hone in on the topic of hemorrhoids and discuss what they are, natural ways to treat them and prevent them, and what we've been doing wrong!  Topics Discussed: → Different types of hemorrhoids → What causes hemorrhoids → What to look for if you have one → When to see a doctor → Typical time it takes for them to go away → Home treatments and what NOT to do → Is surgery for everyone → Different types of surgery options → Surgery recovery time  → What to expect from surgery → How to prevent hemorrhoids  As always, if you have any questions for the show please email us at digestthispod@gmail.com. And if you like this show, please share it, rate it, review it and subscribe to it on your favorite podcast app.  Sponsored By:  → Fatty15 | For 15% off the starter kit go to https://fatty15.com/digest → Seven Sundays | Go to https://sevensundays.com/ and use code: lilsip for 20% off Timestamps: → 00:00:00 - Introduction  → 00:02:36 - What are hemorrhoids  → 00:07:10 - Stress & digestion  → 00:09:12 - Sitting too long on the toilet  → 00:10:46 - Office chair donuts  → 00:12:06 - Hemorrhoid treatments  → 00:16:14 - Fiber intake  → 00:20:31 - Hydration level  → 00:23:18 - Size range  → 00:24:35 - When to see a doctor  → 00:26:17 - Recovery time→ 00:29:09 - Hemorrhoid surgery & recovery  → 00:33:43 - Pain management & level → 00:36:35 - Surgery options  → 00:39:03 - Recurrent hemorrhoids  → 00:41:11 - Untreated hemorrhoids  → 00:43:12 - Hemorrhoid prevention  Check Out Dr. Chung: → YouTube: Your Friendly Proctologist | @yourfriendlyproctologist → Instagram: @YourFriendlyProctologist  | https://www.instagram.com/yourfriendlyproctologist/ → Website | https://crsurgeryoc.com  Check Out Bethany: → Bethany's Instagram: @lilsipper → YouTube → Bethany's Website → Discounts & My Favorite Products → My Digestive Support Protein Powder → Gut Reset Book  → Get my Newsletters (Friday Finds) Learn more about your ad choices. Visit megaphone.fm/adchoices

If you've been told your embryos look good, your lining is appropriate, and your hormones are in range, yet implantation keeps failing, it can leave you with a nagging feeling that something is missing, but you can't quite put your finger on it. Most couples don't repeat IVF or transfers casually. They follow the plan that's laid out, adjust protocols, and keep moving forward because that's what makes sense. When outcomes don't change, the explanation often shifts to chance, timing, or trying again. In this episode, we talk about why those explanations often feel unsatisfying, and why implantation failure can persist even when everything looks reasonable on paper. Not because you haven't done enough, but because the full picture may never have been looked at all at once. This conversation is about stepping back and asking better questions before moving forward again. In this episode, we explore: Why "good embryos" and "normal labs" don't always translate into implantation How focusing on individual results can miss what's happening across the whole system Why changing protocols doesn't always address repeat outcomes The kinds of patterns that tend to go unexplored when everything looks fine How to think more clearly about whether another cycle is actually the next step Rather than offering another checklist or protocol, this episode helps you zoom out and understand why implantation is rarely a single-factor issue. I'm Sarah Clark, founder of Fab Fertile and host of Get Pregnant Naturally. For over a decade, my team and I have reviewed hundreds of low AMH and failed IVF cases using functional testing alongside conventional fertility care. We specialize in helping couples identify the physiological patterns driving poor outcomes so decisions are grounded in interpretation, not guesswork. If you've been moving from cycle to cycle without a clear way to evaluate what's actually been addressed, I created a free resource called the Embryo Audit Checklist. It helps you organize past cycles and labs so you can see what's been looked at and what may not have been considered yet. Access it here.

Dr. Iyad Alnahhas interviews Drs. David Schiff and Ranjit Bindra about their recent manuscript entitled "Phase I/II and Window-of-Opportunity Study of Pamiparib and Metronomic Temozolomide for Recurrent IDH Mutant Gliomas", published online in Neuro-Oncology in October 2025.

'Somni', sueño en catalán, es el título del nuevo disco de Snarky Puppy. Grabado en directo en la ciudad holandesa de Utrecht, los días 17, 18 y 19 de enero del año pasado, con The Metropole Orkest dirigida por Jules Buckley. Composiciones de Michael League, inspiradas en distintas convenciones sobre los sueños y el hecho de soñar, con arreglos de Jochen Neuffer, Sam Gale, Buckley y el propio League, como 'Between worlds', 'Recurrent', 'Waves upon waves', 'As you are but not as you were', 'Only here and nowhere else' o 'It stays with youEscuchar audio

Asthma affects nearly one in twelve children — and when it's not recognized early or treated well, it can quietly alter how a child's lungs develop over time. Recurrent cough, wheezing, or shortness of breath are signs of chronic airway inflammation, not just passing illnesses. On this episode, host Dr. Jillian Woodruff speaks with Dr. Jered Weinstock - board certified pulmonologist at Providence Medical Group Pediatric Subspecialty Clinic - to explore what causes childhood asthma, why some children improve as they grow, and how timely, appropriate care can protect developing lungs and prevent long-term complications.

Shoot us a Text.Episode #1247: Canada slashes EV tariffs in a controversial China deal, OpenAI kicks off its ad-supported ChatGPT Go plan, and Recurrent CEO Scott Case calls out the real EV story: a booming used market dealers can't afford to miss.Show Notes with links: In a surprise move, Canada struck a deal with China to allow 49,000 Chinese-made EVs into the country annually at a dramatically lower tariff—down from 106% to just 6.1%—in exchange for agricultural trade concessions. The move has stirred both optimism and outrage across the automotive industry.The deal drew sharp criticism from Unifor and industry leaders, who say it rewards unfair labor practices.Critics say it could hurt Canadian auto jobs and complicate USMCA negotiations with the U.S.One of the qualifications is that the vehicles be priced around $30k CAD (25K USD)Don't call it a slow down says , Scott Case, CEO of Recurrent in is Automotive News Op Ed. Despite media headlines suggesting electric vehicle demand is cooling, Case says the narrative is missing the real story and it is that used EVs are booming as he urges dealers to ignore short-term noise and prepare for a long-term shift.Case argues that demand isn't falling, it's shifting to lower-cost used EVs as new prices soar.The used EV market is set to grow 5x, driven by a wave of off-lease EVs hitting the market in 2026.“Winning in the EV market means selling $30K vehicles with 300-mile range and Tesla charging access. In 2026, that means used EVs.” —Scott Case, Recurrent CEO OpenAI just opened the ad door inside ChatGPT as it launches its lowest-cost plan worldwide. That's right, ads are coming to the AI assistant for free and Go users in the U.S., marking a major monetization pivot ahead of a planned IPO.ChatGPT Go is now available globally at $8/month and includes GPT‑5.2 Instant access.Ads will appear as “Sponsored Recommendations” under responses for Go and free users. Sam Altman once called ads a “last resort,” but now says he's okay with them “if it doesn't violate user trust.”“Ads support our commitment to making AI accessible… by helping us keep ChatGPT available at free and affordable price points.” —OpenAI blogThis episode of the Automotive State of the Union is brought to you by Amazon Autos: Meet customers where they shop: reach high-intent buyers shopping for their next car on the #1 online retailer.Join Paul J Daly and Kyle Mountsier every morning for the Automotive State of the Union podcast as they connect the dots across car dealerships, retail trends, emerging tech like AI, and cultural shifts—bringing clarity, speed, and people-first insight to automotive leaders navigating a rapidly changing industry.Get the Daily Push Back email at https://www.asotu.com/ JOIN the conversation on LinkedIn at: https://www.linkedin.com/company/asotu/

Send me a question or story!Recurrent infections can be so difficult in our allergic patients. Learn how to minimize severity of frequency of pyoderma on this week's episode of The Derm Vet podcast!1. Work up the underlying allergies2. Support the skin barrier3. Adjust topical therapy accordingly4. Recognize historical patterns5. Refer to a dermatologist early in the disease00:00 – Intro02:24 – Working up the underlying allergies04:53 – Support the skin barrier07:36 – Adjust your topical therapy accordingly10:27 – Recognize historical patterns13:02 – Referring these patients early13:56 – Overview14:32 – Outro

Send us a textWelcome back Rounds Table Listeners! We are back today with a solo episode with Dr. John Fralick. This week, he discusses a recently published trial examining the effect of caffeinated coffee consumption compared with abstinence from coffee and caffeine on recurrent atrial fibrillation (AF). Here we go!Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation:The DECAF Randomized Clinical Trial (0:00 – 4:32).The Good Stuff (4:33 – 5:29):Moss in space! (https://www.cbc.ca/news/science/space-moss-9.6984791)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

Send us a textMartin Foster hosts a candid conversation with Katherine Torres-Pummill, the dynamic General Manager of Recurrent's Military Vertical. Katherine shares her journey from growing up in New York City as a first-generation American to leading some of the most influential military-focused media brands—including Task and Purpose, The War Zone, and We Are the Mighty.-Quick Episode Summary:Katherine Torres-Pummill shares leadership lessons, military community insights, and inspiration.-SEO Description:Passing The Torch podcast: Katherine Torres-Pummill shares leadership lessons, military family insights, and her journey in media and public service.-

Welcome to Season 2 of the Orthobullets Podcast.Today's show is CoinFlips, where expert speakers discuss grey zone decisions in orthopedic surgery. This episode will feature doctors Robert Gillespie, Evan Lederman, Christopher Klifto, & Peter Johnston. They will discuss the case titled ⁠"⁠Recurrent Shoulder Instability s/p RSA in 72M⁠.⁠⁠⁠"⁠Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube

In this Listener Series episode, Kayleigh is joined by Bella, who courageously shares her journey through infertility, a high-risk twin pregnancy, perinatal depression, placenta previa, repeated hospitalizations, and an emergency C-section at just under 33 weeks.Bella walks us through the shock of conceiving triplets after one round of Clomid, the grief of losing one baby early in pregnancy, and the fear and uncertainty that followed as complications continued to stack. From significant bleeding episodes and preterm labor to an emergency birth that separated her from her babies, Bella's story sheds light on the physical and emotional toll of high-risk pregnancy and NICU life.Together, Kayleigh and Bella explore not only what happened medically, but the lasting emotional impact, including grief over missed milestones, infertility due to medical necessity, and learning how to cope when the birth and motherhood journey looks nothing like what you imagined.This episode is a powerful reminder that survival does not erase trauma, and that community can be a lifeline.In this episode, we discuss:

Results of a phase II trial of olaparib in combination with ceralasertib in patients with recurrent and unresectable osteosarcomaOsteosarcoma Webinar Series: Katie Janeway, MD and Suzanne Forrest, MD join us on OsteoBites to discuss results of a phase II trial of olaparib in combination with ceralasertib in patients with recurrent and unresectable osteosarcoma.Dr. Janeway received her MD and MMSc from Harvard Medical School. She completed her pediatrics residency and her Pediatric Hematology-Oncology fellowship at Boston Children's Hospital and Dana-Farber Cancer Institute. She is an Associate Professor of Pediatrics, a Senior Physician who cares for young people with sarcoma, and Director of Clinical Genomics. Dr. Janeway's research is focused on precision oncology and bone sarcomas. She leads clinical trials both as an independent investigator and as the Chair of the Children's Oncology Group (COG) Bone Tumor Committee. The Janeway Laboratory leads several studies, which have enrolled and sequenced more than 2,500 patients with childhood cancers. They are using this data to deepen the understanding of clinical and genomic factors explaining prognosis and treatment response, and resistance, with a focus on sarcomas. In collaboration with Count Me In, the group is innovating patient partnerships in sarcoma research.Dr. Forrest completed her medical school training at Yale University, followed by pediatrics training in the Boston Combined Residency Program. She then pursued a pediatric oncology fellowship at Dana-Farber Cancer Institute / Boston Children's Hospital. Currently, she serves as an Assistant Professor of Pediatrics at Harvard Medical School and an Attending Physician in the Department of Hematology/Oncology at Dana-Farber / Boston Children's Cancer and Blood Disorders Center. Her research focuses on developing novel clinical trials that utilize cancer genomics to guide treatment strategies for pediatric solid tumors.After a short presentation on this research, they will take questions from attendees. Share your questions in advance with us at Christina@MIBAgents.org.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/RMT865. CME/NCPD/CPE/AAPA/IPCE credit will be available until November 25, 2026.Ahead of the Immunotherapy Curve in Head and Neck Cancer: Preparing for Expanding Immune Options in Locally Advanced and Recurrent/Metastatic Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb and Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/RMT865. CME/NCPD/CPE/AAPA/IPCE credit will be available until November 25, 2026.Ahead of the Immunotherapy Curve in Head and Neck Cancer: Preparing for Expanding Immune Options in Locally Advanced and Recurrent/Metastatic Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb and Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/RMT865. CME/NCPD/CPE/AAPA/IPCE credit will be available until November 25, 2026.Ahead of the Immunotherapy Curve in Head and Neck Cancer: Preparing for Expanding Immune Options in Locally Advanced and Recurrent/Metastatic Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb and Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.

Send us a textGrab your trainers, your dog lead, or even shake your jingle bells, and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom.  In the first of two episodes this month, Fi and Nik discuss : Spotting adrenal crisis. Adrenal insufficiency and Addison's disease can be easy to miss. We've recently updated our article on this, so we thought we'd share it as a Pearl, distilling the 2024 NICE guidance for you.Recurrent bacterial vaginosis: time to consider partner treatment? Bacterial vaginosis is the commonest cause of pathological vaginal discharge in women of reproductive age. But it's not an easy diagnosis for us to confirm – although we can suspect it clinically and manage empirically.  We'll give you a refresher on BV infection and diagnosis in primary care and then think about managing recurrent BV, where there's a new development.Listen as soon as you can to ensure you have full access to all the free resources. Further Pearls from November will be covered next time.Useful LinksAdrenal insufficiency and Addison's diseaseFor professionals:The Society of Endocrinology – adrenal crisisFor patients:Addison's Disease Self-help Group (include sections on emergency kits and sick day rules; there doesn't appear to be a patient group for other forms of adrenal insufficiency) GP Trainee Essentials support package information, and the Red Whale CalendarSend us your feedback podcast@redwhale.co.uk or send a voice message Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited. Find out more here. Follow us: X, Facebook, Instagram, LinkedInDisclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast....

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/RMT865. CME/NCPD/CPE/AAPA/IPCE credit will be available until November 25, 2026.Ahead of the Immunotherapy Curve in Head and Neck Cancer: Preparing for Expanding Immune Options in Locally Advanced and Recurrent/Metastatic Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb and Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.

On this, our 304th Evolutionary Lens livestream, we discuss the mainstream media's pivot, in which they now tentatively accept that some children have died from the mRNA Covid shots. We discuss failing trust in science, why it will not be quick to fix the institutions or to people them with honest scientists, and the rebels in the hills who are keeping the flame alive. Also, the application of the phrase “safe and effective” to products that are neither. Then: hominids have been making and controlling fire for far longer than we had thought. And: hadrosaurid dinosaurs were, perhaps, quite clumsy at sex.*****Our sponsors:Caraway: Non-toxic, highly functional & beautiful cookware and bakeware. http://Carawayhome.com/DH10 to for up to 25% off your next purchase.Masa Chips: Delicious chips made with corn, salt, and beef tallow—nothing else—in loads of great flavors. Go to http://masachips.com/DarkHorse, use code DarkHorse, for 20% off.CrowdHealth: Pay for healthcare with crowdfunding instead of insurance. It's way better. Use code DarkHorse at http://JoinCrowdHealth.com to get 1st 3 months for $99/month.*****Join us on Locals! Get access to our Discord server, exclusive live streams, live chats for all streams, and early access to many podcasts: https://darkhorse.locals.comHeather's newsletter, Natural Selections (subscribe to get free weekly essays in your inbox): https://naturalselections.substack.comOur book, A Hunter-Gatherer's Guide to the 21st Century, is available everywhere books are sold, including from Amazon: https://amzn.to/3AGANGg (commission earned)Check out our store! Epic tabby, digital book burning, saddle up the dire wolves, and more: https://darkhorsestore.org*****Mentioned in this episode:The Atlantic: Yes, Some Children May Have Died From COVID Shots: https://www.theatlantic.com/health/2025/12/prasad-memo-covid-vaccine-deaths/685175/Myocarditis and mRNA shots in Science Translational Medicine: https://www.science.org/doi/10.1126/scitranslmed.adq0143Earliest evidence of making fire: SciAm links to original research: https://www.scientificamerican.com/article/ancient-humans-were-making-fire-350-000-years-earlier-than-scientists/Recurrent pattern of tail injuries in hadrosaurid dinosaurs: https://www.cell.com/iscience/pdf/S2589-0042(25)02000-0.pdfSupport the show

In this episode, we sit down with Alex, who opens up about the heartbreak, confusion, and sheer emotional exhaustion of navigating multiple miscarriages while living halfway across the world from home. Now based in Singapore with her husband - and with zero plans to head back to the UK - Alex has had to make sense of her losses within a healthcare system that doesn't always cushion its words or soften the blows. Cultural differences meant that some of the medical conversations she faced landed with a thud: blunt, clinical, sometimes bordering on cruel.Throughout the episode, Alex describes the emotional toll of repeated miscarriages - the way each loss chips away at you until you feel like this cracked, fragile version of yourself, desperately trying to glue the pieces back together again. Her IVF journey has involved genetic testing, endless decisions, and the constant tug-of-war between hope and self-protection. She's made lifestyle changes, like going gluten-free, in her determination to give future embryos the best possible chance.And woven through all of this is the gang: the friends, the online communities, the people who show up and get it when the world feels impossibly heavy. Alex's story is a powerful reminder of how vital compassion and understanding are when talking about pregnancy loss - and how much it matters when someone finally says, “I see you… and you're not alone.”Key TakeawaysAlex relocated to Singapore for her husband's work and is settled there long-term.She has experienced multiple miscarriages, each bringing its own unique heartbreak.Cultural differences in Singapore's healthcare system can lead to abrupt or blunt communication.After receiving a harsh diagnosis, Alex trusted her instincts and sought a second opinion.The emotional impact of loss can feel like being a cracked vase, with resilience chipped away piece by piece.Her IVF journey included genetic testing after repeated miscarriages.She has made lifestyle changes, including going gluten-free, to support her fertility.Support from friends and online communities has been essential throughout her journey.The episode highlights how deeply compassion and sensitivity are needed when discussing pregnancy loss.We are The Worst Girl Gang Ever Foundation. We're all about bringing people together who are going through the tough stuff — baby loss, infertility, and everything in between — and making sure no one has to face it alone. Our community is full of honesty, compassion, and real talk, offering support, understanding, and hope when it's needed most. You can find out more and connect with us over at www.theworstgirlgangever.co.uk

Recurrent pregnancy loss (RPL) affects approximately 5% of couples and is an emotional burden on those affected. There is some evidence that vaginal progesterone supplementation may be considered in patients with recurrent pregnancy loss who are experiencing vaginal bleeding during the first trimester. But what about prophylactic low dose aspirin in the first trimester, or preconceptionally, for unexplained RPL? Is that evidence-based? A new publication from the SMFM's journal Pregnancy has examined this. Listen in for details. 1. 22 November 2025: Low-dose aspirin in unexplained recurrent pregnancy loss: A systematic review and meta-analysis (Pregnancy): https://obgyn.onlinelibrary.wiley.com/doi/10.1002/pmf2.700992. American College of Obstetricians and Gynecologists' Committee on Obstetric Practice, T. Flint Porter, Cynthia Gyanff-Bannerman, Tracy Manuck. Low-Dose Aspirin Use During Pregnancy. American College of Obstetricians and Gynecologists (2018)3. Naimi AI, Perkins NJ, Sjaarda LA, et al. The Effect of Preconception-Initiated Low-Dose Aspirin on Human Chorionic Gonadotropin-Detected Pregnancy, Pregnancy Loss, and Live Birth : Per Protocol Analysis of a Randomized Trial. Annals of Internal Medicine. 2021;174(5):595-601. doi:10.7326/M20-0469.4. Lee EE, Jun JK, Lee EB.Management of Women With Antiphospholipid Antibodies or Antiphospholipid Syndrome During Pregnancy. Journal of Korean Medical Science. 2021;36(4):e24. doi:10.3346/jkms.2021.36.e24.5. de Assis V, Giugni CS, Ros ST. Evaluation of Recurrent Pregnancy Loss. Obstet Gynecol. 2024 May 1;143(5):645-659. doi: 10.1097/AOG.0000000000005498. Epub 2024 Jan 4. PMID: 38176012.

Thank you so much to Kristyn for sharing her MTHFR story with us. Kristyn has only known she had an MTHFR gene variant for three months, but it makes sense of many of the symptoms she has had her whole life like fatigue, difficulty sleeping, and anxiety. MTHFR could be contributing to her recurrent pericarditis and kidney disease.Kristyn shares her journey with diet and supplements and trying to balance more energy with more sleep.This story is generously shared with permission to post to Youtube.00:00 - Intro00:44 - Kristyn discovers MTHFR01:04 - Recurrent pericarditis02:04 - Long-standing fatigue02:28 - Anxiety03:36 - Sleep difficulty04:04 - Early menopause with MTHFR and COVID vaccine04:51 - Symptoms but nothing shows up on lab tests05:16 - High protein diet05:54 - Starting supplements with MTHFR07:11 - The balance between having more energy and not disturbing sleep07:39 - Bad reactions to medications08:03 - Arcas for pericarditis09:23 - Seeing signs of MTHFR in other people10:24 - Energy changes with diet10:59 - Possible food sensitivities11:48 - Cayenne pepper for pain13:09 - Thank you, KristynThanks so much for watching! I have so many other resources for you. Here is the full version of this interview: https://youtu.be/DGkmqSwDYkwIf you would like to tell your own MTHFR story, you can schedule with Dr. Amy here: ⁠https://calendly.com/amy-tohealthwiththat/new-meeting⁠Check out the website first for lots of FREE stuff:WEBSITE: https://tohealthwiththat.com/ Order Dr. Amy's book MTHFR Easy: Get Healthy For Life: https://amzn.to/47tT31YPaperback and audiobook versions are coming soon.This story was shared graciously and generously with permission to post on the podcast, Youtube, and in print if that happens in the future.

Kilowatt Podcast - Episode SummaryIn this episode of Kilowatt, Bodie dives into the latest in electric vehicle and energy news. Tesla gets the green light to test robotaxis with safety drivers in Arizona. Polestar 3 owners in the U.S. can now power their homes with their vehicles thanks to a partnership with dcbel, showcasing real-world benefits of vehicle-to-home (V2H) technology. Meanwhile, GM is telling suppliers to move away from Chinese sourcing by 2027 amid rising geopolitical tensions. Bodie also discusses two key Recurrent studies showing that modern EV batteries degrade less than expected over three years and almost never need replacement. This data could ease fears for anyone considering a used EV. The episode wraps with practical advice on which EV generations to consider and why the battery concerns are largely overblown.Support the Show

Send us a textThis week on the Less Stressed Life, Dr. David Hanscom joins me for his 4th appearance to explain why anxiety isn't psychological—it's physiological—a survival response that we can learn to regulate, not control. We talk about how unprocessed emotions and repetitive thoughts get stored in the body as pain and how tools like expressive writing, calming the body, and softening the ego help break those loops.You'll walk away with a new way to think about anxiety, pain, and healing—one that focuses on awareness, compassion, and creating safety in your body so your mind can follow. It's about rewiring your nervous system, not forcing it.Dr. Hanscom's past episodes: • Ep 71: Roadmap out of Anxiety and Chronic Pain • Ep 72: Anger & Anxiety in the Family • Ep 325: Overwhelm & PainKEY TAKEAWAYS: • Anxiety and anger are body states, not character flaws • Calm the physiology first; thoughts will follow • Expressive writing helps separate from looping thoughts • Awareness and compassion are core to lasting changeFree resource: Try Dr. Hanscom's Expressive Writing Exercise (PDF), a foundational tool from The DOC Journey to help calm the nervous system and release looping thoughts. ABOUT GUEST:David Hanscom, MD is a former complex spine surgeon who left his 32-year Seattle practice to help people heal from chronic physical and emotional pain. After overcoming his own 15-year struggle with anxiety and pain, he developed the Dynamic Healing approach, which focuses on calming the body's threat physiology and rewiring the nervous system for lasting relief.He's the author of Back in Control: A Surgeon's Roadmap Out of Chronic Pain and the upcoming Calm Your Body, Heal Your Mind: Transcend Pain, Anxiety, Anger, and Repetitive Unwanted Thoughts (June 2026).WHERE TO GUEST:Websites: https://backincontrol.com/ and https://thedocjourney.com/Instagram: https://www.instagram.com/drdavidhanscom/Facebook: https://www.facebook.com/drdavidhanscomYouTube: https://www.youtube.com/user/DrDavidHanscomWHERE TO FIND CHRISTA:Website: https://www.christabiegler.com/Instagram: @anti.inflammatory.nutritionistPodcast Instagram: @lessstressedlifeYouTube: https://www.youtube.com/@lessstressedlifeLeave a review, submit a questions for the podcast or take one of my quizzes here: ****https://www.christabiegler.com/linksSPONSOR:Thank you to our friends at Jigsaw Health for being such an incredible sponsor and partner.

 Episode OverviewIn this intense yet engaging episode, Michelle opens up about her most detailed memories of time spent at Area 51 and other alleged joint extraterrestrial–military facilities. Paul guides the conversation, asking clarifying questions and connecting Michelle's experiences to broader themes discussed in previous episodes.Key Topics Covered1. Michelle's Early MemoriesFirst impressions of being transported to a desert facility with massive hangars and blinding floodlights.The sense of being “guided” rather than forcibly taken.Fragmented recall of alien escorts, advanced equipment, and an underground complex where military personnel receive them.2. Area 51 EncountersMichelle describes corridors beneath the surface lined with alien ships.Recollections of humanoid ETs interacting with military personnel.A huge underground where both human and non-human figures appeared to communicate—sometimes verbally, sometimes telepathically.3. Other Bases & Hidden LocationsPaul asks about facilities outside Nevada.Michelle and Paul recall experiences in an old city in the desert that is part of a joint alien/military base.Descriptions of training exercises to develop mental and physical acuity.Recurrent themes of secrecy, compartmentalization, and a combined ET–military presence.4. Emotional ImpactMichelle and Paul reflect on the fear, confusion, and awe these experiences brought.Discussion about missing time, recurring dreams, and attempts at memory recovery.Listener TakeawaysEpisode 43 gives a deep dive into Michelle and Paul's personal encounters.Sets the stage for future episodes exploring the human side of extraterrestrial contact.  Episode Credits:Written, edited and produced by Paul & MichelleArtwork created by MIchelle & PaulMusic written and produced by I.C.D.LINKS: Listen to us here: SpookyCoop , find us @ spookycoop.com and follow us on: FaceBook | BlueSky | X (formerly Twitter) | Threads | Instagram | TikTok

On today's edition of the cast, we talk about Billboard's recent announcement that they're altering the recurrent rules for songs that have overstayed their welcome on the Hot 100 charts, changes that were largely made due to the current stagnation on the chart from tracks that have overstayed their welcome, and songs that were played relentlessly by FM radio and streaming algorithms. We talk about the nitty gritty of the rules, and how it's a breath of fresh air that will allow an influx of new songs to gain traction, and keep a level of continuity while allowing some newcomers to sniff their first taste of chart success. We also talk about how this rule correlates to the Modern Rock Charts and how they've been largely immune to the recurrent rule, and has in recent years improved somewhat in terms of the quality of the artists that are populating the chart. I also play you the latest tune from Yellowcard "Better Days" that became their first chart topper on the Alternative Airplay chart spending 3 weeks at #1 on the Alternative Airplay chart.

What if tomorrow's AI stares back with hidden inner life - and we're blind to it? Philosopher Eric Schwitzgebel shares his new thesis from AI and Consciousness (2026): an unbreakable "fog" of uncertainty means we'll build legions of disputably conscious machines before we ever know. Join Dr Eric Schwitzgebel and Dr Tevin Naidu as they unpack why consciousness detection is doomed, how mimicry fools us, and what humble action looks like in the void.Send detailed comments on the manuscript by Dec 15 to receive a signed hard-copy of AI and Consciousness + your name in print! Your voice matters. Email all comments to " eschwitz " at domain: " ucr.edu" for a copy of this paper or click this link: https://faculty.ucr.edu/~eschwitz/SchwitzAbs/AIConsciousness.htmMind. Matter. Meaning. Subscribe for philosophy that hits home. Is AI conscious yet? Debate below!

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Jaime Roque follows the life of a familiar image across LA, beginning with the 2001 backlash to Alma López's digital artwork Our Lady.What looked like a small museum fight opens a bigger story about who gets to remake a figure many people call sacred—and why that matters in everyday neighborhoods, not just in galleries.Jaime meets the people keeping the image alive in different ways. In downtown, Manuel treats the classic print like family and warns against changing it. In Boyle Heights, artist Nico Aviña rolls out a seven-foot plywood Guadalupe holding an eviction notice, a moving reminder of how families and their stories are being pushed out. Online, Oscar Rodríguez—known as @lavirgencita—photographs and maps murals before they're painted over, building a simple record so the glow doesn't disappear. Even at a ball game, a tiny pin on a cap feels like a small altar, proof that the image still travels with us.The episode also looks back to the figure's early roots on Tepeyac Hill—a mix of Indigenous and Spanish worlds that helps explain why she carries both faith and culture. Through these voices and places, Jaime and his guests ask straight questions with real stakes: Who gets to redraw her? When is it devotion, and when is it pride or protest? Recurrent lands in that middle space—where street corners, shop walls, and phone screens can teach, comfort, and push back all at once—inviting listeners to see how a shared picture can hold a community together even as the city changes.This episode was inspired by the Visualizing the Virgin Mary exhibition.Special thanks to Alma Lopez, Nico Avina, Oscar Rodriguez, Melissa Casas, and Alejandro Jaramillo. Additional music provided by Splice. Rights and Clearances by Gina White.

Dr Sharonne Hayes, Professor of cardiovascular medicine and founding director of Mayo Clinic women's heart clinic, and Dr. Marysia Tweet, Associate Professor of cardiovascular medicine, and co-leader of the Spontaneous Coronary Artery Dissection Registry and leader in women's heart health join the show for this amazing November chapter of Always on EM. They are world experts on Spontaneous Coronary Artery Dissection authoring over 60 peer reviewed articles on the topic and in this chapter we explore with them the pitfalls and pearls related to making this diagnosis in the ED. SCAD is an important cause of myocardial infarction especially in patients who would not otherwise seem to be at risk for heart attacks for example active young women without comorbidities, and its imperitive that we as emergency physicians are current on this diagnosis.   DONATE TO DR JIM GREGOIRE SCHOLARSHIP FUND To honor the life of Dr. Jim Gregoire, dear friend of this show, consider donating to his scholarship fund. Go to https://give.mayoclinic.org/give/616870/#!/donation/checkout Go to: What would you like your donation to support? Choose “other” Enter: James Gregoire Scholarship Fund   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @Marysia_Tweet; @SharonneHayes YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @SharonneHayes Email - AlwaysOnEM@gmail.com   DO YOU HAVE SCAD? DOES YOUR PATIENT HAVE SCAD? WANT TO GET CONNECTED? SCAD Research: www.scadresearch.org National Coalition for Women with Heart Disease: www.womenheart.org Mayo Clinic Womens Heart clinic: https://www.mayoclinic.org/departments-centers/womens-heart-clinic/overview/ovc-20442061   REFERENCES & LINKS Saleh G, Al-Abcha A, Chaaban K, Adi MZ, Tweet M, Collins JD, Alkhouli M, Gulati R. Concomitant Takotsubo Cardiomyopathy and Spontaneous Coronary Artery Dissection: Exploring the Role of Cardiac Mechanics on Coronary Disruption. JACC Cardiovasc Imaging. 2025 Oct;18(10):1161-1166. doi: 10.1016/j.jcmg.2025.05.020. Epub 2025 Aug 5. PMID: 40758075. Baqal O, Karikalan SA, Hasabo EA, Tareen H, Futela P, Qasba RK, Shafqat A, Qasba RK, Hayes SN, Tweet MS, El Masry HZ, Lee KS, Shen WK, Sorajja D. In- hospital and long-term outcomes in spontaneous coronary artery dissection with concurrent cardiac arrest: Systematic review and meta-analysis. Heart Rhythm O2. 2025 Apr 24;6(6):843-853. doi: 10.1016/j.hroo.2025.03.023. PMID: 40717849; PMCID: PMC12287955. Morosato M, Gaspardone C, Romagnolo D, Pagnesi M, Baldetti L, Dormio S, Federico F, Scandroglio AM, Chieffo A, Godino C, Margonato A, Adamo M, Metra M, Tchetche D, Dumonteil N, Tweet MS, Saw J, Beneduce A. Left Main Spontaneous Coronary Artery Dissection: Clinical Features, Management, and Outcomes. JACC Cardiovasc Interv. 2025 Apr 28;18(8):975-983. doi: 10.1016/j.jcin.2025.01.427. Epub 2025 Apr 9. PMID: 40208153; PMCID: PMC12290918. Tweet MS, Pellikka PA, Gulati R, Gochanour BR, Barrett-O'Keefe Z, Raphael CE, Best PJM, Hayes SN. Coronary Artery Tortuosity and Spontaneous Coronary Artery Dissection: Association With Echocardiography and Global Longitudinal Strain, Fibromuscular Dysplasia, and Outcomes. J Am Soc Echocardiogr. 2024 May;37(5):518-529. doi: 10.1016/j.echo.2024.02.013. Epub 2024 Mar 11. PMID: 38467311; PMCID: PMC11605948. Tweet MS, Hayes SN, Grimaldo ABG, Rose CH. Pregnancy After Spontaneous Coronary Artery Dissection: Counseling Patients Who Intend Future Pregnancy. JACC Adv. 2023 Dec;2(10):100714. doi: 10.1016/j.jacadv.2023.100714. Epub 2023 Nov 14. PMID: 38915307; PMCID: PMC11194843. Tarabochia AD, Tan NY, Lewis BR, Slusser JP, Hayes SN, Best PJM, Gulati R, Deshmukh AJ, Tweet MS. Association of Spontaneous Coronary Artery Dissection With Atrial Arrhythmias. Am J Cardiol. 2023 Jan 1;186:203-208. doi: 10.1016/j.amjcard.2022.09.032. Epub 2022 Oct 31. PMID: 36328832; PMCID: PMC10403149. Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Lu Y, Spatz ES, Gupta A, Khera R, Ng VG, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Depression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience). Am J Cardiol. 2022 Jun 15;173:33-38. doi: 10.1016/j.amjcard.2022.03.005. Epub 2022 Mar 29. PMID: 35365290; PMCID: PMC9133198. Johnson AK, Tweet MS, Rouleau SG, Sadosty AT, Hayes SN, Raukar NP. The presentation of spontaneous coronary artery dissection in the emergency department: Signs and symptoms in an unsuspecting population. Acad Emerg Med. 2022 Apr;29(4):423-428. doi: 10.1111/acem.14426. Epub 2021 Dec 26. PMID: 34897898; PMCID: PMC10403148. Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Khera R, Lu Y, Spatz ES, Ng VG, Gupta A, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Health status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience. PLoS One. 2022 Mar 23;17(3):e0265624. doi: 10.1371/journal.pone.0265624. PMID: 35320296; PMCID: PMC8942215. Adlam D, Tweet MS, Gulati R, Kotecha D, Rao P, Moss AJ, Hayes SN. Spontaneous Coronary Artery Dissection: Pitfalls of Angiographic Diagnosis and an Approach to Ambiguous Cases. JACC Cardiovasc Interv. 2021 Aug 23;14(16):1743-1756. doi: 10.1016/j.jcin.2021.06.027. PMID: 34412792; PMCID: PMC8383825. Kok SN, Tweet MS. Recurrent spontaneous coronary artery dissection. Expert Rev Cardiovasc Ther. 2021 Mar;19(3):201-210. doi: 10.1080/14779072.2021.1877538. Epub 2021 Feb 26. PMID: 33455483. Campbell KH, Tweet MS. Coronary Disease in Pregnancy: Myocardial Infarction and Spontaneous Coronary Artery Dissection. Clin Obstet Gynecol. 2020 Dec;63(4):852-867. doi: 10.1097/GRF.0000000000000558. PMID: 32701519; PMCID: PMC10767871. Tweet MS, Young KA, Best PJM, Hyun M, Gulati R, Rose CH, Hayes SN. Association of Pregnancy With Recurrence of Spontaneous Coronary Artery Dissection Among Women With Prior Coronary Artery Dissection. JAMA Netw Open. 2020 Sep 1;3(9):e2018170. doi: 10.1001/jamanetworkopen.2020. PMID: 32965500; PMCID: PMC7512056. Hayes SN, Tweet MS, Adlam D, Kim ESH, Gulati R, Price JE, Rose CH. Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Aug 25;76(8):961-984. doi: 10.1016/j.jacc.2020.05.084. PMID: 32819471. Johnson AK, Hayes SN, Sawchuk C, Johnson MP, Best PJ, Gulati R, Tweet MS. Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors. J Am Heart Assoc. 2020 May 5;9(9):e014372. doi: 10.1161/JAHA.119.014372. Epub 2020 Apr 28. PMID: 32342736; PMCID: PMC7428589. Tweet MS, Akhtar NJ, Hayes SN, Best PJ, Gulati R, Araoz PA. Spontaneous coronary artery dissection: Acute findings on coronary computed tomography angiography. Eur Heart J Acute Cardiovasc Care. 2019 Aug;8(5):467-475. doi: 10.1177/2048872617753799. Epub 2018 Jan 29. PMID: 29376398; PMCID: PMC6027604. Tan NY, Tweet MS. Spontaneous coronary artery dissection: etiology and recurrence. Expert Rev Cardiovasc Ther. 2019 Jul;17(7):497-510. doi: 10.1080/14779072.2019.1635011. Epub 2019 Jul 5. PMID: 31232618. Waterbury TM, Tweet MS, Hayes SN, Eleid MF, Bell MR, Lerman A, Singh M, Best PJM, Lewis BR, Rihal CS, Gersh BJ, Gulati R. Early Natural History of Spontaneous Coronary Artery Dissection. Circ Cardiovasc Interv. 2018 Sep;11(9):e006772. doi: 10.1161/CIRCINTERVENTIONS.118. PMID: 30354594. Hayes SN, Kim ESH, Saw J, Adlam D, Arslanian-Engoren C, Economy KE, Ganesh SK, Gulati R, Lindsay ME, Mieres JH, Naderi S, Shah S, Thaler DE, Tweet MS, Wood MJ; American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association. Circulation. 2018 May 8;137(19):e523-e557. doi: 10.1161/CIR.0000000000000564. Epub 2018 Feb 22. PMID: 29472380; PMCID: PMC5957087. Tweet MS, Kok SN, Hayes SN. Spontaneous coronary artery dissection in women: What is known and what is yet to be understood. Clin Cardiol. 2018 Feb;41(2):203-210. doi: 10.1002/clc.22909. Epub 2018 Mar 1. PMID: 29493808; PMCID: PMC5953427. Tweet MS, Codsi E, Best PJM, Gulati R, Rose CH, Hayes SN. Menstrual Chest Pain in Women With History of Spontaneous Coronary Artery Dissection. J Am Coll Cardiol. 2017 Oct 31;70(18):2308-2309. doi: 10.1016/j.jacc.2017.08.071. PMID: 29073960; PMCID: PMC5957076. Lindor RA, Tweet MS, Goyal KA, Lohse CM, Gulati R, Hayes SN, Sadosty AT. Emergency Department Presentation of Patients with Spontaneous Coronary Artery Dissection. J Emerg Med. 2017 Mar;52(3):286-291. doi: 10.1016/j.jemermed.2016.09. Epub 2016 Oct 8. PMID: 27727035. Tweet MS, Gulati R, Williamson EE, Vrtiska TJ, Hayes SN. Multimodality Imaging for Spontaneous Coronary Artery Dissection in Women. JACC Cardiovasc Imaging. 2016 Apr;9(4):436-50. doi: 10.1016/j.jcmg.2016.01.009. PMID: 27056163. Tweet MS, Gulati R, Hayes SN. What Clinicians Should Know Αbout Spontaneous Coronary Artery Dissection. Mayo Clin Proc. 2015 Aug;90(8):1125-30. doi: 10.1016/j.mayocp.2015.05.010. PMID: 26250728. Prasad M, Tweet MS, Hayes SN, Leng S, Liang JJ, Eleid MF, Gulati R, Vrtiska TJ. Prevalence of extracoronary vascular abnormalities and fibromuscular dysplasia in patients with spontaneous coronary artery dissection. Am J Cardiol. 2015 Jun 15;115(12):1672-7. doi: 10.1016/j.amjcard.2015.03.011. Epub 2015 Mar 23. PMID: 25929580. Goel K, Tweet M, Olson TM, Maleszewski JJ, Gulati R, Hayes SN. Familial spontaneous coronary artery dissection: evidence for genetic susceptibility. JAMA Intern Med. 2015 May;175(5):821-6. doi: 10.1001/jamainternmed.2014. PMID: 25798899. Liang JJ, Prasad M, Tweet MS, Hayes SN, Gulati R, Breen JF, Leng S, Vrtiska TJ. A novel application of CT angiography to detect extracoronary vascular abnormalities in patients with spontaneous coronary artery dissection. J Cardiovasc Comput Tomogr. 2014 May-Jun;8(3):189-97. doi: 10.1016/j.jcct.2014.02.001. Epub 2014 Apr 4. PMID: 24939067. Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ, Gersh BJ, Khambatta S, Best PJ, Rihal CS, Gulati R. Clinical features, management, and prognosis of spontaneous coronary artery dissection. Circulation. 2012 Jul 31;126(5):579-88. doi: 10.1161/CIRCULATIONAHA.112. Epub 2012 Jul 16. PMID: 22800851. Tweet MS, Gulati R, Aase LA, Hayes SN. Spontaneous coronary artery dissection: a disease-specific, social networking community-initiated study. Mayo Clin Proc. 2011 Sep;86(9):845-50. doi: 10.4065/mcp.2011.0312. PMID: 21878595; PMCID: PMC3257995.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

AUA Guidelines: Recurrent Uncomplicated Urinary Tract Infections in Women Co-Hosts: A. Lenore Ackerman, MD, PhD & Melissa R. Kaufman, MD, PhD Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025) Ackerman AL, Bradley M, D'Anci KE, Hickling D, Kim SK, Kirkby E. Updates to Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025). J Urol. 0(0). doi: 10.1097/JU.0000000000004723

Recurrent urinary tract infections (UTIs) are a common challenge for people with spinal cord injury, but new research shows that many suspected cases aren't true infections. In this episode, Madison Hughes and Dr. Chris Elliott discuss how recurrent UTIs are diagnosed and managed in the spinal cord injury population, the role of urodynamics and bladder diaries, and why patient education and non-antibiotic strategies can make such a big difference. 

Don't forget to subscribe to our newsletter, Hyphenly; it's our no-fluff love letter with hot takes, heartfelt stories, and all the feels of living in between cultures. Come for the nuance, stay for the vibes! Link below https://hyphenly.beehiiv.com What does “enough” really mean? In this profoundly personal conversation, Saadia Khan sits down with Jaime Roque, musician, storyteller, and host of Recurrent. This Getty podcast uncovers the hidden stories behind monuments, places, and people. Born to Mexican immigrant parents, Jaime grew up between California's Central Valley and Los Angeles, surrounded by music, community, and the sounds of his family's jewelry shop. From farmwork to fatherhood, he reflects on how loss, love, and art shape his identity and why he now embraces what he calls “the art of enough.” Saadia and Jaime explore how storytelling helps us reclaim what's sacred, challenge expectations, and honor the people who shaped us.  This episode is an invitation to slow down, find meaning in the quiet moments, and celebrate the fullness of our identities. Join us as we create new intellectual engagement for our audience. You can find more information at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://immigrantlypod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Please share the love and leave us a review on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to help more people find us!  You can connect with Saadia on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG @itssaadiak⁠⁠ Email: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠saadia@immigrantlypod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Host & Producer: Saadia Khan I Content Writer: Saadia Khan I Editorial review: Shei Yu I Sound Designer & Editor: Lou Raskin I Immigrantly Theme Music: Simon Hutchinson | Other Music: Epidemic Sound Immigrantly Podcast is an Immigrantly Media Production. For advertising inquiries, contact us at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@immigrantlypod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Don't forget to subscribe to Immigrantly Uninterrupted ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠for insightful podcasts. Follow us on social media for updates and behind-the-scenes content. Learn more about your ad choices. Visit megaphone.fm/adchoices

In season two of ReCurrent: Stories about What We Gain by Keeping the Past Present, host Jaime Roque explores how culture builds community—how a camera passed from mentor to student, a long-lost record, or a familiar icon screen printed onto a jersey can bind people across time.In each episode, Jaime delves into the collaborations, memories, and reimaginings that shape who we are. He shows how something as simple as a photograph, a song, or a familiar icon can unlock a world of connection and meaning. Join Jaime as he uncovers the profound impact of keeping the past alive in the present—and discover what it opens for our future.Made in the wild—in the streets, archives, and neighborhoods where Getty stories are also found—ReCurrent shows how cultural heritage keeps us close while making room for who we're becoming.

If you've been treated for early breast cancer your overall risk for recurrence is small, a new large, long term study finds. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says these risks can be pinned to … Small risks of recurrent breast cancer may exist after treatment, Elizabeth Tracey reports Read More »

In this powerful episode of The Worst Girl Gang Ever, we sit down with community member Hannah as she bravely shares her deeply personal journey through pregnancy, miscarriage, and recurrent loss.Hannah talks candidly about:Experiencing an empty sac pregnancy and the shock of “no baby at the scan.”The devastation of multiple miscarriages and navigating hospital delays, D&C procedures, and painful medical management.The emotional challenges of parenting after loss and the longing for another child despite fear and anxiety.The lack of support in workplaces after miscarriage and why compassionate policies are so vital.How advocating for yourself, pushing for answers, and learning about fertility health (supplements, bloodwork, lifestyle changes) can make a difference.The power of community, finding support after baby loss, and breaking the silence around miscarriage grief.Hannah also reflects on how discovering resources, peer groups, and specialist advice gave her the tools to ask better questions and take charge of her care — something every woman navigating fertility struggles deserves.Whether you've experienced miscarriage yourself, know someone who has, or want to understand how to support parents going through pregnancy loss, this episode offers raw honesty, hope, and solidarity.About The Worst Girl Gang EverThe Worst Girl Gang Ever is a real, honest, and emotive podcast that covers the heartbreaking subject of miscarriage, infertility, and baby loss. Expect raw conversations about unspoken experiences, hosted by TWGGE founders Bex Gunn and Laura Buckingham. This show aims to break the silence and open dialogue around miscarriage and pregnancy loss. No more shame, no more taboo—let's change the narrative for future generations.Support and Resources:Access The WarriorshipThe Warriorship is our free peer to peer membership platform, connecting you with others who ‘just get it' through whats app groups, online drop in sessions, a book club, creative workshops and informative webinars. Join now and instantly connect with others who understand the challenges you face.⁠⁠⁠⁠https://theworstgirlgangever.co.uk/membership/ ⁠⁠Our bookWe are here to tell you that you are entitled to grieve, and that your grief is not disproportionate to your loss. We are here to open up the dialogue around miscarriage, so we don't perpetuate the shame, judgement and isolation so many of us feel following pregnancy loss. We are here to equip you with knowledge, tools and guidance to support and help you in whatever way you need.⁠⁠https://www.amazon.co.uk/gp/aw/d/0008524998/ref=tmm_pap_swatch_0?ie=UTF8&⁠⁠

Guest: Justine Galloway, Progyny Member Host: Dan Bulger, Progyny      Many of the stories we share on this show end with successful pregnancy, that's the goal of family building, after all. But not every journey reaches that destination, and it's important to shine a light on those stories. Sometimes the family building journey means embracing the family you already have and giving yourself permission to come first.  Today's episode features Justine Galloway, who is no stranger to overcoming obstacles. As an avid runner, diagnosed with focal dystonia, a neurological condition that made running forward nearly impossible without falling, she reinvented herself, going on to complete two half-marathons, the NYC Marathon, and even setting a Guinness World Record all by running backwards. That same grit carried her into the world of family building.  Justine got married at 38 and was hopeful about starting her family. At first it seemed fairly easy, they got pregnant quickly but soon miscarried, which was not abnormal for a first-time pregnancy. But after three miscarriages in one year, she knew something wasn't right.  That's when she turned to IVF. The medications and shots were difficult, but with the support of her partner, it was doable. Still, the cycles didn't bring the results they hoped for. The couple found new hope when Justine had access to Progyny through her employer. It felt like they could really try again. She got pregnant again, and she even graduated from the fertility clinic into the care of her OB-GYN. But when she came back to check the heartbeat, she was met with the devastating news again.  That's when Justine knew, after five years of dedicating their time to having a baby, they needed to move on. She needed to put her mind and body first. She wants people listening to this podcast to know that it's okay to make that decision, to choose yourself and your partner as family, and that you are not alone in this.   For more information, visit Progyny's Podcast page and Progyny's Education page for more resources. Be sure to follow us on Instagram, @ThisisInfertilityPodcast and use the #ThisisInfertility. Have a question, comment, or want to share your story? Email us at thisisinfertility@progyny.com.  

Read the full show notes for this episode on Dr. Aimee's website. I'm excited to welcome Dr. Dana McQueen, a highly knowledgeable reproductive endocrinologist and board-certified OB/GYN from Reproductive Medicine Associates (RMA). We dive into the topic of Recurrent Pregnancy Loss (RPL), a deeply emotional and complex issue that many couples face. Dr. McQueen sheds light on the latest research, potential causes, and the treatments available to help couples navigate this challenging journey. Dr. McQueen also highlights chronic endometritis, a condition that is often overlooked but could be an important factor in miscarriage. She explains how it differs from endometriosis and why diagnosing it is crucial for some patients. In addition to the science, we cover practical guidance for couples, including what male partners can do to check their sperm health and the importance of identifying conditions like chronic endometritis. In this episode, we cover: The latest advancements in understanding the causes of miscarriage, including chromosome errors and male factors. The role of sperm DNA fragmentation and how male partners can get tested. Chronic endometritis: what it is, how it's diagnosed, and why it matters. The differences between chronic endometritis and endometriosis. New research and treatment options, including genetic testing for embryos during IVF. Find Dr. Dana McQueen at RMA here. Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, October 20, 2025 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom. Click to find The Egg Whisperer Show podcast on your favorite podcasting app.   Watch videos of Dr. Aimee answer Ask the Egg Whisperer Questions on YouTube.  Sign up for The Egg Whisperer newsletter to get updates  Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

Urologist Fara Bellows discusses her article "When recurrent UTIs might actually be bladder cancer." Fara shares the story of a 91-year-old patient whose recurrent urinary infections masked an underlying bladder cancer diagnosis, illustrating how easily symptoms can be misattributed. She explains risk factors such as smoking, prior radiation, and occupational exposures, and highlights the alarming statistics that nearly 20,000 women will be diagnosed with bladder cancer in 2025, with close to 5,000 deaths. Fara emphasizes the dangers of delayed diagnosis in women due to symptom overlap with common conditions, and she outlines the three key diagnostic tools—urine cytology, imaging, and cystoscopy—that can save lives when used early. Listeners will learn why vigilance in primary care, proactive referrals, and patient advocacy are crucial to ensuring timely and accurate diagnoses. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

In this powerful episode of The Worst Girl Gang Ever, we sit down with community member Hannah as she bravely shares her deeply personal journey through pregnancy, miscarriage, and recurrent loss. Hannah talks candidly about: Experiencing an empty sac pregnancy and the shock of “no baby at the scan.” The devastation of multiple miscarriages and navigating hospital delays, D&C procedures, and painful medical management. The emotional challenges of parenting after loss and the longing for another child despite fear and anxiety. The lack of support in workplaces after miscarriage and why compassionate policies are so vital. How advocating for yourself, pushing for answers, and learning about fertility health (supplements, bloodwork, lifestyle changes) can make a difference. The power of community, finding support after baby loss, and breaking the silence around miscarriage grief. Hannah also reflects on how discovering resources, peer groups, and specialist advice gave her the tools to ask better questions and take charge of her care — something every woman navigating fertility struggles deserves. Whether you've experienced miscarriage yourself, know someone who has, or want to understand how to support parents going through pregnancy loss, this episode offers raw honesty, hope, and solidarity. About The Worst Girl Gang Ever The Worst Girl Gang Ever is a real, honest, and emotive podcast that covers the heartbreaking subject of miscarriage, infertility, and baby loss. Expect raw conversations about unspoken experiences, hosted by TWGGE founders Bex Gunn and Laura Buckingham. This show aims to break the silence and open dialogue around miscarriage and pregnancy loss. No more shame, no more taboo—let's change the narrative for future generations. Support and Resources: Access The Warriorship The Warriorship is our free peer to peer membership platform, connecting you with others who ‘just get it' through whats app groups, online drop in sessions, a book club, creative workshops and informative webinars. Join now and instantly connect with others who understand the challenges you face.⁠ https://theworstgirlgangever.co.uk/membership/ ⁠ Our book We are here to tell you that you are entitled to grieve, and that your grief is not disproportionate to your loss. We are here to open up the dialogue around miscarriage, so we don't perpetuate the shame, judgement and isolation so many of us feel following pregnancy loss. We are here to equip you with knowledge, tools and guidance to support and help you in whatever way you need. ⁠https://www.amazon.co.uk/gp/aw/d/0008524998/ref=tmm_pap_swatch_0?ie=UTF8&⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Recurrent high-grade glioblastoma is a rare and aggressive brain tumor, which today is generally treated with surgery and chemotherapy. Outcomes are poor, with survival ranging from three to nine months and five-year survival rates less than 10 percent. Candel Therapeutics is developing viral immunotherapies that both kill tumor cells directly and enlist the patient's own immune system in the fight against cancer. It's experimental therapy CAN-3110 uses a modified herpes simplex virus that carries a viral gene that is designed to allow the virus to replicate in tumor cells while avoiding healthy cells. We spoke to Paul Peter Tak, president and CEO of Candel, about its viral immunotherapy, how it works, and what clinical studies have shown to date.

In our exclusive interview, Dr Chase discussed the management of recurrent endometrial cancer, emphasizing the importance of biomarker profiles and previous therapies. For first recurrences, she explained that carboplatin and paclitaxel with pembrolizumab (Keytruda) or dostarlimab-gxly (Jemperli) is recommended for patients with mismatch repair–deficient (dMMR) disease, whereas those with MMR-proficient (pMMR) disease may benefit from carboplatin, paclitaxel, and pembrolizumab (Keytruda) or lenvatinib (Lenvima). She also highlighted findings from the phase 3 RUBY trial (NCT03981796) that supported the FDA approval of dostarlimab, showing significant improvements in progression-free and overall survival in both dMMR and pMMR patients. Chase also noted the rising incidence of endometrial cancer, its deadly nature, and the importance of clinical trials for advancing treatment options. 

Dr Shoghik Akoghlanian visits the studio as we consider recurrent fever syndromes in children. Tune in as we explore typical fevers… and more concerning ones. Learn about PFAPA and Familial Mediterranean Fever. We hope you can join us!