Podcasts about risk factors

Aotearoa continues to have one of the highest leptospirosis rates among developed countries, with flooding (notably the Hawkes Bay floods in 2023) being one of the main catalysts.  A recent study shows that other causes include exposure to rodents, working with uncovered cuts, and handling of livestock. The carried lepto strains are currently not protected by any existing vaccines. Last week, producer Faith spoke to researcher and epidemiologist Professor Jackie Benschop from Massey University about the disease, and what needs to be done. 

Nutritionist Leyla Muedin discusses recent advancements in the detection and prevention of Alzheimer's disease. Topics include the new FDA-approved Lumipulse blood test, the role of a ketogenic diet in improving mitochondrial health, and the significance of lifestyle changes such as social and cognitive activities. The episode also highlights promising research from the University of California Irvine on using natural compounds like nicotinamide and EGCG to rejuvenate aging brain cells and address the buildup of Alzheimer's-associated proteins. Leyla also provides insights into the difference between Alzheimer's and general dementia and emphasizes the importance of accurate diagnosis and appropriate treatments.

Dr. Bruce Baird reveals how shifting responsibility back to patients through education and clear communication frees dentists from unnecessary stress and builds a stronger practice.

Gestational diabetes (GDM) is one of the most common health issues during pregnancy, and diagnosing it is more complicated than you might think. In this episode, Dr. Dekker is joined by EBB Research Team member Dr. Morgan Richardson Cayama to cover the newly updated evidence on how GDM is diagnosed. They walk through the physiology behind GDM, current testing methods, and why there's still international disagreement about how to screen. Together, they examine the results of large randomized trials comparing the one-step and two-step screening methods, the research on early screening with hemoglobin A1C, and the evidence on alternatives to the Glucola drink, including candy and home blood sugar monitoring. They also review the risks of skipping screening entirely, and how weight bias and other systemic factors can impact diagnosis and care.   (02:28) What is Gestational Diabetes and Why Is It So Common? (06:30) Risk Factors, Size Bias, and the Role of Race and Ethnicity (10:40) Why We Screen and the Origins of the Controversy (13:17) Comparing the One-Step and Two-Step Methods (19:55) What New Research Says About Health Outcomes (23:45) Should We Screen for GDM Earlier in Pregnancy? (28:11) Can Hemoglobin A1C Replace the Glucola Drink? (32:44) Alternatives: Candy, Food, and Home Monitoring (40:04) What International Guidelines Recommend (43:07) Declining GDM Testing: What the Evidence Shows (47:47) Is Sperm Linked to Gestational Diabetes Risk? (51:29) Takeaways and the Future of GDM Diagnosis   Resources Download the free two-page handout in English or Spanish [NEED LINK] Explore Real Food for Gestational Diabetes by Lily Nichols: realfoodforgd.com For a full list of resources, visit ebbirth.com/inducinggdm For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

I'm Dr. Daniel Cameron, and today I'm addressing a question I often see in my practice: What are the risk factors for chronic Lyme disease?Chronic Lyme SymptomsSome patients do not fully recover from Lyme disease. They experience a broad range of symptoms, including ongoing fatigue, pain, sleep problems, neurologic changes, emotional strain, and disruption of daily life. These challenges can affect school, parenting, and work responsibilities.Common chronic Lyme manifestations include:Musculoskeletal: chronic arthritis, muscle pain, stiffness, and tendon inflammation.Neurologic and psychiatric: brain fog, memory issues, neuropathy, sensory changes, depression, irritability, mood swings, and PANS. Post-treatment Lyme disease syndrome (PTLDS) is often debated, but I view it as a potential ongoing infection rather than simply a syndrome.Cardiovascular/dysautonomia: POTS, Lyme carditis, arrhythmias, chest pain, and dizziness.Other manifestations: sensory overload (light, sound, heat, cold, or smell sensitivity), sometimes related to dysautonomic issues.Risk Factors for Chronic Lyme DiseaseWhile formal assessments are ongoing, in my practice I see several consistent contributors:Severe initial infection such as neurologic Lyme meningitis or carditis.Treatment delays, sometimes months or years.Early systemic involvement at onset—widespread fatigue, pain, neurological symptoms, or functional loss.Co-infections such as Babesia and other tick-borne pathogens.Reinfections and relapses, which can increase the likelihood of chronic complications.Key Takeaways for CliniciansScreen patients carefully for these risk factors.Monitor for co-infections, especially in high-risk or relapsing patients.Do not dismiss persistent symptoms, even if a formal diagnosis has not yet been established.Advice for PatientsSeek early treatment—timing matters.If symptoms persist, pursue a second opinion or find a physician experienced in managing chronic manifestations of Lyme disease.Watch for co-infections, especially Babesia, which may complicate recovery and even mimic other conditions (e.g., menopause).Advocate for comprehensive care for yourself and your family.Thank you for joining me. Please leave your questions and comments below—I read them all and respond where I can.

The Journal of Rheumatology's Editor-in-Chief Earl Silverman discusses this month's selection of articles that are most relevant to the clinical rheumatologist. Modifiable Lifestyle Factors, Genetic Susceptibility, and Incident Radiographic Axial Spondyloarthritis - doi.org/10.3899/jrheum.2025-0042 Prevalence, Risk Factors, and Outcomes of Chronic Kidney Disease in Patients With Systemic Lupus Erythematosus With and Without Lupus Nephritis - doi.org/10.3899/jrheum.2024-1087 Outcomes in Systemic Sclerosis–Associated Interstitial Lung Disease Based on Serological Profiles With a Focus on Anticentromere and Anti-RNA Polymerase III Antibodies - doi.org/10.3899/jrheum.2024-1063 Clinically Inactive Disease and Remission in Patients With Juvenile Idiopathic Arthritis Receiving Tofacitinib: Post Hoc Analysis of a Phase III Trial - doi.org/10.3899/jrheum.2024-0536 Long-Term Effectiveness and Safety of Denosumab for Osteoporosis in Patients With Rheumatic Diseases - doi.org/10.3899/jrheum.2024-1321

We break down pneumothorax: risks, diagnosis, and management pearls. Hosts: Christopher Pham, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Pneumothorax.mp3 Download Leave a Comment Tags: Chest Trauma, Pulmonary, Trauma Show Notes Risk Factors for Pneumothorax Secondary pneumothorax Trauma: rib fractures, blunt chest trauma (as in the case). Iatrogenic: central line placement, thoracentesis, pleural procedures. Primary spontaneous pneumothorax Young, tall, thin males (10–30 years). Connective tissue disorders: Marfan, Ehlers-Danlos. Underlying lung disease: COPD with bullae, interstitial lung disease, CF, TB, malignancy. Technically, anyone is at risk. Symptoms & Differential Diagnosis Typical PTX presentation: Dyspnea, chest pain, pleuritic discomfort. Exam clues: unilateral decreased breath sounds, focal tenderness/crepitus. Red flags (suggest tension PTX): JVD Tracheal deviation Hypotension, shock physiology Severe tachycardia, hypoxia Differential diagnoses: Pulmonary: asthma, COPD, pneumonia, pulmonary edema (SCAPE), ILD, infections. Cardiac: ACS, CHF, pericarditis. PE and other acute causes of dyspnea. Diagnostics Bloodwork: limited role, except type & screen if intervention likely. EKG: reasonable given chest pain/shortness of breath.

As you draft your fantasy football squad this weekend, we want you to relax, have fun, and realize that all the touts who seem so *certain* about everything will be proven wrong in under a week. Draft players you like, the ones you think are good -- you will make mistakes because we all do, but then we'll spend the entire season reviewing tape and fixing them. For today, we'll talk about roster construction early in drafts by rating each player in the ADP top 36 from 1-to-10: how *risky* are they? Plus a heavily revised Joe Mixon profile from the August 29 Almanac Update. Phew! Guest: Jeff Bell from FootballGuys.com.   NOTES: Sponsor - www.HungryRoot.com/harris for 40% off your first delivery (and free veggies for life) of healthy groceries and recipes that fit your family's lifestyle Sponsor - www.shopify.com/harris for an e-commerce platform that'll make your small business feel like it's selling like a Fortune 500 company Sponsor - www.fantrax.com/harris for the most customizable, yet simplest fantasy sports platform around Follow Jeff Bell - https://bsky.app/profile/4whomjbelltolls.bsky.social Follow our show on Bluesky - https://bsky.app/profile/harrisfootball.com Follow on Twitter - @HarrisFootball Become a patron - www.patreon.com/harrisfootball Become a Person of the Book - https://www.amazon.com/Christopher-Harris/e/B007V3P4KK Watch the YouTube channel - www.youtube.com/harrisfootball Harris Football Yacht Club Dictionary - https://harrisfootball.github.io/dictionary.html Join the Harris Football Subreddit - www.reddit.com/r/HarrisFootball Subscribe To the Yacht Club Premium Podcast - https://harrisfootball.supportingcast.fm/   Jeff's Risk Factors For The First Three ADP Rounds: 1. Ja'Marr Chase - 1 2. Bijan Robinson - 4 3. Saquon Barkley - 4 4. Jahmyr Gibbs - 3 5. Justin Jefferson - 5 6. CeeDee Lamb - 1 7. Christian McCaffrey - 3 8. Amon-Ra St. Brown - 5 9. Malik Nabers - 4 10. Nico Collins - 2 11. Derrick Henry - 2 12. Ashton Jeanty - 4 13. Puka Nacua - 6 14. Brian Thomas - 5 15. De'Von Achane - 7 16. Drake London - 1 17. Brock Bowers - 2 18. A.J. Brown - 6 19. Jonathan Taylor - 1 20. Bucky Irving - 6 21. Josh Jacobs - 1 22. Chase Brown - 4 23. Lamar Jackson - 6 24. Josh Allen - 6 25. Ladd McConkey - 3 26. Trey McBride - 2 27. Kyren Williams - 4 28. Tee Higgins - 3 29. Tyreek Hill - 10 30. James Cook - 4 31. Jayden Daniels - 7 32. Jaxon Smith-Njigba - 4 33. Omarion Hampton - 4 34. George Kittle - 3 35. Garrett Wilson - 8 36. Mike Evans - 8   Chris's Risk Factors For The First Three ADP Rounds: 1. Ja'Marr Chase - 1 2. Bijan Robinson - 3 3. Saquon Barkley - 2 4. Jahmyr Gibbs - 4 5. Justin Jefferson - 3 6. CeeDee Lamb - 2 7. Christian McCaffrey - 8 8. Amon-Ra St. Brown - 3 9. Malik Nabers - 4 10. Nico Collins - 3 11. Derrick Henry - 3 12. Ashton Jeanty - 7 13. Puka Nacua - 6 14. Brian Thomas - 4 15. De'Von Achane - 8 16. Drake London - 3 17. Brock Bowers - 8 18. A.J. Brown - 4 19. Jonathan Taylor - 4 20. Bucky Irving - 7 21. Josh Jacobs - 2 22. Chase Brown - 4 23. Lamar Jackson - 3 24. Josh Allen - 3 25. Ladd McConkey - 3 26. Trey McBride - 5 27. Kyren Williams - 3 28. Tee Higgins - 5 29. Tyreek Hill - 9 30. James Cook - 4 31. Jayden Daniels - 4 32. Jaxon Smith-Njigba - 3 33. Omarion Hampton - 6 34. George Kittle - 2 35. Garrett Wilson - 7 36. Mike Evans - 6

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Tired of Toilets & Trash? Notes vs. Rentals: The Ultimate Investor Showdown!

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Cancer Prevention & Risk Factors with guest Dr. Melinda Irwin August 24, 2025 Yale Cancer Center visit: http://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095

Angela talks to Dr Dale Bredesden about the critical relationship between metabolic health and cognitive function, particularly in the context of aging and hormonal changes such as perimenopause and menopause, stressing the importance of early intervention and active prevention strategies to mitigate the risk of cognitive decline, including Alzheimer's disease. KEY TAKEAWAYS: Early Detection and Prevention: It's crucial for individuals aged 35 and over to engage in active prevention and optimise their metabolic health to reduce the risk of cognitive decline and Alzheimer's disease Risk Factors for Cognitive Decline: Various factors contribute to cognitive decline Impact of Diet: A diet high in simple carbohydrates, particularly those containing high fructose corn syrup, can lead to insulin resistance and negatively affect brain health Importance of Sleep: Quality sleep is essential for brain health. Individuals should aim for at least seven hours of sleep, with sufficient REM and deep sleep TIMESTAMPS AND KEY TOPICS: [00:02:48] Alzheimer's prevention strategies. [00:04:03] Risky behaviors for brain health. [00:09:41] Air pollution and cognitive decline. [00:12:18] Mild ketosis and brain health. VALUABLE RESOURCES Click here for discounts on all the products I personally use and recommend A BIG thank you to our sponsors who make the show possible: Make Longevity a Lifestyle — Not by doing more, but by doing what matters. Join a powerful community of women who get you inside Live Younger: Longevity for Women, my brand-new membership designed to help you reverse your biological age with science-backed strategies that fit real life. Founding Member offer is open for a limited time —⁠Learn more here Link to full episode  ABOUT THE HOST Angela Foster is an award winning Nutritionist, Health & Performance Coach, Speaker and Host of the High Performance Health podcast. A former Corporate lawyer turned industry leader in biohacking and health optimisation for women, Angela has been featured in various media including Huff Post, Runners world, The Health Optimisation Summit, BrainTap, The Women's Biohacking Conference, Livestrong & Natural Health Magazine. Angela is the creator of BioSyncing®️ a blueprint for ambitious entrepreneurial women to biohack their health so they can 10X how they show up in their business and their family without burning out. CONTACT DETAILS Instagram Facebook LinkedIn Disclaimer: The High Performance Health Podcast is for general information purposes only and do not constitute the practice of professional or coaching advice and no client relationship is formed. The use of information on this podcast, or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for medical or other professional advice, diagnosis, or treatment. Users should seek the assistance of their medical doctor or other health care professional for before taking any steps to implement any of the items discussed in this podcast. This Podcast has been brought to you by Disruptive Media. https://disruptivemedia.co.uk/

This is a hybrid heart disease risk factor post of a podcast with Prof Bruce Lanphear on lead and a piece I was asked to write for the Washington Post on risk factors for heart disease.First, the podcast. You may have thought the problem with lead exposure was circumscribed to children, but it's a much bigger issue than that. I'll concentrate on the exposure risk to adults in this interview, including the lead-estrogen hypothesis. Bruce has been working on the subject of lead exposure for more than 30 years. Let me emphasize that the problem is not going away, as highlighted in a recent New England Journal of Medicine piece on lead contamination in Milwaukee schools, “The Latest Episode in an Ongoing Toxic Pandemic.”Transcript with links to the audio and citationsEric Topol (00:05):Well, hello. This is Eric Topol with Ground Truths, and I'm very delighted to welcome Professor Bruce Lanphear from Simon Fraser University in British Columbia for a very interesting topic, and that's about lead exposure. We tend to think about lead poisoning with the Flint, Michigan, but there's a lot more to this story. So welcome, Bruce.Bruce Lanphear (00:32):Thank you, Eric. It's great to be here.Eric Topol (00:33):Yeah. So you had a New England Journal of Medicine (NEJM) Review in October last year, which was probably a wake up to me, and I'm sure to many others. We'll link to that, where you reviewed the whole topic, the title is called Lead Poisoning. But of course it's not just about a big dose, but rather chronic exposure. So maybe you could give us a bit of an overview of that review that you wrote for NEJM.Bruce Lanphear (01:05):Yeah, so we really focused on the things where we feel like there's a definitive link. Things like lead and diminished IQ in children, lead and coronary heart disease, lead and chronic renal disease. As you mentioned, we've typically thought of lead as sort of the overt lead poisoning where somebody becomes acutely ill. But over the past century what we've learned is that lead is one of those toxic chemicals where it's the chronic wear and tear on our bodies that catches up and it's at the root of many of these chronic diseases that are causing problems today.Eric Topol (01:43):Yeah, it's pretty striking. The one that grabbed me and kind of almost fell out of my chair was that in 2019 when I guess the most recent data there is 5.5 million cardiovascular deaths ascribed to relatively low levels, or I guess there is no safe level of lead exposure, that's really striking. That's a lot of people dying from something that cardiology and medical community is not really aware of. And there's a figure 3 [BELOW] that we will also show in the transcript, where you show the level where you start to see a takeoff. It starts very low and by 50 μg/liter, you're seeing a twofold risk and there's no threshold, it keeps going up. How many of us do you think are exposed to that type of level as adults, Bruce?Bruce Lanphear (02:39):Well, as adults, if we go back in time, all of us. If you go back to the 1970s when lead was still in gasoline, the median blood lead level of Americans was about 13 to 15 µg/dL. So we've all been exposed historically to those levels, and part of the reason we've begun to see a striking decline in coronary heart disease, which peaked in 1968. And by 1978, there was a 20% decline, 190,000 more people were alive than expected. So even in that first decade, there was this striking decline in coronary heart disease. And so, in addition to the prospective studies that have found this link between an increase in lead exposure and death from cardiovascular disease and more specifically coronary heart disease. We can look back in time and see how the decline in leaded gasoline led to a decline in heart disease and hypertension.Eric Topol (03:41):Yeah, but it looks like it's still a problem. And you have a phenomenal graph that's encouraging, where you see this 95% reduction in the lead exposure from the 1970s. And as you said, the factors that can be ascribed to like getting rid of lead from gasoline and others. But what is troubling is that we still have a lot of people that this could be a problem. Now, one of the things that was fascinating is that you get into that herbal supplements could be a risk factor. That we don't do screening, of course, should we do screening? And there's certain people that particularly that you consider at high risk that should get screened. So I wasn't aware, I mean the one type of supplements that you zoomed in on, how do you say it? Ayurvedic?Supplements With LeadBruce Lanphear (04:39):Oh yeah. So this is Ayurvedic medicine and in fact, I just was on a Zoom call three weeks ago with a husband and wife who live in India. The young woman had taken Ayurvedic medicine and because of that, her blood lead levels increased to 70 µg/dL, and several months later she was pregnant, and she was trying to figure out what to do with this. Ayurvedic medicine is not well regulated. And so, that's one of the most important sources when we think about India, for example. And I think you pointed out a really important thing is number one, we don't know that there's any safe level even though blood lead levels in the United States and Europe, for example, have come down by over 95%. The levels that we're exposed to and especially the levels in our bones are 10 to 100 times higher than our pre-industrial ancestors.Bruce Lanphear (05:36):So we haven't yet reached those levels that our ancestors were exposed to. Are there effects at even lower and lower levels? Everything would suggest, we should assume that there is, but we don't know down below, let's say one microgram per deciliter or that's the equivalent of 10 parts per billion of lead and blood. What we also know though is when leaded gasoline was restricted in the United States and Canada and elsewhere, the companies turned to the industrializing countries and started to market it there. And so, we saw first the epidemic of coronary heart disease in the United States, Canada, Europe. Then that's come down over the past 50 years. At the same time, it was rising in low to middle income countries. So today over 95% of the burden of disease from lead including heart disease is found in industrializing countries.Eric Topol (06:34):Right. Now, it's pretty striking, of course. Is it true that airlines fuel is still with lead today?Bruce Lanphear (06:45):Well, not commercial airlines. It's going to be a small single piston aircraft. So for example, when we did a study down around the Santa Clara County Airport, Reid-Hillview, and we can see that the children who live within a half mile of the airport had blood lead levels about 10% higher than children that live further away. And the children who live downwind, 25% higher still. Now, nobody's mapped out the health effects, but one of the things that's particularly troubling about emissions from small aircraft is that the particle size of lead is extraordinarily small, and we know how nanoparticles because they have larger surface area can be more problematic. They also can probably go straight up into the brain or across the pulmonary tissues, and so those small particles we should be particularly worried about. But it's been such a long journey to try to figure out how to get that out of aircraft. It's a problem. The EPA recognized it. They said it's an endangerment, but the industry is still pushing back.Eric Topol (07:55):Yeah, I mean, it's interesting that we still have these problems, and I am going to in a minute ask you what we can do to just eradicate lead as much as possible, but we're not there yet. But one study that seemed to be hard to believe that you cited in the review. A year after a ban leaded fuel in NASCAR races, mortality from coronary heart disease declined significantly in communities near racetracks. Can you talk about that one because it's a little bit like the one you just mentioned with the airports?Bruce Lanphear (08:30):Yeah. Now that study particularly, this was by Alex Hollingsworth, was particularly looking at people over 65. And we're working on a follow-up study that will look at people below 65, but it was quite striking. When NASCAR took lead out of their fuel, he compared the rates of coronary heart disease of people that live nearby compared to a control group populations that live further away. And he did see a pretty striking reduction. One of the things we also want to look at in our follow-up is how quickly does that risk begin to taper off? That's going to be really important in terms of trying to develop a strategy around preventing lead poisoning. How quickly do we expect to see it fall? I think it's probably going to be within 12 to 24 months that we'll see benefits.Eric Topol (09:20):That's interesting because as you show in a really nice graphic in adults, which are the people who would be listening to this podcast. Of course, they ought to be concerned too about children and all and reproductive health. But the point about the skeleton, 95% of the lead is there and the main organs, which we haven't mentioned the kidney and the kidney injury that occurs no less the cardiovascular, the blood pressure elevation. So these are really, and you mentioned not necessarily highlighted in that graphic, but potential cognitive hit as well. You also wrote about how people who have symptoms of abdominal pain, memory impairment, and high blood pressure that's unexplained, maybe they should get a blood level screening. I assume those are easy to get, right?Bruce Lanphear (10:17):Oh yeah, absolutely. You can get those in any hospital, any clinic across the country. We're still struggling with having those available where it's most needed in the industrializing countries, but certainly available here. Now, we don't expect that for most people who have those symptoms, lead poisoning is going to be the cause, right. It'd still be unusual unless you work in an industry, for example, smelting batteries to recycle them. We don't expect it to be real common, and we're not even sure, Eric, whether we should be doing widespread screening. If I looked at this as a population scientist, the real focus should be on identifying the sources. We mostly know where those are here and radically moving it down. Getting rid of the lead service lines, which was such a big part of what President Biden was doing, and it was perfect. For every dollar invested to reduce lead exposure from those lead service lines. Ronnie Levin at Harvard said there'd be a 35-fold return in cost, benefits really, and this has always been true, that reducing lead exposure throughout the past 40 years has always been shown to be amazingly cost beneficial. The problem is operating within a free market health system, even though there's tremendous social benefits, that benefit isn't going to be monetized or privatized. And so, who's going to make those decisions? We hope our government is, but that doesn't always play out.Eric Topol (11:52):Well. What's interesting is, as opposed to the problems we have today that are prominent such as the microplastic, nanoplastics, the air pollution, the forever chemicals, that just keep getting worse, I mean, they are just cumulative. This one, there was tremendous improvement, but it's still not enough. And I guess you're zooming in on the lead lines. That'd be the most important thing to work on today. Another thing that has come up, there's been trials, as you may I'm sure, because all over this field of chelation, there's a trial that was run by the NIH, supported by NH that looked at chelation to prevent coronary disease. Is there any evidence that people who have a problem with lead would benefit from chelation therapy?Bruce Lanphear (12:44):Well, there's two major studies that have been done, and Tony Lamas was in charge of both of them. The first one Trial to Assess Chelation Therapy (TACT) study, it was a randomized controlled trial, not intended specifically to focus on lead, but rather it was to look at sort of this alternative therapy. They found significant benefits about an 18% reduction in subsequent cardiac events. That led to a second study that was just published last year, and it was focused on people who had diabetes. They saw some benefit, but it wasn't significant. So whether that's because there wasn't enough variability and exposure, it's not entirely clear, but we've seen this with lead in IQ deficits in kids where we can show that we can reduce blood lead levels. But ultimately what tends to happen is once you've taken lead out of the blood, some of it's released again from the bone, but you still have all that lead in the bone that's there. You get some of it out, but you're not going to get the bulk of it out.The Lead-Estrogen HypothesisEric Topol (13:47):Right. It's a reservoir that's hard to reckon with. Yeah. Now another thing, you have a Substack that is called Plagues, Pollution & Poverty, and you wrote a really provocative piece in that earlier and April called How Estrogen Keeps Lead - and Heart Attacks - in Check, and basically you got into the lead estrogen hypothesis.Eric Topol (14:10):Can you enlighten us about that?Bruce Lanphear (14:12):Yeah. A lot of the seminal work in this area was done by Ellen Silbergeld, who's a brilliant and somewhat peculiar toxicologist and Ellen for years, I focused on childhood lead exposure, and for years Ellen would tell me, almost demolish me for not studying adults. And because she had found back in 1988 that as women go into menopause, their blood lead levels spike increased by about 30%, and that's where most of our lead is stored is in our bone. And so, as I was thinking about this, it all became clear because blood lead levels in boys and girls is about the same. It's comparable up until menarche, and then girls young women's blood leads fall by about 20%. And they stay 20% lower throughout the reproductive years until menopause. And especially during those first few years around menopause, perimenopause, you see fairly striking increases in the weakening of the bone and blood lead levels.Bruce Lanphear (15:19):So that might very well help to explain why estrogen is protected, because what happens is throughout the reproductive life, women are losing a little bit of lead every month. And estrogen is at its lowest during that time, and that's going to be when blood lead is at its highest because estrogen pushes lead into the bone. Not only that, women lose lead into the developing fetus when they're pregnant. So what Ellen found is that there was less of a spike around menopause for the women that had three or four pregnancies because they had offloaded that into their babies. So all of this, if you put it together, and this is of course in a very short note of it, you can see that lead increases dyslipidemia, it leads to tears in the endothelium of the arterial wall, it's going to increase thrombosis. All of these things that we think of as the classic atherosclerosis. Well, what estrogen does is the opposite of those. It decreases dyslipidemia, it repairs the arterial endothelial wall. So how much of it is that estrogen is protective, and how much is it that it's moving lead out of the system, making it less biologically available?Eric Topol (16:46):Yeah, I know. It's really interesting. Quite provocative. Should be followed up on, for sure. Just getting to you, you're a physician and epidemiologist, MD MPH, and you have spent your career on this sort of thing, right? I mean, is your middle name lead or what do you work on all the time?Bruce Lanphear (17:09):Yeah, I've been doing this for about 30 years, and one of my mentors, Herb Needleman spent 40 years of his career on it. And in some ways, Eric, it seems to me particularly in these very difficult entrenched problems like lead, we don't have any pharmaceutical company reaching out to us to promote what we do. We've got industry trying to squash what we do.Bruce Lanphear (17:35):It really does take a career to really make a dent in this stuff. And in a way, you can look at my trajectory and it is really following up on what Herb Needleman did and what Clare Patterson did, and that was finding the effects at lower and lower levels. Because what we do with lead and most other toxic chemicals, the ones that don't cause cancer, is we assume that there's a safe level or threshold until we prove otherwise. And yet when you look at the evidence, whether it's about asbestos and mesothelioma, air pollution and cardiovascular mortality, lead and cardiovascular mortality, benzene and leukemia, none of those exhibit a threshold. In some cases, the risks are steepest proportionately at the lowest measurable levels, and that really raises some tremendous challenges, right? Because how are we going to bring air pollution or lead down to zero? But at the same time, it also provides these tremendous opportunities because we know that they're causing disease. We know what the sources are. If we could only bring about the political will to address them, we could prevent a lot of death, disease, and disability. I mean, about 20% of deaths around the world every year are from air pollution, lead, and other toxic chemicals, and yet the amount of money we invest in them is just paltry compared to what we invest in other things. Which is not to pit one against the other, but it's to say we haven't invested enough in these.Eric Topol (19:14):No, absolutely. I think your point, just to make sure that it's clear, is that even at low levels, this is of course where most of the population exposure would be, and that's why that's so incriminating. Now, one of the things I just want to end up with is that we know that these are tiny, tiny particles of lead, and then the question is how they can synergize and find particulate matter of air pollution in the nanoplastic, microplastic story and binding to forever chemicals, PFAS. How do you process all that? Because it's not just a single hit here, it's also the fact that there's ability to have binding to the other environmental toxins that are not going away.Bruce Lanphear (20:10):That's right. And in a way, when we talk about lead playing this tremendous role in the rise and decline of coronary heart disease, we can't entirely separate it out, for example, from air pollution or cigarette smoke for that matter, nor plastic. So for example, with air pollution, if we look at air pollution over the past century, up until the 1980s, even into the 1990s, it was leaded, right? So you couldn't separate them. If you look at cigarette smoke, cigarette tobacco in the 1940s and 1950s was grown in fields where they used lead arsenic as an insecticide. So smokers even today have blood lead levels that are 20% higher than non-smokers, and people who are not smokers but exposed to secondhand smoke have blood lead levels 20% higher than non-smokers who aren't exposed to secondhand smoke. So in a way, we should try to tease apart these differences, but it's going to be really challenging. In a way we can almost think about them as a spectrum of exposures. Now with plastics, you can really think of plastics as a form of pollution because it's not just one thing. There's all these additives, whether it's the PFAS chemicals or lead, which is used as a stabilizer. And so, all of them really are kind of integrated into each other, which again, maybe there's some opportunity there if we really were ready to tackle.Eric Topol (21:40):And interestingly, just yesterday, it was announced by the current administration that they're stopping all the prior efforts on the forever chemicals that were initiated in the water supply. And I mean, if there's one takeaway from our discussion, it's that we have to get all over this and we're not paying enough attention to our environmental exposures. You've really highlighted spotlighted the lead story. And obviously there are others that are, instead of getting somewhat better, they're actually going in the opposite direction. And they're all tied together that's what is so striking here, and they all do many bad things to our bodies. So I don't know how, I'm obviously really interested in promoting healthy aging, and unless we get on this, we're chasing our tails, right?Bruce Lanphear (22:31):Well, I think that's right, Eric. And I was reading the tips that you'd written about in preparation for your book release, and you focused understandably on what each of us can do, how we can modify our own lifestyles. We almost need six tips about what our government should do in order to make it harder for us to become sick, or to encourage those healthy behaviors that you talked about. That's a big part of it as well. One of the things we're celebrating the hundredth anniversary. This is not really something to celebrate, but we are. The hundredth anniversary of the addition of tetraethyl lead to gasoline. And one of the key things about that addition, there was this debate because when it was being manufactured, 80% of the workers at a plant in New Jersey suffered from severe lead poisoning, and five died, and it was enough that New York City, Philadelphia and New Jersey banned tetraethyl lead.Bruce Lanphear (23:31):Then there was this convening by the US Surgeon General to determine whether it was safe to add tetraethyl lead to gasoline. One scientist, Yandell Henderson said, absolutely not. You're going to create a scourge worse than tuberculosis with slow lead poisoning and hardening of your arteries. Robert Kehoe, who represented the industry said, we know lead is toxic, but until you've shown that it's toxic when added to gasoline, you have no right to prohibit us from using it. So that is now known as the Kehoe rule, and it's relevant not only for lead, but for PFAS, for air pollution, for all these other things, because what it set as a precedent, until you've shown that these chemicals or pollution is toxic when used in commerce, you have no right to prohibit industry from using it. And that's the fix we're in.Eric Topol (24:27):Well, it sounds too much like the tobacco story and so many other things that were missed opportunities to promote public health. Now, is Canada doing any better than us on this stuff?Bruce Lanphear (24:40):In some ways, but not in others. And one of the interesting thing is we don't have standards, we have guidelines. And amazingly, the cities generally try to conform to those guidance levels. With water lead, we're down to five parts per billion. The US is sticking around with ten parts per billion, but it's not even really very, it's not enforced very well. So we are doing better in some ways, not so good in other ways. The European Union, generally speaking, is doing much better than North America.Eric Topol (25:15):Yeah, well, it doesn't look very encouraging at the moment, but hopefully someday we'll get there. Bruce, this has been a really fascinating discussion. I think we all should be thankful to you for dedicating your career to a topic that a lot of us are not up on, and you hopefully are getting us all into a state of awareness. And congratulations on that review, which was masterful and keep up the great work. Thank you.Bruce Lanphear (25:42):Thank you, Eric. I appreciate it.________________________________________________My Recommendations for Preventing Heart Disease (Markedly Truncated from Text and Graphics Provided in SUPER AGERS)Recently the Washington Post asked me for a listicle of 10 ways to prevent heart disease. I generally avoid making such lists but many people have de-subscribed to this newspaper, never subscribed, or missed the post, so here it is with links to citations:Guest column by Eric Topol, MDThe buildup of cholesterol and other substances in the wall of our arteries, known as atherosclerosis, is common. It can lead to severe plaques that narrow the artery and limit blood flow, or to a crack in the artery wall that can trigger blood clot formation, resulting in a heart attack.While we've seen some major advances in treating heart disease, it remains the leading killer in the United States, even though about 80 percent of cases are considered preventable. There are evidence-based steps you can take to stave it off. As a cardiologist, here's what I recommend to my patients.1. Do both aerobic and resistance exerciseThis is considered the single most effective medical intervention to protect against atherosclerosis and promote healthy aging. Physical activity lowers inflammation in the body. Evidence has shown that both aerobic and strength training forms of exercise are important. But only 1 in 4 Americans meet the two activity guidelines from the American Heart Association: aerobic exercise of 150 minutes per week of at least moderate physical activity, such as walking, bicycling on level ground, dancing or gardening, and strength training for at least two sessions per week, which typically translates to 60 minutes weekly.The protective benefit of exercise is seen with even relatively low levels of activity, such as around 2,500 steps per day (via sustained physical activity, not starting and stopping), and generally increases proportionately with more activity. It used to be thought that people who exercise only on the weekend — known as “weekend warriors” — put themselves in danger, but recent data shows the benefits of exercise can be derived from weekend-only workouts, too.2. Follow an anti-inflammatory dietA predominantly plant-based diet — high in fiber and rich in vegetables, fruits and whole grains, as seen with the Mediterranean diet — has considerable evidence from large-scale observational and randomized trials for reducing body-wide inflammation and improving cardiovascular outcomes.Foods rich in omega-3 fatty acids, such as salmon, also form part of a diet that suppresses inflammation. On the other hand, red meat and ultra-processed foods are pro-inflammatory, and you should limit your consumption. High protein intake of more than 1.4 grams per kilogram of body weight per day — around 95 grams for someone who is 150 pounds — has also been linked to promoting inflammation and to atherosclerosis in experimental models. That is particularly related to animal-based proteins and the role of leucine, an essential amino acid that is obtained only by diet.3. Maintain a healthy weightBeing overweight or obese indicates an excess of white adipose tissue. This kind of tissue can increase the risk of heart disease because it stores fat cells, known as adipocytes, which release substances that contribute to inflammation.In studies, we've seen that glucagon-like peptide (GLP-1) drugs can reduce inflammation with weight loss, and a significant reduction of heart attacks and strokes among high-risk patients treated for obesity. Lean body weight also helps protect against atrial fibrillation, the most common heart rhythm abnormality.4. Know and avoid metabolic syndrome and prediabetesTied into obesity, in part, is the problem of insulin resistance and metabolic syndrome. Two out of three people with obesity have this syndrome, which is defined as having three out of five features: high fasting blood glucose, high fasting triglycerides, high blood pressure, low high-density lipoprotein (HDL) and central adiposity (waist circumference of more than 40 inches in men, 35 inches in women).Metabolic syndrome is also present in a high proportion of people without obesity, about 50 million Americans. Prediabetes often overlaps with it. Prediabetes is defined as a hemoglobin A1c (a measure of how much glucose is stuck to your red blood cells) between 5.7 and 6.4 percent, or a fasting glucose between 100 and 125 milligrams per deciliter.Both metabolic syndrome and prediabetes carry an increased risk of heart disease and can be prevented — and countered — by weight loss, exercise and an optimal diet.As the glucagon-like peptide drug family moves to pills and less expense in the future, these medications may prove helpful for reducing risk in people with metabolic syndrome and prediabetes. For those with Type 2 diabetes, the goal is optimizing glucose management and maximal attention to lifestyle factors.5. Keep your blood pressure in a healthy rangeHypertension is an important risk factor for heart disease and is exceptionally common as we age. The optimal blood pressure is 120/80 mm Hg or lower. But with aging, there is often an elevation of systolic blood pressure to about 130 mm Hg, related to stiffening of arteries. While common, it is still considered elevated.Ideally, everyone should monitor their blood pressure with a home device to make sure they haven't developed hypertension. A mild abnormality of blood pressure will typically improve with lifestyle changes, but more substantial elevations will probably require medications.6. Find out your genetic riskWe now have the means of determining your genetic risk of coronary artery disease with what is known as a polygenic risk score, derived from a gene chip. The term polygenic refers to hundreds of DNA variants in the genome that are linked to risk of heart disease. This is very different from a family history, because we're a product of both our mother's and father's genomes, and the way the DNA variants come together in each of us can vary considerably for combinations of variants.That means you could have high or low risk for heart disease that is different from your familial pattern. People with a high polygenic risk score benefit the most from medications to lower cholesterol, such as statins. A polygenic risk score can be obtained from a number of commercial companies, though it isn't typically covered by insurance.I don't recommend getting a calcium score of your coronary arteries via a computed tomography (CT) scan. This test is overused and often induces overwhelming anxiety in patients with a high calcium score but without symptoms or bona fide risk. If you have symptoms suggestive of coronary artery disease, such as chest discomfort with exercise, then a CT angiogram may be helpful to map the coronary arteries. It is much more informative than a calcium score.7. Check your blood lipidsThe main lipid abnormality that requires attention is low-density cholesterol (LDL), which is often high and for people with increased risk of heart disease should certainly be addressed. While lifestyle improvements can help, significant elevation typically requires medications such as a statin; ezetimibe; bempedoic acid; or injectables such as evolocumab (Repatha), alirocumab (Praluent) or inclisiran (Leqvio). The higher the risk, the more aggressive LDL lowering may be considered.It should be noted that the use of potent statins, such as rosuvastatin or atorvastatin, especially at high doses, is linked to inducing glucose intolerance and risk of Type 2 diabetes. While this is not a common side effect, it requires attention since it is often missed from lack of awareness.A low high-density lipoprotein (HDL) cholesterol often responds to weight loss and exercise. We used to think that high HDL was indicative of “good cholesterol,” but more recent evidence suggests that is not the case and it may reflect increased risk when very high.To get a comprehensive assessment of risk via your blood lipids, it's important to get the apolipoprotein B (apoB) test at least once because about 20 percent of people have normal LDL and a high apoB.Like low HDL, high fasting triglycerides may indicate insulin resistance as part of the metabolic syndrome and will often respond to lifestyle factors.The lipoprotein known as Lp(a) should also be assessed at least once because it indicates risk when elevated. The good news is scientists are on the cusp of finally having medications to lower it, with five different drugs in late-stage clinical trials.8. Reduce exposure to environmental pollutantsIn recent years, we've learned a lot about the substantial pro-inflammatory effects of air pollution, microplastics and forever chemicals, all of which have been linked to a higher risk of heart disease. In one study, microplastics or nanoplastics in the artery wall were found in about 60 percent of more than 300 people. Researchers found a vicious inflammatory response around the plastics, and a four- to fivefold risk of heart attacks or strokes during three years of follow-up.While we need policy changes to address these toxic substances in the environment, risk can be reduced by paying attention to air and water quality using filtration or purification devices, less use of plastic water bottles and plastic storage, and, in general, being much more aware and wary of our pervasive use of plastics.9. Don't smoke This point, it should be well known that cigarette smoking is a potent risk factor for coronary artery disease and should be completely avoided.10. Get Good SleepAlthough we tend to connect sleep health with brain and cognitive function, there's evidence that sleep regularity and quality are associated with less risk of heart disease. Regularity means adhering to a routine schedule as much as possible, and its benefit may be due to our body's preference for maintaining its circadian rhythm. Sleep quality — meaning with fewer interruptions — and maximal deep sleep can be tracked with smartwatches, fitness bands, rings or mattress sensors.Sleep apnea, when breathing stops and starts during sleep, is fairly common and often unsuspected. So if you're having trouble sleeping or you snore loudly, talk to your doctor about ruling out the condition. Testing for sleep apnea can involve checking for good oxygen saturation throughout one's sleep. That can be done through a sleep study or at home using rings or smartwatches that include oxygen saturation in their sensors and body movement algorithms that pick up disturbed breathing.Eric Topol, MD, is a cardiologist, professor and executive vice president of Scripps Research in San Diego. He is the author of “Super Agers: An Evidence-Based Approach to Longevity” and the author of Ground Truths on Substack.*********************°°°°°°°°°°°°°°°°°°°°Thanks to many of you Ground Truths subscribers who helped put SUPER AGERS on the NYT bestseller list for 4 weeks.Here are 2 recent, informative, and fun conversations I had on the topicMichael Shermer, The SkepticRuss Roberts, EconTalk I'm also very appreciative for your reading and subscribing to Ground Truths.If you found this interesting PLEASE share it!That makes the work involved in putting these together especially worthwhile.All content on Ground Truths—its newsletters, analyses, and podcasts, are free, open-access.Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don't hesitate to post comments and give me feedback. Let me know topics that you would like to see covered.Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past three years. Just a week ago we just had nearly 50 interns (high school, college and medical students) present posters of the work they did over the summer and it was exhilarating! Some photos below Get full access to Ground Truths at erictopol.substack.com/subscribe

In his weekly clinical update, Dr. Griffin with Vincent Racaniello re-address the dangers of drinking raw milk, the Legionnaire's outbreak in Harlem and results of a vaccine knowledge survey done by emergency departments before Dr. Griffin deep dives into recent statistics on RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, reports of influenza-associated acute necrotizing encephalopathy or neuropsychiatric events in children, whether or not the NB.1.8.1 should be included in the fall 2025 vaccines, the effectiveness of Pfizer and MODERNA vaccines against the JN.1 variant, risk of children developing severe disease from SARS-CoV-2 infection, where to find PEMGARDA, long COVID treatment center, where to go for answers to your long COVID questions, the association of “virus rebound” and post-acute sequelae among hospitalized patients, effectiveness of COVID-19 vaccines against long COVID, predictors for distinct COVID-19 sequelae including immune disturbances and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Florida Department of Health Provides Update on Raw Milk(Florida Health) Raw milk linked to 21 E coli, Campylobacter infections in Florida (CIDRAP) Legionnaires' Disease: In Harlem (NYC Health) NYC health officials report Harlem Legionnaires' outbreak(CIDRAP) Emergency Department Survey of Vaccination Knowledge, Vaccination Coverage, and Willingness to Receive Vaccines in an Emergency Department Among Underserved Populations  (CDC: MMWR) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Measles (CDC Measles (Rubeola)) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts(ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) Influenza-Associated Acute Necrotizing Encephalopathy in US Children (JAMA) Influenza With and Without Oseltamivir Treatment and Neuropsychiatric Events Among Children and Adolescents(JAMA Neurology) FDA-CDC-DOD: 2025-2046 influenza vaccine composition (FDA) RSV: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) ENFLONSIA: novel drug approvals 2025 (FDA) RSV-Network (CDC Respiratory Syncytial virus Infection) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Antigenic and Virological Characteristics of SARS-CoV-2 Variant BA.3.2, XFG, and NB.1.8.1 (bioRxiV) Effectiveness of the BNT162b2 and mRNA-1273 JN.1-adapted vaccines against COVID-19-associated hospitalisation and death: a Danish, nationwide, register-based, cohort study (LANCET: Infectious Diseases) Hospitalization for COVID-19 and Risk Factors for Severe Disease Among Children: 2022–2024 (Pediatrics) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Metformin and Time to Sustained Recovery in Adults With COVID-19 (JAMA Internal Medicine) Drug interaction checker (University of Liverpool) Paxlovid (Pfizer) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) SARS-CoV-2 rebound and post-acute mortality and hospitalization among patients admitted with COVID-19(Nature Communications) Steroids,dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Effectiveness of COVID-19 vaccines against post COVID-19 condition/long COVID (CMI: Clinical Microbiology and Infection) Precision Symptom Phenotyping Identifies Early Clinical and Proteomic Predictors of Distinct COVID-19 Sequelae (JID) Systemic and SARS-CoV-2 specific Immune Disturbances in Individuals With Post–COVID Syndrome (JID) Reaching out to US house representative Letters read on TWiV 1242 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

Tired of Toilets & Trash? Notes vs. Rentals: The Ultimate Investor Showdown!

Hormones play a bigger role in bladder health than most women realize. In this week's episode of "while you wait…" podcast, I break down how estrogen shifts during perimenopause, menopause, postpartum, and even certain birth control methods can affect urgency, leaking, and pelvic floor function. I also explain why vaginal estrogen may be part of the solution, common risk factors for incontinence, and how lifestyle factors like weight, sleep, and stress can make symptoms better or worse.Timeline:00:30 Introduction and Overview01:04 Hormonal Changes and Bladder Health04:50 Genetic and Risk Factors for Incontinence07:31 Non-Hormonal Factors Affecting Incontinence09:28 Communicating Symptoms with Doctors12:40 Hormone Therapy and Bladder Symptoms15:15 Conclusion and Final Thoughts

Send us a textIn this episode of CLOT Conversations, experts discuss recent research on cancer-associated thrombosis and the predictors of recurrent venous thromboembolism (VTE) and anticoagulant-related bleeding. Dr. Faizan Khan, a leading researcher in the field, explains the results of their study that aimed to offer a comprehensive understanding of the prognostic factors associated with these risks. Hear what he says about the evidence for associations of several patient- and cancer-related factors, and the risk of recurrent VTE. This research is expected to inform clinical practice by promoting a more individualized approach to anticoagulant management in cancer patients.Reference: Khan, F., Tritschler, T., Marx, C. E., Lanting, V., Rochwerg, B., Tran, A., ... & Carrier, M. (2025). Predictors of recurrent venous thromboembolism and bleeding in patients with cancer: a meta-analysis. European Heart Journal, ehaf453.https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf453/8170116?login=falseSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Melissa E. Middeldorp, MPH, PhD is joined by Thomas F. Deering, BS, MBA, MD, FHRS, CCDS, and T. Jared Bunch, MD, FHRS to discuss a 31-item questionnaire was developed and distributed among healthcare professionals via the EHRA network and social media between 23 September and 21 October 2024. https://www.hrsonline.org/education/TheLead https://academic.oup.com/europace/article/27/4/euaf075/8099191?login=false Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s):   T. Deering: Honoraria/Speaking/Consulting: Sanofi, Pacemate, Pfizer, Inc., Omny Health, Preventice Research: Abbott, Boston Scientific, Medtronic, Biotronik, Biosense Webster, Inc.,  Stock Options - Privately Held: HeartBeam Officer, Trustee, Director, Committee Chair: Board Membership T. Bunch: Honoraria/Speaking/Consulting: Pfizer, Inc. Heart Rhythm Society

Recognizing learning and development needs is an essential step for those wanting to improve operational effectiveness. Translating those needs into an actionable plan, however, is the key to unlocking true potential and the only way shift will occur. In this episode, AEU LEAD Director Joe White shares recommendations for developing a comprehensive learning and development strategy that works.View this episode on the AEU website.About JoeAs Director of AEU LEAD, Joe White focuses on helping members transform operational goals into actionable plans through a structured change management process. Prior to joining AEU, Joe was a senior consultant for E.I. DuPont's consulting division, DuPont Sustainable Solutions (DSS). He joined DSS in 2011 to develop the next generation of safety practices using extensive research in behavioral sciences he's compiled over a period of nearly two decades. His efforts resulted in the development of The Risk Factor, which is now the flagship instructor-led offering for the consulting division. Combined, Joe has 26 years of operational safety experience, the majority of which was with DuPont. Joe has been published in Occupational Health & Safety Magazine for his prominent work in safety relative to behavioral and neurosciences and is an event speaker at many leading industry conferences including National Safety Council (NSC) Congress and Expos, American Wind Energy Association (AWEA), and National Maritime Safety Association (NMSA). Joe is a graduate of Virginia Commonwealth University and has a B.S., in Safety and Risk Administration.Where you can find JoeConnect with Joe on LinkedIn======================Supervisor Skills: Secrets of Success is a production of AEU LEAD, a division of The American Equity Underwriters, Inc. With 60 years of combined industry experience, our supervisor training program gives mid-level managers in the maritime industry the skills needed to influence employees, customers, and peers. This increases employee engagement, reduces turnover and rework, and ultimately results in higher profits for their companies. Find AEU: amequity.com | Linkedin | Facebook

A patient walks in with a persistent runny nose. Is it allergies, or something more dangerous? In this episode of the BackTable ENT Podcast, two renowned rhinologists, Dr. Satyan Sreenath and Dr. Sanjeet Rangarajan, delve into the evaluation and management of cerebrospinal fluid (CSF) leaks at the anterior skull base with host Dr. Gopi Shah. --- SYNPOSIS The discussion encompasses patient presentations, differential diagnosis, physical examination, and imaging techniques for localization. They also explore the impact of underlying conditions such as idiopathic intracranial hypertension (IIH) and obstructive sleep apnea (OSA) on CSF leaks. Dr. Sreenath and Dr. Rangarjan offer insight into diagnostic strategies, patient management, and surgical planning, providing a comprehensive overview of best practices in managing this complex condition. --- TIMESTAMPS 00:00 - Introduction 02:48 - Patient Presentation and Initial Evaluation04:45 - Common Symptoms and Diagnostic Challenges06:02 - Risk Factors and Etiologies of CSF Leaks10:59 - Management and Treatment Approaches16:55 - Physical Examination and Diagnostic Techniques22:35 - Patient Instructions for Sample Collection24:29 - Differentiating CSF Leaks from Other Conditions26:12 - Endoscopic Examination Techniques30:21 - Imaging and Diagnostic Approaches33:14 - Surgical Planning and Considerations45:23 - Concluding Thoughts --- RESOURCES Satyan Sreenath https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999 Sanjeet Rangarajan https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-1649568395

A recent Review discusses the epidemiology, risk factors, diagnosis, and treatment of ovarian cancer. William Cliby, MD, and John Weroha, MD, PhD, both from the Mayo Clinic in Rochester, Minnesota, discuss this and more with JAMA Associate Editor Margaret Wheeler, MD. Related Content: Ovarian Cancer Endometriosis Typology and Ovarian Cancer Risk Screening for Ovarian Cancer ----------------------------------- JAMA Editors' Summary

In this JACC Deep Dive, Harlan M. Krumholz, MD, SM, FACC reviews a study by Covani, et al that uses OCT imaging in over 1,500 ACS patients to show how increasing cardiovascular risk factor burden—like smoking, diabetes, and hypertension—is strongly associated with vulnerable plaque features such as thin caps, inflammation, and rupture. The findings were most pronounced in STEMI patients and reinforce the biological impact of cumulative risk. Reviewers found the core results intuitive but pushed for deeper mechanistic insights, leading to a stronger final paper with improved clarity, additional analyses, and a more nuanced understanding of how traditional risk factors shape plaque instability.

Drs Kaniksha Desai and Caroline Nguyen discuss postpartum thyroiditis, including risk factors, diagnostic workup, and management strategies. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/index/list_15483_0

Over a billion people worldwide struggle with high blood pressure...     But what if you could significantly lower your risk of serious health complications—even before your numbers are fully under control?     On today's show, I'll break down a groundbreaking 14-year study involving nearly 300,000 participants.     The research uncovered 8 powerful lifestyle factors that can reduce the risk of death related to high blood pressure by up to 53%.     I'll also share practical, science-backed strategies to support heart health, longevity, and overall wellness—so you can take charge of your health journey starting today.      Tune in to today's Cabral Concept 3448 to learn how to outlive high blood pressure—and feel free to share your thoughts after the show!   - - - For Everything Mentioned In Today's Show: StephenCabral.com/3448 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

August 2025 Journal Club Podcast Title: Comparative Analysis of Outcomes and Kyphotic Risk Factors After Cervical Laminoplasty in 2 Different Ossification of the Posterior Longitudinal Ligament Groups and Cervical Spondylotic Myelopathy To read journal article: https://journals.lww.com/neurosurgery/fulltext/2025/08000/comparative_analysis_of_outcomes_and_kyphotic_risk.5.aspx Author: Hyun Woong Mun Guest Faculty: Benjamin Elder Moderator: Roxana Beladi Committee Co-Chair: Rafael Vega

Show notes at pharmacyjoe.com/episode1043. In this episode, I'll discuss the risk factors for not attaining target beta-lactam levels in ICU patients. The post 1043: Three risk factors for not attaining target beta-lactam levels in ICU patients appeared first on Pharmacy Joe.

This episode first aired on March 7, 2025.CSREs are conducted after a veteran screens positive for potential suicide risk, as part of the VA's ongoing effort to reduce the number of veterans who die by suicide. In the ongoing effort to reduce the number of veterans who die by suicide, a study identifies key factors that predict whether veterans who received a Comprehensive Suicide Risk Evaluation, the standardized suicide risk assessment implemented nationally in the Veterans Health Administration, will go on to die by their own hands.Additional Resources:Veterans Crisis Line: Accessible by phone by dialing 988 and pressing "1", by text at 838255 and by online chat.U.S. Department of Veterans Affairs Suicide PreventionUniversity of Michigan Institute for Firearm Injury Prevention Extreme Risk Protection Order Information and Implementation ToolkitIf you or someone you know may be considering suicide, or having a mental health or addiction-related crisis, the 988 Lifeline is available for free to anyone, at all times, in both English and Spanish. Call 988 from any phone, text 988 from a mobile device, or visit their live webchat, information on available help, and live help via videophone for people who are Deaf or hard of hearing, or contact the Crisis Text Line by texting TALK to 741741.Episode TranscriptFor more on this story and for others like it, visit the Health Lab website where you can subscribe to our Health Lab newsletters to receive the latest in health research and information to your inbox each week. Health Lab is a part of the Michigan Medicine Podcast Network, and is produced by the Michigan Medicine Department of Communication. You can listen to Health Lab wherever you get your podcasts.All Health Lab content including health news, best practices and research insights are for informational purposes only and are not a substitute for professional medical guidance. Always seek the advice of a health care provider for questions about your health and treatment options. Hosted on Acast. See acast.com/privacy for more information.

In this episode of Ask a Nutritionist, Britni Vincent, RD, unpacks the science behind women's increased risk for Alzheimer's. She explores the role of estrogen, blood sugar, inflammation, gut health, and even common foods and oils that could either protect or harm the brain. You'll walk away with realistic, food-first strategies to support your brain - from coconut oil and leafy greens to cutting sugar and caring for your gut. If Alzheimer's runs in your family, or you're just serious about prevention, this is a must-listen.

In this episode of Ask a Nutritionist, Britni Vincent, RD, unpacks the science behind women's increased risk for Alzheimer's. She explores the role of estrogen, blood sugar, inflammation, gut health, and even common foods and oils that could either protect or harm the brain. You'll walk away with realistic, food-first strategies to support your brain - from coconut oil and leafy greens to cutting sugar and caring for your gut. If Alzheimer's runs in your family, or you're just serious about prevention, this is a must-listen.

Host Mikalyn DeFoor, MD Guest interviewee Nicholas A. Apseloff, MD, discussing his review article, “Primary Anterior Cruciate Ligament Injury: Extrinsic and Intrinsic Risk Factors” from the July 1, 2025 issue Article summarized from the July 1, 2025 issue Review article ““FATAL Graft”: A Diagnostic Algorithm for the Workup of Anterior Cruciate Ligament Reconstruction Graft Failure” Articles summarized from the July 15, 2025 issue Two-part series: Review article “Shoulder Arthroplasty: Current Evidence and Techniques on Infection Diagnosis and Treatment” Review article “Shoulder Arthroplasty: Current Evidence and Techniques on Infection Prevention” Follow this link to download these and other articles from the July 1, 2025 issue of JAAOS and the July 15, 2025 issue of JAAOS. The JAAOS Unplugged podcast series is brought to you by the Journal of the American Academy of Orthopaedic Surgeons and the AAOS Resident Assembly.

In today's episode we are discussing 2 journal club articles relating to risk factors of glaucoma with our Mayo Clinic colleague Dr Arthur Sit.   Long-Term Systemic Use of Calcium Channel Blockers and Incidence of Primary Open-Angle Glaucoma - Ophthalmology Glaucoma Relationship between Intraocular Pressure Fluctuation and Visual Field Progression Rates in the United Kingdom Glaucoma Treatment Study - PubMed Subscribe to the podcast:  https://MayoClinicOphthalmology.podbean.com Follow and reach out to us on X and IG: @mayocliniceye

In this episode, I'm joined once again by Nyema Hermiston, a homeopath and author of Planning Parenthood in the Age of Autism. While not centered solely on homeopathy, our conversation dives deep into the extensive research Nyema uncovered about autism risk factors—and the practical, empowering steps parents can take to reduce them. From the role of nutrition and environmental toxins to the overuse of common medications, Nyema sheds light on simple yet impactful choices that can support healthier outcomes for future children. With compassion and clarity, she shares why informed decision-making is key, especially for those planning to conceive. This episode is not about blame or fear, but about offering hope, awareness, and supportive tools for families at all stages of the parenting journey. Episode Highlights: 07:16 - Inspiration Behind the Book 10:53 - How modern lifestyle choices can impact autism risk 15:10 - Empowering Parents with Information 20:36 - Most surprising findings from Nyema's research on autism 24:02 - Antibiotics and Autism Risk 27:54 - Practical Tips for Parents 30:46 - The Importance of Education for Parents 34:55 - Pain Medications and Autism Link 38:36 - Re-Education of Parents 42:34 - The Role of Fevers in Health 49:52 - Best place to get Nyema's book 50:45 - How homeopaths can benefit from the book About my Guests: Nyema Hermiston is a highly experienced healthcare practitioner whose career spans nursing, naturopathy, and homeopathy. Originally trained as a Registered Nurse, Nyema went on to study naturopathy and later specialised in homeopathy, earning an Advanced Diploma and a BSc (Hons) from Middlesex University in London. She has held prominent leadership roles in the field, including President of the Australian Homeopathic Association (NSW), Executive Officer of the Australian Register of Homeopaths, and currently serves as President of The Aurum Project, a charity dedicated to homeopathic research. With a special interest in acute childhood illnesses, Nyema is passionate about helping young children avoid unnecessary side effects from conventional medications. Her deep concern about the rising incidence of behavioural and learning disorders in children has driven her to explore and address their underlying causes through integrative, evidence-based approaches. Find out more about Nyema Website:https://karunahealthcare.com.au/ LinkedIn: https://www.linkedin.com/in/nyema-hermiston-rn-nd-adv-dip-hom-bschons-978ab879/ More info about the book and to purchase here: https://shop.karunahealthcare.com.au/collections/general-books/products/planning-parenthood-in-the-age-of-autism-a-research-based-guide   If you would like to support the Homeopathy Hangout Podcast, please consider making a donation by visiting www.EugenieKruger.com and click the DONATE button at the top of the site. Every donation about $10 will receive a shout-out on a future episode. Join my Homeopathy Hangout Podcast Facebook community here: https://www.facebook.com/groups/HelloHomies Follow me on Instagram https://www.instagram.com/eugeniekrugerhomeopathy/ Here is the link to my free 30-minute Homeopathy@Home online course: https://www.youtube.com/watch?v=vqBUpxO4pZQ&t=438s Upon completion of the course - and if you live in Australia - you can join my Facebook group for free acute advice (you'll need to answer a couple of questions about the course upon request to join): www.facebook.com/groups/eughom

Psychiatrist Carolyn Rodriguez studies hoarding disorder and says that all of us have attachments to our possessions. But for many, these attachments can disrupt daily life and even pose health risks. For those with loved ones who struggle with hoarding disorder, she says treatments exist, including cognitive behavioral therapy (CBT). Lately, she's been studying how virtual reality can augment CBT through virtual discarding practice and ways brain stimulation may improve symptoms. But, Rodriguez says, never underestimate the value of empathy for those in need of help, as she tells host Russ Altman on this episode of Stanford Engineering's The Future of Everything podcast.Have a question for Russ? Send it our way in writing or via voice memo, and it might be featured on an upcoming episode. Please introduce yourself, let us know where you're listening from, and share your question. You can send questions to thefutureofeverything@stanford.edu.Episode Reference Links:Stanford Profile: Carolyn RodriguezConnect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>> Twitter/X / Instagram / LinkedIn / FacebookChapters:(00:00:00) IntroductionRuss Altman introduces Carolyn Rodriguez, a professor of psychiatry and behavioral science at Stanford University.(00:02:47) Motivation to Study Hoarding DisorderWhy Carolyn chose to focus her research on hoarding disorder.(00:03:44) Collecting Versus HoardingDistinguishing between normal behavior and clinically significant hoarding.(00:05:47) Prevalence of Hoarding DisorderThe universality and pervasiveness of hoarding disorder.(00:07:11) The Brain Science Behind HoardingEarly neuroscience findings on attachment and discarding behavior.(00:08:47) Dopamine and Excessive AcquisitionThe connection between hoarding and potential dopamine reward pathways.(00:09:55) Risk Factors and Cognitive ChallengesPersonality traits, genetics, and processing difficulties involved in hoarding.(00:11:14) Gender Differences and Insight IssuesGender prevalence in treatment-seeking and the concept of anosognosia.(00:12:35) The “Why” Behind HoardingHow motivations and emotional attachments influence behavior.(00:13:50) Onset and Progression of DisorderTypical onset age, aging effects, and early warning signs.(00:15:05) Historical References to HoardingAccounts from ancient literature of hoarding-like behavior(00:17:16) Attachment to ObjectsThe emotional, aesthetic, and identity-based reasons people retain objects.(00:20:45) Current Treatment OptionsThe treatment landscape, including lack of medications and focus on CBT.(00:22:30) Chronic Nature of Hoarding DisorderFraming hoarding as a long-term condition with hopeful outcomes.(00:23:08) Virtual Reality for TreatmentA study on using VR to safely practice letting go of personal items.(00:25:58) Neuromodulation ResearchUsing non-invasive brain stimulation to reduce acquisition urges.(00:27:00) Advice for Individuals and FamiliesThe importance of empathy and self-care for individuals and caregivers.(00:28:47) Conclusion Connect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>>Twitter/X / Instagram / LinkedIn / Facebook

Discover the secret powers of real estate syndications with Rob Natale. Learn how passive investing, tax benefits, and strategic planning can unlock your financial freedom and help you achieve work-optional living.See full article: https://www.unitedstatesrealestateinvestor.com/discovering-financial-freedom-treasures-through-real-estate-syndications-with-rob-natale/(00:03) - Introduction to The REI Agent Podcast(00:20) - Erica's Absence: Weekly Update with Mattias(01:10) - Preview of Syndications and Fund of Funds(02:30) - Facing Fear and Overcoming Self-Doubt(05:15) - Rob Natale Joins the Show: From Wall Street to Real Estate(07:45) - What is a Syndication? Breaking it Down(10:20) - Understanding the Fund of Funds Model(12:00) - Rob's Journey into Passive Real Estate Investing(15:40) - Why Real Estate Syndications Are Not Common Knowledge(18:00) - Vetting General Partners and Minimizing Risk(22:30) - Understanding Deal Structures and Risk Factors(26:10) - Tax Benefits and Cost Segregation in Real Estate(30:45) - Building Your Financial Team for Success(34:20) - Accredited vs. Non-Accredited Investors Explained(38:00) - Tools and Resources for Learning About Syndications(41:15) - Rob's Book Recommendation: The Power of One More(43:00) - Closing Thoughts and Connecting with Rob NataleContact Rob NataleNorth Square CapitalFacebookInstagramLinkedIn--For more investing insight, go to reiagent.com

Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Today we're going to talk about thymosin alpa 1, what it is, how it works, and why some doctors are using it to help those with Lyme disease What Is Thymosin Alpha 1? Let's start with the basics. Now we've talked about thymosin alpha 1 before in the context of immune health, but as a quick refresher, Thymosin alpha 1, or Tα1, is a peptide — a small chain of amino acids — that occurs naturally in the body.  It was first isolated from the thymus gland, which is an important immune organ responsible for developing and regulating T cells, especially during childhood. T cells are a type of white blood cell that play a central role in the immune system by identifying and destroying infected or abnormal cells and coordinating immune responses. Over time, our thymus shrinks and our immune response tends to slow down — which may partly explain why chronic infections or immune dysregulation become more common with age. Thymosin alpha 1 acts like an immune system coach — it doesn't directly kill pathogens, but it enhances the immune system's ability to detect and fight infections. In fact, it's made a big impact around the world.   Since its discovery in the 1970s, it's been used in over 35 countries to help treat conditions like hepatitis B and C, certain cancers, and even sepsis. During the COVID-19 pandemic, researchers explored its potential to calm immune overreactions and improve patient outcomes. It's also popular in veterinary medicine for helping dogs with chronic infections. Plus, some doctors are now investigating its role in boosting vaccine effectiveness and supporting people with autoimmune diseases or age-related immune decline — making thymosin alpha 1 a real immune multitasker. Thymosin Alpha 1 and Lyme Disease So why are doctors using thymosin alpha 1 in Lyme disease? Well, for many people, Lyme can become a long, drawn-out illness. And while antibiotics are usually the first-line treatment, some patients don't recover fully — instead, they develop lingering symptoms like fatigue, brain fog, joint pain, or neurological issues. This condition is known as Post-Treatment Lyme Disease Syndrome, or PTLDS — and we'll dive deeper into that in just a minute. In Lyme patients, Thymosin alpha 1 is being used off-label to: Rebalance the immune system Enhance the activity of T cells and natural killer cells Calm overactive inflammation Reduce the intensity and frequency of flare-ups or immune crashes Doctors report that patients using thymosin alpha 1 often feel more resilient — with improved energy, mental clarity, and fewer immune complications — especially in cases involving co-infections like Babesia, Bartonella, or Epstein-Barr virus. What Is PTLDS? Now let's dig into what happens after Lyme disease treatment for some patients. Post-Treatment Lyme Disease Syndrome, or PTLDS, affects roughly 5 to 20 percent of people who have been treated for Lyme disease. Even after completing a full course of antibiotics, they continue to experience significant symptoms that can last for months — or even years. Some of the most common symptoms of PTLDS include: Chronic fatigue that doesn't improve with rest Brain fog, poor memory, or difficulty concentrating (sometimes called 'Lyme brain') Joint and muscle pain Sleep disturbances Numbness, tingling, or burning sensations (peripheral neuropathy) Depression, anxiety, or mood swings Sensitivity to light, sound, or smells Dizziness or balance issues And often, fluctuating or cyclical symptoms — where you feel better for a while, then suddenly crash These symptoms can be disabling, and they're often not reflected in standard lab tests, which can make patients feel dismissed or misdiagnosed. Why Does PTLDS Happen? Researchers are still working to understand why PTLDS happens, but here are some of the leading theories: Immune system dysregulation – The infection may trigger a chronic inflammatory state that lingers long after the bacteria are gone. Persistent infection – Some believe the bacteria can go into a low-metabolic or dormant state, evading antibiotics and reactivating later. Tissue damage – Nerve and joint tissues may have been injured and take a long time to heal. Autoimmune activation – The body may start attacking its own tissues after the infection — similar to what happens in rheumatic fever. Undiagnosed co-infections – Other pathogens like Bartonella or Babesia may still be active and complicate recovery. This is where thymosin alpha 1 may offer a new path — not as a cure, but as a modulator that can help restore immune balance and reduce inflammatory damage. Thymosin Alpha 1 Risk Factors and Who Should Avoid It Thymosin alpha 1 is generally considered safe and well tolerated, especially because it mimics a peptide your body already makes. But like all therapies, it's not for everyone. Possible side effects include: Mild injection site reactions Fatigue, nausea, or headache (usually early in treatment) Not everyone is a good candidate for thymosin alpha 1, so it's important to know who should be cautious. For starters, if you're pregnant or breastfeeding, it's best to avoid it—there just isn't enough safety data available yet. People taking immunosuppressant medications, like those who've had organ transplants, should also steer clear because thymosin alpha 1 stimulates the immune system and could interfere with those drugs. And if you have an autoimmune condition, it's a bit of a gray area. While some people tolerate it well with low, carefully monitored doses, others might experience a flare, so it's definitely something to discuss with a knowledgeable healthcare provider. It's best to always consult with a healthcare provider experienced in peptide therapies and Lyme disease before starting treatment. The Bottom Line So to sum it all up, thymosin alpha 1 is a promising immune-supporting peptide that's gaining attention in the world of chronic illness—especially for conditions like Lyme disease and PTLDS. It's not a replacement for antibiotics and it doesn't directly kill infections, but it may help bring balance to an immune system that's either overreacting or underperforming. It's also being used to calm inflammation, support healing, and help people feel more resilient as they work through long-term symptoms. If you or a loved one are struggling with lingering symptoms from Lyme disease, chronic fatigue, or an immune system that just won't seem to bounce back, you're not alone. Talk to your family physician and ask if they can steer you toward a specialist familiar with peptide therapy and Lyme disease. Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Until next time, be well, be patient, and as always, have a happy, healthy week.

In this episode of the Saving Lives Podcast, we review a comprehensive 2025 meta-analysis on mortality risk factors in pulmonary embolism. Learn which clinical signs, biomarkers, and imaging findings most strongly predict outcomes — and how they can guide triage and therapy decisions in acute PE cases. A must-listen for anyone managing thromboembolic disease in the critically ill patients.The Vasopressor & Inotrope HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: You W, Fan XY, Chen Y, Wang XL, Song J, Nie CC, Dong Q. Risk Factors for Mortality in Patients with Pulmonary Embolism-A Meta-Analysis. J Intensive Care Med. 2025 May 5:8850666251326539. doi: 10.1177/08850666251326539. Epub ahead of print. PMID: 40320917.

Modern Wisdom: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- Dr. Daniel Amen is a psychiatrist, brain-health researcher, founder of the Amen Clinics & New York Times bestselling author. You only get one brain, so how do you keep it healthy for life? Dr. Daniel Amen has scanned over half a million brains and knows exactly what helps and what hurts your brain. Using cutting-edge research and science-backed strategies, Dr. Amen reveals the keys to keeping your mind sharp and your body thriving. Expect to learn how to kill your automatic negative thoughts (ANTS), what a healthy brain should look like, what is contributing to the mental health crisis of the younger generations, the true impacts of alcohol, weed and other substances on your brain, the best supplements to take for brain health, how to rewire your brain to be a better romantic partner, how to get rid of brain fog, the best exercises and activity for a better functioning brain, and much more… Sponsors: See discounts for all the products I use and recommend: https://chriswillx.com/deals Get a 20% discount on Nomatic's amazing luggage at https://nomatic.com/modernwisdom Get a Free Sample Pack of LMNT's most popular Flavours with your first purchase at https://drinklmnt.com/modernwisdom Get the best bloodwork analysis in America at https://functionhealth.com/modernwisdom Get 35% off your first subscription on the best supplements from Momentous at https://livemomentous.com/modernwisdom Extra Stuff: Get my free reading list of 100 books to read before you die: https://chriswillx.com/books Try my productivity energy drink Neutonic: https://neutonic.com/modernwisdom Episodes You Might Enjoy: #577 - David Goggins - This Is How To Master Your Life: https://tinyurl.com/43hv6y59 #712 - Dr Jordan Peterson - How To Destroy Your Negative Beliefs: https://tinyurl.com/2rtz7avf #700 - Dr Andrew Huberman - The Secret Tools To Hack Your Brain: https://tinyurl.com/3ccn5vkp - Get In Touch: Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact - Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of 'Science of Slink,' Dr. Rosy Boa delves into what every pole dancer should know about exercising in extreme heat. Key topics include the physiological adaptations to heat acclimatization that typically occur within two weeks, the symptoms and handling of heat exhaustion versus heat stroke, and specific risk factors such as dehydration and medications. She also shares practical tips for pole dancers, such as managing equipment and grip issues, staying hydrated, and taking frequent breaks to avoid heat-related illnesses. Emphasis is placed on listening to one's body, recognizing the varied individual responses to heat, and prioritizing safety over performance.Are you a pole nerd interested in trying out online pole classes with Slink Through Strength? We'd love to have you! Use the code “podcast” for 10% off the Intro Pack and try out all of our unique online pole classes: https://app.acuityscheduling.com/catalog/25a67bd1/?productId=1828315&clearCart=true Chapters:00:00 Introduction and Episode Overview01:45 The Science of Sweating02:54 Heat Acclimatization in Athletes06:52 Physiological Adaptations to Heat11:27 Recognizing and Preventing Heat Exhaustion and Heat Stroke18:06 Risk Factors for Heat-Related Illnesses24:34 Pole Dancing in Hot Conditions29:52 Final Tips and RecommendationsCitations/further reading:Mayo Foundation for Medical Education and Research. (2023, April 6). Heat exhaustion. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250Howe, A. S., & Boden, B. P. (2007). Heat-related illness in athletes. The American journal of sports medicine, 35(8), 1384-1395.Nobel, G., Tribukait, A., Mekjavic, I. B., & Eiken, O. (2012). Effects of motion sickness on thermoregulatory responses in a thermoneutral air environment. European journal of applied physiology, 112, 1717-1723.Périard, J. D., Racinais, S., & Sawka, M. N. (2015). Adaptations and mechanisms of human heat acclimation: applications for competitive athletes and sports. Scandinavian journal of medicine & science in sports, 25, 20-38.Sawka, M. N., Leon, L. R., Montain, S. J., & Sonna, L. A. (2011). Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress. Compr Physiol, 1(4), 1883-1928.

In this episode of PT Snacks Podcast, host Kasey Hankins addresses the challenge of identifying and treating bone stress injuries (BSIs) before they progress into stress fractures. Kasey delves into the biology of bone stress, detailing how osteoblasts and osteoclasts respond to stress, and discusses common risk factors for BSIs among athletes and military personnel. The episode offers practical advice on clinical assessment, including the limitations of x-rays and the benefits of MRIs, and provides strategies for effective treatment and prevention through offloading, load restoration, and performance enhancement phases. Listeners are encouraged to watch out for early symptoms and are directed to additional resources for continuing education.00:00 Introduction to Bone Stress Injuries01:15 Understanding Bone Stress Injuries (BSIs)04:18 Risk Factors and Clinical Presentation07:20 Diagnosis and Imaging Techniques09:15 Treatment and Rehabilitation Phases13:03 Summary and Additional ResourcesGet $126 off an individual MedBridge subscription or 10% off a group plan during their Mid-Year Anniversary Sale, June 23–30! Use code PTSNACKSPODCASTSUMMER at checkout.

Dr. Daniel Amen is a psychiatrist, brain-health researcher, founder of the Amen Clinics & New York Times bestselling author. You only get one brain, so how do you keep it healthy for life? Dr. Daniel Amen has scanned over half a million brains and knows exactly what helps and what hurts your brain. Using cutting-edge research and science-backed strategies, Dr. Amen reveals the keys to keeping your mind sharp and your body thriving. Expect to learn how to kill your automatic negative thoughts (ANTS), what a healthy brain should look like, what is contributing to the mental health crisis of the younger generations, the true impacts of alcohol, weed and other substances on your brain, the best supplements to take for brain health, how to rewire your brain to be a better romantic partner, how to get rid of brain fog, the best exercises and activity for a better functioning brain, and much more… Sponsors: See discounts for all the products I use and recommend: https://chriswillx.com/deals Get a 20% discount on Nomatic's amazing luggage at https://nomatic.com/modernwisdom Get a Free Sample Pack of LMNT's most popular Flavours with your first purchase at https://drinklmnt.com/modernwisdom Get the best bloodwork analysis in America at https://functionhealth.com/modernwisdom Get 35% off your first subscription on the best supplements from Momentous at https://livemomentous.com/modernwisdom Extra Stuff: Get my free reading list of 100 books to read before you die: https://chriswillx.com/books Try my productivity energy drink Neutonic: https://neutonic.com/modernwisdom Episodes You Might Enjoy: #577 - David Goggins - This Is How To Master Your Life: https://tinyurl.com/43hv6y59 #712 - Dr Jordan Peterson - How To Destroy Your Negative Beliefs: https://tinyurl.com/2rtz7avf #700 - Dr Andrew Huberman - The Secret Tools To Hack Your Brain: https://tinyurl.com/3ccn5vkp - Get In Touch: Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact - Learn more about your ad choices. Visit megaphone.fm/adchoices

If you've ever been prescribed medication for overactive bladder, you might wonder what it's actually doing and what the risks are. In this episode, I break down the two main types of medications used to treat OAB: anticholinergics and beta-3 agonists. We'll talk about how they work, the side effects (including memory concerns), and how to weigh the benefits and risks. I also explore alternative options like Botox and nerve stimulation, and why shared decision-making with your provider matters more than ever. If bladder urgency or leaking has been part of your life, this episode will help you make informed, confident choices about your treatment path.For more information on this topic: https://journals.lww.com/fpmrs/abstract/2017/05000/augs_consensus_statement__association_of.4.aspx#:~:text=Given%20the%20available%20evidence%2C%20which,medications%20in%20patients%20at%20risk.https://pubmed.ncbi.nlm.nih.gov/34213600/Timeline00:30 Introduction to Overactive Bladder 00:48 Behavioral Treatments for Overactive Bladder 00:57 Medications for Overactive Bladder 01:18 Anticholinergic Medications and Memory Concerns 01:37 Types of Medications for Overactive Bladder 03:55 Studies on Anticholinergics and Cognitive Impairment 03:23 Clinical Guidelines and Recommendations 04:26 Prevalence and Types of Overactive Bladder 05:00 Side Effects and Risk Factors 05:38 Research Findings on Anticholinergics 08:32 Considerations for Prescribing Medications 10:38 Alternative Treatments and Final Thoughts

This month's FLOW delves into the 'Iron Ladies' research - they investigate iron deficiency's prevalence among women with bleeding disorders, the importance of routine screening, the challenges in setting standardized care practices, and the historical exclusion of women from clinical trials. Featuring Dr. Megnahn McCormick, a doctor passionate about treating iron deficiency.   Program Notes:   Episode Links: Bloodstream Media: https://www.bloodstreammedia.com/ The Iron Ladies Study: The Iron Ladies: Prevalence and Risk Factors of Iron Deficiency in Females With Bleeding Disorders - McCormick - Haemophilia - Wiley Online Library A study presenting the data available through the ATHN dataset on women and girls with bleeding disorders* A Cross-Sectional Study of Women and Girls with Congenital Bleeding Disorders: The American Thrombosis and Hemostasis Network Cohort | Journal of Women's Health *includes a discussion on how participation in the dataset is not complete and how work is being done to remedy this! An article about the impact of Thalidomide on FDA regulation: How medical research changed after thalidomide More in depth on Thalidomide: Clinical Trials in Pregnancy and the “Shadows of Thalidomide”:Revisiting the Legacy of Frances Kelsey - PMC Information about what is identified as a “normal” hemoglobin; and how  women who are iron-replete hemoglobin values are similar to men:  “These findings highlight sex-based inequities that lead to normalization of disease states and the critical need to update hematologic ranges truly reflective of iron repletion.” Sex, lies, and iron deficiency: a call to change ferritin reference ranges | Hematology, ASH Education Program | American Society of Hematology 2021 article, Iron Ladies: Variation in the Identification and Management of Iron Deficiency in Women with Bleeding Disorders: https://www.sciencedirect.com/science/article/pii/S0006497121030202   How's Your Flow? We wanna know (Calendly link): https://calendly.com/flowtalk/flow-talk-period-pain-stories   HOST: Jessica RIchmond Website: jrich.online IG, @jessicalaurenrichmond  Twitter @geniuspills  Tik Tok @jrichsocal   HOST: Sarah Watson Website: sarahwatsonlpc.com Podcast: Behind The Bedroom Door Facebook: @sarahwatsonlpcsextherapy IG @swsxtherapy Twitter @swsextherapy   Presenting Sponsor: #Takeda, visit bleedingdisorders.com to learn more.   Connect with BloodStream Media: Find all of our bleeding disorders podcasts on  BloodStreamMedia.com BloodStream on Facebook  BloodStream on Twitter    Check out Believe Limited's Other Work: BloodFeed: bloodfeed.com Bombardier Blood: bombardierblood.com Hemophilia: The Musical: breakingthroughhemophilia.com My Beautiful Stutter: mybeautifulstutter.com/ Stop The Bleeding!: stbhemo.com Teen Impact Awards: teenimpactawards.com The Science Fair: thesciencefair.org  

Today, we're digging DEEP into a topic that's as terrifying as it is necessary—how to spot the warning signs when someone isn't who they seem to be. Seriously, this episode had me clutching my pearls and simultaneously feeling more empowered than ever. I'm bringing you someone who has literally walked into the darkest places on earth—prisons, forensic hospitals, you name it—and come out without losing her compassion or her curiosity. Dr. Gwen Adshead is a forensic psychotherapist, author of "The Devil You Know," and all-around badass when it comes to deciphering what really lies beneath the “mask of normalcy.” We talk about manipulative personalities, red flags in relationships, attachment styles, and build out a legit tool belt for keeping our power and protecting ourselves from harm. Ladies, if you've ever felt like you missed the signs, if you've ever asked yourself, “What did I not see coming?” or just want to build the skills to stand tall no matter who's in front of you—THIS is the episode you need. Grab your notebook, because Dr. Gwen drops truth bombs, actionable red flags, and shows you how to keep your cool even in the most toxic situations. Let's get STRONGER and SAFER together. You ready? SHOWNOTES 00:00 How Evil Can Wear a Mask: Spotting Dangerous Traits 00:06:39 The "False Mask of Normalcy" and Why We Miss the Signs 00:07:00 11 Red Flags That Reveal Who's Behind the Mask 00:19:09 What is Attachment Theory? And Why It Matters for Women 00:22:02 Why Pregnancy Triggers Domestic Violence 00:29:23 Rule Breakers and Risk Factors 00:32:08 Grandiosity, Narcissism, and Dangerous Audacity 00:34:46 Why Absolute Thinking Becomes a Trap—For Us AND Them 00:37:05 False Victimhood as Manipulation 00:39:34 How to Talk to a Psychopath: Staying Emotionally Sober 00:43:44 Protecting Your Sense of Reality 00:45:10 Building Your Personal Tool Belt: Never Let Anyone Take Your Power! FOLLOW DR. GWEN ADSHEAD: Book: The Devil You Know (available on Amazon: https://www.amazon.com/Devil-You-Know-Gwen-Adshead/dp/198213480X ) BBC Lectures: https://www.bbc.co.uk/programmes/m001rm8y (also available via YouTube search) Academic Profile: https://scholar.google.com/scholar?q=Gwen+Adshead CHECK OUT OUR SPONSORS Vital Proteins: Get 20% off by going to ⁠https://www.vitalproteins.com⁠ and entering promo code WOI at check out.  BIOptimizers: Head to⁠ https://bioptimizers.com/impact ⁠and use code IMPACT for 10% off.  OneSkin: Get 15% off with code LISA at ⁠https://oneskin.co ⁠ Netsuite: Download the new e-book Navigating Global Trade: 3 Insights for Leaders at ⁠http://NetSuite.com/women⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Chronic sinusitis might be doing more than just clogging your nose–it could be clouding your brain. In this episode of Backtable ENT, Dr. Aria Jafari, an assistant professor at the University of Washington and co-director of the Neuroendocrinology Advanced Sinus and Skull-base Surgery Fellowship, discusses the connection between sinusitis and cognitive dysfunction with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Jafari shares how his interest in this field developed and details his research on the relationship between chronic rhinosinusitis (CRS) and brain function. The conversation highlights the comprehensive impact of sinus inflammation on overall health, emphasizing the importance of viewing CRS as a whole-body condition. They also discuss patient experiences, the methodologies used to assess cognitive dysfunction, potential treatments, and what's next in the research frontier.---TIMESTAMPS00:00 - Introduction 06:18 - The Impact of CRS on Quality of Life14:02 - Understanding Brain Fog and Cognitive Dysfunction24:29 - Pathophysiology and Theories of Cognitive Dysfunction27:44 - Chronic Inflammation and Cognitive Effects28:59 - Impact of Biologics on Cognitive Function31:28 - Risk Factors for Cognitive Dysfunction35:02 - Olfactory Symptoms 37:13 - Future Research and Treatment Approaches45:31 - Conclusion and Final Thoughts --- RESOURCES Dr. Aria Jafari https://www.uwmedicine.org/bios/aria-jafari

This week we move into the arena of preventive cardiology when we review a recent report from the team at Northwestern and Princeton on the impact of early childhood food insecurity on cardiovascular health of people in young adulthood. How does food insecurity in young childhood impact the cardiac health of adults? Why is most of the impact seen on BMI but not other measures of cardiovascular health. How can food programs that support improved food and nutrition security work to improve long term cardiovascular health of children and adults? Do the benefits of such programs outweight their costs? Dr. Nilay Shah of Northwestern University shares his deep insights into his work and these questions this week.DOI: 10.1001/jamacardio.2025.1062

Episode Highlights With Dr. Anne Marie FineWhat happened with autism and why rates have risen from 1 in 10,000 to 1 in 31Some of the multi-faceted reasons that it might be on the riseWhat the literature actually says… you might be surprisedBeyond the genetic theory… the interaction between genes and environment Genes load the gun, environment pulls the triggerWomen with the highest BPA exposure had the highest risk of having children with autismThe CDC is actually keeping track of Americans' chemical exposureWhat to know about mercury and autism risk and how it was taken out of vaccines by 2001The specific study about the Hep B vaccine and why it's relevant Mercury was replaced with aluminum and why this is important How to become the EPA of your own home and avoid some of the biggest risk factorsResources MentionedDr. AnneMarieFine and emeiglobal on InstagramHer LinkedIn and her FacebookHow to Thrive in a Toxic World course: contains a bonus video presentation on environmental contributors to autism.Jaspr air filter - use code wellnessmama for a discountRadiant Life Water Filter

Why do so many promising solutions in education, medicine, and criminal justice fail to scale up into great policy? And can a new breed of “implementation scientists” crack the code? SOURCES:Patti Chamberlain, senior research scientist at the Oregon Social Learning Center.John List, professor of economics at the University of Chicago.Lauren Supplee, former deputy chief operating officer at Child Trends.Dana L. Suskind, professor of surgery at the University of Chicago. RESOURCES:“How Can Experiments Play a Greater Role in Public Policy? 12 Proposals from an Economic Model of Scaling,” by Omar Al-Ubaydli, John List, Claire Mackevicius, Min Sok Lee, and Dana Suskind.“The Science of Using Science: Towards an Understanding of the Threats to Scaling Experiments,” by Omar Al-Ubaydli, John List, and Dana Suskind (The Field Experiments Website, 2019).“Inconsistent Device Use in Pediatric Cochlear Implant Users: Prevalence and Risk Factors,” by K.B.Wiseman and A.D. Warner-Czyz (U.S. National Library of Medicine National Institutes of Health, 2018). EXTRAS:"Why Do Most Ideas Fail to Scale?" by Freakonomics Radio (2022)."The Price of Doing Business with John List," by People I (Mostly) Admire (2022).Child Trends.Oregon Social Learning Center.T.M.W. Center for Early Learning and Public Health.The Field Experiments Website.