Podcasts about Subcutaneous

Blood Sweat & Gear 304 Coaches Skip Hill, Andrew Berry, Scott McNally 00:00 Introduction & Youtube Friendly Advertisers 01:21 Exploring IGF-1 LR3 for Muscle Growth 05:26 Subcutaneous vs. Intramuscular Injections of Tren 08:18 Orals 4 wks on, 4 wks off 14:02 Evaluating Compound Effectiveness for Muscle Growth 17:05 Injectable L-Carnitine Making a comeback 19:15 Retatrutide - New Experiment with timing 21:20 Filling the muscle out on Retatrutide 25:09 Discussion on Estradiol Supplementation 29:00 Building Trust with Sources and sourcing legit products 37:12 Spotting fake sources 41:45 Highest Liver Vales on Orals in Prep 46:00 Appetite Changes with Anabolic Use 48:25 Longest Dianabol ( Metandienone ) Cycle 49:00 Carb Timing, Fat Loss Windows and Insulin Spikes 54:45 Showcasing Success Stories ✅ ✅New Peptide and Research Chem Affiliate : https://modernaminos.com/?ref=thinkbig ✅ ✅Code THINKBIG

***JOIN THE NEXT MASTER YOUR FASTING CHALLENGE THAT STARTS June 25th, 2025!*** We'll GUIDE you on how to FAST to LOSE FAT for good, and use 'fast cycling' to achieve uncommon results! ⁠⁠⁠⁠REGISTER HERE!⁠⁠⁠⁠ Click the Link for DATES, DETAILS, and FAQs! This episode reveals how fasting literally shrinks fat cells by keeping insulin low, with Dr. Scott and Tommy breaking down the science behind why 95% of diets fail but fasting succeeds long-term. Discover how consistent fasting can boost your metabolic rate by 300 calories per day - that's 2,100 extra calories burned weekly without additional exercise. Learn the crucial difference between visceral and subcutaneous fat storage, why fructose from drinks creates dangerous belly fat, and how overfilled fat cells become metabolically active troublemakers that block satiety signals. The hosts share why protein must be your priority during eating windows (aim for 40% of your intake), when to shift your eating window earlier in the day for better insulin sensitivity, and how to avoid the "breakfast blunder" that keeps you hungry all day. If you're tired of the diet roller coaster and want a sustainable approach that works with your body's natural fat-burning mechanisms, this episode provides the insulin-focused strategy for lasting results. ⁠⁠Take the NEW FASTING PERSONA QUIZ! - The Key to Unlocking Sustainable Weight Loss With Fasting!⁠⁠⁠ Resources and Downloads: ⁠⁠⁠SIGN UP FOR THE DROP OF THE ULTIMATE GUIDE TO BLOOD SUGAR CONTROL⁠⁠⁠ ⁠⁠⁠GRAB THE OPTIMAL RANGES FOR LAB WORK HERE! - NEW RESOURCE! ⁠ ⁠⁠⁠FREE RESOURCE - DOWNLOAD THE NEW BLUEPRINT TO FASTING FOR FAT LOSS!⁠⁠⁠ ⁠⁠⁠SLEEP GUIDE DIRECT DOWNLOAD⁠⁠⁠ ⁠⁠⁠DOWNLOAD THE FASTING TRANSFORMATION JOURNAL HERE!⁠⁠⁠ Partner Links: Get your⁠⁠⁠ FREE BOX OF LMNT⁠⁠⁠ hydration support for the perfect electrolyte balance for your fasting lifestyle with your first purchase⁠⁠⁠ here!⁠⁠⁠ Get ⁠⁠⁠30% off a Keto-Mojo⁠⁠⁠ blood glucose and ketone monitor (discount shown at checkout)! ⁠⁠⁠Click here!⁠⁠⁠ Our Community: Let's continue the conversation. Click the link below to JOIN the ⁠⁠⁠Fasting For Life Community⁠⁠⁠, a group of like-minded, new, and experienced fasters! The first two rules of fasting need not apply! If you enjoy the podcast, please tap the stars below and consider leaving a short review on Apple Podcasts/iTunes. It takes less than 60 seconds, and it helps bring you the best original content each week. We also enjoy reading them!

Guest: Jorge Nieva, MD As cancer treatment continues to evolve, at-home subcutaneous immunotherapy is at the forefront of decentralized care and research. Here to share his insights on how this delivery model could impact clinical trials and cancer care is Dr. Jorge Nieva, Associate Professor of Clinical Medicine at the University of Southern California's Keck School of Medicine.

Guest: Jorge Nieva, MD Despite the promising benefits for cancer patients, the at-home administration of subcutaneous immunotherapy poses complex operational and logistical challenges, like cost, payer preferences, and patient safety. Tune in to hear Dr. Jorge Nieva discuss these key factors and considerations impacting the implementation of at-home subcutaneous cancer immunotherapy delivery. Dr. Nieva is an Associate Professor of Clinical Medicine at the University of Southern California's Keck School of Medicine.

Guest: Jorge Nieva, MD As immunotherapy becomes a cornerstone for treating a growing number of solid tumors, reducing the logistical burden of in-office care is essential. Fortunately, the at-home administration of subcutaneous formulations of immunotherapy agents like atezolizumab could help transform the way we care for patients with cancer. Learn more with Dr. Jorge Nieva, Associate Professor of Clinical Medicine at the University of Southern California's Keck School of Medicine.

Guest: Jorge Nieva, MD Can the immune checkpoint inhibitor atezolizumab be safely administered subcutaneously at home for patients with non-small cell lung cancer (NSCLC)? That's the exact question an ongoing study is seeking to answer, and here to discuss the study's objective, design, and potential implications for home-based subcutaneous cancer therapies is Dr. Jorge Nivea. He's an Associate Professor of Clinical Medicine at the University of Southern California's Keck School of Medicine.

Titan Medical Center Owner/CEO John Tsikouris along side Titan athlete and bodybuilder Big Dru discuss the Enhanced games swimmer who reportedly broke the world record being on PEDs, they also discuss the difference between Subcutaneous and Visceral Fat, and lately they answer YOUR health and fitness questions.

The FDA approval of TAVR for asymptomatic AS, digital health, subcutaneous vs transvenous ICD, and cryptogenic stroke in young adults are discussed by John Mandrola, MD. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I  FDA announces approval for TAVR in pts with asymptomatic AS Edwards Press Release https://www.edwards.com/newsroom/news/2025-05-01-edwards-tavr-receives-fda-approval-for-patients-with-asymptomatic-severe-aortic-stenosis Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis (EARLY TAVR) https://www.nejm.org/doi/full/10.1056/NEJMoa2405880 EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec Asymptomatic Aortic Stenosis: 'Time to Act' or Not So Fast? https://www.medscape.com/viewarticle/asymptomatic-aortic-stenosis-time-act-or-not-so-fast-2025a10005o9 II PPG that Can Distinguish source of Tachycardia Machine-learning guided differentiation between photoplethysmography waveforms of supraventricular and ventricular origin https://doi.org/10.1016/j.cmpb.2025.108798 III PRAETORIAN -XL trial Device-related Complications in Transvenous Versus Subcutaneous Defibrillator Therapy During Long-term Follow-up: the PRAETORIAN-XL Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074576 Subcutaneous or Transvenous Defibrillator Therapy (PRAETORIAN trial) https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 Subcutaneous or Transvenous Defibrillator Therapy Letter to Editor https://www.nejm.org/doi/full/10.1056/NEJMc2034917 The PRAETORIAN Trial: Guarded Approach to Subcutaneous ICD Best https://www.medscape.com/viewarticle/937156 IV Stroke in Young People Burden of Modifiable Risk Factors in Young-Onset Cryptogenic Ischemic Stroke by High-Risk Patent Foramen Ovale https://www.ahajournals.org/doi/10.1161/STROKEAHA.124.049855 Migraine: A Key Factor in Young Adults With Unexplained Stroke https://www.medscape.com/viewarticle/migraine-key-factor-young-adults-unexplained-stroke-2025a10009jj U.S. stroke rate declining in adults 75 and older, yet rising in adults 49 and younger ASA statement https://newsroom.heart.org/news/u-s-stroke-rate-declining-in-adults-75-and-older-yet-rising-in-adults-49-and-younger Increasing stroke in the young https://doi.org/10.1016/j.ajpc.2020.100085 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

BSG Bodybuilding Coaching Podcast - Growth Hormone Weekly Breakdown, Timing with Training, Insulin, Food. Intramuscular vs Subcutaneous? Off Season vs Cut Protocol. PLUS Retatrutide Dosing & Loading Carbs. Coaches Skip Hill, Andrew Berry, Scott McNally Ft Paul Barnett of Anabolic Bodybuilding 0:00 Teaser 0:20 Welcome Paul Barnett ! 1:40 Splitting 60iu GH Per Week 5:30 GH Cosmetic fullness & Leaner Look 7:15 GH Increased Fat Burning Effect & Blood Sugar 8:25 Insulin Timing & GH 12:25 GH Off Season vs Fat Loss Dieting 13:10 Days on GH vs Days Off 15:30 Pau's GH timing 17:00 IM vs Sub Q 20:10 Maintaining Strength AFTER Cycle 24:45 Getting stronger on cruise ? 28:30 Judging Bodyfat Percentage 38:40 300 Test, 300 Deca, 300 EQ - Cycle Critique 47:30 Retatrutide - Effect Low Dosing 49:30 Being Flat on Retatrutide & Filling Out 51:30 Retatrutide Side Effects 56:00 Paul's Surgery & Recovery Protocol 1:02:00 How Paul got injured 1:05:45 Anabolic Bodybuilding! 1:06:00 Bodybuilding Travel Plans For The Guys This Year Follow Paul on ⁨@anabolicbodybuilding⁩ Reach out to the guys for coaching !

Featuring an interview with Dr William K Oh, including the following topics: Use of secondary hormonal agents for patients with metastatic hormone-sensitive prostate cancer (0:00) Data supporting the clinical activity of PARP inhibitors for metastatic castration-resistant prostate cancer (mCRPC) (11:10) Radiopharmaceuticals for the treatment of mCRPC (16:53) Available data on cabozantinib for mCRPC (24:38) Cabozantinib combinations for advanced renal cell carcinoma (RCC) (26:17) Subcutaneous nivolumab versus intravenous nivolumab for advanced RCC (30:00) Addition of nivolumab to tivozanib compared to tivozanib alone in advanced relapsed/refractory RCC previously treated with an immune checkpoint inhibitor (31:28) Long-term follow-up with belzutifan for relapsed/refractory advanced RCC (33:39) Major findings from the NIAGARA study of perioperative durvalumab for muscle-invasive bladder cancer (MIBC) (35:44) Data surrounding adjuvant immunotherapy for MIBC (38:07) Clinical development of TAR-200 for high-risk non-muscle-invasive bladder cancer (39:44) Updated analysis of EV-302 study of enfortumab vedotin in combination with pembrolizumab for previously untreated advanced urothelial cancer (UC) (41:06) Implementation of emerging data in the treatment landscape of UC (41:56) CME information and select publications

Join host Michael S. Lloyd, MD,FHRS and episode participants Karim Benali, MD, PhD and Reinoud Knops, MD, PhD as they discuss this recent article that focuses on unique aspects of implantable defibrillators as experienced by young patients. The team gathered in person for this lively discussion at EHRA 2025 in Vienna. Bonus video footage of the episode is available on heartrhythm365.org. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIRCEP.124.013365 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific   Contributor Disclosure(s): K. Benali: Nothing to disclose. R. Knops: Honoraria/Speaking/Consulting: Boston Scientific, Metronic, Inc., Cairdac, Abbott Membership on Advisory Committees: Kestra, Inc.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Matthew Hadfield, MD Subcutaneous cancer immunotherapies may offer a faster, more resource-efficient alternative to intravenous administration, improving patient convenience and accessibility while maintaining efficacy. However, careful monitoring for immunotherapy-related toxicities remains essential. Joining Dr. Charles Turck to discuss these key considerations for subcutaneous cancer immunotherapies is Dr. Matthew Hadfield, Assistant Professor of Medicine at Brown University/Alpert School of Medicine.

Dr. Gillett, James O'Hara and Jim Lavalle scientifically dismantle biohacking, longevity, & peptides. Jim Lavalle: James LaValle is an internationally recognized clinical pharmacist, author, board-certified clinical nutritionist, and expert and educator in integrative and precision health. James is best known for his expertise in personalized integrative therapies uncovering the underlying metabolic issues that keep people from feeling healthy and vital. A thought leader in drug/nutrient depletion issues he has published 4 books and 3 databases in this area alone. He has over 35 years of experience integrating natural and integrative therapies into various medical and business models. His latest research is in drug-induced microbiome disruption.Follow Jim:► https://www.instagram.com/therealjimlavalle/► https://www.instagram.com/metabolic_elite/More about Jim:► https://www.jimlavalle.com/► http://www.metaboliccode.com/► www.metabolicelite.co00:00 Intro01:47

Bryan Mazlish is CEO of Surf Bio, a company focused on novel subcutaneous formulations of biologics to enable patients to self-administer these treatments at home. The limitations of subcutaneous administration have historically made time-consuming IV infusions necessary for many biologics. The growing number of biologics and biosimilars in development will further strain the capacity of infusion centers, making subcutaneous administration a way to increase access, reduce healthcare costs, and improve patient adherence. Bryan explains, "Surf Bio is focused on enhancing the ability for patients to take a lot of the innovative and novel biologics that are currently on the market and in development. The vast majority of these historically have required a trip to the infusion center at the hospital, which is quite burdensome and takes a lot of time and resources from the patients and the healthcare system. We focus on creating novel formulations of those same drugs. These biologics can be self-administered at home in seconds instead of requiring a patient to spend the better part of the day commuting to and from an infusion center and sitting in a chair." "When you formulate biologics, they typically are formulated in water and concentrated to very high levels. They become extremely viscous and, consequently, not injectable. So, the ability to inject very high-concentration biologics subcutaneously is limited by the volume that can be administered and the concentration of the biologic that can be squeezed into that volume. As a consequence of this, historically, a large quantity of drug has been diluted at great levels and then dripped into your bloodstream through the intravenous route, which can typically take an hour or, in some cases, multiple hours." #SurfBio #BiologicsDelivery #SubcutaneousInnovation #HealthcareEfficiency surf.bio Download the transcript here

Bryan Mazlish is CEO of Surf Bio, a company focused on novel subcutaneous formulations of biologics to enable patients to self-administer these treatments at home. The limitations of subcutaneous administration have historically made time-consuming IV infusions necessary for many biologics. The growing number of biologics and biosimilars in development will further strain the capacity of infusion centers, making subcutaneous administration a way to increase access, reduce healthcare costs, and improve patient adherence. Bryan explains, "Surf Bio is focused on enhancing the ability for patients to take a lot of the innovative and novel biologics that are currently on the market and in development. The vast majority of these historically have required a trip to the infusion center at the hospital, which is quite burdensome and takes a lot of time and resources from the patients and the healthcare system. We focus on creating novel formulations of those same drugs. These biologics can be self-administered at home in seconds instead of requiring a patient to spend the better part of the day commuting to and from an infusion center and sitting in a chair." "When you formulate biologics, they typically are formulated in water and concentrated to very high levels. They become extremely viscous and, consequently, not injectable. So, the ability to inject very high-concentration biologics subcutaneously is limited by the volume that can be administered and the concentration of the biologic that can be squeezed into that volume. As a consequence of this, historically, a large quantity of drug has been diluted at great levels and then dripped into your bloodstream through the intravenous route, which can typically take an hour or, in some cases, multiple hours." #SurfBio #BiologicsDelivery #SubcutaneousInnovation #HealthcareEfficiency surf.bio Listen to the podcast here

Get My Book On Amazon: https://a.co/d/avbaV48Download The Peptide Cheat Sheet: https://peptidecheatsheet.carrd.co/Download The Bioregulator Cheat Sheet: https://bioregulatorcheatsheet.carrd.co/In this Q&A video, I dive deep into your peptides questions—from dosage comparisons and injection techniques to protocol stacks for endurance, recovery, muscle growth, and even hormone optimization.Below are the exact timestamps with each question I answered:0:00 – [Music Introduction]0:10 – Introduction & overview of the Q&A session1:59 – Five Amino 1 MQ: Liquid vs Pills Dosage Comparison3:02 – Peptide and Supplement Protocol for Endurance Events (50k, 50 mile, 100 mile)5:01 – SLU PP332: Injectable vs Oral – Which Is Better?5:20 – Best Peptides for Jiu-Jitsu Performance, Endurance, and Recovery6:22 – SLU PP332 Dosage for Endurance: When to Take It?7:16 – Best Stack for Pre and Post Training for Endurance and Performance8:14 – Best Way to Inject: Intramuscular vs Subcutaneous for Different Peptides9:01 – How to Inject If You Have Very Little Body Fat Left9:51 – Mixing Instructions for Pinealon10:15 – Reconstituting and Dosing a Blend of GHK, TB500, and BPC 15710:54 – Is Pre-loading Multiple Peptides in the Same Syringe Safe?11:29 – How to Use and Convert Doses with the Autopens12:34 – Which Blood Tests Should You Monitor While Using Peptides?13:12 – Peptides for Injury and Pain Relief14:01 – Best Peptides for Lower Back Pain and Localized Injections15:05 – Best Peptides for Tendon and Ligament Injuries15:18 – Peptides for Nerve Pain/Neuropathy15:58 – Is a BPC 157 Cream Effective for Sports Injuries?17:38 – Are GH Peptides Safe for a 20-Year-Old Baseball Pitcher?18:05 – Peptides for Muscle Growth at Age 20 (Tesmelone, CHC, etc.)18:36 – How to Cycle Off and What's the Best Replacement?19:00 – Optimal Micro Dosing for Matsi with Reatutide19:57 – Best Stack for Muscle Gain in a 45-Year-Old Woman on Tzapatide20:04 – Peptides for Building Muscle in Adults 55+24:03 – Should You Cycle Off GLP-1s or Stay on Them Long Term?26:44 – Why Do GLP-1s Stop Working and How Can You Restart Results?30:14 – Cervodide vs Trptide Ratutide: Similarities and Differences31:34 – Testosterone and High Hematocrit: Is TRT Safe?32:29 – Optimal Testosterone Levels for a 59-Year-Old Man34:02 – Can Adding Low-Dose Estradiol to TRT Improve Libido?34:18 – How Do I Manage RBC Levels on TRT?35:45 – What Can Post-Menopausal Women Take Instead of HGH and Test Cyp?36:00 – Peptides for Hair Regrowth in Women with Male Pattern Hair Loss49:30 – What's the Best Fat Loss Stack for Fasted Cardio?51:05 – How Does Cagrilintide Tide Fit Into Fat Loss Protocols?51:52 – Does BPC 157 in Angiogenesis Increase Cancer Risk?52:46 – Can MOTS-c and L-Carnitine Raise Heart Rate?52:54 – Injectable vs Oral L-carintiine: Which Is Better?53:07 – How to Adjust Dosing for a BPC and TB500 Blend53:44 – What Is SB01 for Degenerative Disc Disease?54:14 – Best Peptides for Lung Health (COPD, Flem, etc.)54:59 – Should You Take Peptides With Food or Before Meals?55:30 – How Can I Make Peptide Injections Less Painful?55:58 – Can BPC 157/TB500 Be Used as a Nasal Spray or an Eye Drop?56:38 – VIP: Nasal Spray vs Subcutaneous Injection – Which Is Better?

Dr. Hugo Morales Briceno interviews Prof. Ray Chaudhuri to discuss the real world-use of levodopa subcutaneous infusion in patients with Parkinson's disease.

This episode features Amy Brown (Marie Curie Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK. Swansea University Medical School, Swansea University, Swansea, UK)   What is already known about the topic? The third World Health Organization Global Patient Safety Challenge ‘Medication without harm', emphasises the need for improved infrastructure through better reporting practices and cross-organisational learning from adverse events and near misses. Medication is implicated in one-fifth of serious palliative care patient safety incidents, with approximately 25% of these incidents involving continuous subcutaneous infusions. Inadequate analysis of continuous subcutaneous infusions as safety-critical, risk-prone interventions dependent on complex structural and human factor issues is a lost opportunity for learning.     What this paper adds? Continuous subcutaneous infusion incidents occur across all settings including the home, hospices and hospitals and particularly after the transfer of patients between settings with harm present in nearly three-quarters of reports. Multiple points of system failure were identified in continuous subcutaneous infusion incident reports including monitoring and supply (405, 31%), administration (383, 29%) and prescribing (268, 20%); recurring contributory factors included discontinuity of care within and between care settings, inadequate time, inadequate staffing and unfamiliarity with protocols. Narrative descriptions of psychological and social harm, alongside physical harm risk, are not being adequately recognised or responded to through existing approaches to measure harm in palliative care, hindering learning in practice   Implications for practice, theory, or policy The structural changes needed to minimise harm and maximise safety in palliative care are likely to be replicated in other parts of the world where patient safety reporting practices are less well established, for example, shifting from focussing on lack of experience and competency at an individual practitioner-level to addressing deficits in working environments and infrastructures for care provision. When patients move between care locations, more attention should be given to the timeliness and effective transfer of medication management (e.g. if someone is discharged from hospital to a care home that rarely uses continuous subcutaneous infusions for palliative care, this needs to be preceded by refreshing staff skills and ensuring they can access further community support if needed). Professional training and further research are needed to increase quality of reporting of psychological and social harms (including for families and other stakeholders involved) to facilitate organisational learning and pinpoint precise targets for further improvement.     Full paper available from:     https://journals.sagepub.com/doi/full/10.1177/02692163241287639  If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:  a.nwosu@lancaster.ac.uk

Welcome to the Oncology Brothers Podcast! In this episode, Drs. Rohit and Rahul Gosain are joined by Dr. Saby George from Roswell Park Comprehensive Cancer Center to discuss the recent approval of subcutaneous nivolumab based on the CheckMate-67T study. Join us as we delve into: •⁠  ⁠The study design and findings of CheckMate-67T •⁠  ⁠The implications of subcutaneous nivolumab for patients and healthcare providers •⁠  ⁠Safety signals and side effects associated with the new formulation •⁠  ⁠The significant time savings for patients receiving treatment •⁠  ⁠Real-world experiences from patients involved in the trial This episode highlights how the subcutaneous formulation of nivolumab can enhance patient care by reducing time spent in infusion centers while maintaining efficacy and safety. Tune in to learn more about this exciting advancement in cancer treatment and its potential impact on patient quality of life! Don't forget to like, subscribe, and check out our other episodes for more insights on FDA drug approvals, conference highlights, and treatment algorithms. We are the Oncology Brothers! YouTube: https://youtu.be/4blP8jqizUQ Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers Subscribe to our channel for more insights on oncology treatments and patient care!

In this AANEM podcast, Dr. Stino interviews Dr. Allen on the groundbreaking ADHERE study, published in Lancet Neurology in 2024, which investigated efgartigimod for treating chronic inflammatory demyelinating polyneuropathy (CIDP). As the largest CIDP trial to date with 322 patients across 146 sites, it marked the first major study of a targeted biologic therapy in CIDP. The trial featured a unique two-stage design: An open-label response phase followed by a randomized controlled phase for responders. Dr. Allen explains the rationale behind targeting IgG in CIDP, despite its less clear antibody-mediated mechanism compared to myasthenia gravis. The study demonstrated a 66-70% response rate in the open-label phase, with significantly lower relapse rates compared to placebo in the randomized phase. This research represents a significant advancement in CIDP treatment options, offering a weekly subcutaneous administration that could reduce treatment burden compared to traditional therapies.

In today's episode, supported by Bristol Myers Squibb, we had the pleasure of speaking with Roxana S. Dronca, MD, about the FDA approval of subcutaneous nivolumab and hyaluronidase-nvhy (Opdivo Qvantig; subcutaneous nivolumab) for advanced or metastatic solid tumors. Dr Dronca is a professor of oncology, a consultant in the Division of Hematology/Oncology in the Department of Internal Medicine, and director of the Mayo Clinic Comprehensive Cancer Center in Jacksonville, Florida. On December 27, 2024, the FDA approved subcutaneous nivolumab across approved adult, solid tumor nivolumab indications, including as monotherapy, monotherapy maintenance after completion of nivolumab in combination with ipilimumab (Yervoy), or in combination with cabozantinib (Cabometyx) or chemotherapy. This regulatory decision was backed by findings from the phase 3 CheckMate-67T trial (NCT04810078) and includes indications for melanoma, renal cell carcinoma, non–small cell lung cancer, urothelial carcinoma, head and neck squamous cell carcinoma, colorectal cancer, esophageal carcinoma, esophageal adenocarcinoma, hepatocellular carcinoma, gastric cancer, and gastroesophageal junction cancer. In our exclusive interview, Dr Dronca discussed the significance of this FDA approval across multiple solid tumor indications, pivotal findings from the CheckMate-67T trial, and how this approval represents a paradigm shift in modern cancer care delivery.

Join us each week as we do a quick review of three compelling stories from the pharma world — one good, one bad and one ugly. Up this week:   The good — FDA approves Opdivo subcutaneous version The bad — Marinus Pharmaceuticals sells operations The ugly — Novo Nordisk pushes back against compounding pharmacies   

 Hormonal shifts during perimenopause can lead to changes in fat distribution, increasing health risks. Understanding the types of fat can help women make informed decisions about their health. Tune in this week as Sarah shares the difference between visceral fat and subcutaneous fat and their unique impacts on health, especially during perimenopause. Check out our website at https://burnfatandfeast.com to find out more about how you can ignite your life and live fully.  GRAB ONE OF OUR FREEBIES: Week of Meals (with grocery list and recipes) Ultimate Guide to Intermittent Fasting For Women 5 Days to Burning Fat and Increasing Energy Training Fat Burning Guide Metabolism and Hormone Checklist Fast Food Guide Free LIVE workout Alcohol & Macros Guide Protein & Portions Guide Connect with us on your favorite social media platform: Instagram: www.instagram.com/burnfatandfeast Facebook: www.facebook.com/burnfatandfeast TikTok: @burnfatandfeast LinkedIn: https://www.linkedin.com/company/burn-fat-and-feast/ Join our FREE Facebook community to be surrounded by other women on a mission to live their best lives.  Rate, Review and Follow on Apple Podcasts If you love this show, please consider rating and reviewing the show! This helps us support more people just like you, move toward the life they desire and deserve. Click here, scroll to the bottom, tap to rate with five stars and select “Write a Review”. Then be sure to let us know what you loved most about the episode.  Also, if you haven't done so, follow the podcast. We add episodes every week to the feed and if you're not following, there's a good chance you'll miss out. Follow now!

Show Notes   1. Jeremias S. Skyrizi overtakes Humira: “product hopping” leaves biosimilar market in limbo. The Center for Biosimilars. November 7, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/skyrizi-overtakes-humira-product-hopping-leaves-biosimilar-market-in-limbo 2. Jeremias S. Celltrion sets sights on 2030 with expanded biosimilar portfolio, market reach. The Center for Biosimilars. November 6, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/celltrion-sets-sights-on-2030-with-expanded-biosimilar-portfolio-market-reach 3. Ferreri D. Making the cost of IBD care sustainable. The Center for Biosimilars. November 2, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/making-the-cost-of-ibd-care-sustainable 4. Ferreri D. Achieving PFS in advanced gastric cancer with HLX02 biosimilar, chemotherapy. The Center for Biosimilars. November 23, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/achieving-pfs-in-advanced-gastric-cancer-with-hlx02-biosimilar-chemotherapy 5. Ferreri D. Subcutaneous infliximab CT-P13 superior to placebo as maintenance therapy for IBD. The Center for Biosimilars. November 16, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/subcutaneous-infliximab-ct-p13-superior-to-placebo-as-maintenance-therapy-for-ibd 6. Ferreri D. Challenges, obstacles, and future directions for anti-TNF biosimilars in IBD. The Center for Biosimilars.November 9, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/challenges-obstacles-and-future-directions-for-anti-tnf-biosimilars-in-ibd 7. Jeremias S. Breaking down biosimilar barriers: the patent system.The Center for Biosimilars. November 11, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/breaking-down-biosimilar-barriers-the-patent-system 8. Jeremias S. Breaking down biosimilar barriers: payer and PBM policies. The Center for Biosimilars. November 13, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/breaking-down-biosimilar-barriers-payer-and-pbm-policies 9. Poore D. Breaking down biosimilar barriers: interchangeability. The Center for Biosimilars. November 14, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/breaking-down-biosimilar-barriers-interchangeability 10. The Center for Biosimilars Staff. Webinar: streamlining the regulatory process to advance access to biosimilars. The Center for Biosimilars. November 21, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/webinar-streamlining-the-regulatory-process-to-advance-access-to-biosimilars 11. Jeremias S. Can global policies to boost biosimilar adoption work in the US? The Center for Biosimilars. November 17, 2024. Accessed November 27, 2024. https://www.centerforbiosimilars.com/view/can-global-policies-to-boost-biosimilar-adoption-work-in-the-us-

“Although the patient is spending a little less time in the clinic, the administration actually requires the nurse to be at the chairside the entire time. This has allowed nurses to spend potentially uninterrupted time to sit and converse with the patients that they may not have had with an IV infusion. It's been a wonderful unintentional outcome from the development of the large-volume subcutaneous injections,” Crystal Derosier, MSN, RN, OCN®, clinical specialist at Dana-Farber Cancer Institute, in Boston, MA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about administering high-volume subcutaneous injections in cancer care. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 22, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the administration of high-volume subcutaneous injections. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 326: Intramuscular Injections: The Oncology Nurse's Role Episode 285: Transarterial Chemoembolization: The Oncology Nurse's Role Episode 271: Intraventricular and Intrathecal Administration: The Oncology Nurse's Role Episode 265: Intravesical Administration: The Oncology Nurse's Role Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role ONS Voice articles: Administration Considerations Amid the Large-Volume Subcutaneous Injection Revolution FDA Approves Atezolizumab and Hyaluronidase-Tqjs for Subcutaneous Injection Make Subcutaneous Administration More Comfortable for Your Patients Oncology Drug Reference Sheet: Pertuzumab, Trastuzumab, and Hyaluronidase-Zzxf Subcutaneous Injection ONS Voice Oncology Drug Reference Sheets ONS book: Access Device Guidelines: Recommendations for Nursing Practice and Education (Fourth Edition) ONS course: ONS/ONCC Chemotherapy Immunotherapy Certificate™ Clinical Journal of Oncology Nursing article: Subcutaneous Administration: Evolution, Challenges, and the Role of Hyaluronidase Oncology Nursing Forum article: Administration of Subcutaneous Monoclonal Antibodies in Patients With Cancer To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an Oncology Nursing Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Some challenges with subcutaneous injections are with the administration, especially when we're thinking about large-volume drugs. … Some of these patients who have been through multiple therapies, they've been on a long journey, or just in general they may have small amounts of subcutaneous injection areas and tissues, so that could be problematic. … Also, some patients may want to go back to receiving IV medications if they experience severe pain at an injection site during administration, or maybe they had a site-related reaction. This is where the nurses play a huge, crucial role in the administration of these subcutaneous drugs.” TS 5:17 “When administering large-volume subcutaneous injections, good ergonomics is very important during the administration because this can help reduce the fatigue and discomfort not only for [nurses] but for the patients as well. If you're trying to hold the needle in place for 5–10 minutes, it's a lot of work. Your arms can start to shake, and that shaking can cause discomfort for the patient as well. The utilization of a winged infusion set for these large volumes allows more space between the patient and the nurse, which supports better ergonomics.” TS 11:20 “When they came to the market, there was an unfounded concern from patients and practitioners that these injections would not be as effective as their IV counterparts. This is totally incorrect. We know that these options have the same efficacy and may actually also help to reduce the incidence of any infusion-related reactions, as well as lower side-effect impacts on patients, so overall, a lot of improvement with these high-volume subcutaneous injections for the patient experience.” TS 21:37 “I'm just really looking forward to the future landscape of oncology practice and drug approvals and drug administration. It's so important that subcutaneous injections have really made a name for themselves in nursing practice today. We continue to see more subcutaneous formulations on the market that are available for patients, allowing them less time in infusion chairs and more flexibility and freedom outside of the healthcare setting.” TS 24:39

Join us each week as we do a quick review of three compelling stories from the pharma world — one good, one bad and one ugly. Up this week:   The good — Roche snags FDA nod for subcutaneous cancer immunotherapy  The bad — Moderna to cut R&D expenses by $1.1B  The ugly — Teva reaches $80M opioid settlement with Baltimore 

DermSurgery Digest at the Microscope dives deep into the latest dermatology literature exploring the latest techniques and diagnosis approaches. Each quarterly episode features interesting and relevant articles from Dermatologic Surgery, American Journal of Dermatopathology, Journal of Cutaneous Pathology, American Journal of Surgical Pathology and more.  This episode features articles on cutaneous and subcutaneous leiomyosarcoma.Contributors to this podcast include Naomi Lawrence, MD, Dermatologic Surgery Digital Content Editor; Ashley Elsensohn, MD, MPH, DermSurgery Digest At the Microscope co-host; Christine Ahn, MD; Jeff Gardner, MD; Marina K. Ibraheim, MD; and Michael P. Lee, MD.Articles featured include:Kraft S, Fletcher CD. Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma". Am J Surg Pathol. 2011 Apr;35(4):599-607. doi: 10.1097/PAS.0b013e31820e6093. PMID: 21358302.Kazlouskaya V, Lai YC, Khachemoune A. Leiomyosarcoma of the skin: review of the literature with an emphasis on prognosis and management. Int J Dermatol. 2020 Feb;59(2):165-172. doi: 10.1111/ijd.14705. Epub 2019 Nov 14. PMID: 31729020.Winchester DS, Hocker TL, Brewer JD, Baum CL, Hochwalt PC, Arpey CJ, Otley CC, Roenigk RK. Leiomyosarcoma of the skin: clinical, histopathologic, and prognostic factors that influence outcomes. J Am Acad Dermatol. 2014 Nov;71(5):919-25. doi: 10.1016/j.jaad.2014.07.020. Epub 2014 Aug 29. PMID: 25174541.Bresler SC, Gosnell HL, Ko JS, Angeles CV, Ronen S, Billings SD, Patel RM. Subcutaneous Leiomyosarcoma: An Aggressive Malignancy Portending a Significant Risk of Metastasis and Death. Am J Surg Pathol. 2023 Dec 1;47(12):1417-1424. doi: 10.1097/PAS.0000000000002126. Epub 2023 Sep 19. PMID: 37727934.Listeners are encouraged to submit questions for podcast hosts to answer in a later episode. To submit your questions, email communicationstaff@asds.net.

Show notes at pharmacyjoe.com/episode949. In this episode, I'll discuss subcutaneous insulin for the treatment of diabetic ketoacidosis (DKA). The post 949: How well does subcutaneous insulin work for DKA treatment? appeared first on Pharmacy Joe.

This past winter, Dr. Rich Griffey, healthcare quality leader from Washington University School of Medicine and Emergency Medicine, came to present grand rounds on a new way to care for patients with mild to moderate DKA, which they call the SQuID protocol. This talk serves to inspire us to look even at some of our well established conditions and see what we could do differently, as well as appreciate the value that healthcare quality improvement integrated with research methods and implementation science thinking can do when they all come together for the improvement of patient care. Come be inspired with us! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs  

In this episode, I delve into the main factors determining where we store body fat and two strategies to help get more definition in “stubborn” areas. Links and resources: Blog article: “How to Lose Stubborn Fat” – https://www.fittotransformtraining.com/blog/stubborn-fat “Subcutaneous fat loss is greater than visceral fat loss with diet and exercise, weight-loss promoting drugs and bariatric surgery: a critical review and meta-analysis” by Merlotti and colleagues (2017) – https://www.nature.com/articles/ijo201731  Pod ep. 53: “Why you stop sticking to your diet (and what to do about it)” – https://podcasters.spotify.com/pod/show/fit-to-transform/episodes/Why-you-stop-sticking-to-your-diet-and-what-to-do-about-it---Ep--53-e26rl1t  “Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity” by Speakman and colleagues (2011) – https://pubmed.ncbi.nlm.nih.gov/22065844/  Sign up for one on one coaching with me: ⁠https://www.fittotransformtraining.com/coaching.html⁠ Follow me on Instagram @nikias_fittotransform: ⁠http://instagram.com/nikias_fittotransform/⁠ Visit my website: ⁠https://www.fittotransformtraining.com⁠ Sign up for my free newsletter: ⁠https://mailchi.mp/157389602fb0/mailinglist⁠ Sign up for the No Quit Kit email series on retraining your mindset for long-term fat loss success: ⁠https://mailchi.mp/4b368c26baa8/noquitkitsignup⁠

The Fast and the Furious!! Dave and the Doc set out on a two-day fast together!! Will it go as planned? Of course not, but not in the way you might think!

This month, we spoke with Natasha B. Leighl, BSc, MMSc, MD, Medical Oncologist at the Princess Margaret Cancer Centre in Toronto, Canada. Leighl discussed the PALOMA-3 trial results, shared at the American Society of Clinical Oncology 2024 Conference.

Download The Peptide Cheat Sheet: https://peptidecheatsheet.carrd.co/

This episode features Sheryn Tan (University of Adelaide, Adelaide, SA, Australia) and Dr Stephen Bacchi (Flinders University, Bedford Park, SA, Australia; Lyell McEwin Hospital, Elizabeth Vale, SA, Australia)   What is already known about the topic? In palliative care patients for whom there is a need for non-oral antiseizure medications, and a preference to avoid intravenous access, options are primarily limited to benzodiazepines. In circumstances where the sedative effects of benzodiazepines are to be avoided, the use of subcutaneous levetiracetam have been reported. There are limited guidelines available regarding the possible use of subcutaneous sodium valproate.   What this paper adds? Several studies have described successful use of subcutaneous sodium valproate in palliative care to manage seizures. While limited, the available data described few adverse effects, aside from an isolated local reaction that is resolved with a change of site. Current routine medication resources may not reflect this potential use of sodium valproate, and palliative care has unique medication considerations that may not apply to medication administration in other settings.   Implications for practice, theory, or policy Although data are limited, existing studies present enough evidence to argue for the inclusion of subcutaneous valproate in the palliative care armamentarium for selected circumstances. Full paper available from:     https://journals.sagepub.com/doi/10.1177/02692163241234597   If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:  a.nwosu@lancaster.ac.uk

Download Dr. Gus's FREE Body Composition Handbook HEREDr. Peter Attia's Referenced Article HEREIn the pursuit of health and wellness, managing body composition is often overlooked or misunderstood. Yet, it's a crucial aspect that can significantly impact our overall well-being. One of the fundamental concepts in body composition management is understanding the difference between subcutaneous fat and non-subcutaneous fat, and the importance of maintaining adequate lean body mass through weight training and proper nutrition.Subcutaneous Fat vs. Non-Subcutaneous Fat: What's the Difference?Subcutaneous fat refers to the fat stored directly under the skin. It's the fat you can pinch and feel. While excess subcutaneous fat can affect your appearance and self-esteem, it's generally less harmful to health compared to non-subcutaneous fat.Non-subcutaneous fat, on the other hand, includes visceral fat and fat stored around organs. This type of fat poses more significant health risks as it's associated with various metabolic disorders, including cardiovascular disease, diabetes, and certain cancers. Unlike subcutaneous fat, visceral fat is not visible and requires more attention for effective management.The Importance of Maintaining Lean Body MassLean body mass encompasses everything in your body except for fat - muscles, bones, organs, and fluids. Preserving lean body mass is vital for several reasons:Metabolic Health: Lean muscle mass plays a crucial role in regulating metabolism. The more muscle you have, the more calories your body burns at rest, making weight management more manageable.Functional Strength: Building and maintaining muscle strength is essential for performing daily activities with ease and reducing the risk of injury, particularly as we age.Bone Health: Resistance training, which is often used to build lean muscle mass, also strengthens bones, reducing the risk of osteoporosis and fractures.The Role of Weight Training and Protein ConsumptionWeight training, or resistance training, is one of the most effective ways to increase lean body mass. By challenging your muscles with progressively heavier weights, you stimulate muscle growth and improve overall body composition.

Primo In TRT, Best Exercise For Quads, Coaches Skip Hill, Andrew Berry & Scott McNally Tackle Your Listener Questions

Today, I'd like to discuss a study conducted by researchers in Germany.Dr. Manuel Cornely, a prolific author on lipedema, spearheaded this investigation.The paper, titled Assessing the Healthiness of Subcutaneous Adipose Tissue Expansion in Lipedema through Circulating Parameters, debuted in October 2022 within the pages of Frontiers in Endocrinology.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GUE865. CME/MOC/NCPD/CPE/AAPA/IPCE credit will be available until March 7, 2025.Exploring New Routes in Immuno-Oncology: Understanding the Role of Subcutaneous Immune Checkpoint Inhibitors & Preparing for Innovative Delivery Approaches in the Clinic In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerProf. Laurence Albiges, MD, PhD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Amgen Inc.; Astellas Pharma US, Inc.; Bristol Myers Squibb; Eisai Inc.; F. Hoffmann-La Roche Ltd; Ipsen Biopharmaceuticals, Inc.; Janssen Pharmaceuticals, Inc.; Merck & Co., Inc.; Merck Sharp & Dohme; Novartis Pharmaceuticals Corporation; and Pfizer Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GUE865. CME/MOC/NCPD/CPE/AAPA/IPCE credit will be available until March 7, 2025.Exploring New Routes in Immuno-Oncology: Understanding the Role of Subcutaneous Immune Checkpoint Inhibitors & Preparing for Innovative Delivery Approaches in the Clinic In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerProf. Laurence Albiges, MD, PhD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Amgen Inc.; Astellas Pharma US, Inc.; Bristol Myers Squibb; Eisai Inc.; F. Hoffmann-La Roche Ltd; Ipsen Biopharmaceuticals, Inc.; Janssen Pharmaceuticals, Inc.; Merck & Co., Inc.; Merck Sharp & Dohme; Novartis Pharmaceuticals Corporation; and Pfizer Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More common in type 1 diabetes. Triggered by decreased circulating insulin. The body needs energy but cannot use glucose because it can't get it into the cells. This leads to increased metabolism of free fatty acids and the increased production of ketones. The buildup of ketones causes acidosis. The kidneys attempt to compensate for the acidosis by increasing diuresis. These patients present as dry and altered, with sweet-smelling breath and Kussmaul (fast and deep) respirations. HSS More common in type 2 diabetes. In this condition there is still enough circulating insulin to avoid the breakdown of fats for energy but not enough insulin to prevent hyperglycemia. Serum glucose levels are very high – around 600 to 1200 mg/dl. Also presents similarly to DKA with the patient being dry and altered. Important labs to monitor Serum glucose Potassium Phosphorus Magnesium Anion gap (Na - Cl - HCO3) Renal function (Creatinine and BUN) ABG/VBG for pH Urinalysis and urine ketones by dipstick Treatment Identify the cause, i.e. Has the patient stopped taking their insulin? Aggressive hydration with isotonic fluids. Normal Saline (NS) vs Lactated Ringers (LR)? LR might resolve the DKA/HHS faster with less risk of hypernatremia. Should you bolus with insulin? No, just start a drip. 0.1-0.14 units per kg of insulin. Make sure you have your potassium back before starting insulin as the insulin can shift the potassium into the cells and lead to dangerous hypokalemia. Should you treat hyponatremia? Make sure to correct for hyperglycemia before treating. This artificially depresses the sodium. Should you give bicarb? Replace if the pH < 6.9. Otherwise, it won't do anything to help. Don't intubate, if the patient is breathing fast it is because they are compensating for their acidosis. References Andrade-Castellanos, C. A., Colunga-Lozano, L. E., Delgado-Figueroa, N., & Gonzalez-Padilla, D. A. (2016). Subcutaneous rapid-acting insulin analogues for diabetic ketoacidosis. The Cochrane database of systematic reviews, 2016(1), CD011281. https://doi.org/10.1002/14651858.CD011281.pub2 Chaithongdi, N., Subauste, J. S., Koch, C. A., & Geraci, S. A. (2011). Diagnosis and management of hyperglycemic emergencies. Hormones (Athens, Greece), 10(4), 250–260. https://doi.org/10.14310/horm.2002.1316 Dhatariya, K. K., Glaser, N. S., Codner, E., & Umpierrez, G. E. (2020). Diabetic ketoacidosis. Nature reviews. Disease primers, 6(1), 40. https://doi.org/10.1038/s41572-020-0165-1 Duhon, B., Attridge, R. L., Franco-Martinez, A. C., Maxwell, P. R., & Hughes, D. W. (2013). Intravenous sodium bicarbonate therapy in severely acidotic diabetic ketoacidosis. The Annals of pharmacotherapy, 47(7-8), 970–975. https://doi.org/10.1345/aph.1S014 Modi, A., Agrawal, A., & Morgan, F. (2017). Euglycemic Diabetic Ketoacidosis: A Review. Current diabetes reviews, 13(3), 315–321. https://doi.org/10.2174/1573399812666160421121307 Self, W. H., Evans, C. S., Jenkins, C. A., Brown, R. M., Casey, J. D., Collins, S. P., Coston, T. D., Felbinger, M., Flemmons, L. N., Hellervik, S. M., Lindsell, C. J., Liu, D., McCoin, N. S., Niswender, K. D., Slovis, C. M., Stollings, J. L., Wang, L., Rice, T. W., Semler, M. W., & Pragmatic Critical Care Research Group (2020). Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA network open, 3(11), e2024596. https://doi.org/10.1001/jamanetworkopen.2020.24596 Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSII

J Am Coll Cardiol 1995;26:57-65.Background Patients with diabetes have higher short- and long-term rates of mortality following acute myocardial infarction (AMI). Possible explanations for this include increased fatty acid metabolism, compromising glycolysis in ischemic and nonischemic areas as well as impairment of platelet and fibrinolytic function. This led to the theory that both processes could be improved with insulin infusion. Small studies at the time provided conflicting results. The Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) trial sought to test the hypothesis that rapid improvement of metabolic control in diabetic patients with AMI by means of insulin-glucose infusion would decrease early mortality and that continued good metabolic control would improve subsequent prognosis.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients Patients admitted to the CCUs of 19 Swedish hospitals with suspected AMI within the preceding 24 hours with a blood glucose level >11 mmol/l (198 mg/dl) with or without a previous history of diabetes mellitus. Exclusion criteria included inability to participate for reasons of health, refusal to give consent, residence outside the catchment area or enrollment in other studies.Baseline characteristics There were 1,240 patients who met inclusion criteria and 50% were excluded, mainly due to inability or unwillingness to participate. Compared to those enrolled, excluded patients were older (72 years of age) and more were women. The majority of those enrolled were men (62%) at an average age of 68 years. Nearly 40% had a history of previous MI and 22% had congestive heart failure. The mean time from the onset of symptoms to randomization was 13 hours. More than 80% of patients were non-insulin dependent. The average HbA1c at randomization was 8% and the blood glucose was 279 mg/dl.Procedures Patients randomized to insulin therapy were started on an insulin-glucose infusion at 30 ml/h and blood glucose was checked after 1 hour. The infusion rate was adjusted according to protocol. The infusion was continued until stable normoglycemia was attained for ≥24 hours. Subcutaneous administration of insulin was given immediately after cessation of the infusion, according to a multidose regimen, with the aim of maintaining normoglycemia. Serum potassium was measured immediately before the infusion and then after 6, 12, and 24 hr and was checked immediately in patients who developed any kind of clinically significant arrhythmia. Control patients were treated according to standard coronary care unit practice and did not receive insulin unless it was deemed clinically indicated.Endpoints The primary endpoint was all-cause mortality at 3 months. The investigators hypothesized that the insulin-glucose infusion followed by multidose subcutaneous insulin for 3 months would reduce the mortality rate by 30%, from a 35% mortality rate in the control group (35/100 to 24.5/100). Based on that assumption, a sample size of 600 was needed to demonstrate the expected mortality reduction with a 5% significance level and power of 80%.Results 620 patients were randomized, 306 to the intervention group and 314 to the control group. The blood glucose level was significantly lower in the insulin group 24 hours after randomization (173 mg/dl vs 211 mg/dl; p

Our societal beauty standards typically uplift leaner bodies. But when it comes to our skin, maintaining subcutaneous body fat is crucial to supporting a youthful appearance.In this episode, host Dr. Sethi discusses the role of subcutaneous fat and how it projects the skin and smoothes wrinkles for a youthful appearance. She explains how subcutaneous fat can diminish naturally through processes like aging and weight loss – and how people can restore this volume even after it is lost. Through methods like Sculptra injections, facial fillers, and fat transfer procedures, people can help restore fat underneath the skin. The episode covers each of these options and explains how they function to provide volume to the face and even other areas of the body.As the founder of RenewMD Beauty Medical Spas and a woman of color, Dr. Sethi is dedicated to spreading science-backed skincare information on The Skin Report. Listen to this episode to learn more about subcutaneous fat and volume restoration options!Follow and DM a question for Dr. Sethi to answer on The Skin Report Podcast: RenewMD Beauty Instagram:https://www.instagram.com/renewmd_beauty/RenewMD Beauty Medical Spas, California:https://renewmdwellness.com/Special OffersGlass Skin Trio Special Offer 25% off Promo Code: GlassTrio25Skin By Dr. Sethi - Holiday Season Offer 25% off Promo Code: HolidaySkin25

Lard mimics our natural skin oils. It has the same ph balance and lipid balance as our skin does. This is one reason we might want to consider not only cooking with it, but using it for skin care! Charles Mayfield, author, regenerative farmer, and founder of Farrow (lard-based skincare) today explains how lard is good for both our health and our skin.   He goes over lard's nutrient profile, why it's been maligned or misunderstood for so long, and how he stumbled into discovering its wonders himself. Charles also offers simple tips for healthy living, inside and out!   Check out his website: farrow.life - https://farrow.life/ Become a member of the Weston A. Price Foundation - https://www.westonaprice.org/why-join/ Support our sponsors Paleo Valley - https://paleovalley.com/promos/wise-traditions-multi-product-page?utm_source=affiliate&utm_medium=podcast and Pluck Seasoning - https://shop.eatpluck.com/pages/wise

Show notes To learn more about the FDA approval of Zymfentra, click here. To learn more about the results from the LIBERTY trials, click here. 

Dr. Jack Cush reviews RheumNow's top entries the PMR Campaign, news, journal reports and regulatory actions.

Dr. Seager discusses science and best-practices with cold immersions for supporting hormonal health. Sponsored: Support your Workout Sessions and Healthy Hydration with this Creatine Electrolyte Combo by MYOXCIENCE: bit.ly/electrolyte-stix Save 12% with code podcast at checkout Save $350 off an amazing Cold Water Immersion tank with code HIH350: morozkoforge.com Show Notes:   2:25 Surprise is a basic human emotion that opens all your senses. Surprise updates your belief systems. 03:20 Complete freedom from stress is death. Stress is part of what makes us alive. There is a systemic beneficial response. 03:40 Thermal contrast is used to measure physiologic responses to stress. Adapting to this kind of stress is a measure of your resilience. 04:40 It is your beliefs about stress being harmful that cause harm to your health. 05:00 Our ancestors lived in discomfort and sought comfort. We should be seeking discomfort. Intentional discomfort with recovery makes us more resilient. 07:10 Water cold as 60 degrees will help your metabolism. Psychological resilience begins at water about 39 degrees. 09:50 HRV improves with cold exposure. Your heart rate should expand or contract to adjust to the demands of your body. HRV is a physiologic measure of your psychological resilience. It makes your heart more resilient. 11:30 Ice cold water exposure activates thermogenesis, the autonomic nervous system, and production of neurotransmitters and hormones that your body needs when your fight/flight system is on high alert. 13:10 When you come out of the ice water, you feel like superman. 14:30 Autonomic conflict theory: You will gasp. Gasp reflex activates fight/flight, increases your heart rate. If you cannot calm your breath, you may hyperventilate. A countervailing reflex is the dive reflex where you automatically shut down your breath and metabolism goes into conservation mode. It conserves oxygen and builds up carbon dioxide and slows your metabolism. 61:10 Your heart rate goes up In an ice water bath, and your liver releases glycogen into your bloodstream to fuel your muscles. 16:30 Tipton's hypothesis is that if you are subject to both the gasp and the dive at the same time, it will create an autonomic conflict that may cause your heart to skip a beat. It is potentially an issue with people with arrythmia. However, there are no documented cases of heart arrythmia and cold emersion causing issues. 17:25 Contraindications of cold exposure: drowning, hyperventilation, and breath hold. Hyperventilation purges the carbon dioxide from your system and can shut down the receptors that give you the urge to breathe. 18:40 Go feet first. Bathe sober. Breathe continuously. 20:25 Primary Raynaud is a complex extreme over reaction to cold. It is partly physiological and part psychological. In general, cold induces vasal restriction. To protect your core, your body changes the circulation of your blood, shutting off circulation to your fingers, toes, and limbs. It reduces heat extraction.  Secondary Raynaud is a vascular disorder caused by some other disease. 22:10 Anxiety makes a Raynaud response worse, which makes the anxiety worse. 22:25 Exposure therapy has been a successful method for overcoming primary Raynaud. 28:40 You can micro dose cold exposure. The first 15 seconds bring on an autonomic response, fight/flight. Consistency is important. 32:14 Tom brought down his PSA to 0.8 with keto and more consistent ice baths. 32:40 Testosterone goes up when a cold bath is done before exercise. Do not ice bath for recovery if you are trying to build muscle mass. 36:00 Precool (cold exposure) before exercise for peak muscle power, endurance. Precooling protects mitochondria. Testosterone response goes way up. 36:55 Cold stimulation in women raises saliva testosterone. Testosterone is the dominant sex hormone in women, but not to the same levels as men. Testosterone is important for women at all ages. Menopausal women who experience a testosterone deficiency have no FDA approved treatments. 42:40 Brown fat is an essential organ. 30% of babies' weight is brown fat. 43:40 Without regular cold exposure, you will lose all your brown fat. By age 40, 95% of Americans have 0 detectable brown fat. 43:55 Metabolic disorders are associated with a lack of brown fat. It is a secretory organ. It makes hormones. It makes more thyroid stimulating hormone than any other thing in your body.  Thyroid and brown fat work together. If your brown fat has dissipated, there is nothing to modulate thyroid activity.  Hyper or hypothyroidism is common in people with no brown fat. 44:40 Cold exposure is a potential remedy for thyroid disorder that does not require a lifetime of RX meds. 45:00 Beiging white fat, recruits more brown fat into your body. Brown fat produces neuroprotective hormones for your brain, thyroid stimulating hormone, and it will modulate your metabolism to bring it back to order. 46:55 Everyone's body is evolutionarily designed to expect cold exposure, exercise, and certain nutrition. 48:25 People who live in thermal neutral environments generally have a higher rate of adiposity. 49:00 Cold exposure burns fat and calories when you are in it, but your body compensates for the caloric deficit after.  50:10 Cold exposure remodels your fat. It changes visceral fat into subcutaneous fat. Subcutaneous fat can be benign. Visceral fat (pot belly fat) can kill you. 50:40 Electrical impedance meter is not calibrated for brown fat. Don't worry about absolute numbers. 54:40 Eleven minutes a week is enough time to keep brown fat working. 59:44 Ice bath can provide the emotional arousal needed to consolidate short-term memory into vivid long-term memory. 01:00:40 Shivering can be for thermogenesis, and it can be for nervous system release. Your nervous system can release trauma via trembling. PTSD is unresolved stress. Trauma is when stress has no release or resolution. 01:06:55When buying an ice bath: What is its temperature? Is it grounded? The tub must be electrically connected to the earth. What kind of water treatment does it have? Ozone is the most powerful water disinfectant for cold water. 01:10:40 Tom adds Epsom salt, potassium sulfate, zinc sulfate, and he does not shower after. Magnesium is stored in your bones, not your blood. Keep chloride out of your ice bath.

Antiarrhythmic drugs in patients with CAD, observational studies, GLP-1 agonists, and the subcutaneous ICD are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. AAD in Patients with CAD - The Feasibility and Safety of Flecainide Use Among Patients With Varying Degrees of Coronary Disease https://doi.org/10.1016/j.jacep.2022.12.021 - Three Questions for Evidence-Based Cardiac Electrophysiology https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 - The Cardiac Arrhythmia Suppression Trial (CAST) https://www.nejm.org/doi/full/10.1056/nejm198908103210608 II. GLP-1 Agonists Tirzepatide Powers Weight Loss in Two More Pivotal Trials https://www.medscape.com/viewarticle/994889 Semaglutide Use Surges in US Adults With Type 2 Diabetes https://www.medscape.com/viewarticle/994873 - Tirzepatide Once Weekly for the Treatment of Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2206038 - Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(23)01200-X III. S-ICD S-ICD Shows Virtues, Limits in 'Real World' Postmarket Study https://www.medscape.com/viewarticle/994851 - Postapproval Study of a Subcutaneous Implantable Cardioverter-Defibrillator System https://doi.org/10.1016/j.jacc.2023.05.034 - Subcutaneous or Transvenous Defibrillator Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 - Letter to the Editor  https://www.nejm.org/doi/full/10.1056/NEJMc2034917 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net