Podcasts about symptomatic

Summary In this truncated replay from a session at the 2025 SF Derm Annual Conference, Dr. Daniel Butler, Dr. Lawrence Eichenfield, Dr. Jason Hawkes, Dr. Shyam Joshi, and Dr. Bob Geng discuss the workup for chronic urticaria, focusing on testing approaches, the role of biomarkers, and insights into immune deficiencies. These panelists share their experiences and guidelines, emphasizing the importance of symptomatic management and the variability of lab results in clinical practice. Takeaways - Initial workup for chronic urticaria often does not require specific testing. - Testing may be justified if standard treatments fail. - International guidelines differ from US guidelines regarding testing. - Biomarkers currently available are not reliable for treatment decisions. - Symptomatic management should be prioritized over extensive testing. - Clinical trials show variability in lab results over time. - Excessive lab testing can lead to confusion and unnecessary anxiety for patients. - Understanding patient history is crucial in diagnosing immune deficiencies. - The role of family history is significant in identifying X-linked conditions. - Collaboration among dermatologists is essential for advancing treatment approaches. Chapters 00:00 - Introduction to Chronic Urticaria Workup 02:47 - Testing Approaches and Guidelines for Chronic Urticaria 05:41 - The Role of Biomarkers in Treatment Decisions 08:16 - Clinical Insights on Immune Deficiencies 11:14 - Variability in Lab Results and Clinical Trials 14:07 - Conclusion and Future Directions in Dermatology

The permanent closure of Sabic's cracker and other facilities at Wilton, UK, shows how tough conditions are in Europe with recyclers also feeling the pinch. -          Closure of UK polymer recycling facilities has been a shock to the industry-          European recyclers find it hard to compete against imports, more support for local recycling needed -          Regulations are helping recycling sector, but more action needed-          Outlook for Europe recycling more positive than for base chemicals-          Chemical plant closures remove good quality jobs which are tough to replace-          Wilton, UK site is perfect for development of circular economy-          EU-US 15% tariff deal removes threat of 30% but many questions remainIn this ICIS Think Tank podcast, Will Beacham interviews James McLeary, managing director for Biffa Polymers and ICIS Insight Editor Tom Brown. 

In the eighth episode of season 4, special host Dr. Cara English, Chief Executive Officer (CEO) and Chief Academic Officer (CAO) of Cummings Graduate Institute for Behavioral Health Studies (CGI), sits down with Dr. David Clarke, President and Co-Founder of the Association for the Treatment of Neuroplastic Symptoms. Together, they look into the emerging science of neuroplastic pain, which are chronic symptoms caused by learned neural pathways in the brain rather than disease or injury. Dr. Clarke shares how these misunderstood conditions are being redefined through the lens of mind-body medicine. Tune in to explore how neuroplasticity is reshaping our understanding of chronic illness.About the Special Host:Dr. Cara English, DBH is the Chief Executive Officer and Chief Academic Officer of Cummings Graduate Institute for Behavioral Health Studies (CGI) and Founder of Terra's Tribe, a maternal mental health advocacy organization in Phoenix, Arizona. Dr. English spearheaded a perinatal behavioral health integration project at Willow Birth Center from 2016 to 2020 that received international acclaim through the publication of outcomes in the International Journal of Integrated Care. Dr. English served as Vice-President of the Postpartum Support International – Arizona Chapter Founding Board of Directors and co-chaired the Education and Legislative Advocacy Committees. She currently serves on the Maternal Mortality Review Program and the Maternal Health Taskforce for the State of Arizona. She served as one of three Arizonan 2020 Mom Nonprofit Policy Fellows in 2021. For her work to establish Cummings Graduate Institute for Behavioral Health Studies, Cara was awarded the Psyche Award from the Nicholas & Dorothy Cummings Foundation in 2018 and is more recently the recipient of the 2022 Sierra Tucson Compassion Recognition for her work to improve perinatal mental health integration in Arizona.About the Guest:David D. Clarke, MD is President of the Association for Treatment of Neuroplastic Symptoms, and Clinical Assistant Professor of Gastroenterology Emeritus at Oregon Health & Science University in Portland, Oregon.  He is board-certified in Gastroenterology and Internal Medicine and has treated over 7000 patients whose symptoms were not explained by disease or injury but rather by stress or trauma. His book for patients, They Can't Find Anything Wrong!, was praised by a president of the American Psychosomatic Society as “truly remarkable.” He has also edited two textbooks on stress-based conditions, co-produced three documentary films, lectures across North America and Europe and has done hundreds of interviews for TV, Radio, and podcasts.www.Symptomatic.me 

Symptomatic gallstones that can't be treated with surgery? Interventional radiology can help. In this episode of BackTable, Dr. John Smirniotopoulos, IR at MedStar Health, joins Dr. Michael Barraza to share the latest advancements and techniques in biliary endoscopy. --- SYNPOSIS Dr. Smirniotopoulos reflects on his early work with cholangioscopy at Cornell, highlighting ongoing innovation and evolving tools. The conversation covers the practical aspects of patient selection, procedural steps, and overcoming technical challenges. Dr. Smirniotopoulos shares his personal experiences managing small and large biliary stones, emphasizing the important role of selecting appropriate equipment to navigate procedural challenges. Dr. Smirniotopoulos also highlights the collaborative role of surgeons and gastroenterologists throughout patient management. He also provides insights into the management of biliary strictures and emphasizes the importance of accurate billing and coding. The episode concludes with advice for clinicians seeking to integrate these techniques into their practice. --- TIMESTAMPS 00:00 - Introduction01:09 - Early Experiences with Biliary Endoscopy03:35 - Procedure Techniques and Tools05:36 - Patient Selection and Case Studies11:01 - Advanced Techniques and Equipment14:02 - Patient Management and Follow-Up18:21 - Technical Considerations and Best Practices20:14 - Managing Stones in the Gallbladder35:42 - Collaborating with Surgeons and GI Teams37:59 - Advice for New Practitioners

In the second installment of this two-part series, Dr. Jeff Ratliff and Dr. Brin E. Freund discuss clinical guidance for managing patients who may experience neurotoxicity from CAR T-cell, with a specific focus on seizure risk.  Show reference:  https://www.neurology.org/doi/10.1212/WNL.0000000000213535 

In part one of this two-part series, Dr. Jeff Ratliff and Dr. Brin E. Freund discuss the incidence of acute symptomatic seizures during CAR T-cell therapy.  Show reference:  https://www.neurology.org/doi/10.1212/WNL.0000000000213535   

Dr. Jeff Ratliff talks with Dr. Brin E. Freund about the evaluated incidence and risk factors for acute symptomatic seizures during CAR T-cell therapy. Read the related article in Neurology®.  Disclosures can be found at Neurology.org. 

Dr. David Clarke shares his 40-year journey as a medical consultant specializing in neuroplastic conditions—real physical symptoms generated by the brain in response to stress, trauma, or emotional challenges. He explains how these conditions affect 20% of adults and 40% of doctor visits, yet remain frequently misdiagnosed despite being highly treatable.• Neuroplastic symptoms are physical manifestations created by the brain in response to stress or trauma• These conditions affect strong individuals carrying burdens they've normalized, not "weak" or "neurotic" people• Adverse childhood experiences (ACEs) can create lasting impacts through stressful personality traits, triggers, and unrecognized emotions• Brain circuits physically change with chronic stress and can change back with appropriate treatment• The brain creates all sensations—even with physical injuries, pain signals originate in the brain• Long Covid and similar conditions may involve neuroplastic mechanisms that maintain symptoms after initial triggers• Recovery includes reframing self-perception from weakness to strength, setting boundaries, and processing emotions• Transformation extends beyond symptom relief to improved relationships and becoming "who you were meant to be"Visit Symptomatic Me to take a 12-item questionnaire assessing for neuroplastic symptoms, and check out "The Story Behind the Symptoms" podcast where Dr. Clarke interviews patients about their recovery journeys.Symptomatic.MeMessage the podcast! - questions will be answered on my youtube channel :) For more information about Long Covid Breathing courses & workshops, please check out LongCovidBreathing.com (music credit - Brock Hewitt, Rule of Life) Support the show~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~The Long Covid Podcast is self-produced & self funded. If you enjoy what you hear and are able to, please Buy me a coffee or purchase a mug to help cover costsTranscripts available on individual episodes herePodcast, website & blog: www.LongCovidPodcast.comFacebook @LongCovidPodcastInstagram Twitter @LongCovidPodFacebook Creativity GroupSubscribe to mailing listPlease get in touch with feedback, suggestions or how you're doing - I love to hear from you, via socials or LongCovidPodcast@gmail.com**Disclaimer - you should not rely on any medical information contained in this Podcast and related materials in making medical, health-related or other decisions. Please consult a doctor or other health professional**

In this episode, Dr. Thomas McGinn and guest expert Dr. Nezar Falluji discuss a new NEJM publication that explores the approaches for patients with symptomatic severe tricuspid regurgitation, comparing the outcomes and adverse events of transcatheter replacement to medical therapy.Guest: Dr. Nezar Falluji, Interventional CardiologistSystem Physician Vice President, CommonSpirit Health National Cardiovascular Service LineArticle discussed: https://www.nejm.org/doi/full/10.1056/NEJMoa2401918?query=WB&cid=NEJM%20Weekend%20Briefing,%20January%2011,%202025%20DM2381304_NEJM_Non_Subscriber&bid=-1550043199

Send us a textJoin our host, Dr. Byron Stephens, as he speaks with Dr. Michael Kelly and Dr. Steven Glassman, two of the authors of Scoliosis Research Society–funded research recently published in the Journal of American Medical Association -- Surgery. Congratulations to all the authors on this outstanding achievement!The study, Long-Term Outcomes of Operative Versus Nonoperative Treatment for Adult Symptomatic Lumbar Scoliosis (ASLS): Durability of Treatment Effects and Impact of Related Serious Adverse Events Through 8-Year Follow-Up, was published in the Journal on April 2, 2025.To bring the study to its full 8-year follow up allowing for the JAMA publication, funding was provided by the SRS and several of the SRS industry partners and the International Spine Study Group . The SRS community and the study investigators appreciate the additional investments provided above and beyond their support of SRS, made by Globus Medical, K2M/Stryker Spine, Medtronic, NuVasive, and Zimmer Biomet.*The Scoliosis Research Society (SRS) podcast is aimed at delivering the most current and trusted information to clinicians that care for patients with scoliosis and other spinal conditions. From news in the world of spinal conditions, to discussions with thought leaders in the field, we aim to provide up-to-date, quality information that will impact the daily practice of spinal conditions.

Neuro-ophthalmic deficits significantly impair quality of life by limiting participation in employment, educational, and recreational activities. Low-vision occupational therapy can improve cognition and mental health by helping patients adjust to visual disturbances. In this episode, Katie Grouse, MD, FAAN, speaks with Sachin Kedar, MD, FAAN, author of the article “Symptomatic Treatment of Neuro-ophthalmic Visual Disturbances” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Kedar is the Cyrus H Stoner professor of ophthalmology and a professor of neurology at Emory University School of Medicine in Atlanta, Georgia. Additional Resources Read the article: Symptomatic Treatment of Neuro-ophthalmic Visual Disturbances Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Guest: @AIIMS1992 Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Sachin Kedar about his article on symptomatic treatment of neuro-ophthalmic visual disturbances, which appears in the April 2025 Continuum issue on neuro-ophthalmology. Welcome to the podcast, and please introduce yourself to our audience. Dr Kedar: Thank you, Katie. This is Sachin Kedar. I'm a neuro-ophthalmologist at Emory University, and I've been doing this for more than fifteen years now. I trained in both neurology and ophthalmology, with a fellowship in neuro-ophthalmology in between. It's a pleasure to be here. Dr Grouse: Well, we are so happy to have you, and I'm just so excited to be discussing this article with you, which I found to be a real treasure trove of useful clinical information on a topic that many find isn't covered enough in their neurologic training. I strongly recommend all of our listeners who work with patients with visual disturbances to check this out. I wanted to start by asking you what you hope will be the main takeaway from this article for our listeners? Dr Kedar: The most important takeaway from this article is, just keep vision on your radar when you are evaluating your patients with neurological disorders. Have a list of a few symptoms, do a basic screening vision, and ask patients about how their vision is impacting the quality of life. Things like activities of daily living, hobbies, whether they can cook, dress, ambulate, drive, read, interact with others. It is very important for us to do so because vision can be impacted by a lot of neurological diseases. Dr Grouse: What in the article do you think would come as the biggest surprise to our listeners? Dr Kedar: The fact that impairment of vision can magnify and amplify neurological deficits in a lot of what we think of as core neurological disorders should come as a surprise to most of the audience. Dr Grouse: On that note, I think it's probably helpful if you could remind us about the types of visual disturbances we should be thinking about and screening for in our patients? Dr Kedar: Patients who have neurological diseases can have a whole host of visual deficits. The simplest ones are deficits of central vision. They can have problems with their visual field. They can have abnormalities of color vision or even contrast sensitivity. A lot of our patients also complain of light sensitivity, eyes feeling tired when they're doing their usual stuff. Some of our patients can have double vision, they can have shaky vision, which leads to their sense of imbalance and maybe a fall risk to them. Dr Grouse: It's really helpful to think about all the different aspects in which vision can be affected, not just sort of the classic loss of vision. Now, your article also serves as a really important reminder, which you alluded to earlier, about how impactful visual disturbances can be on daily activities. Could you elaborate a little further on this, and particularly the various domains that can be affected when there are visual disturbances present? Dr Kedar: So, when I look at how visual disturbances affect quality of life, I look at two broad categories. One is activities of basic daily living. These would be things like, are you able to cook? Are you able to ambulate not just in your home, but in your neighborhood? Are you able to drive to your doctor's appointment or to visit with your family? Are you able to dress yourself appropriately? Are you able to visualize the clothing and choose them appropriately? And then the second category is recreational activities. Are you able to read? Are you able to watch television? Are you able to visit the theatre? Are you able to travel? Are you able to participate in group activities, be it with your family or be it with your social group? It is very important for us to ask our patients if they have problems doing any of this because it really can adversely impact the quality of life. Dr Grouse: I think, certainly with all the things we try to get through talking with our patients, this may not be something that we do spend a lot of time on. So, I think it's it is a good reminder that when we can, being able to ask about these are going to be really important and help us hit on a lot of other things we may not even realize or know to ask about. Now, I was really struck when I was reading your article by the meta-analysis that you had quoted that had showed 47% higher risk of developing dementia among the visually impaired compared to those without visual impairments. Should we be doing more in-depth visual testing on all of our patients with cognitive symptoms? Dr Kedar: This is actually the most interesting part of this article, and kind of hones in on the importance of vision in neurological disorders. Now I want to clarify that patients with visual disorders, it's not a causative influence on dementia, but if you have a patient with an underlying cognitive disorder, any kind of visual disturbance will significantly make it worse. And this has been shown in several studies, both in the neurologic and in the ophthalmological literature. So, I quoted one of the big meta-analysis over there, but studies have clearly shown that if you have these patients and treat them for their visual deficits, their cognitive indices can actually significantly improve. To answer your question, I would say a neurologist should include basic vision screening as part of every single evaluation. Now, I know it's a hard thing in, you know, these days when we are literally running on the hamster wheel, but I can assure you that it won't take you more than 2 to 3 minutes of your time to do this basic screening; in fact, you can have one of your assistants included as part of the vital signs assessment. What are these basic screening tools? Measure the visual acuity for both near and distance. Check and see if their visual field's off with the confrontation. Look at their eye movements. Are they able to move their eyes in all directions? Are the eyes stable when they're trying to fixate on a particular point? I think if you can do these basic things, you will have achieved quite a bit. Dr Grouse: That's really helpful, and thanks for going through some of the standard, or really, you know, solid basic foundation of visual testing we should be thinking about doing. I wanted to move on to some more details about the visual disturbances. You made an excellent point that there are many types of primary ophthalmologic conditions that can cause visual disturbances that we should keep in mind. So maybe not things that we think about a lot on a day-to-day basis, but, you know, are still there and very common. What are some of the most common ones, and when should we be referring them to see an ophthalmologist? Dr Kedar: So, it depends on the age group of your patient population. Now, the majority of us are adult neurologists, and so the kinds of ophthalmic conditions that we see in this population is going to be different from the pediatric age group. So in the adult population, we might see patients with uncorrected refractive error, presbyopia, patients who have cataracts creep on them, they may have glaucoma, they may have macular degeneration, and these tend to have a slightly higher incidence in the older age group. Now for those of us who are taking care of the younger population, uncorrected refractive errors, strabismus and amblyopia tend to be fairly common causes of visual deprivation in this age group. What I would encourage all of our neurologists is, make sure that your patients get a basic eye examination at least once a year. Just like you want them to go to their primary care and get an annual maintenance visit, everybody should go to the ophthalmologist or the optometrist and get a basic examination. And, if you're resourceful enough, have your patients bring a copy of that assessment. Whether it is normal or there's some abnormality, it is going to help you in the management. Dr Grouse: Absolutely. I think that's a great piece of advice, to think of it almost, like, them seeing their primary care doctor, which of course we offer encourage our patients to do, thinking of this as another very important piece of standard primary care. If a patient comes to you reporting difficulty reading due to possible visual disturbances, I'm curious, can you walk us through how you would approach this evaluation? Dr Kedar: It is not a very common presenting complaint of our patients, even in the neuro-ophthalmology clinic. It's a very rare patient that I see who comes and says, I cannot read or, I have difficulty reading. Most of the patients will come saying, oh, I cannot see. And then you have to dig in to find out, what does that actually mean? What can you not see? Is it a problem in your driving? Is it a problem in your reading? Or is it a problem that occurs at all times? Now you asked me, how do you approach this evaluation? One of the things that all of us, whether we are neurologists, ophthalmologists, or neuro-ophthalmologists, forget to do is to actually have the patient read a paragraph, a sentence, when they are in clinic. And that will give you a lot of ideas about what might actually be going wrong with the patient. Now, as far as how do I approach this evaluation, I will do a basic screening examination to make sure that their visual acuity is good for both distance and near. A lot of us tend to do either distance or near and we will miss the other parameter. You want to do a basic confrontation visual field to make sure that they do not have any subtle deficits that's impacting their ability to read. Examine the eye movements, do a fundoscopic examination. Now, once you've done this basic screening, as a neurologist, you already have some idea of whether your patient has a lesion along the visual pathways. If you suspect that this is a problem with, say, the visual pathways, ask your ophthalmology colleague to do a formal visual field assessment, and that'll pick up subtle deficits of central visual field. And lastly, don't forget higher visual function testing or cortical visual function testing. So basically, you're looking for neglect, phenomenon, or simultanagnosia, all of which tends to have an impact on reading. So, in the manuscript I have a schema of how you can approach a patient with reading difficulties, and in that ischemia you will see categories of where things can go wrong during the process of reading. And if you can approach your patient systematically through one of those domains, there's a fairly good chance that you'll be able to pick up a problem. Dr Grouse: Going a little further on to when you do identify problems with loss of central or peripheral vision, what are some strategies for symptomatic management of these types of visual disturbances? Dr Kedar: As a neurologist, if you pick up a problem with the vision, you have to send this patient to an eye care provider. The vast majority of people who have visual disturbances, it's from an eye disease. You know, as I alluded to earlier, it can be something as simple as uncorrected refractive error, and that can be fixed easily. A lot of patients in our older age group will have dry eye syndrome, which means they are unable to adequately lubricate the surface of the eye, and as a result, it degrades the quality of their vision. So, they tend to get intermittent episodes of blurred vision, or they tend to get glare. They tend to get various forms of optical aberration. Patients can have cataracts, patients can have glaucoma or macular degeneration. And in all of those instances, the goal is to treat the underlying disease, optimize the vision, and then see what the residual deficit is. By and large, if a patient has a problem with the central vision, then magnification will help them for activities that they perform at near; say, reading. Now for patients with peripheral vision problem, it's a different entity altogether. Again, once you've identified what the underlying cause is, your first goal is to treat it. So, for example, if your patient has glaucoma, which is affecting peripheral vision, you're going to treat glaucoma to make sure that the visual field does not progress. Now a lot of what happens after that is rehabilitation, and that is always geared towards the specific activities that are affected. Is it reading? Is it ambulating? Is it watching television? Is it driving? And then you can advise as a neurologist, you can advise your occupational therapist or low vision specialist and say, hey, my patient is not able to do this particular activity. Can we help them? Dr Grouse: Moving on from that, I wanted to also hit on your approach when patients have disorders of ocular motility. What are some things you can do for symptomatic management of that? Dr Kedar: So, patients with ocular motility can have two separate symptoms. Two, you know, two disabling symptoms, as they would call it. One is double vision and the other is oscillopsia, or the feeling or the visualization of the environment moving in response to your eyes not being able to stay still. Typically, you would see this in nystagmus. Now, let's start with diplopia. Diplopia is a fairly common presenting complaint for neurologists, ophthalmologists, and the neuro-ophthalmologist. The first aspect in the management of diplopia is to differentiate between monocular diplopia and binocular diplopia. Now, monocular diplopia is when the double vision persists even after covering one eye. And that is never a neurological issue. It's almost always an ophthalmic problem, which means the patient will then have to be assessed by an eye care provider to identify what's causing it. And again, refractive error, cataracts, opacities, they can do it. Now, if the patient is able to see single vision by covering one eye at a time, that's binocular diplopia. Now, in patients with binocular diplopia in the very early stages of the disease, the standard treatment regimen is just monocular occlusion. Cover one eye, the diplopia goes away, and then give it time to improve on its own. So, this is what we would typically do in a patient with, say, acute sixth nerve palsy or fourth nerve palsy or third nerve palsy, maybe expect spontaneous improvement in a few months. Now if the double vision does not improve and persists long term, then the neuro-ophthalmologist or the ophthalmologist will monitor the amount of deviation to see if it fluctuates or if it stays the same. So, what are the treatment options that we have in a patient who absolutely refuses any intervention or is not a candidate for any intervention? Monocular occlusion still remains the viable option. Now, patients who have stable ocular deviation can benefit from using prisms in their glasses, or they can be sent to a surgeon to have a strabismus surgery that can realign their eyes. So, again, a broad answer, but there are options available that we can use. Dr Grouse: Thank you for that overview. I think that's just really helpful to keep in mind as we're working with these patients and thinking about what their options are. And then finally, I wanted to touch on patients with higher-order vision processing and attention difficulties. What are some strategies for them? Dr Kedar: These are frankly the most difficult patients that I get to manage in my clinic, simply because there is no effective therapies for managing them. In fact, I think neurologists are far better at this than ophthalmologists or even neuro-ophthalmologists. In patients with attentional disorders, everything boils down to the underlying cause, whether you can treat it or whether it is a slowly progressive, you know, condition, such as from neurodegenerative diseases. And that tailors our goals towards therapy. The primary goal is for safety. A lot of these patients who have visual disturbances from vision processing or attention, they are at accident and fall risk. They have problems with social interactions. And, importantly, there is a gap of understanding of what's going on, not just from their side but also from the family's side. So, I tend to approach these patients from a safety perspective and social interaction perspective. Now, I have a table listed in the manuscript which will go into details of what the specific things are. But in a nutshell, if your patient has neglect in a specific part of the visual field, they have accident risk on that side. Simple things like walking through a doorway, they can hurt their shoulders or their knees when they bang into the wall on that side because they are unable to judge what's on the other side. Another example would be a patient who has simultanagnosia or a downgaze policy, such as from progressive super nuclear policy. They are unable to look down fast enough, or they are simply unable to look down and appreciate things that are on the floor, and so they can trip and fall. Walking downstairs is also not a huge risk because they are unable to judge distances as they walk down. A lot of what we see in these patients are things that we have to advise occupational therapists and help them improve these safety parameters at home. Another thing that we often forget is patients can inadvertently cause a social incident when they tend to ignore people on their affected side. So, if there is a family gathering, they tend to consistently ignore a group of people who are sitting on the affected side as opposed to the other side. And I've had more than a few patients who've come and said that, I may have offended some of my friends and family. In those instances, it's always helpful when they are in clinic to demonstrate to the family how this can be awkward and how this can be mitigated. So, having everybody sit on one side is a useful strategy. Advise your family and friends before a gathering that, hey, this may happen. And it is not because it is deliberate, but it's because of the medical condition. And that goes a lot, you know, further in helping our patients come out of social isolation because they are also afraid of offending people, you know. And they can also participate socially, and it can overall improve their quality of life. Dr Grouse: That's a really helpful tip, and something I'll keep in mind with my patients with neglect and visual field cuts. Thank you so much for coming to talk with us today. Your article has been so helpful, and I urge everybody listening today to take a look. Dr Kedar: Thank you, Katie. It was wonderful talking to you. Dr Grouse: I've been interviewing Dr Sachin Kedar about his article on symptomatic treatment of neuro-ophthalmic visual disturbances, which appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

PodChatLive 179: Words relating to symptomatic flat feet in children, effects of foot orthoses wedging, and questioning whether biomechanical experiments are of any valueContact us: getinvolved@podchatlive.comLinks from today episode:Foot orthosis with posterior-medial posting alone produces similar effects than anterior-medial plus posterior-medial postings on the lower limb mechanics and muscle activation during normal walkingThe F-words relating to symptomatic flexible flat feet: A scoping reviewThe correlation between biomechanical experiments and clinical studies in orthopedics: a systematic review

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 slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/BRK865. CME/MOC/NCPD/AAPA credit will be available until April 29, 2026.Exploring the Promise of Biomarkers and ATTs in Diagnosing and Treating Early Symptomatic Alzheimer's Disease: Key Takeaways From AD/PD 2025 and AAN 2025 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 by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/BRK865. CME/MOC/NCPD/AAPA credit will be available until April 29, 2026.Exploring the Promise of Biomarkers and ATTs in Diagnosing and Treating Early Symptomatic Alzheimer's Disease: Key Takeaways From AD/PD 2025 and AAN 2025 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 by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/BRK865. CME/MOC/NCPD/AAPA credit will be available until April 29, 2026.Exploring the Promise of Biomarkers and ATTs in Diagnosing and Treating Early Symptomatic Alzheimer's Disease: Key Takeaways From AD/PD 2025 and AAN 2025 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 by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/BRK865. CME/MOC/NCPD/AAPA credit will be available until April 29, 2026.Exploring the Promise of Biomarkers and ATTs in Diagnosing and Treating Early Symptomatic Alzheimer's Disease: Key Takeaways From AD/PD 2025 and AAN 2025 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 by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/BRK865. CME/MOC/NCPD/AAPA credit will be available until April 29, 2026.Exploring the Promise of Biomarkers and ATTs in Diagnosing and Treating Early Symptomatic Alzheimer's Disease: Key Takeaways From AD/PD 2025 and AAN 2025 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 by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/BRK865. CME/MOC/NCPD/AAPA credit will be available until April 29, 2026.Exploring the Promise of Biomarkers and ATTs in Diagnosing and Treating Early Symptomatic Alzheimer's Disease: Key Takeaways From AD/PD 2025 and AAN 2025 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 by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation

The Robyn Engelson Podcast Ever wish you had a wellness mentor with over decades of experience whispering million dollar health tips in your ear? That's exactly what you will get each week when you tune into The Robyn Engelson Podcast. I'm your host–a sought after autoimmune and wellness expert, corporate drop-out turned serial entrepreneur, and lifestyle transformer. Each week, I'll be bringing you inspiring guests, insights, and mindset tools to empower you to be energized, compress time, and start living instead of existing.    Episode Title:  Exhausted, in pain, anxious and your labs say you're "fine"? Host: Robyn Engelson Guest:  Dr. David Clarke Episode Summary: In this powerful episode, Robyn sits down with Dr. David Clarke, a renowned expert in mind-body medicine, to explore the hidden connection between emotional trauma and chronic physical symptoms. Dr. Clarke explains how many people suffer from real, debilitating issues—such as fatigue, pain, or digestive problems, even when their medical tests come back normal. The conversation dives into how unresolved childhood stress and emotional pain can manifest physically, especially when left unacknowledged. Dr. Clarke shares stories from his practice, emphasizing the importance of listening to patients' life experiences, not just their lab results. Together, they discuss why so many women are dismissed by the healthcare system and how compassion, awareness, and emotional healing can be the missing key to true recovery. This episode offers a new lens to understand your symptoms and encourages you to trust your body's signals and your own story.   You'll learn: How unresolved emotional trauma and chronic stress can manifest as real physical symptoms The role of mind-body connection in chronic illness—and why standard medical tests often miss the root cause Why patients with normal labs still suffer, and how emotional history can reveal hidden clues How adverse childhood experiences and past life stressors can influence present-day health The importance of validating your symptoms and seeking trauma-informed care The healing power of compassionate listening—and how the right doctor-patient relationship can change your entire recovery journey   Memorable Quotes: “Healing the thyroid isn't just about labs—it's about listening to your story.” “So many patients are dismissed because their symptoms don't show up on paper. That doesn't mean they're not real.” “Compassionate care isn't optional—it's essential to true healing.” “The gut and thyroid are in constant conversation. When one's off, the other listens.” “You don't need to be your own doctor—but you do need to be your own advocate.”   Resources & Mentions: Dr. David Clarke's insights on compassionate care and thyroid healing Research on the gut-thyroid connection in autoimmune diseases Functional medicine approaches for diagnosing beyond standard lab work Clinics focusing on integrative and empathetic thyroid care   Actionable Steps for Listeners: Trust Your Instincts: If your body says something's wrong—even when labs say you're "fine"—don't ignore it. Your symptoms are valid. Prioritize Gut Health: Gut health plays a powerful role in thyroid and hormone regulation. Seek guidance from professionals familiar with both. Understand Inflammation & Genetics: Learn how these hidden factors might be draining your energy and impacting your thyroid without obvious signs. Advocate for Compassionate Care: Don't settle for being dismissed. Find a provider who listens, explains, and respects your health journey   Final Thought: When patients feel dismissed or unheard, it delays healing. That's why compassion matters just as much as science. Your symptoms aren't imaginary—they're messages. When we slow down, listen, and connect the dots between gut health, inflammation, genetics, and thyroid function, we find answers others often miss. True healing begins when you're seen, heard, and supported. You deserve that kind of care.   What listeners have to say: Dr. David brings such calm clarity to complex issues. His approach made me feel seen, heard, and finally understood. This episode gave me real hope for healing what I thought I'd have to live with forever.   Loved this episode? If you found value in this conversation, don't forget to leave a review! Scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Your feedback helps us create content that supports your journey to thriving, not just surviving.   Connect with Dr. David: LinkedIn Instagram Facebook   About Dr. David Clarke: Dr. David Clarke is the President of the Association for Treatment of Neuroplastic Symptoms (ATNS), a 501(c)(3) nonprofit dedicated to ending the chronic pain epidemic. Dr. Clarke holds an MD from the University of Connecticut School of Medicine and is Board-certified in Internal Medicine and Gastroenterology. His organization's mission is to advance the awareness, diagnosis, and treatment of stress-related, brain-generated medical conditions. Learn more at Symptomatic.Me..   Connect with Robyn: Book Robyn to speak Get Robyn's #1 best selling book, Exhausted To Energized - 90 Days To Your Best Self  Get Robyn's free video  Sign up for Robyn's personal letter  View Robyn's website Follow Robyn on LinkedIn Robyn's Facebook Watch Robyn on Instagram    

He's not an #$$hole, He's Symptomatic - Erin Maccabee & Cinnamon Reiheld   Episode Summary In this episode of the First Responder Wellness Podcast, host Conrad Weaver is joined by Erin Maccabee and Cinnamon Reiheld for a powerful conversation about the mental health challenges faced by first responders. They explore how trauma, desensitization, and high ACEs scores impact emotional well-being, and why compassion, vulnerability, and peer support are essential for healing. Erin and Cinnamon share their personal journeys, discuss the cultural stigma around mental health in emergency services, and offer actionable steps first responders can take toward recovery and resilience. Whether you're on the front lines or supporting someone who is, this episode delivers insight, hope, and a path forward. Together, they explore: The personal journeys that led Erin and Cinnamon into the field of first responder wellness The often-hidden trauma and emotional toll these professionals face daily How compassion, peer support, and vulnerability can break through the stigma and silence The evolution of mental health awareness in emergency services and the importance of grassroots movements The powerful connection between high ACEs scores (Adverse Childhood Experiences) and career choices in high-stress professions Listeners will walk away with a deeper understanding of the emotional landscape of first responders, actionable strategies for healing, and the critical role of community support and mental health training in fostering long-term wellness.

LifeBlood: We talked about the brain body connection, how over 50 million Americans are suffering from neurosplastic symptoms without realizing it, how childhood trauma manifests in physical pain and what can be done about it, and how to know if you're being afflicted by this, with Dr. David Clarke, President of the Association for Treatment of Neuroplastic Symptoms.   Listen to learn what to do if you feel you're constantly swimming against the current! You can learn more about David at Symptomatic.ME, Facebook, Instagram, YouTube, and Linkedin. Thanks, as always for listening! If you got some value and enjoyed the show, please leave us a review here: ​​https://ratethispodcast.com/lifebloodpodcast You can learn more about us at LifeBlood.Live, Twitter, LinkedIn, Instagram, YouTube and Facebook or you'd like to be a guest on the show, contact us at contact@LifeBlood.Live.  Stay up to date by getting our monthly updates. Want to say “Thanks!” You can buy us a cup of coffee. https://www.buymeacoffee.com/lifeblood Copyright LifeBlood 2025.

In this podcast, George Lawson and Hermione Lyall discuss their paper 'Polymicrogyria in infants with symptomatic congenital cytomegalovirus at birth is associated with epilepsy: A retrospective, descriptive cohort study'.   The paper is available here: https://doi.org/10.1111/dmcn.16250   Follow DMCN on Podbean for more:  https://dmcn.podbean.com/ ___ Watch DMCN Podcasts on YouTube: https://bit.ly/2ONCYiC __ DMCN Journal: Developmental Medicine & Child Neurology (DMCN) has defined the field of paediatric neurology and childhood-onset neurodisability for over 60 years. DMCN disseminates the latest clinical research results globally to enhance the care and improve the lives of disabled children and their families.   DMCN Journal - https://onlinelibrary.wiley.com/journal/14698749 ___ Find us on Twitter! @mackeithpress - https://twitter.com/mackeithpress

Miho Fukui, MD, JACC: Case Reports Associate Editor, is joined by author Ree Lu, MD, discussing this study from Cho et al presented at ACC.25 and published in JACC: Case Reports. Intravenous leiomyomatosis (IVL) is a rare benign uterine growth that extends into the venous system. This case describes a 48-year-old female who presented with 1 month of chest pain and dyspnea on exertion. She was found to have a right atrial mass that transiently crossed into the right ventricle with associated moderate tricuspid regurgitation. Computed tomography revealed a uterine mass with contiguous intravascular extension through the inferior vena cava terminating in the right atrium. This case of symptomatic tricuspid valve obstruction due to IVL illustrates the importance of maintaining preload. Chest and abdominal imaging may be necessary to identify the source of the mass and ensure appropriate surgical planning.

Exploring Neuroplastic Pain: Insights from Dr. David ClarkeIn this episode, host Deborah interviews Dr. David Clarke, President of the Association for Treatment of Neuroplastic Symptoms (ATNS). They discuss the chronic pain epidemic, neuroplasticity, and its link to stress-related and brain-generated medical conditions. Dr. Clarke highlights various conditions such as fibromyalgia, migraines, and chronic fatigue as examples of neuroplastic pain. He emphasizes the importance of understanding one's life stressors and adverse childhood experiences (ACEs) in diagnosing and treating these conditions. Deborah and Dr. Clarke also delve into the effectiveness of pain relief psychotherapy compared to traditional CBT. They underscore the essential role of self-esteem and the accurate understanding of personal experiences in relieving chronic pain and stress symptoms. The conversation sheds light on the necessity for modern healthcare to incorporate these insights for better patient outcomes.00:00 Introduction to Dr. David Clarke and ATNS00:58 Understanding Neuroplasticity03:04 Chronic Pain and Stress Connection05:52 Adverse Childhood Experiences (ACEs) and Chronic Illness12:56 Pain Relief Psychotherapy and Its Effectiveness18:31 Differences Between CBT and Pain Relief Psychology24:54 The Language of Physical Symptoms28:28 Protective Programs and Boundary Setting29:01 Impact of Adverse Childhood Experiences (ACEs)29:42 Rebuilding Self-Esteem30:51 Therapeutic Techniques and Exercises31:56 The Role of Affirmations33:42 Understanding False Belief Systems34:10 Brain and Body Connection35:49 Journey into Gastroenterology and Neuroplasticity43:52 Challenges in Modern Healthcare45:26 The Importance of Collaboration in Healthcare46:05 Subtle Forms of Toxicity47:17 Patient Resistance and Acceptance49:27 The Power of Placebo and Effective Treatments51:20 Success Stories and TransformationsTo learn more visit: Symptomatic.Me

Dr Tap discusses the significance of the FDA approval of vimseltinib for symptomatic TGCT, in which surgical resection may worsen functional limitation or cause severe morbidity. He also discussed key efficacy and safety data from the pivotal phase 3 MOTION trial and the increasingly important role that multidisciplinary collaboration will play as this targeted therapy is further integrated into clinical practice. 

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral edema (HACE) is a severe form of AMS marked by encephalopathic changes Symptoms begin at elevations as low as 6500 feet above sea level for people who ascend rapidly May develop more severe symptoms at higher altitudes The pathophysiology involves cerebral vasodilation Occurs in everyone ascending to high altitudes but is more pronounces in those that develop symptoms The reduced partial pressure of oxygen induces hypoxic vasodilation in the brain, which results in edema and, ultimately, HACE in some patients Symptomatic presentation Headache, nausea, and sleeping difficulties occur within 2-24 hours of arrival at altitude HACE may occur between 12-72 hours after AMS and presents with ataxia, confusion, irritability, and ultimately results in coma if left untreated Clinical presentation may be mistaken for simple exhaustion, so clinicians should maintain a high index of suspicion Notably, if symptoms occur more than 2 days after arrival at altitude, clinicians should seek an alternative diagnosis but maintain AMS/HACE on the differential Treatment and management AMS Adjunctive oxygen and descent to lower altitude Acetazolamide is used as a preventive measure but is not helpful in acute treatment +/- dexamethasone HACE Patients with HACE should receive dexamethasone to help reduce cerebral edema Immediate descent to a lower altitude References Burtscher M, Wille M, Menz V, Faulhaber M, Gatterer H. Symptom progression in acute mountain sickness during a 12-hour exposure to normobaric hypoxia equivalent to 4500 m. High Alt Med Biol. 2014;15(4):446-451. doi:10.1089/ham.2014.1039 Levine BD, Yoshimura K, Kobayashi T, Fukushima M, Shibamoto T, Ueda G. Dexamethasone in the treatment of acute mountain sickness. N Engl J Med. 1989;321(25):1707-1713. doi:10.1056/NEJM198912213212504 Luks AM, Beidleman BA, Freer L, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 Update. Wilderness Environ Med. 2024;35(1_suppl):2S-19S. doi:10.1016/j.wem.2023.05.013 Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

Malachi and the moment. Return to me. (3.6-8) Symptomatic sin. “Will a man rob God? Yet you are robbing me.” (3.8-9) Tangible turning. Tithes and Offerings. (10a) And I will return to you. (10b-12)

Introducing Case #25: Trent (Pt. 1) from Symptomatic: A Medical Mystery Podcast.Follow the show: Symptomatic: A Medical Mystery PodcastTrent was a vibrant and successful insurance assessor when his life took an unexpected turn. While working under a car, he sensed something was off. It wasn’t until later that day -- when his legs stopped responding while driving -- that the severity of the situation hit him. What followed was a baffling health crisis that turned his world upside down. With two newborn twins at home, Trent's sudden immobility brought his worst fears to life.See omnystudio.com/listener for privacy information.DISCLAIMER: Please note, this is an independent podcast episode not affiliated with, endorsed by, or produced in conjunction with the host podcast feed or any of its media entities. The views and opinions expressed in this episode are solely those of the creators and guests. For any concerns, please reach out to team@podroll.fm.

"'Hopefully this will also gain some more confidence from other IR folks that, you know, if you have an appropriate candidate, and you feel comfortable performing this procedure, that you can now say, 'Hey, this potentially can last you for years.'"—Lucas R. Cusumano, MD, MPHIn this Journal of Vascular and Interventional Radiology (JVIR) audio episode, lead author Lucas R. Cusumano, MD, MPH, speaks with journal Managing Editor Ana Lewis about his December 2024 paper, "Genicular Artery Embolization for Treatment of Symptomatic Knee Osteoarthritis: 2-Year Outcomes from a Prospective IDE Trial."Related resources:Read the original article, "Genicular Artery Embolization for Treatment of Symptomatic Knee Osteoarthritis: 2-Year Outcomes from a Prospective IDE Trial," by Lucas R. Cusumano, MD, MPH, Hiro D. Sparks, MD, Kara E. Masterson, MSN, NP, Scott J. Genshaft, MD, Adam N. Plotnik, MD, and Siddharth A. Padia, MDSIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

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

Dr. Halley Alexander and Dr. Vineet Punia discuss factors influencing the decision to continue or discontinue anti-seizure medications at discharge for patients hospitalized with acute symptomatic seizures. Show reference: https://jamanetwork.com/journals/jamaneurology/article-abstract/2824063 

Dr. Halley Alexander talks with Dr. Vineet Punia about factors influencing the decision to continue or discontinue anti-seizure medications at discharge for patients hospitalized with acute symptomatic seizures.  Read the related article in JAMA.   Disclosures can be found at Neurology.org.

RESHAPE-HF2 – Percutaneous Repair of Moderate-to-Severe or Severe Functional Mitral Regurgitation in Patients with Symptomatic Heart Failure

In this episode of The Shoulder Physio podcast, I am joined by Dr John Kuhn, who is an orthopaedic surgeon and researcher from the United States. Doctor Kuhn and his colleagues, through the MOON shoulder group, have published several high impact studies investigating the management of individuals with rotator cuff tears and the results of these studies have caused some controversy (good controversy, that is). Rotator cuff tears are ubiquitous in musculoskeletal health care. They are both common and often burdensome, so it is important that shoulder surgeons and physiotherapists can agree on best practice management, for the betterment of the individual with the rotator cuff tear. So do John and I agree or not? Listen to find out. Don't miss this wonderful episode with Doctor John Kuhn. Key Papers: Kuhn et al; MOON Shoulder Group. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013 Oct;22(10):1371-9. doi: 10.1016/j.jse.2013.01.026. Epub 2013 Mar 27. PMID: 23540577; PMCID: PMC3748251. Dunn WR et al; MOON Shoulder Group. 2013 Neer Award: predictors of failure of nonoperative treatment of chronic, symptomatic, full-thickness rotator cuff tears. J Shoulder Elbow Surg. 2016 Aug;25(8):1303-11. doi: 10.1016/j.jse.2016.04.030. PMID: 27422460. Kuhn JE et al. The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort. J Bone Joint Surg Am. 2024 Sep 4;106(17):1563-1572. doi: 10.2106/JBJS.23.00978. Epub 2024 Jul 9. PMID: 38980920. Kuhn, 2023. Prevalence, Natural History, and Nonoperative Treatment of Rotator Cuff Disease Check out the Shoulder Physio Online Course here - 40% off for a limited time! Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 John's Research Gate profile See our Disclaimer here: The Shoulder Physio - Disclaimer

Welcome to this exciting LIVE panel discussion, where we gathered six esteemed professionals from the pharmacy industry on November 12th at 6PM ET, to dig into the intriguing world of "Symptomatic: A Medical Mystery Podcast."  Listen in to this fascinating discussion with Pharmaceutical Industry Epidemiologist Dr. Ryan Paul, the CEO of Yaral Pharma, Stephen Beckman, Pharmacogenomics Pharmacist expert, Dr. Becky Winslow, Pharmacy Profession's 'Pain Guy' expert in pain management and Professor at WVU University School of Pharmacy, Dr. Mark Garofoli, and Nutrigenomics Pharmacist pioneer, Dr. Tamar Lawful with panel moderator & founder of the first podcast about the pharmacy profession, the RxPodfather, Todd Eury as we explore the podcast's compelling narratives through a pharmacy care lens.  Hosted by Lauren Bright Pacheco, "Symptomatic" takes listeners on a weekly journey through the complexities of medical mysteries, examining how symptoms can shape patients' lives.  From the initial signs of trouble to the challenges of chronic illnesses and elusive diagnoses, this discussion promises to shed light on the critical intersection of pharmacy and patient care.  Tune in for an engaging conversation that blends expertise with the captivating stories of real-life medical enigmas. Find all Symptomatic episodes here:  https://www.iheart.com/podcast/1119-symptomatic-a-medical-mys-102740051/ 

I believe this world and this life is at the core, truly beautiful and glorious. And, we have some very concerning trends to address. Health care is the number one GNP in America. We spend more money, not on our health, but our unhealth, than on anything else. Why? Lifestyle. Just do the research. It's not happening to it, we are doing it to ourselves. A very unpopular perspective, but in truth, isn't that the best news? You have power, otherwise you are claiming victimhood. Healthcare in America has become sick-management. And we address the symptoms. Even cancer, which my Dad just died of, is a symptom. We try to beat cancer and don't ask…what is causing cancer. We create a new drug to treat every growing problem, without asking why the problem exists and keeps growing. Let's ask. Sign up for a $1/month trial period at shopify.com/kevin Go to shipstation.com and use code KEVIN to sign up for your FREE 60-day trial Get 20% off your first probiotic membership order at pendulumlife.com/drivesyou  Kajabi is offering a free 30-day trial to start your business if you go to Kajabi.com/kevin Go to cozyearth.com/driven and use code DRIVEN for an exclusive 40% discount Join thousands of parents who trust Fabric to protect their family. Apply in minutes at meetfabric.com/WHATDRIVESYOU. If you're concerned about OCD, visit NOCD.com to schedule a free 15-minute call with their team. Learn more about your ad choices. Visit megaphone.fm/adchoices

In her mid-20s and thriving in a fast-paced communications job, Mila Clarke began experiencing symptoms reminiscent of those her mom had managed with diabetes for years. However, as time went on, it became clear that this was different. Little did she know, her life was about to take a significant turn, leading her on an unexpected journey with a chronic illness she never saw coming.Support the show: https://www.steveharveyfm.com/See omnystudio.com/listener for privacy information.

In this episode, Dr. Valentin Fuster delves into a groundbreaking study on the effects of the cardiac myosin inhibitor, Aficamten, on patients with obstructive hypertrophic cardiomyopathy. The findings reveal significant improvements in echocardiographic measures of cardiac function, despite a mild and reversible decrease in left ventricular ejection fraction, highlighting the need for long-term safety evaluations of this promising treatment.

Listener feedback on PFA and STEMI/NSTEMI paradigm, oral semaglutide, symptomatic vs asymptomatic AF, and the win-ratio 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. Listener Feedback Oct 18, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001769 Pulsed Field Ablation https://www.hrsonline.org/guidance/safety-alerts/boston-scientific-cardiac-cryoablation-system STEMI/NSTEMI https://doi.org/10.1016/j.jacadv.2024.101314 II. Oral Semaglutide Press Release: https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=171480 Rationale Paper SOUL trial III. Symptomatic vs Asymptomatic AF Meta-analysis in EHJ   Meta-analysis of rate vs rhythm-control strategies https://doi.org/10.1016/j.jacep.2024.03.006 IV. The Win Ratio Pocock and colleagues https://doi.org/10.1093/eurheartj/ehae647 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

Contributor: Travis Barlock MD Educational Pearls: Assessment of head and neck vascular injury due to blunt trauma Symptomatic patients require screening head and neck CT angiography EAST guidelines include the following criteria for a screening CT angiography in blunt head trauma: Unexplained neurological deficits Arterial nosebleed GCS < 6 Petrous bone fracture Cervical spine fracture Any size fracture through the transverse foramen LeFort fractures type II or type III EAST guidelines include a grading scale for vascular injury: Grade I: Luminal irregularity or dissection with 25% luminal narrowing, intraluminal thrombus, or raised intimal flap Grade III: Pseudoaneurysm Grade IV: Occlusion Grade V: Transection with free extravasation References Bensch FV, Varjonen EA, Pyhältö TT, Koskinen SK. Augmenting Denver criteria yields increased BCVI detection, with screening showing markedly increased risk for subsequent ischemic stroke. Emerg Radiol. 2019;26(4):365-372. doi:10.1007/s10140-019-01677-0 Biffl WL, Moore EE, Offner PJ, et al. Optimizing screening for blunt cerebrovascular injuries. Am J Surg. 1999;178(6):517-522. doi:10.1016/s0002-9610(99)00245-7 Kim DY, Biffl W, Bokhari F, et al. Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(6):875-887. doi:10.1097/TA.0000000000002668 Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

This week we listen in on a debate from the PICS 2024 Symposium that occurred two weeks ago in San Diego. Today's debate is between master surgeon, Professor of Surgery at UCLA, Dr. Glen S. Van Arsdell taking the position of superiority of primary TOF repair and going up against Dr. Van Arsdell is noted master interventional cardiology expert, Professor of Pediatrics at Baylor College of Medicine, Dr. Athar M. Qureshi. Prepare for a spirited 'debate' between these two experts in their field. Apologies in advance for some sound deficiencies but the orators can be heard clearly enough to allow for an engaging back and forth and learning experience. Has either speaker swayed you? Take a listen!

Ronald Chen, MD, MPH, FASTRO, hosts a conversation on the background, methodology, primary recommendations, and implications of the updated External Beam Radiation Therapy for Palliation of Symptomatic Bone Metastases: An ASTRO Clinical Practice Guideline. Alongside Tracy Balboni, MD, MPH, and Sara Alcorn, MD, they discuss recent data and changes to practice patterns such as increased use of advanced treatment approaches (e.g., stereotactic radiation) and reirradiation. The guidelines address five key questions in this context, built upon a systematic review of the available literature and with assessment of evidence quality and recommendation strength.

Ronald Chen, MD, MPH, FASTRO, hosts a conversation on the background, methodology, primary recommendations, and implications of the updated External Beam Radiation Therapy for Palliation of Symptomatic Bone Metastases: An ASTRO Clinical Practice Guideline. Alongside Tracy Balboni, MD, MPH, and Sara Alcorn, MD, they discuss recent data and changes to practice patterns such as increased use of advanced treatment approaches (e.g., stereotactic radiation) and reirradiation. The guidelines address five key questions in this context, built upon a systematic review of the available literature and with assessment of evidence quality and recommendation strength.

The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort Kuhn JE, Dunn WR, Sanders R, et al. J Bone Joint Surg Am. Published Ahead of Print. doi:10.2106/JBJS.23.00978 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

Introducing Case #18: Gary (Part 2) from Symptomatic: A Medical Mystery Podcast.Follow the show: Symptomatic: A Medical Mystery PodcastGary Gravina, a skilled carpenter and Marine, was rushed to the ER in 2016 due to severe flu-like symptoms which morphed into a brutal battle with a mysterious disease. Discover how Gary's dire condition would lead him to Dr. David Fajgenbaum and Dr. Grant Mitchell, who had become experts on his rare disease. See how their collaboration not only saved Gary's life but also significantly impacted the field of medicine.See omnystudio.com/listener for privacy information.DISCLAIMER: Please note, this is an independent podcast episode not affiliated with, endorsed by, or produced in conjunction with the host podcast feed or any of its media entities. The views and opinions expressed in this episode are solely those of the creators and guests. For any concerns, please reach out to team@podroll.fm.

Did you know 1 in 8 women will get breast cancer in their lifetime? Join Lauren Bright Pacheco for a special episode from the 2024 ASCO Annual Meeting in Chicago, where she dives into the best collaborative approach to breast cancer diagnoses and care. Medical oncologist, Dr. Nan Chen, and breast cancer surgeon, Dr. Sarah Shubeck share how their teamwork benefits breast cancer treatment.See omnystudio.com/listener for privacy information.

Welcome to this special episode of the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice. For major FDA decisions in the field of neurology, we release short special episodes to offer a snapshot of the news, including the main takeaways for the clinical community, as well as highlights of the efficacy and safety profile of the agent in question. In this episode, we're covering the recent approval of donanemab as a new treatment for adults with early symptomatic Alzheimer disease (AD). Marketed as Kisunla, donanemab's approval marks the third antiamyloid therapy to get FDA greenlight for early-stage AD, following the controversial approval of aducanumab (Aduhelm; Biogen) in 2021 and lecanemab (Leqembi; Eisai) in 2023. Donanemab, administered as a 350 mg/20 mL once-monthly injection for intravenous infusion, had its approval supported by the phase 3 TRAILBLAZER-ALZ-2 trial (NCT04437511), a large-scale, double-blind, placebo-controlled trial that featured 1736 patients with early-stage AD. Following the approval, NeurologyLive sat down with Joel Salinas, MD, MBA, a behavioral neurologist at NYU Langone and clinical assistant professor in the department of neurology at the NYU Grossman School of Medicine. Salinas, who also serves as the chief medical officer at Isaac Health, discussed the positive impacts of the approval, the importance of patient selection for the medication, and how clinicians should discuss its benefits and harms to patients. In addition, he commented on how approvals like donanemab continue to carry momentum in the AD field going forward.  For more of NeurologyLive's coverage of donanemab's approval, head here: FDA Approves Eli Lilly's Donanemab for Early Symptomatic Alzheimer Disease Episode Breakdown: 2:10 – Positive downstream impacts of donanemab's approval 4:20 – Considerations and caution with prescribing donanemab 6:05 – Salinas on patient-clinician conversations about AD treatments 8:00 – Closing remarks and continued progress in AD field Thanks for listening to the NeurologyLive Mind Moments podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.

Contributor: Taylor Lynch MD Educational Pearls: Anticholinergics are found in many medications, including over-the-counter remedies Medications include: Diphenhydramine Tricyclic antidepressants like amitriptyline Atropine Antipsychotics like olanzapine Antispasmodics - dicyclomine Jimsonweed Muscaria mushrooms Mechanism of action involves competitive antagonism of the muscarinic receptor Symptomatic presentation is easily remembered via the mnemonic: Dry as a bone - anhidrosis due to cholinergic antagonism at sweat glands Red as a beet - cutaneous vasodilation leads to skin flushing Hot as a hare - anhidrotic hyperthermia Blind as a bat - pupillary dilation and ineffective accommodation Mad as a hatter - anxiety, agitation, dysarthria, hallucinations, and others Clinical management ABCs Benzodiazepines for supportive care, agitation, and seizures Sodium bicarbonate for TCA toxicity due to widened QRS Activated charcoal if patient present < 1 hour after ingestion Temperature monitoring Contact poison control with questions Physostigmine controversy Acetylcholinesterase inhibitor Black box warning for asystole and seizure Contraindicated in TCA overdoses Crosses blood-brain barrier, so useful for TCA overdoses Indicated only in certain anticholinergic overdose with delirium Disposition Admission criteria include: symptoms >6 hours, CNS findings, QRS prolongation, hyperthermia, and rhabdomyolysis ICU admission criteria include: delirium, dysrhythmias, seizures, coma, or requirement for physostigmine drip References 1. Arens AM, Shah K, Al-Abri S, Olson KR, Kearney T. Safety and effectiveness of physostigmine: a 10-year retrospective review. Clin Toxicol (Phila). 2018;56(2):101-107. doi:10.1080/15563650.2017.1342828 2. Nguyen TT, Armengol C, Wilhoite G, Cumpston KL, Wills BK. Adverse events from physostigmine: An observational study. Am J Emerg Med. 2018;36(1):141-142. doi:10.1016/j.ajem.2017.07.006 3. Scharman E, Erdman A, Wax P, et al. Diphenhydramine and dimenhydrinate poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol. 2006;44(3):205-223. doi:10.1080/15563650600585920 4. Shervette RE 3rd, Schydlower M, Lampe RM, Fearnow RG. Jimson "loco" weed abuse in adolescents. Pediatrics. 1979;63(4):520-523. 5. Woolf AD, Erdman AR, Nelson LS, et al. Tricyclic antidepressant poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol. 2007;45(3):203-233. doi:10.1080/15563650701226192 Summarized by Jorge Chalit, OMSIII | Edited by Jorge Chalit  

Folks it's time to say "Symptomatic," because we're watching SHANE! Topics include: why is this movie basically Heaven's Gate, the weird glimpse of Hollywood's narrative future it provides, and just how guilt a violent person needs to feel to experience some degree of redemtpion in the eyes of the audience. Warning: Corbin sounds a little weird  Watch Corbin's reccomendation here. Matt reccomended shirts. Next episode is about "GOOD MORNING," which you can watch here. 

After the birth of her first child, Michele was hit with the onset of sporadic tingling and numbness on alternating sides of her face. Despite enduring years of the mysterious symptoms, she had given up hope of finding the root cause. Michele eventually built up walls of shame because of the uncontrollable flare-ups. It was the concern of her family and the unwavering support of her new partner that would reignite her hunt for a proper diagnosis.See omnystudio.com/listener for privacy information.