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The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Antihypertensive Medication Timing and Cardiovascular Events and Death The BedMed Randomized Clinical Trial JAMA 2025. Discussion by: Guest:Susan Kuchera, MDDirector of the Family Medicine Residency ProgramJefferson Health - Abington2. Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy. 2025. Discussion by: Guest:Eden Miller, MDDiabetes and Obesity SpecialistBend, Oregon 3. As-Needed Albuterol–Budesonide in Mild Asthma. The New England Journal of Medicine. Discussion by: Guest:Dylan Selden, MDResident– Family Medicine Residency Program Jefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes 2. Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy 3. Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study 4. Association of Patient Cost Sharing With Adherence to GLP-1RA and Adverse Health Outcomes 5. Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity — A Phase 2 Trial For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
Dra. Denise de Carvalho é médica cirurgiã e endoscopista, autora de três livros e coautora do Tratado de Endoscopia da USP, atua como palestrante em eventos nacionais e internacionais. Atualmente, é mestranda em Práticas Emergentes em Saúde pela Thomas Jefferson University, na Pensilvânia, aprofundando sua atuação em inovação e práticas avançadas na medicina.Temas:00:00 - Intro07:11 - Como Pequenas Atitudes Podem Transformar Sua Saúde15:22 - A Importância do Sistema Digestivo na Energia Diária23:33 - Alimentação Intuitiva Versus Alimentação Estratégica31:44 - O Papel da Nutrição na Prevenção de Doenças Crônicas39:55 - A Relação Entre Excesso de Calorias e Inflamação Silenciosa48:06 - Intestino Permeável: O Que é e Por Que Está em Alta?56:17 - Como Ajudar o Corpo a Gastar Menos Energia na Digestão1:04:28 - O Valor do Autoconhecimento Para Reverter o Quadro Clínico1:12:39 - Levantar Peso é Funcionalidade, Não Estética1:20:50 - O Eixo Cérebro-Intestino e Seu Impacto no Bem-Estar1:29:01 - A Capacidade Humana de Regeneração é SubestimadaDenise:https://www.instagram.com/dra.denise_decarvalho/Youtube:https://www.youtube.com/excepcionaispodcastSiga:Marcelo Toledo: https://instagram.com/marcelotoledoInstagram: https://instagram.com/excepcionaispodcastTikTok: https://tiktok.com/@excepcionaispodcastPatrocinador:Remessa Online - Envie e receba dinheiro do exterior com taxas mais baixas e sem burocracia.https://www.remessaonline.com.br/?utm_medium=display&utm_source=Excepcionais&utm_campaign=RM_Podcast_Excepcionais_Awareness-2025
In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss diagnosis of OSA. In Part 1 we discussed and overview of OSA, Part 3 will discuss treatment options, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400
In this episode of "Coaching Healthcare Leaders," Dr. Lisa interviews Dr. Joel Kahn, an experienced physician and health coach. Dr. Kahn is a medical doctor, a nationally board-certified (NBC-HWC) lifestyle medicine coach, a member of the American College of Lifestyle Medicine, and a Harvard CHEF-certified culinary coach. He obtained his medical degree from Sidney Kimmel Medical College of Thomas Jefferson University, completed his residency in internal medicine at ChristianaCare, and received his medical informatics training at Harvard/Massachusetts General Hospital. Dr. Kahn shares his career journey from medicine to healthcare technology and executive leadership, ultimately focusing on health and wellness coaching for both patients and clinicians. The discussion covers physician burnout, challenges in healthcare technology, and the evolving role of coaching. Dr. Kahn offers practical self-care tips and insights into behavioral change, emphasizing the importance of adaptability and self-care for thriving in the healthcare field. Listeners can connect with Dr. Kahn through his website for further information and coaching support. Introduction and Guest Bio (00:00:03) Dr. Lisa introduces Dr. Joel Kahn, summarizing his background in medicine, business, and health technology. Career Journey and Inflection Points (00:01:27) Dr. Kahn discusses his career path, including pivotal decisions between music, medicine, and software development. Transition to Business and Health Tech (00:03:23) Dr. Kahn describes moving into medical informatics, health tech startups, and the business side of healthcare. Shift to Mindfulness and Coaching (00:04:29) He explains his transition into mindfulness programs, coaching, and becoming a board-certified health and wellness coach. Current Roles and Daily Work (00:07:44) Dr. Kahn outlines his daily activities, including coaching, mentoring, advising, and some clinical work. Challenges in Clinical Practice and Compliance (00:09:17) He discusses ongoing challenges with compliance, technology, and the realities of clinical charting. Coaching Approach and Client Types (00:09:41) Dr. Kahn explains his coaching methods, differentiating between patient clients and clinician/executive clients. Addressing Burnout and Career Transitions (00:11:04) He details his work with healthcare professionals facing burnout and those seeking career changes. Healthcare System Challenges and AI (00:13:58) Dr. Kahn addresses broader healthcare challenges, including the impact of AI, technology, and the evolving role of coaching. Coaching in Healthcare Organizations (00:17:02) He comments on how healthcare systems are beginning to integrate coaching, though often as case management. Growth of Preventive Medicine and Nutrition (00:18:02) Dr. Kahn notes the increasing emphasis on nutrition and preventive health in medical education. Self-Care and Thriving Amid Adversity (00:18:48) He offers practical self-care tips for thriving in challenging environments, emphasizing exercise, stress management, and openness to opportunities. How to Connect with Dr. Kahn (00:19:50) Dr. Kahn shares his website and encourages listeners to reach out for networking or questions.
Join Drs. Neil Skolnik and Sara Wettergreen as they discuss key takeaways from the ADA's 85th Scientific Sessions in Chicago, highlighting advancements in diabetes and obesity care. With guests, Drs. Osagie Ebekozien and Marlon Pragnell, they'll explore how these advancements can positively impact you and your loved ones. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health, Abington, PA Sara Wettergreen, PharmD, BCACP, BC-ADM, Assistant Professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Ambulatory Care Clinical Pharmacist, UCHealth Lone Tree Primary Care, Aurora, CO Osagie Ebekozien, MD, MPH, CPHQ, Chief Quality Officer at the ADA Marlon Pragnell, PhD, Vice President of Research and Science at the ADA Do you have questions or comments you'd like to share with Neil and Sara? Leave a message at (703) 755-7288. Thank you for listening, and don't forget to “follow” Diabetes Day by Day! Additional resources: Patient Standards of Care 2025 Need information on diabetes, ADA programs, or upcoming events? The ADA's Center for Information is here to help. Contact them directly at 1-800-DIABETES (1-800-342-2383) or email AskADA@diabetes.org for personalized guidance and support.
In this special episode on Treatment of Hypercortisolism in Uncontrolled Diabetes our host, Dr. Neil Skolnik, will discuss new evidence showing the surprising prevalence of Hypercortisolism in people with uncontrolled Type 2 Diabetes, and the effect of treatment. This special episode is supported by an independent educational grant from Corcept. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John Buse MD – The Verne S. Caviness Distinguished Professor and director of the Diabetes Center at the University of North Carolina at Chapel Hill School of Medicine, a past president of medicine & science at the American Diabetes Association (ADA), and recipient of the ADA Outstanding Achievement in Clinical Diabetes Research Award, References: Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes. Diabetes Care dc242841 https://doi.org/10.2337/dc24-2841 Inadequately Controlled Type 2 Diabetes and Hypercortisolism: Improved Glycemia With Mifepristone Treatment. Diabetes Care June 2025
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes 2. Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension Meta-Analysis 3. The Diabetes Prevention Program and Its Outcomes Study: NIDDK's Journey Into the Prevention of Type 2 Diabetes and Its Public Health Impact 4. Comparative effectiveness of alternative second‐line oral glucose‐lowering therapies for type 2 diabetes: a precision medicine approach applied to routine data 5. Phase 3 Trial of Semaglutide in Metabolic Dysfunction– Associated Steatohepatitis For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Effects of Combining Coronary Calcium Score With Treatment on PlaqueProgression in Familial Coronary Artery Disease A Randomized Clinical Trial JAMA 2025. Discussion by:Guest: Michael J. Blaha, MD, MPHProfessor of Cardiology and Epidemiology and presently serves as theDirector of Clinical Research for the Johns Hopkins Ciccarone Center for thePrevention of Cardiovascular DiseaseDirector of the Cardiometabolic ClinicProgram Director for the Preventive Cardiology Fellowship.2. Creatine monohydrate pilot in Alzheimer's: Feasibility, brain creatine, and cognition. Alzheimer's Dement. 2025. Discussion by:Guest:Michael Devano, DO Attending Family Physician Christiana Care Health System3. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. The New England Journal of Medicine. Discussion by:Guest:Joseph Gonnella, MD Resident– Family MedicineResidency Program, Jefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
Send us a textWe often hear the phrase, “Love makes a family,” and while it's true that love is the most important ingredient in creating family, for many of our LGBTQ+ kids and beloveds, love also needs to be accompanied by access to reproductive medical support. So today, we're diving into what it really means to create family—from science to love to justice. Sara sits down with reproductive endocrinologist Dr. Jacqueline Gutmann to discuss the avenues available for creating family in queer partnerships.Special Guest: Dr. Jacqueline N. GutmannDr. Jacqueline N. Gutmann (she/her) is a Reproductive Endocrinologist at RMA of Philadelphia and has devoted her career to helping people create their families of choice. She has published numerous articles and has lectured extensively on topics including LGBT family building, third party reproduction, fertility preservation including egg freezing, and the use of complementary and alternative medicine in fertility treatment. She has held numerous leadership positions in local and national professional organizations and is on the medical advisory boards of several patient advocacy groups. She is the recipient of many awards, though the one she values most is the Joyce M. Vargyas, M.D. Visionary Award from Path2Parenthood, for her impact in the fields of fertility, reproductive health, and family building within the LGBTQ+ community. Dr. Gutmann completed her medical education, residency and fellowship at Yale University. She also serves as a Clinical Associate professor of Obstetrics and Gynecology at Thomas Jefferson University.Links from the Show:More about Dr. Gutmann: https://rmanetwork.com/staff/jacqueline-n-gutmann/ Jefferson OB/GYN: https://www.jeffersonhealth.org/locations/obgyn-center-city Join Mama Dragons here: www.mamadragons.org In the Den is made possible by generous donors like you. Help us continue to deliver quality content by becoming a donor today at www.mamadragons.org. Support the showConnect with Mama Dragons:WebsiteInstagramFacebookDonate to this podcast
Tune in to this episode featuring Drs. Neil Skolnik and Sara Wettergreen as they explore the power of storytelling and how it brings us together. Special guests Marlee Seibold and Dr. Saige Kiedinger shared their personal experiences with type 1 diabetes, including— challenges, triumphs, and the everyday moments that have shaped their journeys. We hope that by listening to their stories, you'll gain a deeper understanding of the power of storytelling and feel inspired to share your own journey. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health, Abington, PA Sara Wettergreen, PharmD, BCACP, BC-ADM, Assistant Professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Ambulatory Care Clinical Pharmacist, UCHealth Lone Tree Primary Care, Aurora, CO Marlee Seibold: Storytelling Communications Manager at the ADA and a person living with type 1 diabetes. Dr. Saige Kiedinger: A recent pharmacy school graduate transitioning to residency training, also living with type 1 diabetes. Do you have questions or comments you'd like to share with Neil and Sara? Leave a message at (703) 755-7288. Thank you for listening, and don't forget to “follow” Diabetes Day by Day! Want to share your journey with us? Share it now here.
Annette Donawa, PhD, MSEd, Associate Provost, Office of Continuing Professional Development at Thomas Jefferson University, talks with ACCME President and CEO Graham McMahon, MD, MMSc, about the unique value of CE professionals.
In this special episode on Fish Oil - Facts, Fiction, and EPA our host, Dr. Neil Skolnik, will discuss the evidence distinguishing fish oil from EPA (Icosapent ethyl). This special episode is supported by an independent educational grant from Amarin. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John Osborne MD, PhD - Preventive cardiologist and lipidologist, Chief medical officer of Clear Cardio, LLC Selected References: Omega-3 Fatty Acids: STRENGTH trial - JAMA. 2020;324(22):2268-2280 Icosapent Ethyl: JELIS - Lancet. 2007;369(9567):1090-1098 Icosapent Ethyl: REDUCE-IT - N Engl J Med 2019; 380:11-22 ADA Standards of Care: Diabetes Care 2025;48(Supplement_1):S207–S238 https://doi.org/10.2337/dc25-S010 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: Circulation. 2023;148. doi: 10.1161/CIR.0000000000001168
Some Black men stand out for their sense of style - Sammy Davis Jr., Prince, Colman Domingo. They're all part of a deep historical culture of Black dandyism, where fashion is rooted in resistance and used to counter stereotypes. This year's Met Gala theme and an ongoing exhibition titled “Superfine: Tailoring Black Style” highlight Black dandyism. Host Racquel Williams talks with two Philly fashion experts about the dandy movement, the runway looks, and some tips for men who want to elevate their own style - Prajjé Oscar Jean-Baptiste, a designer and professor at Philly area colleges including Thomas Jefferson University, and Jamel Workman, founder of Dandy Headdress. Then, on Shara in the City, we hop on board a very special trolley to inspire and empower women. The Deeply Rooted Trolley Tour, organized by Harriett's Bookshop and hosted by Starfire, visits women-owned businesses across the city. Shara Dae Howard takes a ride and hears about their next event, a Juneteenth “family reunion” trip. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices
Dr. Kushagra Verma, MD, MS, FAAOS, is a board-certified orthopedic spine surgeon at Advanced Spine Care in Los Alamitos and Marina Del Rey, California.He is fellowship-trained in complex spine surgery and has many years of experience. He offers surgery when it's the best option to ensure the highest quality of life for his patients. Dr. Verma earned a bachelor's degree in biomedical engineering from Cornell University School of Engineering in Ithaca, New York, and a master's degree in molecular biology from the NYU Graduate School of Arts & Sciences in New York City. He completed medical school at NYU School of Medicine in New York City. Dr. Verma also completed an orthopedic surgery residency at Thomas Jefferson University's Rothman Institute in Philadelphia, Pennsylvania, and an adult and pediatric spine fellowship (with a focus on spinal deformities) at the University of California at San Francisco. Dr. Verma has been recognized many times for his expertise. He was selected by The Leading Physicians as a Top Orthopedic Surgeon of the Spine. He also received the Top Doctor Award in Los Alamitos and numerous other professional recognitions for his excellence. Dr. Verma is an experienced college educator with experience at the University of Washington in Seattle, Long Beach Memorial in Long Beach, California, and the Western University of Health Sciences in Pomona, California. He specializes in treating spinal anomalies, including spinal stenosis, scoliosis, spondylolisthesis, disc herniation, and flatback syndrome. Dr. Verma is a member of the American Academy of Orthopaedic Surgeons (AAOS) and the Scoliosis Research Society (SRS).He has contributed to nearly 50 peer-reviewed publications. Dr. Verma spends as much time as patients need to ensure they feel heard with all of their questions addressed. He fully explains their diagnoses, thoroughly reviews all imaging results, and discusses detailed treatment options — always giving patients a voice in their treatments. He uses the latest technological advances and procedures to ensure long-lasting outcomes.
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Intensive Blood-Pressure Control in Patients with Type 2 Diabetes 2. Cardioprotective Glucose-Lowering Agents and Dementia Risk A Systematic Review and Meta-Analysis 3. A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes 4. Screening for Metabolic Dysfunction–Associated Steatotic Liver Disease–Related Advanced Fibrosis 5. Risk of Urogenital Infections in People With Type 2 Diabetes Initiating SGLT2i Versus GLP-1RA in Routine Clinical Care For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Lepodisiran — A Long-Duration Small Interfering RNA Targeting Lipoprotein(a) - New England Journal of Medicine 2025. Discussion by:Guest: Steven E. Nissen, M.D., Chief Academic Officer of the Heart and Vascular Institute at the Cleveland ClinicProfessor of Medicine at the Lerner College of Medicine2. Genitourinary Syndrome of Menopause: AUA/SUFU/AUGS Guideline (2025).Discussion by: Discussion by:Guest:Anupriya Grover-Wenk, DO Faculty– Family Medicine Residency ProgramJefferson Health – Abington3. Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial. Discussion by:Guest: Joseph Gonnella, MDResident– Family Medicine Residency ProgramJefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
In this eye-opening episode of Better Buildings for Humans, host Joe Menchefski is joined by Ann Sussman and Kelsey Bradley from the Human Architecture and Planning Institute (HAPI.org) to explore the fascinating intersection of architecture, biology, and human emotion. Ann and Kelsey reveal how our brains are hardwired to respond to certain visual cues—like faces, fractals, and even the color red—and how this understanding can revolutionize the way we design buildings and cities. From eye-tracking software that predicts where people look first, to how blank facades might make us feel uneasy, this episode unveils the science behind why some spaces feel better than others. Tune in to discover how embracing our biological instincts can lead to more humane, joyful, and walkable environments.More About Ann Sussman and Kelsey BradleyAnn Sussman, RA, an architect, researcher, and teacher is passionate about understanding how buildings impact us. She serves as president of the Human Architecture + Planning Institute, (theHapi.org), a nonprofit devoted to improving the design of the built environment through education and research. Her book Cognitive Architecture, Designing for How We Respond to the Built Environment (Routledge, 2015, 2021) won the 2016 Place Research Award from the Environmental Design Research Association (EDRA). She is co-editor of the forthcoming Handbook of Neuroscience and the Built Environment, (Routledge, 2025) due out this summer. Ann has taught a course on the human perception of architecture, Buildings, Biology + the Brain, at the BAC since 2018. Kelsey Bradley has been working in the nonprofit space since she founded Design Cause Inc. in 2016. Her work led to the successful completion of 10 new primary and secondary school classrooms across multiple communities in Cameroon and Malawi. Kelsey is now focused on how the built environment impacts mental health at an individual and community scale and is excited to further her interests through the work of The Human Architecture and Planning Institute. Kelsey holds a Bachelor of Architecture from Thomas Jefferson University and will be entering a graduate program in urban planning in the fall of 2025.CONTACT:https://www.linkedin.com/in/pgw/?originalSubdomain=caannsussman.com (http://annsussman.com/) https://geneticsofdesign.com/2025/05/20/eye-tracking-buildings-in-lisbon-boston-take-part-in-a-quick-pilot-study/theHapi.org.Where To Find Us:https://bbfhpod.advancedglazings.com/www.advancedglazings.com (http://www.advancedglazings.com/)https://www.linkedin.com/company/better-buildings-for-humans-podcastwww.linkedin.com/in/advanced-glazings-ltd-848b4625https://twitter.com/bbfhpodhttps://twitter.com/Solera_Daylighthttps://www.instagram.com/bbfhpod/https://www.instagram.com/advancedglazingsltd (https://www.instagram.com/advancedglazingsltd/)https://www.facebook.com/AdvancedGlazingsltd
In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss an overview of OSA. In Part 2 we will take a deep dive into diagnosis, Part 3 will discuss treatment options, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Paul Doghramji, MD – Medical Director of Health Services at Ursinus College, Attending Family Physician at Collegeville Family Practice Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Obstructive sleep apnea and obesity: A review of epidemiology, pathophysiology and the effect of weight-loss treatments. Sleep Medicine Reviews 2024;78:1-12
Real strength shows up when life knocks you down and you choose to rise with gratitude, faith, and community. Dr. Douglas Burton shares how a life-altering diagnosis transformed not just his health journey, but his entire perspective on what it means to truly live well. From the operating room to the other side of the patient experience, he opens his heart about the emotional weight of caregiving, the spiritual awakening that came through illness, and the small, intentional shifts that have brought him greater peace than ever before. His story is a powerful reminder that joy is not found in doing more—it's found in slowing down, showing up, and surrounding yourself with love. Key Takeaways: Slowing down and creating space for joy can be more healing than constant striving. Practicing daily gratitude builds emotional resilience and a deeper sense of peace. Community support is a critical part of mental, emotional, and spiritual well-being. Faith and surrender can bring clarity and calm when facing uncertainty or illness. True healing isn't just physical—it's also spiritual, relational, and deeply personal. About Dr. Douglas Burton: Douglas Burton, M.D. is the Marc and Elinor Asher Spine Professor and Chair of the Department of Orthopedic Surgery at the University of Kansas Medical Center. He received his undergraduate degree from Kansas State University in Manhattan, KS and his MD from the University of Texas Southwestern in Dallas, TX. He completed his residency at the University of Kansas Medical Center and completed spine fellowships at The Texas Back Institute in Plano, TX and at Thomas Jefferson University in Philadelphia, PA. In 2003 he was awarded the Marc and Elinor Asher Spine Professorship. Dr. Burton's clinical practice is focused on the diagnosis and treatment of complex spinal disorders in both pediatric and adult patients. In addition to his primary practice location at the University of Kansas Hospital, he also travels to both Hutchinson and Salina, KS for a monthly outreach clinic to provide health care to patients in rural parts of Kansas. He is a member of the American Academy of Orthopaedic Surgeons, the American Orthopaedic Association, the Interurban Orthopaedic Society, the North American Spine Society and the Scoliosis Research Society, where he is the incoming Chair-Elect of the Research Council and member of the Board of Directors. He served as President of the Federation of Spine Associations from 2018 to 2019. In 2019, The American Association of Neurological Surgeons and the American Academy of Orthopaedic Surgeons announced a new partnership, the American Spine Registry (ASR), which will be jointly owned and developed by both organizations. Dr. Burton currently serves as co-chair of the Data Use Committee for the ASR. His research interests include the development of disease specific health related quality of life instruments and the study of complications and outcomes associated with spinal deformity surgery. He has authored or co-authored over 236 peer reviewed publications and serves as a Deputy Editor of Spine Deformity, the official journal of the Scoliosis Research Society. In 2006 he helped found and remains on the Executive Council of the International Spine Study Group. This is a consortium of spinal deformity surgeons and researchers at over 15 top academic centers in the United States and Canada with collaborators in Europe and Japan. They have been performing prospective and retrospective studies on surgical and non-surgical Adult Spinal Deformity patients since their inception. Connect with Dr. Michelle and Bayleigh at: https://smallchangesbigshifts.com hello@smallchangesbigshifts.com https://www.linkedin.com/company/smallchangesbigshifts https://www.facebook.com/SmallChangesBigShifts https://www.instagram.com/smallchangesbigshiftsco Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below! Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app. Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts.
Join Drs. Neil Skolnik and Sara Wettergreen in this episode as they discuss the importance of emotional wellbeing in overall health. They will explore the connection between mental health and diabetes, focusing on how managing a chronic condition can impact the emotional lives of people living with diabetes and their families. Special guest Dr. Kelsey Brzezinski will also join the conversation. Please note that this episode includes discussions of sensitive topics, we encourage you to listen with care and understand that the American Diabetes Association® is not an organization that specializes in mental health and only seeks to bring awareness to factors that coincide with a diabetes diagnosis. If you are experiencing challenges seek the support of a licensed medical or mental health professional. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health, Abington, PA Sara Wettergreen, PharmD, BCACP, BC-ADM, Assistant Professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Ambulatory Care Clinical Pharmacist, UCHealth Lone Tree Primary Care, Aurora, CO Kelsey Brzezinski, PhD, Pediatric Psychologist at Lurie Children's Hospital of Chicago, Assistant Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine, Chicago, IL Do you have questions or comments you'd like to share with Neil and Sara? Leave a message at (703) 755-7288. Thank you for listening, and don't forget to “follow” Diabetes Day by Day! Additional resources: If you or a loved one are experiencing a mental health crisis, please call the 988 Suicide & Crisis Lifeline. SAMHSA mental health help line, which is a no-cost, confidential, 24/7, 365-day-a-year treatment referral and information service available at 1-800-662-HELP (4357). Check out the American Diabetes Association®'s newly updated Mental Health Provider Directory to find to find therapists who specialize in supporting people living with diabetes near you.
Dr. Lopez is a board-certified medical oncologist and integrative oncologist with the Sidney Kimmel Comprehensive Cancer Center, Thomas Jefferson University in Philadelphia. Her clinical focus is women's cancers and integrative oncology. She is working with the Integrative Medicine team to establish both an inpatient and outpatient integrative oncology service. Dr Lopez is committed to working with patients to facilitate healing of mind-body-and spirit and describes her work as one of great honor to be able to walk with patients during this experience. _________ To learn more about the 10 Radical Remission Healing Factors, connect with a certified RR coach or join a virtual or in-person workshop visit www.radicalremission.com. To watch Episode 1 of the Radical Remission Docuseries for free, visit our YouTube channel here. To purchase the full 10-episode Radical Remission Docuseries visit Hay House Online Learning. To learn more about Radical Remission health coaching with Liz or Karla, Click Here Follow us on Social Media: Facebook Instagram YouTube _____
In this special episode on Hypercortisolism in Diabetes our host, Dr. Neil Skolnik, will discuss new evidence showing the surprising prevalence of Hypercortisolism in people with uncontrolled Type 2 Diabetes. This special episode is supported by an independent educational grant from Corcept. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John Buse MD – The Verne S. Caviness Distinguished Professor and director of the Diabetes Center at the University of North Carolina at Chapel Hill School of Medicine, a past president of medicine & science at the American Diabetes Association (ADA), and recipient of the ADA Outstanding Achievement in Clinical Diabetes Research Award, Reference: Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes. Diabetes Care dc242841 https://doi.org/10.2337/dc24-2841
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Lepodisiran — A Long-Duration Small Interfering RNA Targeting Lipoprotein(a) - NEJM 2. Diabetes and Anemia – Diabetes Care 3. Efficacy and Safety of Finerenone in Type 2 Diabetes: A Pooled Analysis of Trials – Diabetes Care 4. Cardiovascular and Kidney Outcomes and Mortality With Long- Acting Injectable and Oral Glucagon-Like Peptide 1 Receptor Agonists in Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Trials – Diabetes Care 5. Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes - NEJM For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
A new episode of Diabetes Day by Day is here! Join Drs. Neil Skolnik and Sara Wettergreen as they share tips to increase movement in honor of April being Move More Month. Since we're all about movement and exercise, we're excited to welcome special guests Adrienne Edge and David Rachal III from the American Diabetes Association®'s (ADA) Project Power program. They'll share how you can get involved and start moving to stay healthy, prevent, or better manage type 2 diabetes. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health, Abington, PA Sara Wettergreen, PharmD, BCACP, BC-ADM, Assistant Professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Ambulatory Care Clinical Pharmacist, UCHealth Lone Tree Primary Care, Aurora, CO Adrienne Edge, Founder of ProFIT Family Wellness, Community Partner and Facilitator Trainer for the ADA's Project Power program David Rachal III, Nationally Respected Leader in Medical Fitness, Wellness, and Entrepreneurial Empowerment, Community Partner and Facilitator Trainer for the ADA's Project Power program Do you have questions or comments you'd like to share with Neil and Sara? Leave a message at (703) 755-7288. Thank you for listening, and don't forget to “follow” Diabetes Day by Day! To learn more about Project Power, be sure to check out: diabetes.org/ProjectPower.
The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease. Annals of Family Medicine 2025. Discussion by:Guest:Barbara Yawn, MD, MSc, MPHAdjunct Professor, Department of Family and Community HealthUniversity of Minnesota Former Chief Scientific Officer at the COPD Foundation2. Optimal dietary patterns for healthy aging. Nature Medicine. Discussion by:Guest:Jessica Stieritz, MD Resident– Family Medicine Residency Program Jefferson Health – Abington3. Amount and intensity of daily total physical activity, step count and risk of incident cancer. British Journal of Sports Medicine. Discussion by:Guest:William Callahan, D.O. Associate Director – Family Medicine Residency ProgramJefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
In this special episode on Early Identification and Delay of Type 1 Diabetes, Dr. Neil Skolnik this emerging area with Dr. Jay Shubrook. This special episode is supported by an independent educational grant from Sanofi. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Jay Shubrook, D.O. - Professor and Director of Diabetes Services, Touro University. Past Chair, The American Diabetes Association Primary Care Advisory Group, Past Chair of the American College of Diabetology. Selected References and Resources referred to the in the Podcast: Webinar Registration (Apr 28, 2025 10:00 AM): Early Detection Saves Lives: Implementing Type 1 Diabetes Screening in Pediatric and Primary Care References: Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care 2024;47(8):1276–1298 An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med 2019;381:603-613 Resources for Auto-antibody Testing: Type 1 Diabetes TrialNet Centers of Excellence Locations Type 1 Risk test Trialnet
Send us a textDr. Judd Hollander with Thomas Jefferson University discussed successful telemedicine implementations with solid ROI. He also discusses strategies in approaching health systems leaders for buy-in.
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Coronary Artery Calcium-Guided Primary Prevention Strategy 2. Health-Related Quality of Life and Health Utility after Metabolic/Bariatric Surgery vs. Medical/Lifestyle Intervention in Individuals with Type 2 Diabetes and Obesity 3. Suicide and suicide attempt in users of GLP-1 receptor agonists: a nationwide case-time-control study 4. Self-Monitored Blood Glucose and Continuous Glucose Monitoring in Youth with Type 1 Diabetes and Medicaid Insurance 5. Gestational Diabetes to Type 2 Diabetes—Is Poor Sleep to Blame? For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
Struggling with leg and/or back pain and overwhelmed by confusing MRI results? You're not alone—and this episode is for you. In this special episode of The Spine Pod, hosts Courtney Schutze and Brady Riesgraf rejoin forces with Dr. Ahilan Sivaganesan (Dr. Siva), a neurosurgeon building an all-encompassing spine program with Hospital for Special Surgery (HSS) at NCH in Naples, Florida. After creating a successful practice at Thomas Jefferson University in Philadelphia, Dr. Siva has taken a bold step into a new frontier—starting from scratch and building a spine program designed to treat the breadth of back and leg pain patients that all too often ‘fall through the cracks.' His goal is to design a new-style spine practice, utilizing the whole spectrum of the care continuum—from conservative care options to surgical treatment methods, specifically aimed at addressing patients' needs earlier, more thoughtfully, and with more innovative options. Dr. Siva offers an honest take on the realities of spine care today—especially for the millions of patients suffering from chronic low back pain who often fall into the category of "non-specific back pain." In this episode, he shares why it's time for spine surgeons to reframe their role—not just as proceduralists, but as clinicians. In the second half of this episode, Dr. Siva breaks down the difference between imaging findings and a true diagnosis. He outlines how to navigate complex radiology reports and explores how endoscopic techniques and motion-preserving implants can offer outpatient alternatives to the traditional spinal fusion. He also walks us through real patient images, demystifying common findings like facet degeneration, spondylosis, and spondylolisthesis, and how a thoughtful, diagnosis-first approach can radically improve care. In this episode, you'll learn: Imaging ≠ Diagnosis MRI results like “annular tear”, “facet arthritis”, and “stenosis” are just part of the story—and why diagnosis should start with your symptoms and physical exam, not your scan. Why So Many Patients Get Lost in the Care Cycle Many people with chronic back and/or leg pain get stuck in a frustrating loop: bouncing between PT, injections, or fusion recommendations—without fully understanding what's causing the pain. How Comprehensive Spine Care Can Redefine the Surgeon's Role Dr. Siva shares how he's reshaped his own mindset: from "what surgery can I offer?" to "what's the root cause of this person's pain?"—and how this shift is foundational to future spine care. The Emergence of Endoscopic Spine Surgery as a First-Line Surgical Intervention For well-selected patients with discogenic or facetogenic back pain, endoscopy offers an outpatient, motion-preserving early-stage alternative—without the drawbacks of traditional fusion. The Importance of Building Comprehensive, Fusion-Free Spine Practices Dr. Siva and his team are using this fresh start to create a more thoughtful, tech-forward, and patient-centered model for spine care—one that listens to patient goals and preserves motion whenever possible. Where You Fit in the Continuum of Care Whether you're at the beginning of your back pain journey or feeling stuck after years of dead-ends, Dr. Siva outlines a more personalized, stepwise approach—one that gives patients options before jumping to fusion. With a passion for patient-centered decision-making, innovation in technique, and humility in practice, Dr. Siva is helping lead a quiet revolution in how back pain is evaluated and treated—and invites us all to be a part of that evolution. Whether you're a surgeon, patient, or industry professional, this episode offers new insight into how we understand—and treat—the most common cause of disability in the world: chronic back pain. Learn more about Dr. Siva and HSS at NCH: LinkedIn: https://www.linkedin.com/in/ahilansiva/ Dr. Siva at HSS at NCH: https://www.hss.edu/physicians_sivaganesan-ahilan.asp If you would like to schedule a consultation with Dr. Siva you can call or email his practice at: 239-624-1700 or ahilan.siva@nchmd.org The information in this podcast is for educational and informational purposes only and is not intended as medical advice. It does not replace consultation with a qualified healthcare professional. Always seek the advice of your physician or another qualified healthcare provider regarding any medical condition or treatment.
Welcome to this special series of Diabetes Core Update, titled, “What's Next”. In this podcast series by the American Diabetes Association where each episode explores the cutting-edge world of diabetes-related treatment and care, looking at new and future enterprises advancing diabetes and obesity care. The series features interviews with leading industry representatives, researchers, and innovators who are shaping this care. From groundbreaking new products and treatments to the latest research advances, "What's Next?" aims to have a broad scope and offers a look at the innovations that are set to transform the landscape of diabetes and related metabolic conditions. This special edition of Diabetes Core Update, “What's Next”, is sponsored by Ciba Health. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Innocent Clement, MD MPH MBA, CEO and Founder of Ciba Health. Discussed in this Podcast: CIBA Health
The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Filling the Evidence Gaps Toward a Coronary Artery Calcium-Guided Primary Prevention Strategy. JAMA Cardiology 2025. Discussion by:Guest: Michael J. Blaha, MD, MPHProfessor of Cardiology and Epidemiology and presently serves as the Director of Clinical Research for theJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease2. Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis. New England Journal of Medicine. Discussion by:Guest:Amreen Syed, DO Resident– Family Medicine Residency ProgramJefferson Health – Abington3. Intranasal Versus Oral Treatments for Allergic Rhinitis: A Systematic Review With Meta-Analysis Journal of Allergy and Clinical Immunology in Practice3. Discussion by:Guest:Michelle Buchbinder, MDResident – Family Medicine Residency Program Jefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Send us a text about this episode.Send us a text about this episode. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
Dr. Eric Kmiec is Director of the Gene Editing Institute of the Helen F. Graham Cancer and Research Institute at Christiana Care Health System. He also holds faculty appointments at the University of Delaware and the Wistar Institute. Eric and his colleagues are working to develop new ways to treat cancer by destroying the genes that cause cancer cells to be resistant to typical therapies like chemotherapy, radiation, or immunotherapy. Throughout his life, Eric has enjoyed sports. He particularly likes playing baseball and hockey, and he still plays baseball competitively in a league in Philadelphia. Eric also spends much of his time doing landscaping and yard work. He Received his B.A. in Microbiology from Rutgers University, his M.S. in Cell Biology and Biochemistry from Southern Illinois University, and his Ph.D. in Molecular Biology and Biochemistry from the University of Florida School of Medicine. He conducted postdoctoral research at the University of Rochester before joining the faculty at the University of California, Davis in 1987. Since then, he has served on the faculty of Thomas Jefferson University, the University of Delaware, and Delaware State University. In addition, Eric founded, consulted for, and served as Vice President of Kimeragen, Inc., he was Chief Scientific Advisor for the Genomics Division of Tapestry Pharmaceuticals, was an Eminent Scholar and Director of the Marshall University Institute for Interdisciplinary Research, and also served as Co-Founder, Chief Scientific Officer, and a Board Member of OrphageniX. Eric has received numerous awards and honors over the course of his career, including receipt of the 2012 Proudford Foundation Unsung Hero Award in Sickle Cell Disease, designation as an Honorary Commander of the 436th Air Wing at Dover Air Force Base in 2013 and 2014, and also induction into the Southern Illinois University, Edwardsville Alumni Hall of Fame in 2012. Further, Eric and the team at the Gene Editing Institute were recently awarded the inaugural Life Sciences and Bio Innovation Award from the Philadelphia-Israeli Chamber of Commerce. In our interview, Eric shared his experiences in life and science.
Join Drs. Neil Skolnik and Sara Wettergreen as they delve into the differences between FDA-approved medications and compounded and counterfeit medications, alongside special guests Dr. Susan Kuchera and Lisa Kessler. They will explore the factors that might influence the decision to use compounded treatments, the risks associated with these treatments, and one of our guests will share their personal experience with obesity treatment. This episode of Diabetes Day by Day is supported by Lilly. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health, Abington, PA Sara Wettergreen, PharmD, BCACP, BC-ADM, Assistant Professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Ambulatory Care Clinical Pharmacist, UCHealth Lone Tree Primary Care, Aurora, CO Susan Kuchera, MD, Clinical Assistant Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington Lisa Kessler, MS, CCC-SLP, Infant-toddler Home-based Pediatric Speech-Language Pathologist Do you have questions or comments you'd like to share with Neil and Sara? Leave a message at (703) 755-7288. Thank you for listening, and don't forget to “follow” Diabetes Day by Day! Learn more about the risks of buying medications online at the BeSafeRx website, the Food and Drug Administration's source for online pharmacy information. Read the American Diabetes Association®'s statement on compounded medications.
Want to share your feedback? Send us a message!Researchers from the Delaware Stuttering Project at the University of Delaware—Dr. Ho Ming Chow, Associate Professor and principal investigator, Sayan Nanda, Ph.D. student, and Dr. Nicole Guarino, research scientist—join host Sara MacIntyre, M.A., CCC-SLP, to discuss their recent article, "Atypical gut microbiota composition in a mouse model of developmental stuttering," published in Scientific Reports (Nature Portfolio). Building upon previous genetic and mouse model research by Dr. Dennis Drayna and colleagues at the NIH [previous podcast episode with Dr. Drayna linked below for background], their study explores the potential link between developmental stuttering and the gut-brain connection by examining gut microbiota differences in GNPTAB mouse models.In this episode, Dr. Chow, Sayan Nanda, and Dr. Guarino provide essential background context before walking through the study's development, methodology, and key findings. They discuss the potential role of the microbiome in other neurodevelopmental conditions, the challenges of translating mouse model research to human studies, and the exciting directions for future research this study has prompted.Article discussed:Nanda, S., Lamot, B., Guarino, N. et al. Atypical gut microbiota composition in a mouse model of developmental stuttering. Sci Rep 14, 23457 (2024). https://doi.org/10.1038/s41598-024-74766-xPrevious Stuttering Foundation Podcast episode referenced, 'Genetics and Stuttering with Dr. Dennis Drayna.'Delaware Stuttering Project WebpageDr. Ho Ming Chow, Associate Professor at the University of Delaware and a principal investigator for the Delaware Stuttering Project, received his Bachelor's and Master's Degrees in Engineering at the University of Hong Kong. After working as an engineer for a few years, he became interested in studying human cognition and went to Germany for his doctoral study. He obtained his Ph.D. in Cognitive Sciences with an emphasis on Cognitive Psychology at the University of Osnabrück. He completed his postdoctoral training at the National Institutes of Health. Before joining the University of Delaware in 2019, he was a research faculty at the University of Michigan and Nemours Children's Hospital, Delaware.Sayan Nanda received his Master of Science in Data Informatics from the University of Southern California and his Bachelor of Technology in Computer Science and Engineering from the Manipal Institute of Technology. Sayan is currently a Ph.D. student in the Communication Sciences and Disorders department at the University of Delaware. Sayan is primarily interested in stuttering research and the application of statistics and machine learning techniques in the same. His focus is on neuroimaging.Dr. Nicole Guarino is an adjunct faculty at the Department of Communication Sciences and Disorders, the University of Delaware. She received her PhD in Neuroscience from Thomas Jefferson University and her B.A. in Neuroscience from Franklin and Marshall College. She has been working in Dr. Chow's lab since 2022 and is interested in the neurobiological bases of stuttering.
In this special episode on Treatment of Heart Failure with Preserved Ejection Fraction (HFpEF) our host, Dr. Neil Skolnik will lead a case-based discussion on HFpEF, presenting challenges and integration of emerging evidence into clinical practice. This special episode is supported by an independent educational grant from Roche. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Susan Kuchera, M.D. - Clinical Assistant Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington. Muthu Vaduganathan M.D. - Cardiologist and Co-Director, Center for Cardiometabolic Implementation Science at Brigham and Women's Hospital and Harvard Medical School; Associate Editor of the Journal of the American College of Cardiology. Selected references referred to the in the Podcast: Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association. Diabetes Care 2022 2023 American College of Cardiology Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction (HFpEF). Journal of the American College of Cardiology 2023 Time to Clinical Benefit of Dapagliflozin in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JAMA Cardiology 2022;7(12):1259-1263
In this episode, Scott Becker speaks with Dr. Joseph Cacchione, CEO of Jefferson Health and Thomas Jefferson University. Dr. Cacchione discusses the system's growth, the challenges facing healthcare—including reimbursement cuts and financial headwinds—and the importance of integrating care delivery with financing.
In this episode, we introduce 2 of our fantastic Blue Ribbon Panel members. Their full bios are listed below. You'll meet the rest of the panel in the next episode!Also, RheumMadness brackets are open through March 31 at 11:59pm ET! Submit your brackets here.First time playing RheumMadness? Check out our new explainer video!Panelists in this podcast:Michele Meltzer, MD, MBE, is an Associate Professor of Medicine at Thomas Jefferson University in Philadelphia, Pennsylvania. She attended Hahnemann Medical School and rheumatology fellowship at Temple University Hospital. In 2007, she completed a Master's of Bioethics at the University of Pennsylvania. Dr. Meltzer has been a ACR committee member of Rheumatologic Care and Ethics and Conflict of Interest committees. She serves as President and founding member of Rheumatology for All, a nonprofit whose mission is to increase access to rheumatology care in resource limited areas. She loves that RheumMadness makes learning about rheumatology fun and is accessible to students worldwide.Lisa Traboco, MD, is a rheumatologist with a passion for digital health, social media, telemedicine, and medical education. She likes to integrate technology into clinical practice and training, as well as participate in systems implementation. She is currently pursuing a Master's in Health Informatics while working at St. Luke's Medical Center – Global City in the Philippines. She is also actively involved in APLAR & has been an exchange scholar to Japan and the ACR. Her interests include learning languages, watching K-dramas & visiting historical museums. Follow her on X at @rheumarhyme and Bluesky at @rheumarhyme.bsky.social.To learn more about RheumMadness:https://sites.duke.edu/rheummadness/Subscribe to our newsletter:https://lists.duke.edu/sympa/subscribe/rheummadnessFind us on social media:Bluesky: @rheummadness.bsky.socialInstagram: https://www.instagram.com/rheummadness/X: Follow #RheumMadnessIntro/outro music: Cheery Monday by Kevin MacLeodLink: https://incompetech.filmmusic.io/song/3495-cheery-mondayLicense: http://creativecommons.org/licenses/by/4.0/
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Dapagliflozin plus calorie restriction for remission of type 2 diabetes 2. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity 3. Effectiveness of Empagliflozin vs Dapagliflozin for Kidney Outcomes in Type 2 Diabetes 4. Tirzepatide Associated With Reduced Albuminuria in Participants With Type 2 Diabetes 5. Use of SGLT2i Versus DPP-4i as an Add-On Therapy and the Risk of PAD-Related Surgical Events (Amputation, Stent Placement, or Vascular Surgery) For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
Get Dr. Mina's Ultimate (Affordable) Skincare Guide here. Get Dr. Mina's free PDF on How to create Healthy Skin Habits here. Join Dr. Mina and Dr. Mansha Sethi as they navigate the ever-evolving world of med spas. In this conversation, they break down popular aesthetic services, discuss industry regulations, and highlight why patient safety should always come first. From understanding the risks of non-physician providers to choosing a reputable med spa, this episode empowers listeners to make informed decisions about cosmetic treatments. Whether you're curious about injectables or considering your first med spa visit, this discussion sheds light on what every patient needs to know before booking an appointment. Key Takeaways: - Med spas offer a variety of non-invasive cosmetic procedures. - Regulation of med spas varies significantly by state. - Only a small percentage of med spas have proper physician oversight. - Complications can arise from aesthetic procedures, even in trained hands. - Patients should be cautious of overly cheap services. - It's essential to verify the qualifications of the providers at med spas. - Hydrafacials and laser hair removal are popular and effective treatments. - Patients should be wary of over-promising treatments and results. - Cleanliness and organization are critical indicators of a reputable med spa. - Collaboration between dermatologists and estheticians enhances patient care. In This Episode: (02:00) Understanding Med Spas: A Comprehensive Overview (06:08) Regulation and Oversight of Med Spas (14:57) Complications and Patient Safety in Aesthetic Procedures (18:51) Choosing the Right Med Spa: Key Considerations (21:04) Best Practices and Treatments at Med Spas (25:23) Red Flags and Warning Signs at Med Spas (28:10) Final Thoughts: Ensuring Safety and Quality in Aesthetic Care Dr. Mansha Sethi is a board-certified dermatologist serving both adult and pediatric patients. She currently practices medical, surgical, and cosmetic dermatology at St. Luke's University Health Network in PA. Part of her job includes training dermatology residents. Prior to this, Dr. Sethi worked at a private practice in Houston, TX. She grew up in Northeast Pennsylvania. She attended Cornell University in Ithaca, NY, for her Bachelor of Science, earning Dean's List each semester for academic record. She received her medical degree from the Lewis Katz School of Medicine at Temple University in Philadelphia. She was selected to present her research at local and national conferences – the Philadelphia Dermatological Society and the American Academy of Dermatology. She completed a year of internal medicine at Jefferson-Abington Hospital and her dermatology residency at Thomas Jefferson University. Philly holds a special place in her heart because she met her husband there. Dr. Sethi is a member of the American Academy of Dermatology (AAD) and the American Society of Dermatologic Surgery. She's one of the social media ambassadors for AAD. Outside work, she enjoys traveling, trying new restaurants, and spending time with family. She's navigating new mom life with her baby boy. Follow Dr. Sethi here: https://www.instagram.com/doctor_sethi Follow Dr. Mina here:- https://instagram.com/drminaskin https://www.facebook.com/drminaskin https://www.youtube.com/@drminaskin https://www.linkedin.com/in/drminaskin/ For more great skin care tips, subscribe to The Skin Real Podcast or visit www.theskinreal.com Baucom & Mina Derm Surgery, LLC Email - scheduling@atlantadermsurgery.com Contact - (404) 844-0496 Instagram - https://www.instagram.com/baucomminamd/ Thanks for listening! The content of this podcast is for entertainment, educational, and informational purposes and does not constitute formal medical advice.
More women than men have died from cardiovascular disease in modern times, yet we continue to believe it is primarily a problem for men. Your cardiometabolic health determines how you are able to show up in the world and can be a key indicator of your health going forward. This is why it is so important to know which signs to pay attention to so that you can pivot as your body pivots. Protecting Your Aliveness with Dr. Sara Gottfried Sara Gottfried, MD is a board-certified physician, researcher, and educator. She graduated from Harvard Medical School and MIT, and completed residency at UCSF. Dr. Gottfried is a global keynote speaker and the author of four New York Times bestselling books about trauma, hormones, and physical and mental health—including her latest titled WOMEN, FOOD, AND HORMONES. Dr. G has also completed a 2-year fellowship in Advanced Cardiometabolic Health at the Metabolic Medical Institute, and she is Clinical Assistant Professor in Dept. of Integrative Medicine and Nutritional Sciences at Thomas Jefferson University, and Director of Precision Medicine at the Marcus Institute of Integrative Health. Her focus is diet, nutrition, and peak performance. In This Episode Differentiating the role of glucose when it comes to your vascular health (12:32) At what age you should start to look at your cardio-metabolic health with a fine tooth comb (20:06) How to work to change the system and protect women at risk for heart attack (24:33) Understanding the advanced cardiovascular markers and how to identify them (34:51) Tips for adjusting your diet if you are dealing with insulin resistance and improving your metabolic flexibility (46:08) Mentioned In This Episode Women Food and Hormones by Dr. Sara Gottfried Related Resources Check out the full show notes page Keep up with everything Dr. Mariza Follow Dr. Mariza on Facebook | Instagram | Twitter | YouTube Related Episodes #314: Why So Many Women Struggle with Stubborn Weight and the Benefits of Keto for Hormone Health with Dr. Sara Gottfried #426: 10 Most Common Reasons Your Glucose Levels are Rising Up
In this exciting episode of the podcast, Dr. Jennie Berkovich interviews Dr. Sarah Cohen, an expert in dysautonomia, to explore the complexities of this often misunderstood condition. Dr. Cohen shares insights into the types of patients she typically works with and how her journey led her to specialize in dysautonomia. They discuss common misconceptions physicians and medical professionals have about patients with dysautonomia and explore potential risk factors, including early signs that may predict the development of the condition. The conversation delves into the gap in Western medicine when it comes to treating dysautonomia and offers an explanation of Ehlers-Danlos Syndrome (EDS), its typical presentations, and the conditions associated with it. Dr. Cohen also reflects on how treatments for dysautonomia have evolved over the years, providing listeners with the latest updates in care. The episode further explores whether there are any preventive measures available for dysautonomic conditions or ways to slow their progression. This episode is a must-listen for anyone interested in dysautonomia, whether you're a healthcare professional or simply curious about the condition. Tune in for expert insights and a deeper understanding of this important health topic! Sarah Cohen Solomon, MD FAAP is the ABP Board Certified Pediatrician at PRISM Spine and Joint, where she specializes in caring for patients with hypermobile Ehlers Danlos Syndrome and related conditions, including Dysautonomia (POTS) and Mast Cell Activation Syndrome. This interest stems from her own lifelong experience with these conditions. After graduating from Sidney Kimmel Medical College of Thomas Jefferson University, Dr. Cohen Solomon remained at the affiliated Nemours Hospital for Children, where she was awarded the Pediatric Academic Excellence Award for Outstanding Research, Education, and/or Advocacy in General Pediatrics for her work expanding the Advocacy curriculum for their residency program. Dr. Cohen Solomon is passionate about breaking down barriers to healthcare and education, by providing children with appropriate accommodations so they can thrive at school among their peers and mentoring medical students with disabilities. _________________________________________________ Sponsor the JOWMA Podcast! Email digitalcontent@jowma.org Become a JOWMA Member! www.jowma.org Follow us on Instagram! www.instagram.com/JOWMA_org Follow us on Twitter! www.twitter.com/JOWMA_med Follow us on Facebook! https://www.facebook.com/JOWMAorg Stay up-to-date with JOWMA news! Sign up for the JOWMA newsletter! https://jowma.us6.list-manage.com/subscribe?u=9b4e9beb287874f9dc7f80289&id=ea3ef44644&mc_cid=dfb442d2a7&mc_eid=e9eee6e41e
Neuroimaging is a tool to classify and ascertain the etiology of epilepsy in people with first or recurrent unprovoked seizures. In addition, imaging may help predict the response to treatment. To maximize diagnostic power, it is essential to order the correct imaging sequences. In this episode, Aaron Berkowitz, MD, PhD, FAAN speaks with Christopher T. Skidmore, MD, author of the article “Neuroimaging in Epilepsy,” in the Continuum February 2025 Epilepsy issue. Dr. Berkowitz is a Continuum® Audio interviewer and professor of clinical neurology at the University of California, San Francisco Dr. Skidmore is an associate professor of neurology and vice-chair for clinical affairs at Thomas Jefferson University, Department of Neurology in Philadelphia, Pennsylvania. Additional Resources Read the article: Neuroimaging in Epilepsy 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 Host: @AaronLBerkowitz Guest: @ctskidmore Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Berkowitz: This is Dr Aaron Berkowitz, and today I'm interviewing Dr Christopher Skidmore about his article on neuroimaging in epilepsy, which appears in the February 2025 Continuum issue on epilepsy. Welcome to the podcast, Dr Skidmore. Would you please introduce yourself to our audience? Dr Skidmore: Thank you for having me today. I'm happy to talk to you, Dr Berkowitz. My name is Christopher Skidmore. I'm an associate professor of neurology at Thomas Jefferson University in Philadelphia. I'm a member of the Jefferson Comprehensive Epilepsy Center and also serve as the vice chair of clinical affairs for the department. Dr Berkowitz: Thank you very much for joining us and for this fantastic article. It's very comprehensive, detailed, a very helpful review of the various types of brain pathology that can lead to epilepsy with very helpful images and descriptions of some of the more common findings like mesial temporal sclerosis and some of the less common ones such as cortical malformations, heterotopia, ganglioglioma, DNET. So, I encourage all of our listeners to read your article and take a close look at those images. So, hopefully you can recognize some of these findings on patients' neuroimaging studies, or if you're studying for the right or the boards, you can recognize some of these less common congenital malformations that can present in childhood or adulthood with epilepsy. In our interview today, what I'd like to do is focus on some practical tips to approaching, ordering, and reviewing different neuroimaging studies in patients with epilepsy. So to start, what's your approach when you're reviewing an MRI for a patient with a first seizure or epilepsy? What sequence do you begin with and why, how do you proceed through the different sequences and planes? What exactly are you looking for? Dr Skidmore: It's an important question. And I think to even take a step back, I think it's really important, when we're ordering the MRI, we really need to be specific and make sure that we're mentioning the words seizures and epilepsy because many radiology centers and many medical centers have different imaging protocols for seizure and epilepsy patients as compared to, like, a stroke patient or a brain tumor patient. I think first off, we really need to make sure that's in the order, so that way the radiologist can properly protocol it. Once I get an image, though, I treat an MRI just like I would a CAT scan approach with any patient, which is to always approach it in the same fashion. So, top down, if I'm looking at an axial image. If I'm looking at a coronal image, I might start at the front of the head and go to the back of the head. And I think taking that very organized approach and looking at the whole brain in total first and looking across the flare image, a T2-weighted image and a T1-weighted image in those different planes, I think it's important to look for as many lesions as you can find. And then using your clinical history. I mean, that's the value of being a neurologist, is that we have the clinical history, we have the neurological exam, we have the history of the seizure semiology that can might tell us, hey, this might be a temporal lobe seizure or hey, I'm thinking about a frontal lobe abnormality. And then that's the advantage that we often have over the radiologist that we can then take that history, that exam, and apply it to the imaging study that we're looking at and then really focus in on those areas. But I think it's important, and as I've illustrated in a few of the cases in the chapter, is that don't just focus on that one spot. You really still need to look at the whole brain to see if there's any other abnormalities as well. Dr Berkowitz: Great, that's a very helpful approach. Lots of pearls there for how to look at the imaging in different planes with different sequences, comparing different structures to each other. Correspondent reminder, listeners, to look at your paper. That's certainly a case where a picture is worth a thousand words, isn't it, where we can describe these. But looking at some of the examples in your paper, I think, will be very helpful as well. So, you mentioned mentioning to the neuroradiologist that we're looking for a cause of seizures or epilepsy and epilepsy protocols or MRI. What is sort of the nature of those protocols if there's not a quote unquote “ready-made” one at someone 's center in their practice or in their local MRI center? What types of things can be communicated to the radiologist as far as particular sequences or types of images that are helpful in this scenario? Dr Skidmore: I spent a fair amount of time in the article going over the specific MRI protocol that was designed by the International League Against Epilepsy. But what I look for in an epilepsy protocol is a high-resolution T2 coronal, a T2 flare weighted image that really traverses the entire temporal lobe from the temporal tip all the way back to the most posterior aspects of the temporal lobe, kind of extending into the occipital lobe a little bit. I also want to see a high resolution. In our center, it's usually a T1 coronal image that images the entire brain with a very, very thin slice, and usually around two millimeters with no gaps. As many of our neurology colleagues are aware, when you get a standard MRI of the brain for a stroke or a brain tumor, you're going to have a relatively thick slice, anywhere from five to eight millimeters, and you're actually typically going to have a gap that's about comparable, five to eight millimeters. That works well for large lesions, strokes, and big brain tumors, but for some of the tiny lesions that we're talking about that can cause intractable epilepsy, you can have a focal cortical dysplasia that's literally eight- under eight millimeters in size. And so, making sure you have that nice T1-weighted image, very thin slices with no gaps, I think is critical to make sure we don't miss these more subtle abnormalities. Dr Berkowitz: Some of the entities you describe in your paper may be subtle and more familiar to pediatric neurologists or specialized pediatric neuroradiologists. It may be more challenging for adult neurologists and adult neuradiologists to recognize, such as some of the various congenital brain malformations that you mentioned. What's your approach to looking for these? Which sequences do you focus on, which planes? How do you use the patient 's clinical history and EEG findings to guide your review of the imaging? Dr Skidmore: It's very important, and the reason we're always looking for a lesion---especially in patients that we're thinking about epilepsy surgery---is because we know if there is a lesion, it increases the likelihood that epilepsy surgery is going to be successful. The approach is basically, as I mentioned a little bit before, is take all the information you have available to you. Is the seizure semiology, is it a hyper motor semiology or hyperkinetic semiology suggestive of frontal lobe epilepsy? Or is it a classic abdominal rising aura with automatisms, whether they be manual or oral automatisms, suggesting mesial temporal lobe epilepsy? And so, take that clinical history that you have to help start to hone your eye into those individual locations. But then, once you're kind of looking in these nonlesional cases, you're also then looking at the EEG and where their temporal lobe spikes, where their frontal lobe spikes, you know, using that and pulling that information in. If they saw a neuropsychologist pulling in the information in from the neuropsychological evaluation; if they have severe reductions in verbal memory, you know, focusing on the dominant temporal lobe. So, in a right-handed individual, typically the left temporal lobe. And kind of then really spending a lot of time going slice at a time, very slowly, because in some of these vocal-cortical dysplasias it can be just the blurring of the gray-white margin. What I find easiest is to identify that gray-white margin and almost track it. Like, you use the mouse to kind of track it around and say, can I outline the exact border of the gray white margin in the frontal lobe that I'm interested in or the temporal lobe that I'm interested in, kind of looking for those subtle abnormalities. Often as neurologists, we don't have the luxury of being able to immediately reformat. As I mentioned, our T1 volume acquisition study is done in the coronal plane, but sometimes you might want it in the axial plane. And so, I might reach out to the radiologist and say, hey, can you reformat this in the axial plane because I'm interested in the frontal lobe epilepsy and it's a little bit better at looking at it in that plane? And I'll have them reformat and put it back on the pack so I can look at it in that manner. And so that's a, kind of another strategy is to take what you have, but also then go back to the radiologist and say, I need to look at it this a different way. Can you reformat it for me? Looking for that gray-white matter junction is the nice way to pick up for kind of subtle cortical dysplasias. And then when you see an abnormality, to be able to put the T1, the T2, and the flare image all up next to each other and use the technology built into most of our browsers to put on what's called the localizer mode, where I can highlight a specific spot that I'm seeing on the T1 and then very easily quickly see, what does it look like on the T2? What does it look like on the flare? To kind of quickly decide, is it a true abnormality or am I only seeing it on one slice because of an artifact on that one imaging sequence? And I think that's the biggest kind of key is to make sure, is it an artifact or is it not an artifact? That's kind of the most common thing that we, I think, get confused with. Dr Berkowitz: So, some very helpful pearls there in terms of reviewing the imaging, being in dialogue with our neuroradiology colleagues to think about potentially reacquiring certain images on certain planes or looking at the images with our neuroradiology colleagues to let them know more about the clinical history and where we're sort of zooming in about possible abnormalities. Dr Skidmore: I would just add in there that when looking at especially the mesial temporal structures, because of a lot of artifacts that can be present in an individual MRI machine, it's not uncommon that the mesial temporal structure will appear brighter because of an MRI magnet artifact. And so, it's a good key to look at the hippocampus compared to the insula. And so, the hippocampus and the insula should have similar signal characteristics. You're seeing the hippocampus is bright, but the insula ipsilateral to it's normal intensity. That would suggest that that's probably a true hyperintensity on the flare-weighted image as opposed to if both are bright, unless you're suspecting a hemispheric abnormality, it's more likely to be a kind of artifact in the MRI machine. Dr Berkowitz: Okay. Those are really helpful tips, not just to analyze the hippocampus and medial temporal lobe itself---let's remember our anatomy and the circuit of Papez---and to look at associated structures for supporting evidence of a possible abnormality in the hippocampus itself. It looks like there may be something subtle. We can use some additional information from the image to try to decide if that is real or artifactual, and of course correlating with the clinical picture and EEG. I'd like to talk briefly now about some other imaging modalities that you discuss in your paper, the use of functional imaging such as PET, SPECT and fMRI. Let's talk a bit about each of these. When would you order a PET scan for a patient with epilepsy? What would you be looking for and how would you be using that to make clinical decisions? Dr Skidmore: Yeah, so these functional imaging modalities are really utilized when we're evaluating somebody that's not responding to medications. So, they're medically intractable, and we're wondering, could they be a candidate for epilepsy surgery? And so, most of these imaging modalities are really relegated to the world of epileptologists at surgical epilepsy centers. I wanted to include them, though, in the article because I do think it's important for general neurologists to understand kind of what they are, because invariably a patient sees me and then they go back to their general neurology and be like, hey, Doctor Skidmore said I had this PET scan abnormality. What do you think? So, I think it's a good idea for general neurologists to kind of understand them. So, probably the oldest that we've utilized is the FDG PET scan, basically looking at fluorodeoxyglucose and the brain's utilization of glucose. As we all remember, again, glucose is the primary molecule for energy and ATP production in the brain. And so basically, by injecting radioactive glucose in the interictal state--- so not during a seizure but in between seizures---areas of the brain that are not taking up the radiotracer will show as being hypometabolic. So, low metabolism. And hypometabolic regions in the interictal state have been associated with onset regions for epileptic seizures. Let's say you have a patient clinical history, you think they have temporal of epilepsy, EEG suggests temporal of epilepsy, but the MRI is nonlesional, meaning there's no abnormality that anybody could appreciate even at a 3 Tesla scanner. We'll get an FDG PET scan and see, is there hypo metabolism in that temporal lobe of interest? And if there is, well, that's been shown through several published papers, that's just as valuable as having an abnormality on the MRI. And so, we often again use these PET scans, especially in nonlesional cases, to try to find that subtle cortical dysplasia. Now you have your nice epilepsy protocol MRI, it says it's nonlesional. You get your PET scan, it shows hypometabolism in a region of the frontal lobe, let's say, in a in a frontal lobe epilepsy case. And then often we go back, we kind of talked about strategy of how you find those subtle lesions. Then you go back and say, well, look, this gyrus specifically on the PET scan said it's abnormal. You end up looking for really subtle, very tiny abnormalities that, even with somebody that's skilled, often at first review gets missed. So, that's how we use the PET scan. The SPECT scan is done typically in the ictal state. So, now somebody's in an epilepsy monitoring unit often, where you're injecting radio tracer at the exact moment that somebody starts having a seizure. And we know when there's increased seizure activity, the increased seizure activity---let's say it's from my right temporal lobe---is going to increase cerebral blood flow transiently to the right temporal lobe. And then if that seizure discharge spreads from the right temporal lobe maybe to the entire right hemisphere and eventually becomes a focal to bilateral tonic chronic seizure by spreading to the other side, the entire brain is going to be hypoperfused at that point. So, if you want to, as soon as the seizure starts, inject that radio tracer to see, where is the blood flow earliest in the seizure? And then we might do an interictal SPECT when you're not having a seizure. Look at, all right, what's the normal blood flow when somebody's not seizing? What's it like when they're having a seizure? And then the area that has increased activity would- might suggest that's where the seizure started from. But we have to be very careful because again, some seizures can spread very rapidly. So, if you delay injecting an injection ten, fifteen, twenty seconds, the seizure could have already propagated to another region of the brain, giving you a false positive in another location. So, you have to be very careful about that modality. I think what's most exciting is the functional MRI because the functional MRI, for many, many centers, is replacing a very old technique called the WADA test. So, in the WADA test, typically you place a catheter angiogram into the internal carotid artery and transiently introduce a sedative medication to put, let's say, the left hemisphere to sleep because you wanted to see what functions were still active in the right hemisphere. And then the surgeon would move the catheter or the right internal carotid artery, and you inject a sedative on that side after the left hemisphere is recovered and see what the left hemisphere can do. And we used that for language dominance, we used that for memory dominance. And while most individuals did fine with angiograms, unfortunately complications do occur and there's injury to the artery, there could be strokes that can- that have happened, which can be quite devastating for the patient. And so, functional MRI is a nice, noninvasive way for us to map out language function, motor function, sensory function, visual function, and is starting to show some usefulness also for mapping out kind of memory function, dominant memory function, meaning verbal memory compared to visual memory. To be able to do those things noninvasively becomes really important because, if we're talking about epilepsy surgery, we want to make you seizure-free but neurologically intact. And so, we need to understand the relationship between where we think the seizures are coming from and where eloquent cortex is so we can properly counsel you and avoid those regions during any planned surgery. Those are the three most common functional imaging modalities that we're using now to supplement the rest of the presurgical work. Dr Berkowitz: Very helpful. So, these are studies, PET, SPECT, and fMRI, that would really be obtained predominantly in patients in whom epilepsy surgery was being considered to have more precise lesion localization, as well as with the fMRI to get a better sense of how to provide the safest maximal resection of epileptogenic tissue while preserving functions. Dr Skidmore: That's a perfect summary. Dr Berkowitz: Fantastic. This has been a really helpful interview with Dr Skidmore and a really fantastic article. As I said, a picture is worth a thousand words, so I definitely encourage you to read the article and look at the images of some of the conditions we've been talking about and some of these findings that can be seen on interictal PET or ictal SPECT to get a sense of the visual aspects of what we've been discussing. So again, today I've been interviewing Dr Christopher Skidmore about his article on neuroimaging and epilepsy, which appears in the most recent issue of Continuum on Epilepsy. Be sure to check out Continuum audio episodes from this and other issues. And thank you so much to our listeners for joining us today. Dr Skidmore: Thank you for having me. 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 this 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.
A new episode of Diabetes Day by Day is here! Join Drs. Neil Skolnik and Sara Wettergreen as they dive into the world of mobile health technology and how it's shaping diabetes management. With so many apps for tracking blood glucose (blood sugar), counting carbs, and logging fitness activities, it can be tough to find the right one. In this episode, we welcome Susan Weiner, MS, RDN, CDCES, FADCES, a nutrition, health, and diabetes expert with knowledge of diabetes-related apps, and Bridget Wood, RD, LD, CDCES, who has lived with type 1 diabetes for over 15 years and has firsthand experience with apps that can assist with diabetes management. Our guests will share valuable insights on how apps can support people living with diabetes and why using them can be beneficial. This episode isn't sponsored, and we're not endorsing any specific app—just sharing examples of ones that have helped others. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health, Abington, PA Sara Wettergreen, PharmD, BCACP, BC-ADM, Assistant Professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Ambulatory Care Clinical Pharmacist, UCHealth Lone Tree Primary Care, Aurora, CO Susan Weiner, MS, RDN, CDCES, FADCES — Columnist at Endocrine Today, Owner of Susan Weiner Nutrition, PLLC, and Nutrition Communicator and Media Consultant, New York City Metropolitan Area Bridget Wood, RD, LD, CDCES — Owner and Clinical Director of Bridget Wood Wellness, LLC, Reno, NV Do you have questions or comments you'd like to share with Neil and Sara? Leave a message at (703) 755-7288. Thank you for listening, and don't forget to “follow” Diabetes Day by Day! For additional resources, be sure to check out: FDA Alert DiabetesWise ADCES Danatech Apps and Platforms Phone apps referenced: Glucose Blood Sugar Tracker Dario Health Livongo by Teladoc Health mySugr Dexcom G7 Tidepool OMRON (for blood pressure)
In this special edition of Diabetes Core Update, host Neil Skolnik, MD, explores the timely and critical topic of compounded medications in diabetes care. In this episode Dr. Skolnik moderates a discussion between a family doctor, a patient, and a pharmacist about practical decision making around the topic of compounded medication for the treatment of overweight and obesity. This special edition of Diabetes Core Update is supported by Lilly. Presented by: Neil Skolnik, MD – Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington–Jefferson Health John Hertig, PharmD, MS, CPPS – Associate Professor, Butler University College of Pharmacy and Health Sciences Susan Kuchera, MD - Clinical Assistant Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington. Lisa Kessler MS, CCC-SLP - Infant-toddler Homebased Pediatric Speech-Language Pathologist Compounded GLP 1 and Dual GIP/GLP 1 Receptor Agonists: A Statement from the American Diabetes Association. Diabetes Care December 2, 2024; dci240091 https://doi.org/10.2337/dci24-0091 PubMed: 39620926 FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss. US FDA Website ( current as of 12/18/2024)
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Large Language Model GPT-4 Compared to Endocrinologist Responses on Initial Choice of Antidiabetic Medication 2. Long term health outcomes in people with diabetes 12 months after hospitalization with COVID-19 in the UK: a prospective cohort study 3. Risk of nephrolithiasis associated with SGLT2 inhibitors versus DPP4 inhibitors among patients with type 2 diabetes: a target trial emulation study 4. Early Screening for Latent Autoimmune Diabetes in Adults to Improve Care—Beyond the Routine 5. Project ECHO Diabetes Trial Improves Outcomes for Medically Underserved People For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
When David Wright went to Iraq as an 18-year-old soldier - he had no idea the battlefield would become a place where he'd enter deep states of bliss. For decades, David remained silent about the intense joy he experienced alongside the horrors of war. Matthew Syed ponders the extraordinary possibility of experiencing joy while suffering and hears more about the remarkable potential of the brain to respond to trauma in unexpected ways. He discovers how others too, like actor Renu Arora, experienced something similar when she was hit by a bus - and considers how such stories might help us shift our perspective on pain. With ex-soldier David Wright, actor/singer/writer Renu Arora, neuroscientist Dr Andrew Newberg, Director of Research at the Marcus Institute of Integrative Medicine at Thomas Jefferson University and Hospital in Philadelphia and Dr Steve Taylor, lecturer at Leeds Beckett University in transpersonal psychology and author of the book Extraordinary Awakenings. Featuring an excerpt sung by Renu Arora from the RSC Enterprise performance recording of Anything Could Happen from The Magician's Elephant. Music by Marc Teitler and lyrics by Nancy Harris. Presenter: Matthew Syed Producer: Vishva Samani Series Editors: Georgia Moodie and Max O'Brien Sound Design and Mix: Daniel Kempson Theme Music by Ioana Selaru A Novel production for BBC Radio 4
In this episode, Scott Becker interviews Dr. Judd Hollander, Senior Vice President of Healthcare Delivery Innovation at Thomas Jefferson University. Dr. Hollander shares insights from his career, including pioneering telemedicine programs, leveraging AI for healthcare solutions, and reshaping the patient experience through innovation.
There are dangers lurking in our food that affect your health and the health of our entire society, and you should know about them. In this episode, get the highlights from two recent Congressional events featuring expert testimony about the regulation of our food supply, as well as testimony from the man who is soon likely to be the most powerful person in our national health care system. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources Joe Rogan Episodes The Joe Rogan Experience. The Joe Rogan Experience. The Joe Rogan Experience. The Joe Rogan Experience. Ron Johnson Scott Bauer. January 3, 2023. AP News. Robert F. Kennedy, Jr. Daniel Cusick. October 28, 2024. Politico. Rachel Treisman. August 5, 2024. NPR. Susanne Craig. May 8, 2024. The New York Times. Department of Health and Human Services U.S. Department of Health and Human Services. FDA “Generally Recognized as Safe” Approach Paulette M. Gaynor et al. April 2006. U.S. Food and Drug Administration. Paulette Gaynor and Sebastian Cianci. December 2005/January 2006. U.S. Food and Drug Administration. Glyphosate September 20, 2023. Phys.org. Lobbying and Conflicts of Interest OpenSecrets. OpenSecrets. OpenSecrets. LinkedIn. Shift from Democrats to Republicans Will Stone and Allison Aubrey. November 15, 2024. NPR. Helena Bottemiller Evich and Darren Samuelsohn. March 17, 2016. Politico. Audio Sources September 25, 2024 Roundtable discussion held by Senator Ron Johnson Participants: , Author, Good Energy; Tech entrepreneur, Levels , Co-founder, Truemed; Advocate, End Chronic Disease , aka the Food Babe, food activist Jillian Michaels, fitness expert, nutritionist, businesswoman, media personality, and author Dr. Chris Palmer, Founder and Director, Metabolic and Mental Health Program and Director, Department of Postgraduate and Continuing Education, McLean Hospital; Assistant Professor of Psychiatry, Harvard Medical School Brigham Buhler, Founder & CEO, Ways2Well Courtney Swan, nutritionist, real food activist, and founder of the popular platform "Realfoodology" , Founder and CEO, HumanCo; co-founder, Hu Kitchen Dr. Marty Makary, Chief of Islet Transplant Surgery, Professor of Surgery, and Public Policy Researcher, Johns Hopkins University Clips Robert F. Kennedy, Jr: When discussing improvements to US healthcare policy, politicians from both parties often say we have the best healthcare system in the world. That is a lie. Robert F. Kennedy, Jr: Every major pillar of the US healthcare system, as a statement of economic fact, makes money when Americans get sick. By far the most valuable asset in this country today is a sick child. The pharma industry, hospital industry, and medical school industry make more money when there are more interventions to perform on Americans, and by requiring insurance companies to take no more than 15% of premiums, Obamacare actually incentivized insurance companies to raise premiums to get 15% of a larger pie. This is why premiums have increased 100% since the passage of Obamacare, making health care the largest driver of inflation, while American life expectancy plummets. We spend four times per capita on health care than the Italians, but Italians live 7.5 years longer than us on average. And incidentally, Americans had the highest life expectancies in the world when I was growing up. Today, we've fallen an average of six years behind our European neighbors. Are we lazier and more suicidal than Italians? Or is there a problem with our system? Are there problems with our incentives? Are there problems with our food? 46:15 Robert F. Kennedy, Jr: So what's causing all of this suffering? I'll name two culprits, first and worst is ultra processed foods. 47:20 Robert F. Kennedy, Jr: The second culprit is toxic chemicals in our food, our medicine and our environment. Robert F. Kennedy, Jr: The good news is that we can change all this, and we can change it very, very, very quickly, and it starts with taking a sledgehammer to corruption, the conflicts in our regulatory agencies and in this building. These conflicts have transformed our regulatory agencies into predators against the American people and particularly our children. 80% of NIH grants go to people who have conflicts of interest, and these scientists are allowed to collect royalties of $150,000 a year on the products that they develop at NIH and then farm out to the pharmaceutical industry. The FDA, the USDA and CDC are all controlled by giant for-profit corporations. Their function is no longer to improve and protect the health of Americans. Their function is to advance the mercantile and commercial interests of the pharmaceutical industry that has transformed them and the food industry that has transformed them into sock puppets for the industry they're supposed to regulate. 75% of FDA funding does not come from taxpayers. It comes from pharma. And pharma executives and consultants and lobbyists cycle in and out of these agencies. Robert F. Kennedy, Jr: Money from the healthcare industry has compromised our regulatory agencies and this body as well. The reality is that many congressional healthcare staffers are worried about impressing their future bosses at pharmaceutical companies rather than doing the right thing for American children. Today, over 100 members of Congress support a bill to fund Ozempic with Medicare at $1,500 a month. Most of these members have taken money from the manufacturer of that product, a European company called Novo Nordisk. As everyone knows, once a drug is approved for Medicare, it goes to Medicaid, and there is a push to recommend Ozempic for Americans as young as six, over a condition, obesity, that is completely preventable and barely even existed 100 years ago. Since 74% of Americans are obese, the cost of all of them, if they take their Ozempic prescriptions, will be $3 trillion a year. This is a drug that has made Novo Nordisk the biggest company in Europe. It's a Danish company, but the Danish government does not recommend it. It recommends a change in diet to treat obesity and exercise. Virtually Novo Nordisk's entire value is based upon its projections of what Ozempic is going to sell to Americans. For half the price of Ozempic, we could purchase regeneratively raised organic agriculture, organic food for every American, three meals a day and a gym membership for every obese American. Why are members of Congress doing the bidding of this Danish company instead of standing up for American farmers and children? Robert F. Kennedy, Jr: For 19 years, solving the childhood chronic disease crisis has been the central goal of my life, and for 19 years, I have prayed to God every morning to put me in a position to end this calamity. I believe we have the opportunity for transformational, bipartisan change to transform American health, to hyper-charge our human capital, to improve our budget, and I believe, to save our spirits and our country. 1:23:10 Sen. Ron Johnson (R-WI): Our next presenter, Dr. Marty Makary also bears a few scars from telling the truth during COVID. Dr. Makary is a surgeon and public policy researcher at Johns Hopkins University. He writes for The Washington Post and The Wall Street Journal, and is the author of two New York Times best selling books, Unaccountable and The Price We Pay. He's been an outspoken opponent of broad vaccine mandates and some COVID restrictions at schools. Dr. Makary holds degrees from Bucknell University, Thomas Jefferson University and Harvard University. Dr. Marty Makary: I'm trained in gastrointestinal surgery. My group at Johns Hopkins does more pancreatic cancer surgery than any hospital in the United States. But at no point in the last 20 years has anyone stopped to ask, why has pancreatic cancer doubled over those 20 years? Who's working on that? Who's looking into it? We are so busy in our health care system, billing and coding and paying each other, and every stakeholder has their gigantic lobby in Washington, DC, and everybody's making a lot of money, except for one stakeholder, the American citizen. They are financing this giant, expensive health care system through their paycheck deduction for health insurance and the Medicare excise tax as we go down this path, billing and coding and medicating. And can we be real for a second? We have poisoned our food supply, engineered highly addictive chemicals that we put into our food, we spray it with pesticides that kill pests. What do you think they do to our gut lining and our microbiome? And then they come in sick. The GI tract is reacting. It's not an acute inflammatory storm, it's a low grade chronic inflammation, and it makes people feel sick, and that inflammation permeates and drives so many of our chronic diseases that we didn't see half a century ago. Who's working on who's looking into this, who's talking about it? Our health care system is playing whack a mole on the back end, and we are not talking about the root causes of our chronic disease epidemic. We can't see the forest from the trees. Sometimes we're so busy in these short visits, billing and coding. We've done a terrible thing to doctors. We've told them, put your head down. Focus on billing and coding. We're going to measure you by your throughput and good job. You did a nice job. We have all these numbers to show for it. Well, the country is getting sicker. We cannot keep going down this path. We have the most over-medicated, sickest population in the world, and no one is talking about the root causes. Dr. Marty Makary: Somebody has got to speak up. Maybe we need to talk about school lunch programs, not just putting every kid on obesity drugs like Ozempic. Maybe we need to talk about treating diabetes with cooking classes, not just throwing insulin at everybody. Maybe we need to talk about environmental exposures that cause cancer, not just the chemo to treat it. We've got to talk about food as medicine. Sen. Ron Johnson (R-WI): So, Dr Makary, I've got a couple questions. First of all, how many years have you been practicing medicine? Dr. Marty Makary: 22 years. Sen. Ron Johnson (R-WI): So we've noticed a shift from decades ago when 80% of doctors are independent to now 80% are working for some hospital association. First of all, what has that meant in terms of doctors' independence and who they are really accountable too? Dr. Marty Makary: The move towards corporate medicine and mass consolidation that we've witnessed in our lifetime has meant more and more doctors are told to put their heads down, do your job: billing and coding short visits. We've not given doctors the time, research, or resources to deal with these chronic diseases. 1:32:45 Sen. Ron Johnson (R-WI): Dr. Casey Means is a medical doctor, New York Times Best Selling Author, tech entrepreneur at Levels, an aspiring regenerative gardener and an outdoor enthusiast. While training as a surgeon, she saw how broken and exploitative the health care system is, and led to focus on how to keep people out of the operating room. And again, I would highly recommend everybody read Good Energy. It's a personal story, and you'll be glad you did. Dr. Casey Means: Over the last 50 years in the United States, we have seen rapidly rising rates of chronic illnesses throughout the entire body. The body and the brain, infertility, obesity, type 2 diabetes and pre-diabetes, Alzheimer's, dementia, cancer, heart disease, stroke, autoimmune disease, migraines, mental illness, chronic pain, fatigue, congenital abnormalities, chronic liver disease, autism, and infant and maternal mortality all going up. Americans live eight fewer years compared to people in Japan or Switzerland, and life expectancy is going down. I took an oath to do no harm, but listen to these stats. We're not only doing harm, we're flagrantly allowing harm. While it sounds grim, there is very good news. We know why all of these diseases are going up, and we know how to fix it. Every disease I mentioned is caused by or worsened by metabolic dysfunction, a word that it is thrilling to hear being used around this table. Metabolic dysfunction is a fundamental distortion of our cellular biology. It stops our cells from making energy appropriately. According to the American College of Cardiology, metabolic dysfunction now affects 93.2% of American adults. This is quite literally the cellular draining of our life force. This process is the result of three processes happening inside our cells, mitochondrial dysfunction, a process called oxidative stress, which is like a wildfire inside our cells, and chronic inflammation throughout the body and the gut, as we've heard about. Metabolic dysfunction is largely not a genetic issue. It's caused by toxic American ultra processed industrial food, toxic American chemicals, toxic American medications, and our toxic sedentary, indoor lifestyles. You would think that the American healthcare system and our government agencies would be clamoring to fix metabolic health and reduce American suffering and costs, but they're not. They are deafeningly silent about metabolic dysfunction and its known causes. It's not an overstatement to say that I learned virtually nothing at Stanford Medical School about the tens of thousands of scientific papers that elucidate these root causes of why American health is plummeting and how environmental factors are causing it. For instance, in medical school, I did not learn that for each additional serving of ultra processed food we eat, early mortality increases by 18%. This now makes up 67% of the foods our kids are eating. I took zero nutrition courses in medical school. I didn't learn that 82% of independently funded studies show harm from processed food, while 93% of industry sponsored studies reflect no harm. In medical school, I didn't learn that 95% of the people who created the recent USDA Food guidelines for America had significant conflicts of interest with the food industry. I did not learn that 1 billion pounds of synthetic pesticides are being sprayed on our food every single year. 99.99% of the farmland in the United States is sprayed with synthetic pesticides, many from China and Germany. And these invisible, tasteless chemicals are strongly linked to autism, ADHD, sex hormone disruption, thyroid disease, sperm dysfunction, Alzheimer's, dementia, birth defects, cancer, obesity, liver dysfunction, female infertility and more, all by hurting our metabolic health. I did not learn that the 8 billion tons of plastic that have been produced just in the last 100 years, plastic was only invented about 100 years ago, are being broken down into micro plastics that are now filling our food, our water, and we are now even inhaling them in our air. And that very recent research from just the past couple of months tells us that now about 0.5% of our brains by weight are now plastic. I didn't learn that there are more than 80,000 toxins that have entered our food, water, air and homes by industry, many of which are banned in Europe, and they are known to alter our gene expression, alter our microbiome composition and the lining of our gut, and disrupt our hormones. I didn't learn that heavy metals like aluminum and lead are present in our food, our baby formula, personal care products, our soil and many of the mandated medications, like vaccines and that these metals are neurotoxic and inflammatory. I didn't learn that the average American walks a paltry 3500 steps per day, even though we know based on science and top journals that walking, simply walking 7000 steps a day, slashes by 40-60% our risk of Alzheimer's, dementia, type two diabetes, cancer and obesity. I certainly did not learn that medical error and medications are the third leading cause of death in the United States. I didn't learn that just five nights of sleep deprivation can induce full blown pre-diabetes. I learned nothing about sleep, and we're getting about 20% less sleep on average than we were 100 years ago. I didn't learn that American children are getting less time outdoors now than a maximum security prisoner. And on average, adults spend 93% of their time indoors, even though we know from the science that separation from sunlight destroys our circadian biology, and circadian biology dictates our cellular biology. I didn't learn that professional organizations that we get our practice guidelines from, like the American Diabetes Association and American Academy of Pediatrics, have taken 10s of millions of dollars from Coke, Cadbury, processed food companies, and vaccine manufacturers like Moderna. I didn't learn that if we address these root causes that all lead to metabolic dysfunction and help patients change their food and lifestyle patterns with a united strong voice, we could reverse the chronic disease crisis in America, save millions of lives, and trillions of dollars in health care costs per year. Instead, doctors are learning that the body is 100 separate parts, and we learn how to drug, we learn how to cut and we learn how to bill. I'll close by saying that what we are dealing with here is so much more than a physical health crisis. This is a spiritual crisis we are choosing death over life. We are we are choosing death over life. We are choosing darkness over light for people and the planet, which are inextricably linked. We are choosing to erroneously believe that we are separate from nature and that we can continue to poison nature and then outsmart it. Our path out will be a renewed respect for the miracle of life and a renewed respect for nature. We can restore health to Americans rapidly with smart policy and courageous leadership. We need a return to courage. We need a return to common sense and intuition. We need a return to awe for the sheer miraculousness of our lives. We need all hands on deck. Thank you. Sen. Ron Johnson (R-WI): I'm not letting you off that easy. I've got a couple questions. So you outlined some basic facts that doctors should know that truthfully, you could cover in one hour of an introductory class in medical school, yes. So why aren't we teaching doctors these things? Dr. Casey Means: The easy thing to say would be, you know, follow the money. That sounds sort of trite, but frankly, I think that is the truth, but not in the way you might think that, like doctors are out to make money, or even medical schools. The money and the core incentive problem, which is that every institution that touches our health in America, from medical schools to pharmaceutical companies to health insurance companies to hospitals offices, they make more money when we are sick and less when we are healthy. That simple, one incentive problem corrodes every aspect of the way medicine is thought about. The way we think about the body, we talked about interconnectedness. It creates a system in which we silo the body into all these separate parts and create that illusion that we all buy into because it's profitable to send people to separate specialties. So it corrodes even the foundational conception of how we think about the body. So it is about incentives and money, but I would say that's the invisible hand. It's not necessarily affecting each doctor's clinical practice or the decision making. It's corroding every lever of the basics of how we even consider what the human body is and what life is. Sen. Ron Johnson (R-WI): In your book, you do a really good job of describing how, because of the specialization of medicine, you don't see the forest for the trees. The fact is, you do need specialized medicine. I mean, doctors can't know it all. So I think the question is, how do we get back to the reward for general practitioners that do focus on what you're writing about? Dr. Casey Means: I have huge respect for doctors, and I am incredibly grateful for the American health care system, which has produced miracles, and we absolutely need continue to have primary care doctors and specialists, and they should be rewarded highly. However, if we focused on what everyone here is talking about, I think we'd have 90% less throughput through our health care system. We would be able to have these doctors probably have a much better life to be honest. You know, because right now, doctors are working 100 hours a week seeing 50, 60, 70 patients, and could actually have more time with patients who develop these acute issues that need to be treated by a doctor. But so many of the things in the specialist office are chronic conditions that we know are fundamentally rooted in the cellular dysfunction I describe, which is metabolic dysfunction, which is created by our lifestyle. So I think that there's always going to be a place for specialists, but so so many, so much fewer. And I think if we had a different conception for the body is interconnected, they would also interact with each other in a very different way, a much more collaborative way. And then, of course, we need to incentivize doctors in the healthcare system towards outcomes, not throughput. 1:46:25 Sen. Ron Johnson (R-WI): Our next presenter is Dr. Chris Palmer. Dr. Palmer is a Harvard trained psychiatrist, researcher and author of Brain Energy, where he explores a groundbreaking connection between metabolic health and mental illness. He is a leader in innovative approaches to treating psychiatric conditions, advocating for the use of diet and metabolic interventions to improve mental health outcomes. Dr. Palmer's work is reshaping how the medical field views and treats mental health disorders. Dr. Chris Palmer: I want to build on what Dr. Means just shared that these chronic diseases we face today. Obesity, diabetes, fatty liver, all share something in common. They are, in fact, metabolic dysfunction. I'm going to go into a little bit of the science, just to make sure we're all on the same page. Although most people think of metabolism as burning calories, it is far more than that. Metabolism is a series of chemical reactions that convert food into energy and building blocks essential for cellular health. When we have metabolic dysfunction, it can drive numerous chronic diseases, which is a paradigm shift in the medical field. Now there is no doubt metabolism is complicated. It really is. It is influenced by biological, psychological, environmental and social factors, and the medical field says this complexity is the reason we can't solve the obesity epidemic because they're still trying to understand every molecular detail of biology. But in fact, we don't need to understand biology in order to understand the cause. The cause is coming from our environment, a toxic environment like poor diet and exposure to harmful chemicals, and these are actually quite easy to study, understand, and address. There is no doubt food plays a key role. It provides the substrate for energy and building blocks. Nutritious foods support metabolism, while ultra processed options can disrupt it. It is shocking that today, in 2024, the FDA allows food manufacturers to introduce brand new chemicals into our food supply without adequate testing. The manufacturer is allowed to determine for themselves whether this substance is safe for you and your family to eat or not. Metabolism's impact goes beyond physical health. I am a psychiatrist. Some of you are probably wondering, why are you here? It also affects mental health. Because guess what? The human brain is an organ too, and when brain metabolism is impaired, it can cause symptoms that we call mental illness. It is no coincidence that as the rates of obesity and diabetes are skyrocketing, so too are the rates of mental illness. In case you didn't know, we have a mental health crisis. We have all time prevalence highs for depression, anxiety, bipolar disorder, deaths of despair, drug overdoses, ADHD and autism. What does the mental health field have to say for this? Well, you know, mental illness is just chemical imbalances, or maybe trauma and stress that is wholly insufficient to explain the epidemic that we are seeing. And in fact, there is a better way to integrate the biopsychosocial factors known to play a role in mental illness. Mental Disorders at their core are often metabolic disorders impacting the brain. It's not surprising to most people that obesity and diabetes might play a role in depression or anxiety, but the rates of autism have quadrupled in just 20 years, and the rates of ADHD have tripled over that same period of time. These are neuro developmental disorders, and many people are struggling to understand, how on earth could they rise so rapidly? But it turns out that metabolism plays a profound role in neurodevelopment, and sure enough, parents with metabolic issues like obesity and diabetes are more likely to have children with autism and ADHD. This is not about fat shaming, because what I am arguing is that the same foods and chemicals and other drivers of obesity that are causing obesity in the parents are affecting the brain health of our children. There is compelling evidence that food plays a direct role in mental health. One study of nearly 300,000 people found that those who eat ultra processed foods daily are three times more likely to struggle with their mental health than people who never or rarely consume them. A systematic review found direct associations between ultra processed food exposure and 32 different health parameters, including mental mental health conditions. Now I'm not here to say that food is the only, or even primary driver of mental illness. Let's go back to something familiar. Trauma and stress do drive mental illness, but for those of you who don't know, trauma and stress are also associated with increased rates of obesity and diabetes. Trauma and stress change human metabolism. We need to put the science together. This brings me to a key point. We cannot separate physical and mental health from metabolic health. Addressing metabolic dysfunction has the potential to prevent and treat a wide range of chronic diseases. Dr. Chris Palmer: In my own work, I have seen firsthand how using metabolic therapies like the ketogenic diet and other dietary interventions can improve even severe mental illnesses like schizophrenia and bipolar disorder, sometimes putting them into lasting remission. These reports are published in peer reviewed, prestigious medical journals. However, there is a larger issue at play that many have talked about, medical education and public health recommendations are really captured by industry and politics, and at best, they often rely on weak epidemiological data, resulting in conflicting or even harmful advice. We heard a reference to this, but in case you didn't know, a long time ago, we demonized saturated fat. And what was the consequence of demonizing saturated fat? We replaced it with "healthy vegetable shortening." That was the phrase we used, "healthy vegetable shortening." Guess what was in that healthy vegetable shortening? It was filled with trans fats, which are now recognized to be so harmful that they've been banned in the United States. Let's not repeat mistakes like this. Dr. Chris Palmer: So what's the problem? Number one, nutrition and mental health research are severely underfunded, with each of them getting less than 5% of the NIH budget. This is no accident. This is the concerted effort of lobbying by industry, food manufacturers, the healthcare industry, they do not want root causes discovered. We need to get back to funding research on the root causes of mental and metabolic disorders, including the effects of foods, chemicals, medications, environmental toxins, on the human brain and metabolism. Dr. Chris Palmer: The issue of micro plastics and nano plastics in the human body is actually, sadly, in its infancy. We have two publications out in the last couple of months demonstrating that micro plastics are, in fact, found in the human brain. And as Dr. Means said, and you recited, 0.5% of the body weight, or the brain's weight, appears to be composed of micro plastics. We need more research to better understand whether these micro plastics are, in fact, associated with harmful conditions, because microplastics are now ubiquitous. So some will argue, well, they're everywhere, and everybody's got them, and it's just a benign thing. Some will argue that the most compelling evidence against that is a study published in the New England Journal of Medicine a few months ago now, in which they were doing routine carotid endarterectomies, taking plaque out of people's carotid arteries. Just routinely doing that for clinical care, and then they analyzed those plaques for micro plastics. 58% of the people had detectable micro plastics in the plaques. So they compared this 58% group who had micro plastics to the ones who didn't, followed them for three years, just three years, and the ones who had micro plastics had four times the mortality. There is strong reason to believe, based on animal data and based on cell biology data, that microplastics are in fact, toxic to the human body, to mitochondrial function, to hormone dysregulation and all sorts of things. There are lots of reasons to believe that, but the scientists will say, we need more research. We need to better understand whether these micro plastics really are associated with higher rates of disease. I think people are terrified of the answer. People are terrified of the answer. And if you think about everything that you consume, and how much of it is not wrapped in plastic, all of those industries are going to oppose research. They are going to oppose research funding to figure this out ASAP, because that will be a monumental change to not just the food industry but our entire economy. Imagining just cleaning up the oceans and trying to get this plastic and then, more importantly, trying to figure out, how are we going to detox humans? How are we going to de-plasticize human beings? How are we going to get these things out? It is an enormous problem, but the reality is, putting our heads in the sand is not going to help. And I am really hopeful that by raising issues and letting people know about this health crisis, that maybe we will get answers quickly. Dr. Chris Palmer: Your question is, why are our health agencies not exploring these questions? It's because the health agencies are largely influenced by the industries they are supposed to be regulating and looking out for. The medical education community is largely controlled by pharmaceutical companies. One and a half billion dollars every year goes to support physician education. That's from pharmaceutical companies. One and a half billion from pharmaceutical companies. So physicians are getting educated with some influence, large influence, I would argue, by them, the health organizations. It's a political issue. The NIH, it's politics. Politicians are selecting people to be on the committees or people to oversee these organizations. Politicians rely on donations from companies and supporters to get re-elected, and the reality is this is not going to be easy to tackle. The challenge is that you'll get ethical politicians who say, I'm not going to take any of that money, and I'm going to try to do the right thing and right now, the way the system is set up, there's a good chance those politicians won't get re-elected, and instead, their opponents, who were more than happy to take millions of dollars in campaign contributions, will get re-elected, and then they will return the favor to their noble campaign donors. We are at a crossroads. We have to decide who are the constituents of the American government. Is it industry, or is it the American people? 2:09:35 Sen. Ron Johnson (R-WI): Calley Means the co-founder of Truemed, a company that enables tax free spending on food and exercise. He recently started an advocacy coalition with leading health and wellness companies called End Chronic Disease. Early in his career, he was a consultant for food and pharma companies. He is now exposing practices they used to weaponize our institutions of trust, and he's doing a great job doing interviews with his sister, Casey. Calley Means: If you think about a medical miracle, it's almost certainly a solution that was invented before 1960 for an acute condition: emergency surgical procedures to ensure a complicated childbirth wasn't a death sentence, sanitation procedures, antibiotics that insured infection was an inconvenience, not deadly, eradicating polio, regular waste management procedures that helped control outbreaks like the bubonic plague, sewage systems that replaced the cesspools and opened drains, preventing human waste from contaminating the water. The US health system is a miracle in solving acute conditions that will kill us right away. But economically, acute conditions aren't great in our modern system, because the patient is quickly cured and is no longer a customer. Start in the 1960s the medical system took the trust engendered by these acute innovations like antibiotics, which were credited with winning World War Two, and they used that trust to ask patients not to question its authority on chronic diseases, which can last a lifetime and are more profitable. But the medicalization of chronic disease in the past 50 years has been an abject failure. Today, we're in a siloed system where there's a treatment for everything. And let's just look at the stats. Heart disease has gone up as more statins are prescribed. Type 2 diabetes has gone up as more Metformin is prescribed. ADHD has gone up as more Adderall is prescribed. Depression and suicide has gone up as more SSRIs are prescribed. Pain has gone up as more opioids are prescribed. Cancer has gone up as we've spent more on cancer. And now JP Morgan literally at the conference in San Francisco, recently, they put up a graph, and they showed us more Ozempic is projected to be prescribed over the next 10 years, obesity rates are going to go up as more is prescribed. Explain that to me. There was clapping. All the bankers were clapping like seals at this graphic. Our intervention based system is by design. In the early 1900s, John D. Rockefeller using that he could use byproducts from oil production to create pharmaceuticals, heavily funded medical schools throughout the United States to teach a curriculum based on the intervention-first model of Dr. William Stewart Halsted, the founding physician of Johns Hopkins, who created the residency-based model that viewed invasive surgical procedures and medication as the highest echelon of medicine. An employee of Rockefeller's was tasked to create the Flexner Report, which outlined a vision for medical education that prioritized interventions and stigmatized nutritional and holistic remedies. Congress affirmed the Flexner Report in 1910 to establish that any credentialed medical institution in the United States had to follow the Halsted-Rockefeller intervention based model that silos disease and downplay viewing the body as an interconnected system. It later came out that Dr. Halsted's cocaine and morphine addiction fueled his day long surgical residencies and most of the medical logic underlying the Flexner Report was wrong. But that hasn't prevented the report and the Halsted-Rockefeller engine based brand of medicine from being the foundational document that Congress uses to regulate medical education today. Calley Means: Our processed food industry was created by the cigarette industry. In the 1980s, after decades of inaction, the Surgeon General and the US government finally, finally said that smoking might be harmful, and smoking rates plummeted. We listened to doctors in this country. We listened to medical leadership, and as smoking rates plummeted, cigarette companies, with their big balance sheets, strategically bought up food companies, and by 1990 the two largest food companies in the world were Philip Morris and RJ Reynolds, two cigarette companies. These cigarette companies moved two departments over from the cigarette department to the food department. They moved the scientists. Cigarette companies were the highest payers of scientists, one of the biggest employers of scientists to make the cigarettes addictive. They moved these addiction specialists, world leading addiction specialists, to the food department by the thousands. And those scientists weaponized our ultra processed food. That is the problem with ultra processed food. You have the best scientists in the world creating this food to be palatable and to be addictive. They then moved their lobbyists over. They used the same playbook, and their lobbyists co-opted the USDA and created the food pyramid. The Food Pyramid was a document created by the cigarette industry through complete corporate capture, and was an ultra processed food marketing document saying that we needed a bunch of carbs and sugar. And we listened to medical experts in this country, the American people, American parents. Many parents who had kids in the 90s thought it was a good thing to do to give their kids a bunch of ultra processed foods and carb consumption went up 20% in the American diet in the next 10 years. The Devil's bargain comes in in that this ultra processed food consumption has been one of the most profitable dynamics in American history for the health care industry. As we've all just been decimated with chronic conditions, the medical industry hasn't. Not only have they been silent on this issue, they've actually been complicit, working for the food industry. I helped funnel money from Coca Cola to the American Diabetes Association. Yeah. 2:31:40 Sen. Ron Johnson (R-WI): Next presenter will be Brigham Buhler. Brigham is the Founder and CEO of Ways2Well, a healthcare company that provides personalized preventive care through telemedicine, with a strong background in the pharmaceutical industry. Brigham is focused on making healthcare more accessible by harnessing the power of technology, delivering effective and tailored treatments. His vision for improving health outcomes has positioned him as a leader in modern patient centered healthcare solutions. Brigham Buhler: We hear people reference President Eisenhower's speech all the time about the military industrial complex, but rarely do we hear the second half of that speech. He also warned us about the rise of the scientific industrial complex. He warned us, if we allow the elite to control the scientific research, it could have dire consequences. 2:36:30 Sen. Ron Johnson (R-WI): I'm going to call an audible here as moderator, I saw that hopefully the future chairman of the Senate Finance Committee, Senator Mike Crapo from Idaho, came into the room. I asked Mike to share his story. He used to wear larger suits, let's put it that way. But he went down the path of the ketogenic diet, I believe. But Mike, why don't you tell your story? And by the way, he's somebody you want to influence. Chairman of Senate Finance Committee makes an awful lot of decisions on Medicare, Medicaid, a lot of things we talked about with Ozempic, now the lobbying group try and make that available, and how harmful, I think, most people in this room think that might be so. Senator Crapo, if you could just kind of tell us your story in terms of your diet change and what results you had. Sen. Mike Crapo (R-ID): Well, first of all, let me thank you. I didn't come here to say anything. I came here to listen, but I appreciate the opportunity to just have a second to tell you my personal story. I'll say before I do that, thank you for Ron Johnson. Senator Johnson is also a member of the Finance Committee, and it is my hope that we can get that committee, which I think has the most powerful jurisdiction, particularly over these areas, of any in the United States Congress, and so I'm hopeful we can get a focus on addressing the government's part of the role in this to get us back on a better track. 2:54:35 Sen. Ron Johnson (R-WI): Vani Hari, known as the Food Babe -- they wrote that for me, that wasn't me, that's my not my nickname -- is a food activist, author and speaker committed to improving food quality and safety. She has built a powerful platform through her blog advocating for transparency in food labeling and the removal of harmful chemicals from processed food. Her activism has spurred significant change in the food industry, encouraging consumers to make healthier, more informed choices, while prompting companies to adopt cleaner practices. Vani Hari: Our government is letting US food companies get away with serving American citizens harmful ingredients that are banned or heavily regulated in other countries. Even worse, American food companies are selling the same exact products overseas without these chemicals, but choose to continue serving us the most toxic version here. It's un-American. One set of ingredients there, and one set of ingredients here. Let me give you some examples. This is McDonald's french fries. I would like to argue that probably nobody in this room has not had a McDonald's french fry, by the way, nobody raised their hand during the staff meeting earlier today. In the US, there's 11 ingredients. In the UK, there's three, and salt is optional. An ingredient called dimethyl polysiloxane is an ingredient preserved with formaldehyde, a neurotoxin, in the US version. This is used as a foaming agent, so they don't have to replace the oil that often, making McDonald's more money here in the United States, but they don't do that across the pond. Here we go, this is Skittles. Notice the long list of ingredient differences, 10 artificial dyes in the US version and titanium dioxide. This ingredient is banned in Europe because it can cause DNA damage. Artificial dyes are made from petroleum, and products containing these dyes require a warning label in Europe that states it may cause adverse effects on activity and attention in children, and they have been linked to cancer and disruptions in the immune system. This on the screen back here, is Gatorade. In the US, they use red 40 and caramel color. In Germany, they don't, they use carrot and sweet potatoes to color their Gatorade. This is Doritos. The US version has three different three different artificial dyes and MSG, the UK version does not and let's look at cereal. General Mills is definitely playing some tricks on us. They launched a new version of Trix just recently in Australia. It has no dyes, they even advertise that, when the US version still does. This is why I became a food activist. My name is Vani Hari, and I only want one thing. I want Americans to be treated the same way as citizens in other countries by our own American companies. Vani Hari: We use over 10,000 food additives here in the United States and in Europe, there's only 400 approved. In 2013, I discovered that Kraft was producing their famous mac and cheese in other countries without artificial dyes. They used Yellow 5 and Yellow 6 here. I was so outraged by this unethical practice that I decided to do something about it. I launched a petition asking Kraft to remove artificial dyes from their products here in the United States, and after 400,000 signatures and a trip to their headquarters, Kraft finally announced they would make the change. I also discovered Subway was selling sandwiches with a chemical called azodicarbonamide in their bread in other countries. This is the same chemical they use in yoga mats and shoe rubber. You know, when you turn a yoga mat sideways and you see the evenly dispersed air bubbles? Well, they wanted to do the same thing in bread, so it would be the same exact product every time you went to a Subway. When the chemical is heated, studies show that it turns into a carcinogen. Not only is this ingredient banned in Europe and Australia, you get fined $450,000 if you get caught using it in Singapore. What's really interesting is when this chemical is heated, studies show that it turns into a carcinogen. Not only is this ingredient banned, but we were able to get Subway to remove azodicarbonamide from their bread in the United States after another successful petition. And as a bonus, there was a ripple effect in almost every bread manufacturer in America followed suit. For years, Starbucks didn't publish their ingredients for their coffee drinks. It was a mystery until I convinced a barista to show me the ingredients on the back of the bottles they were using to make menu items like their famous pumpkin spice lattes. I found out here in the United States, Starbucks was coloring their PSLs with caramel coloring level four, an ingredient made from ammonia and linked to cancer, but using beta carotene from carrots to color their drinks in the UK. After publishing an investigation and widespread media attention, Starbucks removed caramel coloring from all of their drinks in America and started publishing the ingredients for their entire menu. I want to make an important point here. Ordinary people who rallied for safer food shared this information and signed petitions. Were able to make these changes. We did this on our own. But isn't this something that the people in Washington, our elected politicians, should be doing? Vani Hari: Asking companies to remove artificial food dye would make an immediate impact. They don't need to reinvent the wheel. They already have the formulations. As I've shown you, consumption of artificial food dyes has increased by 500% in the last 50 years, and children are the biggest consumers. Yes, those children. Perfect timing. 43% of products marketed towards children in the grocery store contain artificial dyes. Food companies have found in focus groups, children will eat more of their product with an artificial dye because it's more attractive and appealing. And the worst part, American food companies know the harms of these additives because they were forced to remove them overseas due to stricter regulations and to avoid warning labels that would hurt sales. This is one of the most hypocritical policies of food companies, and somebody needs to hold them accountable. Vani Hari: When Michael Taylor was the Deputy Commissioner of the of the FDA, he said, he admitted on NPR, we don't have the resources, we don't have the capabilities to actually regulate food chemicals, because we don't have the staff. There's no one there. We are under this assumption, and I think a lot of Americans are under this assumption, that every single food additive ingredient that you buy at the grocery store has been approved by some regulatory body. It hasn't. It's been approved by the food companies themselves. There's 1000s of chemicals where the food company creates it, submits the safety data, and then the FDA rubber stamps it, because they don't have any other option. 3:09:15 Sen. Ron Johnson (R-WI): So our next presenter is Jason Karp. Jason is the founder and CEO of HumanCo, a mission driven company that invests in and builds brands focused on healthier living and sustainability. In addition to HumanCo, Jason is the co-founder of Hu Kitchen, known for creating the number one premium organic chocolate in the US. My wife will appreciate that. Prior to HumanCo, Jason spent over 21 years in the hedge fund industry, where he was the founder and CEO of an investment fund that managed over $4 billion. Jason graduated summa cum laude from the Wharton School of the University of Pennsylvania. 3:11:10 Jason Karp: I've been a professional investor for 26 years, dealing with big food companies, seeing what happens in their boardrooms, and why we now have so much ultra processed food. Jason Karp: Having studied the evolution of corporations, I believe the root cause of how we got here is an unintended consequence of the unchecked and misguided industrialization of agriculture and food. I believe there are two key drivers behind how we got here. First, America has much looser regulatory approach to approving new ingredients and chemicals than comparable developed countries. Europe, for example, uses a guilty until proven innocent standard for the approval of new chemicals, which mandates that if an ingredient might pose a potential health risk, it should be restricted or banned for up to 10 years until it is proven safe. In complete contrast, our FDA uses an innocent until proven guilty approach for new chemicals or ingredients that's known as GRAS, or Generally Recognized as Safe. This recklessly allows new chemicals into our food system until they are proven harmful. Shockingly, US food companies can use their own independent experts to bring forth a new chemical without the approval of the FDA. It is a travesty that the majority of Americans don't even know they are constantly exposed to 1000s of untested ingredients that are actually banned or regulated in other countries. To put it bluntly, for the last 50 years, we have been running the largest uncontrolled science experiment ever done on humanity without their consent. Jason Karp: And the proof is in the pudding. Our health differences compared to those countries who use stricter standards are overwhelmingly conclusive. When looking at millions of people over decades, on average, Europeans live around five years longer, have less than half our obesity rates, have significantly lower chronic disease, have markedly better mental health, and they spend as little as 1/3 on health care per person as we do in this country. While lobbyists and big food companies may say we cannot trust the standards of these other countries because it over regulates, it stifles innovation, and it bans new chemicals prematurely, I would like to point out that we trust many of these other countries enough to have nuclear weapons. These other countries have demonstrated it is indeed possible to not only have thriving companies, but also prioritize the health of its citizens with a clear do no harm approach towards anything that humans put in or on our bodies. Jason Karp: The second driver, how we got here, is all about incentives. US industrial food companies have been myopically incentivized to reward profit growth, yet bear none of the social costs of poisoning our people and our land. Since the 1960s, America has seen the greatest technology and innovation boom in history. As big food created some of the largest companies in the world, so too did their desire for scaled efficiency. Companies had noble goals of making the food safer, more shelf stable, cheaper and more accessible. However, they also figured out how to encourage more consumption by making food more artificially appealing with brighter colors and engineered taste and texture. This is the genesis of ultra processed food. Because of these misguided regulatory standards, American companies have been highly skilled at maximizing profits without bearing the societal costs. They have replaced natural ingredients with chemicals. They have commodified animals into industrial widgets, and they treat our God given planet as an inexhaustible, abusable resource. Sick Americans are learning the hard way that food and agriculture should not be scaled in the same ways as iPhones. 3:16:50 Jason Karp: They use more chemicals in the US version, because it is more profitable and because we allow them to do so. Jason Karp: Artificial food dyes are cheaper and they are brighter. And the reason that I chose to use artificial food dyes in my public activist letter is because there's basically no counter argument. Many of the things discussed today, I think there is a nuanced debate, but with artificial food dyes, they have shown all over the world that they can use colorants that come from fruit. This is the Canadian version. This is the brightness of the Canadian version, just for visibility, and this is the brightness of artificial food dyes. So of course, Kellogg and other food companies will argue children prefer this over this, just as they would prefer cocaine over sugar. That doesn't make it okay. Calley Means: Senator, can I just say one thing? As Jason and Vani were talking, it brought me back to working for the food industry. We used to pay conservative lobbyists to go to every office and say that it was the "nanny state" to regulate food. And I think that's, as a conservative myself, something that's resonated. I just cannot stress enough that, as we're hopefully learned today, the food industry has rigged our systems beyond recognition. And addressing a rigged market is not an attack on the free market. Is a necessity for a free market to take this corruption out. So I just want to say that. 3:21:00 Sen. Ron Johnson (R-WI): Our next presenter is Jillian Michaels. Ms. Michaels is a globally recognized fitness expert, entrepreneur, and best selling author. With her no nonsense approach to health, she's inspired millions through her fitness programs, books and digital platforms, best known for her role on The Biggest Loser, Michaels promotes a balanced approach to fitness and nutrition and emphasizing long term health and self improvement. Jillian Michaels: The default human condition in the 21st century is obese by design. Specific, traceable forms of what's referred to as structural violence are created by the catastrophic quartet of big farming, big food, Big Pharma, and big insurance. They systematically corrupt every institution of trust, which has led to the global spread of obesity and disease. Dysfunctional and destructive agricultural legislation like the Farm Bill, which favors high yield, genetically engineered crops like corn and soy, leading to the proliferation of empty calories, saturated with all of these toxins that we've been talking about today for three hours, it seems like we can never say enough about it, and then this glut of cheap calories provides a boon to the food industry giants. They just turn it into a bounty of ultra processed, factory-assembled foods and beverages strategically engineered to undermine your society and foster your dependence, like nicotine and cocaine, so we literally cannot eat just one. And to ensure that you don't, added measures are taken to inundate our physical surroundings. We're literally flooded with food, and we are brainwashed by ubiquitous cues to eat, whether it's the Taco Bell advertisement on the side of a bus as you drive to work with a vending machine at your kids school, there is no place we spend time that's left untouched. They're omnipresent. They commandeer the narrative, with 30 billion worth of advertising dollars, commercials marketed to kids, with mega celebrities eating McDonald's and loving it, sponsored dietitians paid to promote junk food on social media, utilizing anti-diet body positivity messaging like, "derail the shame" in relation to fast food consumption, Time Magazine brazenly issuing a defense of ultra processed foods on their cover with the title, "What if altra processed foods aren't as bad as you think?" And when people like us try to sound the alarm, they ensure that we are swiftly labeled as anti-science, fat shamers, and even racists. They launch aggressive lobbying efforts to influence you. Our politicians to shape policy, secure federal grants, tax credits, subsidy dollars, which proliferates their product and heavily pads their bottom line. They have created a perfect storm in which pharmaceuticals that cost hundreds, if not 1000s per month, like Ozempic, that are linked to stomach paralysis, pancreatitis and thyroid cancer, can actually surge. This reinforces a growing dependence on medical interventions to manage weight in a society where systemic change in food production and consumption is desperately needed and also very possible. These monster corporations have mastered the art of distorting the research, influencing the policy, buying the narrative, engineering the environment, and manipulating consumer behavior. Jillian Michaels: While I have been fortunate enough to pull many back from the edge over the course of my 30 year career, I have lost just as many, if not more, than I have saved. I have watched them slip through my fingers, mothers that orphan their children, husbands that widow their wives. I have even watched parents forced to suffer the unthinkable loss of their adult children. There are not words to express the sadness I have felt and the fury knowing that they were literally sacrificed at the altar of unchecked corporate greed. Most Americans are simply too financially strained, psychologically drained and physically addicted to break free without a systemic intervention. Attempting to combat the status quo and the powers that be is beyond swimming upstream. It is like trying to push a rampaging river that's infested with piranhas. After years of trying to turn the tide, I submit that the powers that be are simply too powerful for us to take on alone. I implore the people here that shape the policy to take a stand. The buck must stop with you, while the American people tend to the business of raising children and participating in the workforce to ensure that the wheels of our country go around. They tapped you to stand watch. They tapped you to stand guard. We must hold these bad actors accountable. And I presume the testimonials you heard today moved you. Digest them, discuss them, and act upon them, because if this current trend is allowed to persist, the stakes will be untenable. We are in the middle of an extinction level event. The American people need help. They need heroes. And people of Washington, your constituents chose you to be their champion. Please be the change. Thank you. Sen. Ron Johnson (R-WI): There was one particular piece of legislation or one thing that we could do here in Washington, what would it be? Jillian Michaels: Get rid of Citizens United and get the money out of politics. Sen. Ron Johnson (R-WI): Okay. 3:37:00 Calley Means: To the healthcare staffers slithering behind your bosses, working to impress your future bosses at the pharmaceutical companies, the hospitals, the insurance companies, many of them are in this building, and we are coming for you. 3:37:25 Sen. Ron Johnson (R-WI): Next up is Ms. Courtney Swan. Ms. Swan is a nutritionist, real food activist, and founder of the popular platform, Realfoodology. She advocates for transparency in the food industry, promoting the importance of whole foods and clean eating. Courtney is passionate about educating the public on the benefits of a nutrient dense diet, and she encourages sustainable, chemical-free farming practices to ensure better health for people and the planet. Courtney Swan: Our current agriculture system's origin story involves large chemical companies -- not farmers, chemists. 85% of the food that you are consuming started from a patented seed sold by a chemical corporation that was responsible for creating agent orange in the Vietnam War. Why are chemical companies feeding America? Corn, soy and wheat are not only the most common allergens, but are among the most heavily pesticide sprayed crops today. In 1974 the US started spraying our crops with an herbicide called glyphosate, and in the early 1990s we began to see the release of genetically modified foods into our food supply. It all seems to begin with a chemical company by the name IG Farben, the later parent company of Bayer Farben, provided the chemicals used in Nazi nerve agents and gas chambers. Years later, a second chemical company, Monsanto, joined the war industry with a production of Agent Orange, a toxin used during the Vietnam War. When the wars ended, these companies needed a market for their chemicals, so they pivoted to killing bugs and pests on American farmlands. Monsanto began marketing glyphosate with a catchy name, Roundup. They claimed that these chemicals were harmless and that they safeguarded our crops from pests. So farmers started spraying these supposedly safe chemicals on our farmland. They solved the bug problem, but they also killed the crops. Monsanto offered a solution with the creation of genetically modified, otherwise known as GMO, crops that resisted the glyphosate in the roundup that they were spraying. These Roundup Ready crops allow farmers to spray entire fields of glyphosate to kill off pests without harming the plants, but our food is left covered in toxic chemical residue that doesn't wash, dry, or cook off. Not only is it sprayed to kill pests, but in the final stages of harvest, it is sprayed on the wheat to dry it out. Grains that go into bread and cereals that are in grocery stores and homes of Americans are heavily sprayed with these toxins. It's also being sprayed on oats, chickpeas, almonds, potatoes and more. You can assume that if it's not organic, it is likely contaminated with glyphosate. In America, organic food, by law, cannot contain GMOs and glyphosate, and they are more expensive compared to conventionally grown options, Americans are being forced to pay more for food that isn't poisoned. The Environmental Working Group reported a test of popular wheat-based products and found glyphosate contamination in 80 to 90% of the products on grocery store shelves. Popular foods like Cheerios, Goldfish, chickpea pasta, like Banza, Nature Valley bars, were found have concerning levels of glyphosate. If that is not alarming enough, glyphosate is produced by and distributed from China. In 2018, Bayer bought Monsanto. They currently have patented soybeans, corn, canola and sugar beets, and they are the largest distributor of GMO corn and soybean seeds. Americans deserve a straight answer. Why does an agrochemical company own where our food comes from? Currently, 85 to 100% of corn and soy crops in the US are genetically modified. 80% of GMOs are engineered to withstand glyphosate, and a staggering 280 million pounds of glyphosate are sprayed on American crops annually. We are eating this roundup ready corn, but unlike GMO crops, humans are not Roundup Ready. We are not resistant to these toxins, and it's causing neurological damage, endocrine disruption, it's harming our reproductive health and it's affecting fetal development. Glyphosate is classified as a carcinogen by the World Health Organization's International Agency for Research on Cancer. It is also suspected to contribute towards the rise in celiac disease and gluten sensitivities. They're finding glyphosate in human breast milk, placentas, our organs, and even sperm. It's also being found in our rain and our drinking water. Until January of 2022, many companies made efforts to obscure the presence of GMOs and pesticides in food products from American consumers. It was only then that legislation came into effect mandating that these companies disclose such ingredients with a straightforward label stating, made with bio engineered ingredients, but it's very small on the package. Meanwhile, glyphosate still isn't labeled on our food. Parents in America are unknowingly feeding their children these toxic foods. Dr. Don Huber, a glyphosate researcher, warns that glyphosate will make the outlawed 1970s insecticide DDT look harmless in comparison to glyphosate. Why is the US government subsidizing the most pesticide sprayed crops using taxpayer dollars? These are the exact foods that are driving the epidemic of chronic disease. These crops, heavily sprayed with glyphosate, are then processed into high fructose corn syrup and refined vegetable oils, which are key ingredients for the ultra processed foods that line our supermarket shelves and fill our children's lunches in schools across the nation. Children across America are consuming foods such as Goldfish and Cheerios that are loaded with glyphosate. These crops also feed our livestock, which then produce the eggs, dairy and meat products that we consume. They are in everything. Pick up almost any ultra processed food package on the shelf, and you will see the words, contains corn, wheat and soy on the ingredients panel. Meanwhile, Bayer is doing everything it can to keep consumers in the dark, while our government protects these corporate giants. They fund educational programs at major agricultural universities, they lobby in Washington, and they collaborate with lawmakers to protect their profits over public health. Two congressmen are working with Bayer right now on the Farm Bill to protect Bayer from any liability, despite already having to pay out billions to sick Americans who got cancer from their product. They know that their product is harming people. Sen. Ron Johnson (R-WI): Couple questions. So you really have two issues raised here. Any concern about just GMO seeds and GMO crops, and then you have the contamination, Glycosate, originally is a pre-emergent, but now it's sprayed on the actual crops and getting in the food. Can you differentiate those two problems? I mean, what concerns are the GMO seeds? Maybe other doctors on t
In this episode, Dr. Craig Koniver, M.D., a board-certified physician trained at Brown University and Thomas Jefferson University, discusses the therapeutic application of peptides and hormones for enhancing physical and mental health and performance. We explore GLP-1 analogs for weight loss, BPC-157 for wound healing and reducing inflammation, as well as peptides that increase growth hormone, improve REM sleep, and enhance cognitive function. We also cover testosterone therapy, NAD, NMN, and NR supplementation, methylene blue for mitochondrial health, stem cell therapies, and supplements such as CoEnzyme Q10 and methylated B vitamins. Additionally, we discuss effective dosages, sourcing, safety considerations, and the importance of working with knowledgeable physicians. Whether you're currently using peptides or exogenous hormones, or simply curious about their potential benefits and risks, this episode provides the scientific rationale behind how peptides function, their potential to enhance mental and physical health, and how they can optimize performance. Access the full show notes for this episode at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Joovv: https://joovv.com/huberman BetterHelp: https://betterhelp.com/huberman Function: https://functionhealth.com/huberman Eight Sleep: https://eightsleep.com/huberman Timestamps 00:00:00 Dr. Craig Koniver 00:04:52 Sponsors: Joovv & BetterHelp 00:07:40 What is a Peptide? 00:09:37 GLP-1 Agonists, Semaglutide Weight Loss, Brain Health 00:15:49 GLP-1 Microdoses, Muscle Loss; Inflammation 00:18:43 BPC-157, Inflammation 00:23:27 BPC-157, Injection & Oral Forms; Injury Repair 00:28:43 Sourcing, Anabolic Steroids, Testosterone 00:34:48 Black & Gray Market, Compounding Pharmacies, Purity 00:38:20 Sponsor: AG1 00:39:51 Partnering with a Physician, LPS 00:43:00 BPC-157, Pentadeca Arginate (PDA); Side Effects & Doses 00:46:35 Ipamorelin, GHRP-6, Sleep, Appetite; Tool: Sleep & Growth Hormone 00:54:17 Tesamorelin, Sermorelin, CJC-1295; Stacking Peptides 00:58:45 Sponsor: Function & Eight Sleep 01:01:54 Coenzyme Q10 (CoQ10), Mitochondrial Health 01:05:16 Prescriptions, Physicians & Trust 01:14:09 Agency in Your Health 01:17:13 MK-677, Appetite 01:19:32 Hexarelin; Growth Hormone Secretagogues Dosing 01:21:10 Methylated B Vitamins, Homocysteine 01:24:47 Peptides for Sleep, Pinealon, Epitalon 01:31:03 Glycine, Liver Detoxification; Dosage 01:37:19 GLP-1, Compounding Pharmacies 01:39:03 Stem Cell Therapy, PRP 01:41:18 Thymosin Alpha-1, Cerebrolysin & Brain Health 01:44:17 Peptides for Cognitive Function, Methylene Blue, Doses 01:50:20 Covid, NAD Infusion, NMN & NR Supplements 01:57:13 Nutritional Deficiencies; NAD Dose & Regimen, NMN & NR 02:07:53 PT-141, Vyleesi, Libido; Nausea 02:10:57 FDA Approval & Removal, Pharmaceutical Companies 02:20:17 Positivity, Mindset & Health 02:26:23 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures
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