Podcasts about treatment strategies

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Best podcasts about treatment strategies

Latest podcast episodes about treatment strategies

BackTable ENT
Ep. 220 Managing Nasal Polyps: Treatments and Insights with Dr. Martin Citardi

BackTable ENT

Play Episode Listen Later Apr 29, 2025 58:22


Is the future of nasal polyp treatment right under our nose? In this episode of Backtable ENT, Dr. Martin Citardi, a world-renowned rhinologist and skull-based surgeon at UTHealth Houston, discusses the latest advancements in the management of nasal polyps with hosts Dr. Gopi Shah and Dr. Ashley Agan.---This podcast is supported by:Medtronic ENT---SYNPOSISDr. Citardi shares insights from his comprehensive career, spanning patient care, device, and drug development. The surgeons discuss the evolving treatment landscape, challenges in managing recurrent nasal polyps, the role of steroids and biologics, and the importance of correctly identifying the type of polyps. Additionally, Dr. Citardi emphasizes the need for a better understanding of healthcare economics, particularly concerning the high costs of new treatments. The discussion also touches on the future of research and the need for a system to deploy treatment options effectively.---TIMESTAMPS00:00 - Introduction04:39 - Nasal Polyps: Patient Presentation and Initial Examination10:25 - Detailed Examination and Endoscopy Techniques17:26 - Imaging and Lab Workup20:11 - Treatment Strategies and Patient Management31:08 - Managing Patients with Allergies, AERD, and Asthma34:09 - Biologics vs. Surgery: A Comparative Discussion42:50 - Steroid Delivery Methods and Their Effectiveness52:24 - Follow-Up, Long-Term Management and Future Research57:01 - Conclusion and Final Thoughts---RESOURCESDr. Martin Citardi's Profile:https://www.utphysicians.com/provider/martin-j-citardi/Medtronic ENT:https://www.medtronic.com/en-us/healthcare-professionals/products/ear-nose-throat

Medscape InDiscussion: Type 2 Diabetes
S3 Episode 4: Heart Failure, Incretin Therapies, and Type 2 Diabetes

Medscape InDiscussion: Type 2 Diabetes

Play Episode Listen Later Apr 24, 2025 21:37


Drs Carol H. Wysham and Christopher M. Kramer discuss heart failure and type 2 diabetes, and the role of incretin therapies in the management of HFpEF. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002048. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources The Incidence of Congestive Heart Failure in Type 2 Diabetes: An Update https://pubmed.ncbi.nlm.nih.gov/15277411/ Hypertension in Diabetes: An Update of Basic Mechanisms and Clinical Disease https://pubmed.ncbi.nlm.nih.gov/34601960/ Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update https://pubmed.ncbi.nlm.nih.gov/31167558/ Insulin Resistance and Hyperinsulinaemia in Diabetic Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/26678809/ Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2024 https://pubmed.ncbi.nlm.nih.gov/38078592/ The Paradox of Low BNP Levels in Obesity https://pubmed.ncbi.nlm.nih.gov/21523383 Tirzepatide for Heart Failure With Preserved Ejection Fraction and Obesity https://pubmed.ncbi.nlm.nih.gov/39555826/ Cardiovascular Effects of Incretin-Based Therapies: Integrating Mechanisms With Cardiovascular Outcome Trials https://pubmed.ncbi.nlm.nih.gov/35050311/ Beyond Weight Loss: the Emerging Role of Incretin-Based Treatments in Cardiometabolic HFpEF https://pubmed.ncbi.nlm.nih.gov/38294187/ Heart Failure With Preserved Ejection Fraction: Mechanisms and Treatment Strategies https://pubmed.ncbi.nlm.nih.gov/34379445/ Obesity and Heart Failure With Preserved Ejection Fraction: New Insights and Pathophysiological Targets https://pubmed.ncbi.nlm.nih.gov/35880317/ Epidemiology of Heart Failure in Diabetes: A Disease in Disguise https://pubmed.ncbi.nlm.nih.gov/38334818/ Semaglutide in Patients With Heart Failure With Preserved Ejection Fraction and Obesity https://pubmed.ncbi.nlm.nih.gov/37622681/ Mechanisms of Benefits of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/37674356/ Finerenone in Heart Failure With Mildly Reduced or Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/39225278/ Effects of Tirzepatide on Circulatory Overload and End-Organ Damage in Heart Failure With Preserved Ejection Fraction and Obesity: A Secondary Analysis of the SUMMIT Trial https://pubmed.ncbi.nlm.nih.gov/39551891/ Effects of Tirzepatide on the Clinical Trajectory of Patients With Heart Failure, a Preserved Ejection Fraction, and Obesity https://pubmed.ncbi.nlm.nih.gov/39556714/ Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure: SUMMIT CMR Substudy https://pubmed.ncbi.nlm.nih.gov/39566869/6 Spironolactone for Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/24716680/

Oncology Data Advisor
Mastering Systemic Mastocytosis: From Early Detection to Tailored Treatment Strategies - Module 2

Oncology Data Advisor

Play Episode Listen Later Apr 16, 2025 27:41


In Module 2 of this podcast series, discover strategies for developing personalized management plans for patients with systemic mastocytosis (SM), a rare disease with a wide spectrum of symptoms. This episode highlights the latest advancements in treatment, including tyrosine kinase inhibitors (TKIs), supportive care interventions, and approaches to tailoring therapies based on disease subtype and symptom burden to improve patient outcomes and quality of life. Listen now! Click here to claim credit for this activity: bit.ly/43VoFNP

Rehab Science with Tom Walters
#33: Supraspinatus Tendinopathy: Diagnosis & Treatment Strategies

Rehab Science with Tom Walters

Play Episode Listen Later Apr 15, 2025 15:35


The supraspinatus is one of the four muscles that make up the rotator cuff, originating from the supraspinous fossa of the scapula and inserting onto the greater tubercle of the humerus. Its primary function is to initiate shoulder abduction and contribute to dynamic stability of the glenohumeral joint, particularly by resisting excessive superior translation of the humeral head. Due to its position and role, the supraspinatus is highly susceptible to mechanical compression beneath the acromion, especially in individuals with poor scapular control or altered rotator cuff coordination.  Research suggests that supraspinatus tendinopathy and tears are among the most common sources of rotator cuff-related pain, particularly in overhead athletes and older adults. However, not all supraspinatus pathology is symptomatic, emphasizing the importance of assessing strength, movement patterns, and pain reproduction rather than relying solely on imaging findings when determining clinical relevance. Several studies have shown that rotator cuff tears can be observed on MRI when testing people who are asymptomatic (pain-free), which means they may simply be a normal age-related change. However, if you have pain and limited shoulder function and have evidence of a rotator cuff tear or tendinopathy on imaging, then your symptoms and the image may be correlated.  Here is one study you might like to read if you want to learn more about this research. When treating supraspinatus tendon tears and tendinopathy, physical therapists focus on pain management, restoring shoulder function, and strengthening the rotator cuff and scapular stabilizers. Early rehab emphasizes activity modification, isometric exercises, and gentle mobility work to reduce pain and maintain range of motion. Scapular control exercises help optimize shoulder mechanics, while posterior capsule stretching may be included if tightness contributes to impingement. As symptoms improve, progressive strengthening of the rotator cuff, particularly in external rotation and abduction, helps restore tendon resilience and function. In later rehab stages, eccentric loading, plyometric drills, and functional training are introduced to improve tendon capacity and dynamic stability, especially for individuals returning to overhead activities. Education on load management, proper movement mechanics, and long-term maintenance exercises is essential to prevent recurrence. While partial tears and tendinopathy often respond well to conservative care, full-thickness tears may require surgical consideration, followed by a structured rehabilitation program. Here is a video from my YouTube channel that covers a few exercises that often help people suffering from supraspinatus pain and dysfunction. I hope the tips in this podcast were helpful and you feel better equipped to treat supraspinatus issues! Besides the YouTube video I linked in this episode, my book contains comprehensive programs for the 50 most common orthopedic conditions, including rotator cuff injuries. The programs are broken into three phases and include exercises that can be used to help prevent injuries as well as help you recover from an injury. If you want to learn more about my book, visit my website or click the Amazon link.  Thanks for reading and I hope you have a great day! Dr. Tom

Oncology Data Advisor
Mastering Systemic Mastocytosis: From Early Detection to Tailored Treatment Strategies - Module 1

Oncology Data Advisor

Play Episode Listen Later Apr 15, 2025 30:14


In Module 1 of this podcast series, explore the challenges of diagnosing systemic mastocytosis (SM), a rare and often underdiagnosed mast cell disease. This episode delves into the diverse symptoms of SM—ranging from anaphylaxis and cutaneous issues to gastrointestinal, neuropsychiatric, and musculoskeletal manifestations—and provides essential insights into recognizing the signs, confirming the diagnosis, and improving patient outcomes through early intervention. Listen now! Click on the link to claim your credit now: bit.ly/3Y3ivHM Click here to continue listening to Module 2 of this podcast series: bit.ly/43VoFNP

CME in Minutes: Education in Primary Care
Elizabeth A. Thiele, MD, PhD - Enhancing Diagnosis and Long-Term Care of Patients With Lennox-Gastaut Syndrome: A Case-Based Approach to Optimizing Treatment Strategies

CME in Minutes: Education in Primary Care

Play Episode Listen Later Apr 14, 2025 19:56


Please visit answersincme.com/JTB860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in pediatric epilepsy discusses strategies for optimizing the care of children and adults with Lennox-Gastaut syndrome (LGS). Upon completion of this activity, participants should be better able to: Apply diagnostic criteria to accurately recognize LGS in children and adults; Evaluate the latest pharmacologic treatment strategies available for patients with LGS; and Outline approaches to optimize the long-term care of patients with LGS.

CorConsult Rx: Evidence-Based Medicine and Pharmacy
Dyslipidemia Treatment Strategies and 2025 Guideline Update *ACPE-Accredited*

CorConsult Rx: Evidence-Based Medicine and Pharmacy

Play Episode Listen Later Apr 11, 2025 63:12


On this episode we review the 2025 Clinical Practice Guideline for the Pharmacologic Management of Adults with Dyslipidemia published by the American Association of Clinical Endocrinology. We compare and contrast the common medications used in the management of dyslipidemia and examine how these can be utilized based on the 13 updated recommendations found in the 2025 guidelines.  Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

OncLive® On Air
S12 Ep34: AR Pathway Inhibition Refines Prostate Cancer Treatment Strategies: With Neal Shore, MD, FACS

OncLive® On Air

Play Episode Listen Later Apr 7, 2025 8:16


In today's episode, we had the pleasure of speaking with Neal Shore, MD, FACS, about prostate cancer management and the use of androgen receptor (AR)–directed therapies. Dr Shore is the medical director for the Carolina Urologic Research Center in Myrtle Beach, South Carolina.  In our exclusive interview, we sat down with Dr Shore during the 2025 Bridging the Gaps in Prostate Cancer meeting to discuss the importance of multidisciplinary meetings to address unmet needs for patients with prostate cancer, the need for treatment strategies that improve upon the activity of current standards of care in this disease, the evolving roles of neoadjuvant and adjuvant therapies, and the significance of biomarkers and imaging. He also highlighted treatment advances that have been achieved with AR-directed agents, such as apalutamide (Erleada) and darolutamide (Nubeqa), along with considerations for the optimal intensification and de-intensification of these agents to balance efficacy and quality of life. 

PT Snacks Podcast: Physical Therapy with Dr. Kasey Hogan
123. Overview of Gluteus Medius Tendinopathy

PT Snacks Podcast: Physical Therapy with Dr. Kasey Hogan

Play Episode Listen Later Mar 25, 2025 15:20 Transcription Available


In this episode, we discuss gluteus medius tendinopathy—a common cause of lateral hip pain. This episode breaks down the role of the gluteus medius muscle, the development and risk factors of tendinopathy, and diagnostic strategies. Treatment phases, such as progressive loading and monitoring, and discussed in addition to adjunct treatments such as PRP injections and shockwave therapy. 00:00 Welcome to PTC's Podcast00:40 Introduction to Gluteus Medius Tendinopathy01:26 Understanding the Gluteus Medius Muscle02:36 Causes and Risk Factors of Tendinopathy05:39 Diagnosing Lateral Hip Pain08:57 Treatment Strategies for Tendinopathy12:37 Adjunct Treatments and Final Thoughts13:56 Podcast Wrap-Up and Special OffersSupport the showWhy PT Snacks Podcast?This podcast is your go-to for bite-sized, practical info designed for busy, overwhelmed Physical Therapists and students who want to build confidence in their foundational knowledge without sacrificing life's other priorities. Stay Connected! Never miss an episode—hit follow now! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. Join the email list HERE On Instagram? Find unique content at @dr.kasey.hankins! Need CEUs Fast?Time and resources short? Medbridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: Medbridge Students: Save $75 off a student subscription with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less!(These are affiliate links, but I only recommend Medbridge because it's genuinely valuable.) Optimize Your Patient Care with Tindeq Looking for a reliable dynamometer to enhance your clinical measurements? Tindeq ...

Microbiome (Video)
Decoding the Dark Side of the Human Genome: How Ancient Viruses Shape Aging

Microbiome (Video)

Play Episode Listen Later Mar 7, 2025 46:32


Michael J. Corley, Ph.D., explores groundbreaking research on aging, the role of ancient viruses in our DNA, and the impact of the gut microbiome on longevity. Corley discusses how stress, diet, and exercise influence our genetic health, highlighting the complex interplay between environmental factors and our biological systems. The conversation also touches on individualized treatment strategies and the exciting potential of microbiome science in aging research. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40266]

Health and Medicine (Video)
Decoding the Dark Side of the Human Genome: How Ancient Viruses Shape Aging

Health and Medicine (Video)

Play Episode Listen Later Mar 7, 2025 46:32


Michael J. Corley, Ph.D., explores groundbreaking research on aging, the role of ancient viruses in our DNA, and the impact of the gut microbiome on longevity. Corley discusses how stress, diet, and exercise influence our genetic health, highlighting the complex interplay between environmental factors and our biological systems. The conversation also touches on individualized treatment strategies and the exciting potential of microbiome science in aging research. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40266]

University of California Audio Podcasts (Audio)
Decoding the Dark Side of the Human Genome: How Ancient Viruses Shape Aging

University of California Audio Podcasts (Audio)

Play Episode Listen Later Mar 7, 2025 46:32


Michael J. Corley, Ph.D., explores groundbreaking research on aging, the role of ancient viruses in our DNA, and the impact of the gut microbiome on longevity. Corley discusses how stress, diet, and exercise influence our genetic health, highlighting the complex interplay between environmental factors and our biological systems. The conversation also touches on individualized treatment strategies and the exciting potential of microbiome science in aging research. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40266]

Health and Medicine (Audio)
Decoding the Dark Side of the Human Genome: How Ancient Viruses Shape Aging

Health and Medicine (Audio)

Play Episode Listen Later Mar 7, 2025 46:32


Michael J. Corley, Ph.D., explores groundbreaking research on aging, the role of ancient viruses in our DNA, and the impact of the gut microbiome on longevity. Corley discusses how stress, diet, and exercise influence our genetic health, highlighting the complex interplay between environmental factors and our biological systems. The conversation also touches on individualized treatment strategies and the exciting potential of microbiome science in aging research. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40266]

Aging and Senior Health (Audio)
Decoding the Dark Side of the Human Genome: How Ancient Viruses Shape Aging

Aging and Senior Health (Audio)

Play Episode Listen Later Mar 7, 2025 46:32


Michael J. Corley, Ph.D., explores groundbreaking research on aging, the role of ancient viruses in our DNA, and the impact of the gut microbiome on longevity. Corley discusses how stress, diet, and exercise influence our genetic health, highlighting the complex interplay between environmental factors and our biological systems. The conversation also touches on individualized treatment strategies and the exciting potential of microbiome science in aging research. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40266]

UC San Diego (Audio)
Decoding the Dark Side of the Human Genome: How Ancient Viruses Shape Aging

UC San Diego (Audio)

Play Episode Listen Later Mar 7, 2025 46:32


Michael J. Corley, Ph.D., explores groundbreaking research on aging, the role of ancient viruses in our DNA, and the impact of the gut microbiome on longevity. Corley discusses how stress, diet, and exercise influence our genetic health, highlighting the complex interplay between environmental factors and our biological systems. The conversation also touches on individualized treatment strategies and the exciting potential of microbiome science in aging research. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40266]

CRTonline Podcast
Intellistent Pioneering Innovation Transforming Treatment Strategies for Pediatric Pulmonary Arterial Hypertension and Dilated Cardiomyopathy

CRTonline Podcast

Play Episode Listen Later Mar 4, 2025 6:15


Intellistent Pioneering Innovation Transforming Treatment Strategies for Pediatric Pulmonary Arterial Hypertension and Dilated Cardiomyopathy

The Future of Dermatology
Episode 75 - Exploring Non-Biologic Therapies for Hidradenitis Suppurativa from SF Derm Society 2024 Annual Meeting | The Future of Dermatology Podcast

The Future of Dermatology

Play Episode Listen Later Feb 25, 2025 19:37


Summary In this episode of the Future of Dermatology Podcast, we hear from Dr. Maria Aleshin who spoke at the Annual SF Derm Society's 2024 Meeting. She presents on Hidradenitis Suppurativa (HS) and various non-biologic treatment strategies. Dr. Aleshin covers practical approaches to managing HS flare-ups, long-term management considerations, and the role of antibiotics in treatment. She emphasizes the importance of personalized care and the need for a multifaceted approach to effectively address this challenging skin condition.   Takeaways The pathogenesis of HS is multifactorial, requiring a comprehensive treatment approach. Treatment stacking often involves combining medical, procedural, and lifestyle interventions. Topical therapies like chlorhexidine and benzoyl peroxide are commonly recommended, but alternatives exist. Systemic antibiotics are frequently used for managing HS flares. Hormonal therapies, including oral contraceptives and spironolactone, can be effective for female patients with HS. Metformin may be beneficial for patients with metabolic dysfunction associated with HS. Isotretinoin is not a first-line treatment for HS due to mixed results. Botulinum toxin can help reduce sweating and inflammation in HS patients. Combination antibiotic therapy, particularly clindamycin and rifampin, shows high efficacy but has relapse risks. Urtipenem is a powerful antibiotic reserved for severe HS cases as a bridge to surgery or biologics. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:19 - Understanding Hidradenitis Suppurativa (HS) and Its Complexities 07:10 - Treatment Strategies for Managing HS Flare-Ups 10:21 - Long-Term Management of HS: Hormonal and Metabolic Considerations 13:20 - Antibiotic Therapies for Hidradenitis Suppurativa 17:22 - Severe HS Cases: Advanced Treatment Options and Considerations

PeerVoice Endocrinology & Metabolic Disorders Video
Kris V. Kowdley, MD - Advancing Individualized Treatment Strategies in Patients With Primary Biliary Cholangitis

PeerVoice Endocrinology & Metabolic Disorders Video

Play Episode Listen Later Feb 17, 2025 28:39


Kris V. Kowdley, MD - Advancing Individualized Treatment Strategies in Patients With Primary Biliary Cholangitis

PeerVoice Endocrinology & Metabolic Disorders Audio
Kris V. Kowdley, MD - Advancing Individualized Treatment Strategies in Patients With Primary Biliary Cholangitis

PeerVoice Endocrinology & Metabolic Disorders Audio

Play Episode Listen Later Feb 17, 2025 28:39


Kris V. Kowdley, MD - Advancing Individualized Treatment Strategies in Patients With Primary Biliary Cholangitis

Frequency Specific Microcurrent Podcast
156 - Treating Complex Symptoms and Chronic Conditions with Frequency Specific Microcurrent

Frequency Specific Microcurrent Podcast

Play Episode Listen Later Jan 29, 2025 53:18 Transcription Available


Kim Pittis, LCSP, (PHYS), MT - fsmsports365.com Carolyn McMakin, MA, DC - frequencyspecific.com/getstarted 00:14 A Surprising Medical Case 03:08 Exploring Cranial Nerve Frequencies 04:31 Understanding Muscle Spasticity 06:40 Neurological Insights and Patient Education 09:19 FSM Practitioners and Complex Cases 14:10 Muscle Mechanics and Treatment Strategies 25:39 TMJ and Retrodiscal Tissue Treatment 29:13 Exploring TMJ and Facial Nerve Innervation 30:42 Understanding Trigeminal and Facial Nerve Functions 31:55 Upcoming Events and Notable Speakers 33:18 Heart Health and FSM Applications 43:38 Addressing Stenosis and FSM Treatment 52:19 Concluding Remarks and Next Steps Understanding Complex Neurological Cases The podcast opens with a fascinating case study involving a Ph.D. research biochemist who developed a condition known as Cavernous Hemangioma. This case illustrates the intricacies of treating fragile neurological conditions with FSM. The discussion delves into the importance of understanding cranial nerves and their frequencies, highlighting the necessity of increased secretions in nerves and innovative approaches to manage cranial nerve involvement. Practitioners are encouraged to familiarize themselves with the specifics of cranial nerve treatment, particularly how conditions such as thalamic pain can be influenced by surgery-related changes. Handling Muscle Spasticity and Weakness The session further delves into muscle management, emphasizing the concept of "tight weakness" and "stretch weakness" in muscle physiology. For medical practitioners, understanding the cellular mechanics, including the role of actin and myosin, can be crucial in diagnosing and managing spastic or chronically shortened muscles. The podcast underscores the benefit of FSM in increasing ATP for muscle relaxation and strengthening—both critical for optimal muscle function. Stenosis: Misconceptions and Treatment Strategies Stenosis, a common concern, is addressed with clarity, dismissing the myth that FSM is contraindicated for such conditions. Practitioners learn that understanding the mechanics of spinal fluid flow and managing inflammation are key to effective treatment. Special attention is given to cervical and lumbar stenosis, advising on how to approach these differently based on anatomical and physiological variances. Innovative Techniques for Treating Shoulder and TMJ Issues The podcast emphasizes the versatility of FSM in treating complex conditions like shoulder injuries and TMJ disorders. It introduces the idea of using specific frequencies for labrum and annular ligament issues, which can be potent in resolving chronic pain and dysfunction in shoulder and TMJ patients. Genetic and Mitochondrial Considerations in Treatment The session discusses a genetic condition, SPG7, shedding light on the importance of understanding genetic and mitochondrial contributions to disease progression. For practitioners, using FSM for abnormal protein accumulation and mitochondrial health can stave off advancement in otherwise degenerative conditions. Final Thoughts and Peer Involvement The concluding parts stress the importance of continuous learning and collaboration in the FSM community, urging practitioners to remain curious and collaborative, utilizing tools like Netter's Anatomy for inspiration. Sharing case studies and engaging in forums can enhance understanding and therapeutic outcomes in practice. By internalizing the teachings and discussions from this detailed podcast, medical practitioners can unlock new avenues for healing and patient care, integrating FSM into their standard practices for improved outcomes. As always, engagement with the FSM community for continued learning and sharing of knowledge is encouraged, helping to expand the collective understanding and effectiveness of FSM.  

CorConsult Rx: Evidence-Based Medicine and Pharmacy
Rheumatoid Arthritis: Treatment Strategies for 2025 * ACPE-Accredited *

CorConsult Rx: Evidence-Based Medicine and Pharmacy

Play Episode Listen Later Jan 28, 2025 64:48


On this episode, we evaluate current guidelines and evidence-based treatment strategies for managing rheumatoid arthritis. We compare and contrast the efficacy, safety profiles, and appropriate use of disease-modifying antirheumatic drugs (DMARDs), biologics, and other therapies as well as discuss patient-specific treatment strategies considering factors such as disease severity, comorbidities, and patient preferences.  Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

ReachMD CME
MS Cognitive Insights: Management, Diagnostic, and Treatment Strategies

ReachMD CME

Play Episode Listen Later Jan 24, 2025


CME credits: 1.00 Valid until: 24-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/ms-cognitive-insights-management-diagnostic-and-treatment-strategies/32232/ This series of bite-sized episodes contains important information on the use of high-efficacy disease-modifying therapies (DMTs) in multiple sclerosis (MS). Drs. Ahmed Obeidat and Mark Freedman discuss the role of inflammation in MS pathology, treatment strategies for high-efficacy DMTs, impact on cognition, and use in special populations.

PT Snacks Podcast: Physical Therapy with Dr. Kasey Hogan
114. Effective Treatment Strategies for Patellofemoral Pain Syndrome (PFPS)

PT Snacks Podcast: Physical Therapy with Dr. Kasey Hogan

Play Episode Listen Later Jan 21, 2025 12:30


In Part 2, we focus on evidence-based treatments for Patellofemoral Pain Syndrome (PFP). Learn effective exercise strategies, movement retraining, and what the research says about manual therapy and taping to address muscle weakness, movement dysfunctions, and mobility impairments. This episode gives you the tools to help your patients recover and get back to activity faster. If you missed Part 1, be sure to catch up on how to assess PFP!Resources mentioned:Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning.Patellofemoral Pain Clinical Practice GuidelineSupport the showWhy PT Snacks Podcast?This podcast is your go-to for bite-sized, practical info designed for busy, overwhelmed Physical Therapists and students who want to build confidence in their foundational knowledge without sacrificing life's other priorities. Stay Connected! Never miss an episode—hit follow now! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. On Instagram? Find unique content at @dr.kasey.hankins! Need CEUs Fast?Time and resources short? MedBridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: MedBridge Students: Save 75% with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less!(These are affiliate links, but I only recommend MedBridge because it's genuinely valuable.) Want to Support the Show?Help me keep creating free content by: Sharing the podcast with someone who'd benefit. Contributing directly via the link below (optional, but deeply appreciated). Thanks for tuning in—your support makes this...

Pharmacy Podcast Network
Exploring Non-Stimulant ADHD Treatment Strategies with Dr Richard Price | Managing ADHD- A Lifelong Challenge

Pharmacy Podcast Network

Play Episode Listen Later Jan 20, 2025 35:19


Rabbi Richard Louis Price, M.D. is a Yale & Columbia University-trained psychiatry professor at Weill Cornell Medical College/New York-Presbyterian Hospital. Over the past two decades, he has evaluated over 20,000 patients serving as a medical director at Achieve Behavioral Health in Monsey; Rockland TMS & Wellness Center; Hamaspik of Orange and Rockland Counties; Volunteer Counseling Services in New City; ParCare in Brooklyn, Chai Urgent Care Centers of New York, Pennsylvania, and Florida,, and has a private pediatric and adult psychotherapy and psychopharmacology practice in Monsey, New York. Dr. Price is triple board certified in Psychiatry, Consultation-Liaison/Mind-Body Medicine, and Addiction Medicine and has been awarded numerous patents in the United States, Canada, Europe, and Israel for a novel pharmacotherapy for the treatment of both core and associated symptoms of Autism Spectrum Disorder. Dr. Price has served on the advisory boards and as a national speaker for several pharmaceutical companies, such as Abbvie, Alkermes, Allergan, Almatica, Axsome, Idorsia, Intracellular, Janssen, Jazz, Lumbeck, Neuronetics, Otsuka, Supernus, and Vanda and has been recognized as a top Medical Educator by the American Psychiatric Association. He is also a professional singer and taekwondo black belt.     ADHD ARTICLE PUBLISHED: https://pmc.ncbi.nlm.nih.gov/articles/PMC10374479/ HISTORICAL OVERVIEW OF VILOXAZINE: https://pmc.ncbi.nlm.nih.gov/articles/PMC8219567/  

ReachMD CME
Precision Medicine in Myasthenia Gravis: Crafting Personalized Treatment Strategies

ReachMD CME

Play Episode Listen Later Jan 17, 2025


CME credits: 1.00 Valid until: 17-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/precision-medicine-in-myasthenia-gravis-crafting-personalized-treatment-strategies/32244/ The burden of generalized myasthenia gravis (gMG) on patients and caregivers is substantial. Current traditional therapies are often effective in the short term but bring with them many debilitating side effects. A more targeted approach to treatment that focuses on inhibition of the neonatal FcRn receptor complex is offering an exciting and different treatment option. Join Drs. Nicholas Silvestri and James Howard, Jr, as they discuss the expanding landscape of gMG treatments.

Audible Bleeding
Holding Pressure: AV Fistula/Graft Complications Part 1

Audible Bleeding

Play Episode Listen Later Jan 6, 2025 38:54


Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic.   Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow.  Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4  Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically.  Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss.  There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5  Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter.  SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal.  Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery.  The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow.  Thrombosis of the conduit would put the fistula at risk, rather than the native artery.  The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest.  Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss.   3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas.   Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of  methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9     4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11  Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection.   Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics.  If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References   1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067

CME in Minutes: Education in Primary Care
Jai Radhakrishnan, MD, MS - IgA Nephropathy in Focus: Novel Treatment Strategies for Nephrologists and PCPs

CME in Minutes: Education in Primary Care

Play Episode Listen Later Jan 3, 2025 14:51


Please visit answersincme.com/NRR860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in the treatment of IgA nephropathy (IgAN) discusses novel therapeutic approaches in the management of IgAN. Upon completion of this activity, participants should be better able to: Outline the unmet needs in patients with IgAN; Discuss the clinical implications of new and emerging targeted therapies in IgAN; and Identify patient-centered strategies for long-term management of IgAN.

Treating Blood Cancers
Advancing Treatment Strategies: The Role of Bispecific Antibodies in Lymphoma

Treating Blood Cancers

Play Episode Listen Later Dec 19, 2024 26:25


Celeste Bello, MD, Moffitt Cancer Center, Tampa, FL Recorded on November 21, 2024 Celeste Bello, MD Senior Member, Department of Malignant Hematology Moffitt Cancer Center Tampa, FL Join us as we dive into bispecific antibodies with Dr. Celeste Bello from Moffitt Cancer Center, exploring their mechanisms of action, current indications in lymphoma, and strategies for patient selection and administration. Dr. Bello also discusses side effects, management strategies, and emerging trends in bispecific therapies. Tune in today to learn more!

BackTable Urology
Ep. 205 Optimizing Bladder Health in BPH Treatment Strategies with Dr. Shawn West

BackTable Urology

Play Episode Listen Later Dec 10, 2024 49:09


PT Snacks Podcast: Physical Therapy with Dr. Kasey Hogan
110. Understanding Multidirectional Shoulder Instability: Symptoms, Tests, and Treatment Strategies

PT Snacks Podcast: Physical Therapy with Dr. Kasey Hogan

Play Episode Listen Later Nov 26, 2024 13:13


Medbridge Black Friday Special: Lasts until Dec. 1st! Enjoy $150 off + 1 extra month will be added to your subscription for a total of 13 months.Use promo code PTSNACKSPODCAST13 or click HERE to access!Is your patient presenting with shoulder instability, but the symptoms don't fit the typical mold? In this episode, we break down multidirectional shoulder instability, including:Key symptoms to watch for.The best tests to confirm your diagnosis.Effective treatment strategies to improve shoulder stability.Support the showWhy PT Snacks Podcast?This podcast is your go-to for bite-sized, practical info designed for busy, overwhelmed Physical Therapists and students who want to build confidence in their foundational knowledge without sacrificing life's other priorities. Stay Connected! Never miss an episode—hit follow now! Got questions? Email me at ptsnackspodcast@gmail.com or visit ptsnackspodcast.com. On Instagram? Find unique content at @dr.kasey.hankins! Need CEUs Fast?Time and resources short? MedBridge has you covered: Get 40% off a subscription with code PTSNACKSPODCAST: MedBridge Students: Save 75% with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less!(These are affiliate links, but I only recommend MedBridge because it's genuinely valuable.) Want to Support the Show?Help me keep creating free content by: Sharing the podcast with someone who'd benefit. Contributing directly via the link below (optional, but deeply appreciated). Thanks for tuning in—your support makes this all possible!

PeerVoice Clinical Pharmacology Audio
Onyema Ogbuagu, MD, FACP, FIDSA - Multidrug-Resistant HIV: Evaluating HIV Treatment Strategies as Options Narrow

PeerVoice Clinical Pharmacology Audio

Play Episode Listen Later Nov 21, 2024 25:34


Onyema Ogbuagu, MD, FACP, FIDSA - Multidrug-Resistant HIV: Evaluating HIV Treatment Strategies as Options Narrow

JAMA Clinical Reviews: Interviews about ideas & innovations in medicine, science & clinical practice. Listen & earn CME credi

Mpox is an evolving global health threat, and clinicians should be aware of characteristic signs and symptoms to ensure timely diagnosis and appropriate management. Author Jason Zucker, MD, MS, of Columbia University Irving Medical Center speaks with JAMA Deputy Editor Preeti Malani, MD, MSJ, about the transmission, diagnosis, management, and prevention of mpox. Related Content: Mpox Clinical Presentation, Diagnostic Approaches, and Treatment Strategies The Resurgence of Mpox in Africa Decline of Mpox Antibody Responses After Modified Vaccinia Ankara–Bavarian Nordic Vaccination WHO Announces Mpox Global Plan, Appeals for Funding

CME in Minutes: Education in Primary Care
Jacob Sands, MD / Luis Paz-Ares, MD, PhD - Leveraging Precise Targets to Elevate Outcomes: NSCLC Treatment Strategies for HER2-Directed ADCs

CME in Minutes: Education in Primary Care

Play Episode Listen Later Nov 15, 2024 26:31


Please visit answersincme.com/93496951-replay2860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, experts in NSCLC discuss the clinical implications of the latest data for HER2-directed ADCs in NSCLC. Upon completion of this activity, participants should be better able to: Explain the rationale for antibody drug conjugates (ADCs) in the treatment of advanced non-small cell lung cancer (NSCLC); Identify the latest efficacy and safety data for ADCs in advanced NSCLC; Recognize key clinical factors to optimize the evidence-based use of current and emerging ADCs in advanced NSCLC; and Describe practical, data-driven approaches to effectively integrate current and emerging ADCs into the management of advanced NSCLC.

Rehab Science with Tom Walters
#32: Gluteal Tendinopathy - Diagnosis & Treatment Strategies

Rehab Science with Tom Walters

Play Episode Listen Later Nov 6, 2024 19:26


In today's podcast episode, we are going to look at a condition called gluteal tendinopathy, which is a common cause of lateral hip pain due to an irritation of two of the gluteal tendons (gluteus medius & gluteus minimus).  Previously, this type of pain was thought to be caused by trochanteric bursitis, but more recent research has shown that bursitis only accounts for approximately 20% of these cases (see references below). The majority of lateral hip pain cases are now thought to be due to gluteal tendinopathy or irritation of the gluteal tendons where they attach on the side of the hip (greater trochanter).  Risk factors for developing gluteal tendinopathy include: female gender (4:1 female to male ratio), increased body mass index (BMI), excessive hip adduction during walking/running, prolonged hip flexion (sitting) and weak hip abductors muscles (especially gluteus medius and minimus).  Treatment of this disorder is similar to other tendinopathies in that the focus is on gradually loading and strengthening the gluteal tendons via resistance training exercises that target the hip abductor muscles. These types of exercises not only improve the working capacity of the muscles and their tendons, but also help reduce tendon pain.  My YouTube video below includes a a few exercises that typically help people suffering from gluteal tendinopathy. YouTube Link Here are a couple of articles that you can read to learn more about this disorder. 1. Long SS, Surrey DE, Nazarian LN. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. AJR Am J Roentgenol. 2013;201(5):1083-1086.  2. Pianka MA, Serino J, DeFroda SF, Bodendorfer BM. Greater trochanteric pain syndrome: Evaluation and management of a wide spectrum of pathology. SAGE Open Med. 2021.  3. Ladurner A, Fitzpatrick J, O'Donnell JM. Treatment of Gluteal Tendinopathy: A Systematic Review and Stage-Adjusted Treatment Recommendation. Orthop J Sports Med. 2021;9(7):23259671211016850. I hope the information in this episode was helpful and you feel better equipped to treat gluteal tendinopathy related pain. Besides the YouTube video I linked, my book contains comprehensive programs for the 50 most common orthopedic conditions, including one for gluteal tendinopathy. The programs are broken into three phases and include exercises that can be used to help prevent injuries as well as help you recover from an injury. If you want to learn more about my book, visit my website or click HERE to view the book on Amazon. Thanks for reading and I hope you have a great day! Dr. Tom

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Julie L. Rosenthal, MD, FACC, Ronald Witteles, MD - TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Nov 1, 2024 65:02


This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/TDS865. CME credit will be available until October 23, 2025.TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca LP.Disclosure information is available at the beginning of the video presentation.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Julie L. Rosenthal, MD, FACC, Ronald Witteles, MD - TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Nov 1, 2024 65:02


This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/TDS865. CME credit will be available until October 23, 2025.TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca LP.Disclosure information is available at the beginning of the video presentation.

PeerView Neuroscience & Psychiatry CME/CNE/CPE Audio Podcast
Julie L. Rosenthal, MD, FACC, Ronald Witteles, MD - TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis

PeerView Neuroscience & Psychiatry CME/CNE/CPE Audio Podcast

Play Episode Listen Later Nov 1, 2024 65:02


This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/TDS865. CME credit will be available until October 23, 2025.TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca LP.Disclosure information is available at the beginning of the video presentation.

PeerView Neuroscience & Psychiatry CME/CNE/CPE Video Podcast
Julie L. Rosenthal, MD, FACC, Ronald Witteles, MD - TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis

PeerView Neuroscience & Psychiatry CME/CNE/CPE Video Podcast

Play Episode Listen Later Nov 1, 2024 65:02


This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/TDS865. CME credit will be available until October 23, 2025.TTRansforming the TTReatment of ATTR: A Guide to the Pathophysiology, Diagnosis, and Emerging Treatment Strategies for ATTR Amyloidosis In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca LP.Disclosure information is available at the beginning of the video presentation.

Passing the Counseling NCMHCE narrative exam
Adjustment Disorder - Symptoms, Stressors, and Treatment Strategies

Passing the Counseling NCMHCE narrative exam

Play Episode Listen Later Oct 22, 2024 18:43 Transcription Available


Send us a textUnlock the secrets to understanding and managing adjustment disorder with insights from Dr. Linton Hutchinson and Stacey Frost in our latest Demystifying Disorders episode. Ever wondered how a seemingly small stressor can trigger a significant emotional response? Join us as we dissect the evolution of adjustment disorder from its origins in the 1950s to its current classification in the DSM-5-TR. Learn the intricacies of its diagnostic criteria and the role of identifiable stressors, whether they're singular events or an accumulation that overwhelms one's coping abilities. Through the metaphor of a Michigan basement with persistent seepage, we unravel the acute and chronic nature of this disorder, bringing it to life with Lacey's story—a poignant example of how ongoing stress from a contentious custody battle can manifest in one's life.Dive into effective treatment strategies that differentiate adjustment disorder from conditions like major depressive disorder and PTSD. Discover the tailored interventions designed to address unique symptoms, from mindfulness-based cognitive therapy for anxiety to leveraging a client's inherent strengths. Our conversation champions a strengths-based approach, encouraging clients to enhance their coping mechanisms and build resilience, while offering therapists valuable insights to refine their practice. Whether you're a seasoned professional or a student gearing up for licensure exams, gain actionable knowledge that fosters continued growth in diagnosing and treating adjustment disorder.If you need to study for your national licensing exam, try the free samplers at: LicensureExamsThis podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Gastro Girl
IBS-C Case Challenges: Expert Insights and Treatment Strategies

Gastro Girl

Play Episode Listen Later Oct 22, 2024 43:54


This episode brings together three leading gastroenterology experts to review and discuss complex IBS-C patient cases. Dr. Xiao Jing (Iris) Wang from the Mayo Clinic, Dr. Christopher V. Almario from Cedars-Sinai Medical Center, and Dr. Eric Shah from the University of Michigan delve into the latest research and treatment strategies for managing irritable bowel syndrome with constipation. Each expert offers unique insights into how they would approach these challenging cases, providing valuable guidance for healthcare professionals. Tune in for this special roundtable discussion, brought to you by Ardelyx.  

Pharma Intelligence Podcasts
COPD Treatment Strategies: Q&A with Dr. Kenneth Chinsky

Pharma Intelligence Podcasts

Play Episode Listen Later Oct 11, 2024 14:56


Join us for a discussion on COPD and inhaler choice.

Rehab Science with Tom Walters
Sacroiliac Joint (SIJ) Dysfunction: Diagnosis & Treatment Strategies

Rehab Science with Tom Walters

Play Episode Listen Later Oct 8, 2024 24:35


Today's episode covers sacroiliac or SI joint pain, which is a type of low back pain. The sacroiliac joints are two small synovial joints located on the right and left sides of the low back between the sacrum and the ilium bone of the pelvis. These joints are surrounded by numerous ligaments, which makes them very strong and capable of supporting body weight. Because of their joint shape and the surrounding ligaments, the sacroiliac joints move very little, but are thought to account for a small percentage of back pain cases. Pain associated with sacroiliac joint irritation is usually located on one side of the low back and may radiate into the buttock or back side of the thigh. If you believe you may experiencing pain originating from one or both of your sacroiliac joints, the exercises shown in the video may help.  https://youtu.be/s2bqEP1O6_s?si=MSDpabHhBI58Jae9 Reference: Laslett M. Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint. J Man Manip Ther. 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582421/ Here are a few exercise tools that can help you recover from this type of pain. SI Stabilization Belt: https://amzn.to/4gYmkpE Trigger Point Ball: https://amzn.to/3Ibw0LJ Loop Bands: https://amzn.to/3G3D6QS *My new book contains comprehensive rehab programs for the 50 most common injuries and pain issues, including one for sacroiliac joint pain. Click the link below to learn more and order a copy! https://a.co/d/1q3BjgP  

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Roy S. Herbst, MD, PhD - Elevating Care in Resectable Stage I-III NSCLC: Targeted Therapy and Immunotherapy at the Forefront of Multimodal Treatment Strategies

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Oct 2, 2024 63:31


This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC information, and to apply for credit, please visit us at PeerView.com/CGJ865. CME/MOC credit will be available until October 9, 2025.Elevating Care in Resectable Stage I-III NSCLC: Targeted Therapy and Immunotherapy at the Forefront of Multimodal Treatment Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Roy S. Herbst, MD, PhD - Elevating Care in Resectable Stage I-III NSCLC: Targeted Therapy and Immunotherapy at the Forefront of Multimodal Treatment Strategies

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Oct 2, 2024 63:31


This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC information, and to apply for credit, please visit us at PeerView.com/CGJ865. CME/MOC credit will be available until October 9, 2025.Elevating Care in Resectable Stage I-III NSCLC: Targeted Therapy and Immunotherapy at the Forefront of Multimodal Treatment Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

Cycle Wisdom: Women's Health & Fertility
59. PCOS 103: Targeted Treatment Strategies

Cycle Wisdom: Women's Health & Fertility

Play Episode Listen Later Sep 18, 2024 17:49 Transcription Available


In this episode, Dr. Monica Minjeur explores treatment options for PCOS, depending on your health and fertility goals. She shares a real-life patient story, explaining how personalized care goes beyond standard treatments that are often recommended like oral contraceptives or a one-size-fits-all approach. From lifestyle changes to bioidentical hormones and ovulation stimulators, this episode focuses on restoring balance and addressing root causes. Tune in for practical advice on managing PCOS while keeping your reproductive goals in mind! 

Swallow Your Pride
341 – The Complex World of Auditory Comprehension and Receptive Aphasia: Assessment, Treatment, and More

Swallow Your Pride

Play Episode Listen Later Sep 15, 2024 43:35


You know those awkward moments where you can't hear what someone is saying in a loud environment, so you just nod and agree to whatever they say? …hoping it makes sense to just nod and agree? As a medical SLP, odds are, you've worked with patients who have done this to you. Not because you're providing therapy in a loud environment, but because they have receptive aphasia, or impaired auditory comprehension. While impaired speech and language is easy to pick up on, auditory comprehension is a whole different ballpark… Which is why we're bring on our beloved aphasia & auditory comprehension MedSLP Collective mentor, Brett McCardel! Brett drops dozens of golden knowledge nuggets with us as he shares things like… What impaired auditory comprehension can look like (it really varies!) How auditory comprehension impacts quality of life The two ways we can classify auditory comprehension Assessment tools Treatment considerations And so much more!! If you serve people with aphasia at all, you won't want to miss this episode! And if you want to dig EVEN DEEPER into your aphasia assessment and treatment skills, you might be interested in this month's themed mission inside of the MedSLP Collective! We're dedicating every resource, checklist, in-service, and webinar this month to aphasia - including aphasia in sign language!  Get the show notes here: https://syppodcast.com/341 Aphasia Therapy Approach (00:01:34) Changes in the Meta SLP Collective (00:02:50) Focus on New Resources (00:03:46) Implementation of Material (00:05:42) Diving into Auditory Comprehension (00:07:02) Understanding Auditory Comprehension (00:08:50) Challenges in Auditory Comprehension (00:10:05) Impact on Quality of Life (00:12:04) Classifying Auditory Comprehension Deficits (00:14:44) Assessment of Auditory Comprehension (00:15:35) Common Assessment Tasks (00:18:02) Auditory Processing Model Overview (00:19:13) Auditory Comprehension at Single Word Level (00:20:17) Treatment Approaches for Single Word Level (00:21:24) Research on Auditory Discrimination Skills (00:22:12) Awareness in Auditory Comprehension (00:23:46) Transition to Sentence Level Comprehension (00:25:24) Assessment Tools for Sentence Level (00:27:44) Treatment Strategies for Syntax and Morphology (00:29:21) Discourse Level Assessment (00:33:31) Compensatory Strategies for Discourse Level (00:35:52) AAC and Auditory Comprehension Support (00:36:54) Case Study on Auditory Comprehension (00:37:41) Understanding Auditory Comprehension (00:38:52) Life Participation Approach (00:39:51) Communication Environment Considerations (00:40:00) Functional Treatment Strategies (00:41:00) Holistic Aphasia Treatment (00:41:54) The post 341 – The Complex World of Auditory Comprehension and Receptive Aphasia: Assessment, Treatment, and More appeared first on Swallow Your Pride Podcast.

CorConsult Rx: Evidence-Based Medicine and Pharmacy
Migraine Management: Up to Date Treatment Strategies *ACPE-Accredited*

CorConsult Rx: Evidence-Based Medicine and Pharmacy

Play Episode Listen Later Sep 10, 2024 63:33


On this episode, we discuss the management of migraines. We begin with background info including clinical presentations, potential triggers, and pathophysiology.  We review the current guidelines and evidence-based treatment strategies, including pharmacological and non-pharmacological interventions. We then compare and contrast the efficacy, safety profiles, and appropriate use of acute and preventive therapies, lifestyle modifications, and patient monitoring. Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

Sapio with Buck Joffrey
97: Buck's Boston Heart Cholesterol Balance Test

Sapio with Buck Joffrey

Play Episode Listen Later Aug 19, 2024 21:42


Link to Buck's Results: https://drive.google.com/file/d/19BJaZNYwBxlPx4nR9695Q2NC3nNpgW6y/view?usp=sharing  https://drive.google.com/file/d/1br1ikAJKmgKev9X3jkS7nUPdXpAqMzYd/view?usp=sharing Section 1: Overview of Cholesterol Metabolism Cholesterol in the Body: Cholesterol is essential for cell membrane integrity, hormone synthesis, and bile acid production. It is produced endogenously in the liver and absorbed exogenously from dietary sources. Endogenous Production: Cholesterol is synthesized in the liver through the mevalonate pathway. Key intermediates: Lathosterol and Desmosterol, indicators of cholesterol production rate. Exogenous Absorption: Dietary cholesterol is absorbed in the intestines along with plant sterols like Beta-sitosterol and Campesterol. These sterols compete with cholesterol for absorption, reflecting dietary cholesterol absorption levels. Section 2: Detailed Analysis of the Test Components Production Markers: Lathosterol: Precursor in the cholesterol biosynthesis pathway. Elevated levels indicate increased hepatic cholesterol synthesis (overproduction). Example: Lathosterol level of 329 µmol x 100/mmol in my study indicates hyperactive cholesterol production. Desmosterol: Another precursor in the synthesis pathway, contributing to total cholesterol production. High levels reinforce the diagnosis of increased cholesterol production. Example: Desmosterol level of 74 µmol x 100/mmol in my study supports elevated production. Absorption Markers: Beta-sitosterol: Plant sterol absorbed in the intestines, competes with cholesterol. High levels suggest increased absorption of dietary cholesterol. Example: Beta-sitosterol level of 120 µmol x 100/mmol indicates borderline absorption. Campesterol: Similar to Beta-sitosterol, reflects cholesterol absorption efficiency. Elevated levels indicate increased absorption. Example: Campesterol level of 113 µmol x 100/mmol within normal limits but suggests absorption could be a factor. Cholesterol Balance Score: Ratio of production to absorption markers. A higher score indicates predominant cholesterol production; a lower score indicates absorption as the main issue. Example: Score of 2.4 suggests overproduction is the dominant issue. Section 3: Clinical Implications and Treatment Strategies (10 minutes) Frequency of Overproduction vs. Overabsorption: Common to see patients with either overproduction or overabsorption, but less commonly both. Overproducers: Significant portion of hypercholesterolemia patients, especially those with genetic conditions like Familial Hypercholesterolemia. Overabsorbers: Often have high-cholesterol diets or genetic predispositions. Treatment Implications: Overproducers: Statins are first-line treatment; they inhibit HMG-CoA reductase in cholesterol synthesis. Overabsorbers: Ezetimibe, which inhibits intestinal cholesterol absorption, can be effective. Combination Therapy: Considered for mixed dyslipidemia cases. Case Examples: Example of a patient with high production markers but borderline absorption: Statin therapy may be appropriate, with potential addition of Ezetimibe. Example of a patient who is a high absorber but not a high producer: Dietary changes and Ezetimibe might suffice without statins. Section 4: Physiological Mechanisms and Genetic Considerations Pathophysiology of Cholesterol Production: Overproduction may result from genetic mutations (LDL receptor or PCSK9) or conditions like insulin resistance. Pathophysiology of Cholesterol Absorption: Increased absorption could be due to genetic polymorphisms (NPC1L1 gene), leading to higher dietary cholesterol absorption. Section 5: Practical Application in Clinical Practice Incorporating the Test into Clinical Workflow: Integrate the Boston Heart Cholesterol Balance Test for patients with unexplained hypercholesterolemia or non-responders to standard therapy. Tailor treatment based on whether a patient is an overproducer, an overabsorber, or both. Patient Communication: Explain test results in an understandable way, emphasizing personalized treatment plans.

BackTable Podcast
Ep. 473 Portal Hypertension Treatment Strategies: IR and Hepatology Perspectives with Dr. Thomas Leventhal and Dr. Siobhan Flanagan

BackTable Podcast

Play Episode Listen Later Aug 13, 2024 58:19


The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what's coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology. --- CHECK OUT OUR SPONSOR Cook Medical Embolization https://www.cookmedical.com/interventional-radiology/coils-home/cook-products/?utm_source=backtable&utm_medium=digital&utm_campaign=vasc_ir_p_awa_embolization_2024_amer --- SYNPOSIS The doctors discuss current collaborative approaches that are improving portal hypertension patient care, the impact of contemporary clinical practices in transplant hepatology and IR, and the imminent future of portal hypertension treatments. Dr. Leventhal also gives his insight on what could be on the horizon, touching on in-vitro organ creation, xenotransplants, and stem cells phasing out immunosuppression. --- TIMESTAMPS 00:00 - Introduction 06:10 - Managing Portal Hypertension 07:51 - Current Collaborative Practices 10:38 - Patient Referral and Management 15:25 - Initial Workup for Portal Hypertension 19:27 - Role of Biopsy in Diagnosis 24:02 - Patient Scenarios for TIPS Referral 32:04 - Ultrasound and Intracardiac Echocardiography (ICE) in TIPS 38:09 - Clinical Management 52:48 - Future of Transplant and Organ Growth