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"The accumulation of these malignant and reactive cells, that's what causes the lymph nodes to get big. That's why they grow. And that's why the classic presentation is persistent, painless, enlarged lymph nodes. So when we think of the pathophysiology of Hodgkin lymphoma, there are really two processes contributing to the presentation: One is the physical effects of enlarging lymph nodes or the involved organs. The second is the systemic inflammatory response generated by it and its surrounding immune environment," ONS member Victoria Krogg, DNP, APRN-CNP, AOCNP®, nurse practitioner at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, OH, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about an overview of Hodgkin lymphoma for oncology nurses. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 2, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the pathophysiology and diagnosis of Hodgkin lymphoma. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 208: How to Have Fertility Preservation Conversations With Your Patients Episode 184: Oncologic Emergencies 101: Tumor Lysis Syndrome ONS Voice articles: Diabetes May Increase Hematologic Cancer Risk and Mortality Have Meaningful Conversations With Pediatric, Adolescent, and Young Adult Patients and Their Families Non-Hodgkin Lymphoma Symptoms, Diagnosis, Treatment, and Survivorship Recommendations Clinical Journal of Oncology Nursing articles: Non-Hodgkin Lymphoma: Examining Mycosis Fungoides and Sézary Syndrome in the Context of Oncology Nursing The Unexpected Cancer Journey: Navigating Cancer as Adolescents and Young Adults Tumor Lysis Syndrome in Solid and Hematologic Malignancies: A Guide for Early Detection and Intervention ONS Huddle Cards: Fertility Preservation Oncogenic Viruses Tumor Lysis Syndrome ONS Symptom Management Resource: Fatigue Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library Blood Cancer United: Hodgkin Lymphoma Lymphoma Research Foundation: Hodgkin Lymphoma National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Hodgkin lymphoma can be diagnosed at virtually any age but is more common in younger patients as well as older adults. It kind of skips middle-aged people, but it occurs in our geriatric population as well. There are different prognostic implications depending on the group of patients that are diagnosed with Hodgkin lymphoma. As far as risk factors ... Hodgkin lymphoma is not considered a hereditary disease. There's not a specific gene we know of today that can be passed down to children and put them at risk. But if there is a first-degree relative affected by a lymphoma, we do find that noteworthy. We do consider it a risk factor. But that risk factor isn't necessarily a hereditary component so much as it is having that same genetic susceptibility to Hodgkin's or perhaps sharing common environmental exposures." TS 5:46 "Sometimes the subtypes of Hodgkin lymphoma can vary in terms of presentation. It's certainly not textbook how someone can present. But generally, we worry about enlarged lymph nodes, especially if they are notably enlarged to the point where someone can even see them when they're standing a few feet away from that individual. ... We also worry about what we call B symptoms, related to B lymphocytes, such as unexplained and persistent fevers, drenching night sweats, unexplained weight loss, and new progressive fatigue. ... Interestingly, there is a phenomenon where sometimes people who have an underlying Hodgkin lymphoma will experience lymph node pain or tenderness when they drink alcohol. It's kind of a unique presenting symptom. But I also want to point out that you don't have to have all of these symptoms. A lot of patients are relatively asymptomatic, meaning without symptoms." TS 8:37 "It's always important to consider if there is any very obvious infectious or inflammatory correlate that could explain the enlarged lymph node. Something I've seen in my practice is someone gets a flu vaccine in their right arm and then a couple of days later they notice a lump in their right armpit. And yeah, it might be a flared lymph node, but they also had a vaccine in their arm recently, which would stimulate your lymph node, because the purpose of the vaccine is to have an effect on the immune system. So I always want to make sure—is there something really obvious that could explain these lymph nodes being abnormal? A recent tattoo, recent injury, or infection proximal to where that enlarged lymph node is? So, you have to think of all of that when you're thinking of the differential diagnoses that come to mind." TS 19:19 "Nurses can be monumentally helpful with the education role with any patients who may have lymphoma. It would be helpful if nurses guide patients on the diagnostic process, providing support, guidance and encouragement, and of course, advocating for patients. Also, when you think of Hodgkin lymphoma and you think of the younger patients that are diagnosed with it, there's some additional supportive care that we need to consider, and we may need to refer them for fertility preservation. That can be very daunting for our young patients, so it's helpful to have nursing support in those situations." TS 22:55 "People think of Hodgkin lymphoma as a very treatable disease—and it can be very curable for certain patient populations—but it's not a 100% success rate. We do still have fatalities, so it's a very serious thing. I try to always educate my patients about seeking out care if they notice new lumps or bumps on their bodies. We can observe enlarged lymph nodes most easily on the neck, under the armpit, and in the groin area. If someone were to notice a lump in that area, short-term observation—keeping an eye on it for two weeks is fine—but if it persists past that, they should definitely seek care to get it evaluated." TS 33:18

Welcome to this week's Midlife Minute! Today, I examine partial and full hysterectomies and what we know about their potential long-term effects, clarifying what the research tells us about bone, brain, and cardiovascular health, and what women should discuss with their healthcare providers before and after surgery. IN THIS EPISODE, YOU WILL LEARN: How a partial hysterectomy differs from a full hysterectomy, and the abrupt estrogen changes ovarian removal can produce  Why having a hysterectomy before ages 40-45 can have a greater impact than having surgery closer to natural menopausal age. How a hysterectomy can impact women's bone health What the research reveals about the connection between surgical menopause at a younger age, cognitive decline, and Alzheimer's pathology How a hysterectomy can affect women's cardiovascular health Why starting HRT early after an early-age hysterectomy could be important for your long-term health Why younger women who experience surgical menopause may require higher estradiol doses than the standard menopausal regimens The importance of advocating for yourself, understanding your personal risk, and talking with your clinician about estrogen and other hormone therapy before undergoing surgery Quotes: “Start those conversations early- before you ever have surgery.” “If you are having these surgeries done before 45, before 40, you need HRT!” “We have to manage our stress.” “We have to get enough sleep.” “We should be strength training.” “We should be physically active.” “We should be eating an anti-inflammatory diet.” Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research: Increased Risk of Osteoporosis With Hysterectomy: A Longitudinal Follow-Up Study Using a National Sample Cohort. American Journal of Obstetrics and Gynecology. 2019. Choi HG, Jung YJ, Lee SW.  Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al. Cardiovascular Disease After Hysterectomy in the Nurses' Health Study and Nurses' Health Study II. Obstetrics and Gynecology. 2025. Thao V, Borah B, Stewart EA, et al. Treatment of Women After Bilateral Salpingo-oophorectomy Performed Prior to Natural Menopause. The Journal of the American Medical Association. 2021. Kaunitz AM, Kapoor E, Faubion S. Hysterectomy, Oophorectomy, and Bone Health: A Systematic Review and Meta-Analysis. European Journal of Endocrinology. 2025. Shariful Islam M, Tuesley KM, Wilson LF, et al. Risk of Osteoporosis and Fracture After Hysterectomies Without Oophorectomies: A Systematic Review and Pooled Analysis. Osteoporosis International. 2022. Xu W, Wu W, Yang S, et al. Hysterectomies Are Associated With an Increased Risk of Osteoporosis and Bone Fracture: A Population-Based Cohort Study. PloS One. 2020. Yeh YT, Li PC, Wu KC, et al. Age at Surgical Menopause Influences Cognitive Decline and Alzheimer Pathology in Older Women. Neurology. 2014. Bove R, Secor E, Chibnik LB, et al. Reproductive Period and Risk of Dementia in a Diverse Cohort of Health Care Members. Neurology. 2019. Gilsanz P, Lee C, Corrada MM, et al.  Examining the Association of Hysterectomy With and Without Oophorectomy on Cardiovascular Disease and All-Cause, Cardiovascular or Cancer Mortality: A Systematic Review and Meta-Analysis. BJOG: An International Journal of Obstetrics and Gynecology. 2024. Chen Y, Li F, Liang L, et al. Association of Premature Natural and Surgical Menopause With Incident Cardiovascular Disease. The Journal of the American Medical Association. 2019. Honigberg MC, Zekavat SM, Aragam K, et al Optimizing Health After Early Menopause. Lancet. 2024. Mishra GD, Davies MC, Hillman S, et al. Hormone Replacement Therapy for Women Previously Treated for Endometrial Cancer. The Cochrane Database of Systematic Reviews. 2018. Edey KA, Rundle S, Hickey M.

We're starting Spooky Season off on the right note with the sequel to the Rocky Horror Picture show with equally iconic and well-loved sequel about the dangers of television -- SHOCK TREATMENT. We're joined by a special guest, Frank of FrankPodcasts to talk about this bonkers little musical. Come have some fun with us. Credits: Hosts: Jesse McAnally & Andrew DeWolf Podcast Edited By: Jesse McAnally Keeper of the Cheese: Juliet Antonio This show is a part of the Broadway Podcast Network Social Media: ⁠⁠⁠⁠⁠Our WEBSITE⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Musicals with Cheese on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Musicals W/ Cheese on Instagram⁠⁠⁠⁠⁠ Email us at ⁠⁠⁠⁠⁠musicaltheatrelives@gmail.com⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Merch!!⁠⁠⁠⁠⁠ Jess Socials ⁠⁠⁠⁠⁠Jesse McAnally ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Jess McAnally on Instagram⁠⁠⁠⁠⁠ Andrew Socials ⁠⁠⁠⁠⁠Andrew DeWolf on Instagram⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Andrew DeWolf on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Use our Affiliate Link⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In the first part of this two-part series, Dr. Tesha Monteith and Dr. Tamara Pringsheim provide a brief overview of the guideline recommendations for pharmacologic treatment of migraine prevention in adults.  Show citation:  Potrebic S, Tanveer S, Becker WJ, et al. Pharmacologic Treatment for Migraine Prevention in Adults Practice Guideline Recommendations: Report of the AAN Guidelines Subcommittee and the American Headache Society. Headache. Published online August 31, 2026. doi:10.1111/head.70199 

Despite women making up half the population, women's health has remained an enigma.This is especially evident in the case of maternal mental health, which has been brought to the limelight with the Lindsey Clancy trial.There's a stigma surrounding postpartum depression, anxiety and psychosis. The stigma is worsened by the lack of awareness around the topic.What can be done to improve the treatment of post-partum mental health disorders?Join us for a discussion about mental health with women's health experts on this hour of All Sides.Guests:Tonya Fulwider, executive director, Mental Health America of OhioNicole Hollingshead, clinical psychologist in women's behavioral health, Ohio State Wexner Medical CenterDr. Casia Horseman, psychiatrist, Ohio State Wexner Medical Center photo: Greg Derr / Pool The Patriot Ledger via AP

In this episode, Dr. Rena Malik was joined by Dr. Richard Natale, Dr. Rachel Mann, and Dr. Paul Rusilko and the conversation focused on the comprehensive evaluation and management of erectile dysfunction, including diagnostic workups, the role of penile Doppler, and the impact of underlying health conditions and medications. Several points were raised about the importance of individualized treatment plans, addressing pelvic floor dysfunction, and the effects of lifestyle factors like cycling and masturbation. Become a Member to Receive Exclusive Content: renamalik.supercast.com Schedule an appointment with me: https://www.renamalikmd.com/appointments ▶️Chapters: 00:00 Diagnostic workup for ED00:44 Role of penile Doppler02:01 Venous leak discussion06:45 Treatment options for venous leak08:09 Clinic quality concerns11:08 Can reversing health conditions help ED?13:05 Medications causing ED14:55 Combination/off-label therapies15:50 Cycling and erectile dysfunction17:39 Pelvic floor dysfunction19:37 Depression and erectile dysfunction22:37 Death grip syndrome & masturbation habits27:13 Semen retention myths30:21 Oral medications and ED treatments Stay connected with Dr. Richard Natale, Dr. Rachel Mann, and Dr. Paul Rusilko on social media for daily insights and updates. Don't miss out—follow them now and check out these links! Dr. Richard Natale INSTAGRAM - https://www.instagram.com/cltmenshealth/ FACEBOOK - https://www.facebook.com/DrRichardNatale/ YOUTUBE - https://www.youtube.com/channel/UC7f0TcwCph3edIWVsXeyFRw Dr. Rachel Mann INSTAGRAM - https://www.instagram.com/you_the_mann/ X - https://x.com/You_the_Mann?lang=en Dr. Paul Rusilko INSTAGRAM: https://www.instagram.com/drpaulrusilko/ https://www.instagram.com/upmcurology/ X: https://x.com/UPMCUrolog https://x.com/PaulRusilko Let's Connect!: WEBSITE: http://www.renamalikmd.com YOUTUBE: https://www.youtube.com/@RenaMalikMD INSTAGRAM: http://www.instagram.com/RenaMalikMD TWITTER: http://twitter.com/RenaMalikMD FACEBOOK: https://www.facebook.com/RenaMalikMD/ LINKEDIN: https://www.linkedin.com/in/renadmalik PINTEREST: https://www.pinterest.com/renamalikmd/ TIKTOK: https://www.tiktok.com/RenaMalikMD ------------------------------------------------------ DISCLAIMER: This podcast is purely educational and does not constitute medical advice. The content of this podcast is my personal opinion, and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of information contained in this podcast including but not limited to economic loss, injury, illness or death. Learn more about your ad choices. Visit megaphone.fm/adchoices

Kareem Allam, mayoral candidate for the Vancouver Liberals Learn more about your ad choices. Visit megaphone.fm/adchoices

Phil Mickelson entered a treatment center for family trauma & addiction, Tacko Fall could be the secret weapon for NFL teams, plus A'ja Wilson gets in an altercation with a fan, will she face consequences? Learn more about your ad choices. Visit podcastchoices.com/adchoices

Dr. Lalani and Dr. Wallis kick off the new academic year with special guest Dr. Alejandro Berlin, a clinician-scientist and radiation oncologist at Princess Margaret Cancer Centre. This episode  highlights multidisciplinary care and treatment optimization in localized prostate cancer, focusing on how specialists collaborate to help patients navigate treatment options and their potential quality-of-life impacts. The conversation also examines the evolution of systemic therapy in high-risk disease, including considerations around the optimal duration of ADT and the integration of ARPIs.The View on GU with Lalani & Wallis integrates key clinical data from major conferences and high impact publications, sharing meaningful take home messages for practising clinicians in the field of genitourinary (GU) cancers. Learn more about The View on GU: theviewongu.ca This podcast has been made possible through unrestricted financial support by Johnson & Johnson, Ferring, Pfizer, Tolmar, AbbVie, Astellas, Ipsen, Merck, Bayer, TerSera.

In international football, it's all to play for this evening as Gibraltar prepare for their Nations League clash with Malta. Jose Mari Ruiz is in Malta, we'll be hearing from him ahead of the game, which kicks off at 8:45, with coverage on GBC as from 8:15.October is Breast Cancer awareness month: an opportunity to promote early detection and support research into the most common cancer in women worldwide. We'll be hearing from chair of the Breast Cancer Support Group, Heidi Jeffries, as well as GHA nurses, Gabriella Gilbert and Hayley Stevens.The EV Foundation is providing bursaries to a number of students, providing them access to higher education. Nicole Jones will be here to discuss the bursary scheme which is now in its fourth yearAnd works on the wastewater treatment plant continue with the DPC giving full planning permission for excavation works to proceed. Project Director, Carlito Buhagiar, will give us the latest updates. Hosted on Acast. See acast.com/privacy for more information.

Pack Nation, you hear that? It's the sound of silence from the N F L and the N F C North, and Big Sal is not having it! In today's explosive episode, Sal exposes the pure terror gripping our rivals as they refuse to acknowledge the Green Bay Packers' undeniable rise. He unloads on the hypocrisy of their media and the pathetic cowardice of their silence. Sal dissects how their deliberate quiet is a loud admission of fear and pre-emptive defeat. He calls out their childish denial and declares that the Packers are coming regardless of their spineless attempts to ignore the truth. You don't want to miss Sal's full-send rant on why their silence is the ultimate punchline. Subscribe to Let Me Tell You Somethin', leave a five-star review, and share this episode with every Packers fan you know! Go Pack Go! This episode is brought to you by PrizePicks! Use code PACKDADDY to get started with America's #1 fantasy sports app. https://prizepicks.onelink.me/LME0/PACKDADDY To advertise on this podcast please email: ad-sales@libsyn.com Or go to: https://advertising.libsyn.com/packernetpodcast Check out everything I'm building across the Packers and NFL world: NFL Draft Grades: https://nfldraftgrades.com/ Hashmarks: https://hashmarks.io/

LIVE from ILADS: Tick Boot Camp sits down with Mindy Tobin Daigle, MSN, APRN-BC, a nurse practitioner whose approach to Lyme disease and complex chronic illness was profoundly shaped by her own experience as a patient. Before treating people with Lyme disease, Mindy lived it. After years of misdiagnosis, she was diagnosed with Lyme disease in 2010 following earlier tick exposures. Her illness became multisystemic and severe, affecting her heart, brain, joints, gastrointestinal system, bladder, skin, muscles, and more. At her sickest, she describes being bed-bound, wheelchair-bound, experiencing seizures and aphasia, and dependent on others for basic care. That experience gave her a mission: become the healthcare provider she needed when she was sick and searching for answers. This conversation goes far beyond Lyme disease treatment. Mindy and Tick Boot Camp explore medical gaslighting, listening to patients, compassion versus empathy, realistic expectations for chronic illness recovery, the importance of self-compassion, finding your physical and emotional "edges," and why progress is often measured in inches rather than feet. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. A Nurse Practitioner Who Became the Patient Mindy was already a trained medical professional when she became seriously ill. Her first reported tick bite occurred in South Africa in 1997, followed by additional exposures while she was working as a nurse in Minnesota and Wisconsin. Despite her medical training and access to healthcare, Lyme disease wasn't initially identified as the explanation for her growing collection of symptoms. Mindy describes repeatedly mentioning her history of tick bites only to have the possibility dismissed. Eventually, during a severe pain crisis, physician Dr. Ted Gillespie spent significant time listening to her history and asked a simple question: What about Lyme disease? Testing through Labcorp produced a positive Western blot, but Mindy says that even with that result, she continued encountering resistance to the diagnosis. Eventually, she found her way to Dr. Patricia Salvato in Houston and began treatment. Becoming the Practitioner She Needed Mindy made herself a promise during her illness: If she recovered, she would become the practitioner she had needed when she was lost and sick. That commitment eventually brought her to ILADS. At her first ILADS conference in 2013, Mindy heard the late Dr. Christine Green speak. The following week, she cold-called Dr. Green's office in San Francisco and asked if she could shadow her. That decision turned into a professional relationship lasting more than a decade. Mindy says her personal development as a Lyme patient became inseparable from her professional development as a clinician. From Sympathy to Empathy to Compassion One of the most powerful themes in this conversation is the evolution from sympathy to empathy to compassion. Mindy describes having sympathy as a young nurse and developing greater empathy with experience. After becoming seriously ill herself, she says she developed something deeper: compassion. Her definition of compassion centers on being willing to sit with another person's pain without judgment, interference, or adding to their suffering. For a Lyme patient who has spent years being dismissed, questioned, rushed, or told symptoms are unexplained, simply encountering a practitioner who genuinely listens can be meaningful. What Compassionate Lyme Care Looks Like Compassion isn't simply being nice to patients. For Mindy, it changes how she practices. When a patient arrives overwhelmed, crying, angry, frustrated, struggling with technology, or simply exhausted from managing chronic illness, her first goal isn't to rush through a checklist. She meets the patient where they are. She tells patients: We're not in a rush. The goal is to take the time needed to understand the person in front of her and determine what needs attention. That approach can be particularly important for patients with complex chronic illnesses who may arrive at an appointment carrying years of symptoms, medical records, failed treatments, fear, and frustration. Medical Gaslighting & the Importance of Listening Mindy also discusses the medical dismissal she experienced during her own illness and what patients often describe as medical gaslighting. The conversation explores why healthcare professionals may dismiss patient experiences even when a patient presents with a complicated history or evidence that warrants further investigation. Mindy emphasizes something deceptively simple: Remain curious. A practitioner doesn't have to immediately know every answer. But when something doesn't make sense, curiosity can keep the diagnostic process moving instead of shutting the patient down. For Mindy, listening and believing that a patient is genuinely experiencing what they describe are foundational to the therapeutic relationship. The Last Five Minutes Mindy has developed a practice she calls The Last 5 Minutes: 8 Concepts and Contemplations in Healing. After spending most of an appointment discussing symptoms, medical decision-making, treatment, and care planning, she reserves the final minutes for something different: Healing. It's a moment to put the metaphorical pencils down and talk heart-to-heart about what the patient is experiencing beyond laboratory results and treatment protocols. Her eight concepts and contemplations include: Keyhole Sunset Progress is made in inches, not feet Awareness, Acceptance, Compassion Pain is Information This is your Hero's Journey Healing is possible, with or without a cure Find a micron of joy and build on it Do what you need to do, rest when you need to rest, force nothing Mindy's original essay on the eight concepts offers a deeper exploration of the philosophy she discusses during this interview. Progress Is Made in Inches, Not Feet People with chronic Lyme disease are understandably in a hurry. They want their health back. They want their careers, relationships, independence, energy, and lives back. But recovery doesn't always move at the speed a patient wants. Mindy prepares patients for the possibility of a long process in which progress isn't perfectly linear. There can be improvements followed by setbacks. Instead of interpreting every setback as failure, she encourages patients to recognize that regression can sometimes occur within a larger pattern of progression. Mindy expands on this philosophy in Progress Comes in Inches, Not Feet. Self-Compassion During Lyme Recovery Chronic illness can create a destructive cycle of self-blame. Patients may think: Why aren't I better yet? Did I do something wrong? Why can't my body handle this? Why can't I do what I used to do? Mindy explains that even an excellent medical treatment plan doesn't automatically resolve the patient's relationship with themselves. Healing may also require learning to stop being at war with your own body. That doesn't mean giving up on improvement. It means learning how to pursue improvement without constantly punishing yourself for where you are today. Her writing on self-compassion and healing explores this balance between accepting present limitations and continuing to move forward. Finding Your Edges One of Mindy's most useful metaphors is finding your edges. After extensive treatment, she reached a point where she could no longer tolerate additional treatment in the same way. She learned to recognize the boundaries of what her body could currently handle. Rather than treating those boundaries as permanent walls, she describes living as well as possible within her edges — and periodically testing whether those edges can expand. If you can stand and wash dishes for five minutes, perhaps eventually you try seven. Small improvements matter. Progress in inches can eventually create meaningful change. Sometimes Progress Means Rest Pushing isn't always the answer. Sometimes the next productive step is doing less. Mindy distinguishes genuine restorative rest from simply lying down while remaining mentally stimulated by television, phones, scrolling, or other distractions. The challenge is learning when to push an edge and when the body genuinely needs recovery. That requires awareness, patience, and wisdom. For a practitioner, it also means understanding that two patients with similar diagnoses may need very different guidance at a particular moment. A Biopsychosocial Approach to Lyme Disease Mindy describes her clinical approach as biopsychosocial. That means considering the patient's: Biology Psychology Social environment Physical limitations Emotional health Relationships Stressors Daily circumstances Complex chronic illness doesn't occur in isolation from the rest of a person's life. Treatment may target infections and physical dysfunction, but healing can also involve how someone relates to their illness, themselves, and the world around them. Mindy's own experience as both patient and practitioner gives her a particularly personal perspective on those intersections. Can Having Lyme Disease Make Someone a Different Practitioner? The conversation explores a provocative question: Does personally experiencing Lyme disease change someone's ability to care for Lyme patients? Mindy says her own illness gave her an understanding she didn't have beforehand. She can recognize nuances between different kinds of fatigue, pain, and physical limitations because she has experienced them. At the same time, she points to her longtime mentor Dr. Christine Green as an example of an accomplished Lyme clinician who did not personally have Lyme disease. The distinction isn't that someone must have Lyme disease to become an excellent practitioner. Rather, lived experience can provide another form of knowledge — one that can complement medical education and clinical expertise. Working with Ravel Health At the time of this interview, Mindy had recently begun working with Ravel Health, a virtual care platform focused on complex chronic illness. She explains that the model gives her greater flexibility to structure her schedule around both her patients' needs and her own ongoing health limitations. That matters because Mindy continues to manage symptoms herself. The flexibility allows her to dedicate significant attention to a patient while also building recovery time between demanding appointments. For Mindy, finding a sustainable way to practice is another extension of the same compassion she encourages patients to develop for themselves. The Human Capacity to Overcome The interview ends with hope. Despite everything Mindy has personally experienced — and everything she sees among people living with complex chronic illness — what repeatedly impresses her is the human capacity to overcome adversity. She watches patients face enormous physical and emotional challenges, adapt, continue forward, and sometimes emerge with a different understanding of themselves and their lives. That doesn't minimize how difficult Lyme disease can be. It recognizes that even within an extraordinarily difficult journey, healing, growth, purpose, and progress remain possible. About Mindy Tobin Daigle, MSN, APRN-BC Mindy Tobin Daigle, MSN, APRN-BC is an adult health nurse practitioner with decades of nursing and clinical experience. She has worked extensively with people navigating Lyme disease, vector-borne illness, chronic fatigue, chronic pain, and other complex chronic conditions. For more than a decade, she collaborated with Lyme disease specialist Dr. Christine Green at Green Oaks Medical Center. Her professional work has been profoundly influenced by her own experience as a Lyme disease patient. Read Mindy's The Last 5 Minutes: 8 Concepts and Contemplations in Healing and her related writings about progress in chronic Lyme disease and self-compassion during healing. Key Topics in This Episode Lyme disease, chronic Lyme disease, Mindy Daigle, Lyme disease nurse practitioner, Lyme disease recovery, medical gaslighting, patient validation, compassion in healthcare, empathy, self-compassion, chronic illness recovery, Lyme disease misdiagnosis, Lyme disease treatment, healing from chronic illness, progress in inches, finding your edges, biopsychosocial medicine, patient-centered care, chronic fatigue, chronic pain, Lyme disease advocacy, Ravel Health, Christine Green, and ILADS. About This LIVE from ILADS Interview This short-form conversation was recorded in person at the 2025 International Lyme and Associated Diseases Society Annual Scientific Conference, From Terrain to Treatment: Advances in Vector-Borne Illness, held October 9–12, 2025, in San Antonio, Texas. Because these interviews were recorded live at the conference, they have a different feel from Tick Boot Camp's traditional long-form virtual and studio conversations — shorter, focused, and surrounded by the activity of one of the world's major gatherings of Lyme and tick-borne disease clinicians, researchers, advocates, and innovators. Explore all Tick Boot Camp LIVE from ILADS interviews. More from Tick Boot Camp Hear more conversations with Lyme disease doctors and healthcare professionals about diagnosis, treatment, recovery, and complex tick-borne illness. Explore the Tick Boot Camp Podcast for patient stories and conversations with doctors, researchers, advocates, and other members of the Lyme disease community — all designed to educate, validate, build community, and reinforce that healing is possible. Send us your feedback online: https://pinecast.com/feedback/tick-boot-camp/d1b1d869-51e3-4c37-b025-8a57cb2bd5cb

Dr. David Chao joined The Drive to discuss Joshua Simmons injury and what a normal timeline is for a return to play and treatment plans for the injury.

Beth Capecchi is a psychologist. And she's also someone with attention deficit disorder. She joins AllMomDoes host Julie Lyles Carr for a fascinating conversation about living and working with ADHD, what we know today about attention deficit that we didn't know before, and how God works through all of it.Show Notes: https://bit.ly/4hSYg9UKey Topics:Neuroscience of ADHD and brain chemistryHow ADHD manifests differently in womenThe importance of self-awareness and diagnosisStrengths and superpowers associated with ADHDPractical strategies for managing ADHD in daily lifeThe role of emotional responsiveness and rejection sensitivityParenting with ADHD and managing household tasksThe cultural perception of ADHD and neurodiversitySound Bites:“ADHD people have trouble with making decisions.”“Many women with ADHD are undiagnosed because they don't look hyper.”“Rejection sensitive dysphoria is really just depression when rejected.”Chapters00:00 Introduction and personal chaos of motherhood01:15 Meet Beth Capecchi: Psychologist and ADHD advocate02:44 Understanding ADHD: Overcommitment and decision-making challenges04:27 ADHD in women: Hidden symptoms and late diagnosis06:47 The science of ADHD: Brain wiring and genetics08:43 Core characteristics of ADHD across different personalities09:55 The strengths and superpowers of ADHD11:48 Managing executive function and procrastination13:07 Emotional responsiveness and rejection sensitivity15:07 Parenting with ADHD: Challenges and strengths16:44 Balancing responsibilities and self-compassion19:55 Breaking free from comparison and embracing individuality21:42 The science behind ADHD: Brain chemistry and genetics24:41 Treatment options: Medication, natural strategies, and understanding your brain29:37 The spiritual perspective: God's design and strengths in neurodiversity31:03 Closing thoughts: Embracing messiness and authenticityKeywords: ADHD, women, neuroscience, motherhood, mental health, strategies, strengths, diagnosis, neurodiversity

The culmination of the School District of Philadelphia's highly-publicized facilities plan is still a year away, but the administration is laying the groundwork now to help prepare students at closing facilities for moves to new buildings. In the words of Dr. Tony Watlington Sr., the district will do “whatever it takes” to ensure kids and their families get situated in time. KYW Newsradio Education Reporter Mike DeNardo asks the superintendent for the latest details on the transition, and also for an update on early enrollment figures in the 2026-27 academic year. 00:00 Updates on transition plans for students impacted by next year's facilities plan closures 04:33 Reviewing enrollment figures one month into the new academic year Have a question for Dr. Watlington? Email us at afterschool@kywnewsradio.com and listen for a response on future episodes of "After School!” Catch the show on the air every Wednesday at 3:45 PM ET on KYW Newsradio 103.9 FM.

Men and women are frequently treated differently by healthcare systems according to a review of global research published in the journal, PLOS One. Women with the same medical conditions as men are less likely to be offered the medical treatments offered to men such as surgery, statins, or strong painkillers. They are also less likely to be offered treatment for conditions like cardiovascular conditions, kidney disease and Parkinson's disease. Claudia Hammond is joined by family doctor, Ann Robinson, to discuss.Claudia and Ann also discuss global disparities in access to dermatological care and the announcement that the Jehovah's Witness ban on accepting blood components in transfusions has been lifted.Also, for centuries scientists have thought of the brain as a single, unified organ. But new research reveals that what we call the brain could be two distinct organs that evolved independently over hundreds of millions of years. Claudia speaks to Matthew Grubb, Professor of Neuroscience at King's College London, to ask what we can learn from this revelation and whether he now considers the brain to be two organs.And Paddy Ross, Associate Professor in the Department of Psychology at Durham University, tells us about his research, that children are far more likely than adults to judge a person's emotions by what they hear rather than what they see.Presenter: Claudia Hammond Producer: Jonathan Blackwell

In today's episode, we spoke with Alissa Cooper, MD, and Noura Choudhury, MD. Dr Cooper is a physician at Dana-Farber Cancer Institute and instructor in medicine at Harvard Medical School in Boston, Massachusetts, and Dr Choudhury is an assistant professor of medicine at the University of Chicago in Illinois.In our exclusive interview, Drs Cooper and Choudhury discussed the evolving role of DLL3-targeting T-cell engagers in small cell lung cancer (SCLC), with a focus on tarlatamab-dlle (Imdelltra) and how emerging trial data may reshape the current treatment paradigm across lines of therapy.The discussion opened with the ongoing phase 3 DeLLphi-305 trial (NCT06211036), which is evaluating tarlatamab plus a PD-L1 inhibitor as first-line maintenance therapy following chemoimmunotherapy. Dr Choudhury noted that a positive readout from DeLLphi-305 could significantly diminish the future role of lurbinectedin (Zepzelca) in the maintenance setting, but emphasized that any adoption of tarlatamab as a standard maintenance strategy would require a clear and meaningful overall survival benefit, as well as a favorable toxicity profile compared with existing options. Dr Cooper added that a key outstanding question is whether tarlatamab will carry a different toxicity profile in the maintenance setting compared with the induction and maintenance setting, where higher disease burden may increase the risk of cytokine release syndrome (CRS).The conversation also addressed the investigational agent obrixtamig, another DLL3 x CD3 bispecific T-cell engager in early-phase development, and how clinicians should think about differentiating these agents as the field matures. Both physicians noted that cross-trial comparisons remain premature given differences in study populations and development stage, and expressed that DLL3 testing requirements for investigational agents are unlikely to carry over into a future approved label, consistent with tarlatamab's current FDA indication.On the question of DLL3 immunohistochemistry testing in routine practice, both physicians acknowledged a shifting perspective. While DLL3 is highly expressed in approximately 85% to 90% of SCLC tumors, real-world access to testing varies significantly, and logistical delays may outweigh the benefit of waiting for results before initiating treatment in a disease that can progress rapidly. Dr Choudhury noted that her viewpoint has evolved as emerging data suggest that certain molecular subtypes may derive little benefit from tarlatamab, making more informed patient selection increasingly important. Both agreed that an ideal solution would involve a rapid, commercially integrated assay, but cautioned that liquid biopsy approaches remain hypothesis-generating at this stage.Finally, Drs Cooper and Choudhury reflected on the growing body of real-world experience with tarlatamab since its FDA approval, highlighting ongoing efforts to better characterize who is at highest risk for serious toxicities such as high-grade CRS and immune effector cell–associated neurotoxicity syndrome. Dr Choudhury described a future vision of a risk stratification calculator that could guide decisions about which patients still warrant monitored inpatient administration even if the label is updated to allow outpatient use.

Pregnancy can bring major changes to digestion and bowel habits. But if you're already living with irritable bowel syndrome with constipation (IBS-C), bloating, abdominal discomfort, or chronic constipation, it can be difficult to know what's related to pregnancy—and what may be related to your digestive condition. In this episode of the Gastro Girl Health Podcast, Dr. Lin Chang, Professor of Medicine at the David Geffen School of Medicine at UCLA and a leading expert in disorders of gut-brain interaction and women's digestive health, explains what patients should know about IBS-C and constipation during pregnancy. You'll learn: • How pregnancy-related constipation differs from IBS-C • Why IBS symptoms may change during pregnancy • What may contribute to increased bloating and constipation • Diet and lifestyle strategies to discuss with your healthcare provider • What to know about the low-FODMAP diet during pregnancy • Treatment and medication considerations • Symptoms that shouldn't automatically be attributed to IBS or pregnancy If you're pregnant—or planning a pregnancy—and live with IBS-C or chronic constipation, this conversation can help you better understand your symptoms and prepare for conversations with your healthcare team. This patient education episode was produced by Gastro Girl in collaboration with the American College of Gastroenterology Patient Care Committee. #IBSC #Pregnancy #Constipation #IBS #Bloating #DigestiveHealth  

How do you explain everything that could go wrong with a root canal — without the patient walking out?Why does a signed consent form protect you far less than you think?What should you say in the exact moment after you tell a patient the fee?And which single word is quietly sabotaging every future conversation you have about maintenance?This is Part 2 of our communication masterclass with Dr Zak Kara, principal dentist at Smile Stories in Bournemouth, who coaches and mentors dentists on exactly these conversations. We tackle two questions sent in by the community: how to explain risks without discouraging patients from treatment, and how to present fees — including future maintenance and complications — clearly and confidently. Expect two live role-plays (a molar root canal and a lower wisdom tooth), a respectful disagreement about whether to call people patients or clients, and the fee-presentation sequence I wish I'd had years ago, when I hated every part of talking about money.Protrusive Dental Pearl: Could They Retell It at Home?Measure a consultation by one question: was I understood? Not conversion, not uptake — understanding. The ethical approach tends to deliver the conversion anyway.The practical test: when the patient gets home and someone asks “How was the dentist today?”, can they summarise in a few sentences exactly what the appointment was about and what they need to do next? If not, the explanation isn't finished — however thorough it felt from your side of the chair. That clarity is a skill, and it gets built deliberately.What You'll Take From This EpisodeSix moves for explaining risk — how to make every risk proportionate, personal and paired with your plan to reduce it.A root canal consent, live — plain-English wording, an honest success rate, and the analogy that makes recovery make sense.Common vs rare risks — when a risk deserves a sentence and when it deserves a diagram.The fee presentation sequence — seven steps from the reason to the objection, and why the pause matters most.Words to ban — why fees beat prices and costs, and what to say instead of “permanent.”Maintenance without the awkwardness — setting shared responsibility up front so “redo it for free” never comes up.Highlights of This Episode00:00     TEASER00:48     How to Explain Risks and Fees to Dental Patients04:10     The Biggest Lever in Dental Communication06:53     How to Attract the Right Patients to Your Chair14:29     What Makes a Super Associate?19:58     How to Explain Treatment Risks Without Scaring Patients26:22     Root Canal Consent: A Live Role-Play33:59     Using Analogies to Explain Occlusion and TMD Risk36:08     Wisdom Tooth Consent: Common vs Rare Risks41:07     Why Consent Is a Process, Not a Signature45:45     Midroll51:34     Patients or Clients? What to Call the People You Treat55:12     How to Present Dental Fees With Confidence59:08     A Simple Framework for Presenting Fees1:12:05   When to Discuss Treatment Alternatives1:14:45   Why You Should Never Say "Permanent Crown"1:20:15   A Communication Course for Dentists1:20:51   OUTROFrom the GuestDr Zak Kara is principal dentist at Smile Stories in Bournemouth, and coaches and mentors dentists and their teams in communication. His communication course, developed with Protrusive, teaches from real consultation videos — filmed with patients' permission — broken down play by play: what he said, why, and why he paused where he did.Pre-order the communication course here:

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.In this special episode of Mind Moments, released in recognition of Limb-Girdle Muscular Dystrophy (LGMD) Awareness Day on September 30, Katherine Mathews, MD, professor of pediatrics and neurology at the University of Iowa Carver College of Medicine, joins the podcast to discuss the evolving treatment landscape for LGMD and the potential significance of BBP-418, an investigational oral therapy for LGMD2I/R9.With an FDA decision expected by November 27, 2026, BBP-418 could become the first approved therapy for LGMD2I/R9 and potentially the first treatment approved for any form of LGMD. Mathews breaks down the therapy's FKRP-targeted mechanism, findings from the phase 3 FORTIFY study, and the challenges of conducting clinical trials across genetically diverse and slowly progressive forms of LGMD. She also discusses what a first approval could mean for the broader LGMD community, considerations for bringing patients back into specialty care, and research priorities that could accelerate development of future therapies.Looking for more Neuromuscular discussion? Check out the NeurologyLive® Neuromuscular clinical focus page.Episode Breakdown: 1:15 – BBP-418's mechanism and therapeutic rationale for FKRP-related LGMD2I/R9 4:00 – FORTIFY findings supporting BBP-418's potential effects on muscle and pulmonary function 7:50 – Why genetic heterogeneity and slow progression complicate LGMD clinical trials 10:10 – Neurology News Minute 12:45– What a first FDA-approved LGMD therapy could mean for patients and clinicians 15:40 – Research priorities for accelerating clinical trials and developing future LGMD therapies The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: CHMP Recommends EU Approval for Ocrelizumab in Pediatric Relapsing MS SKY-0515 Shows Sustained Benefit at 15 Months in Huntington Disease FDA Approves Tavapadon for the Treatment of Parkinson Disease Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.

In this episode of Living Well with MS -- where we explore topics relating to living a full and healthy life with multiple sclerosis -- we are pleased to welcome Brett Drummond and Karen Campbell. Brett is from MSTranslate and hosts the European Committee for Treatment and Research In Multiple Sclerosis (ECTRIMS) patient day and podcast. Karen is a nurse and MS researcher who lives with MS and attended the conference this year. Watch this episode on YouTube. Keep reading for the topics, timestamps, and our guest's bio. 00:00 Introduction to ECTRIMS 2025 and Speakers 02:02 Overview of ECTRIMS Conference Highlights 02:41 Brett's Insights on MS Research 09:07 Emerging Treatments and Therapies for MS 15:10 The Role of Viruses in MS 18:28 Lifestyle Modifications and Rehabilitation in MS 20:03 Biomarkers and Their Importance in MS 24:24 Engaging the MS Community in Research 28:24 Karen's Perspective as a Patient and Researcher 33:55 Q&A Session: Addressing Community Questions Watch the original presentation here Connect with Ciara on LinkedIn New to Overcoming MS? Learn why lifestyle matters in MS - begin your journey at our 'Get started' page Connect with others following Overcoming MS on the Live Well Hub Visit the Overcoming MS website Follow us on social media: Facebook Instagram YouTube Pinterest Don't miss out: Subscribe to this podcast and never miss an episode. Listen to our archive of Living Well with MS here. Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS. Support us: If you enjoy this podcast and want to help us continue creating future podcasts, please leave a donation here. Feel free to share your comments and suggestions for future guests and episode topics by emailing podcast@overcomingms.org. If you like Living Well with MS, please leave a 5-star review.

Anxiety, depression and chronic stress are usually approached through psychology and the brain – but what if some of the biological processes influencing our mental health begin much further down, in the gut? In this episode of the MindHealth360 Show, I sit down with Dr. Oscar Coetzee, clinician, researcher and educator working at the intersection of psychology and nutritional science, to explore the gut–brain connection, the microbiome and the nutritional foundations of mental health.  Dr. Coetzee explains how the bacteria living in our gut can influence inflammation, nutrient metabolism and the amino acids needed to make neurotransmitters and why he believes gut and nutritional health deserve greater consideration alongside psychiatry and psychotherapy. Together, we explore the role of anaerobic keystone bacteria, what can happen when beneficial microbial communities are depleted and how increased gut permeability and LPS-producing bacteria may contribute to systemic inflammation and neuroinflammation. We also look at factors that may disrupt this system, from chronic psychological stress (which can affect both nutritional requirements and our ability to digest and assimilate nutrients) and constant digital stimulation, to diet, alcohol, medications and environmental exposures. Dr. Coetzee's message is not simply to take more probiotics or supplements. Instead, he makes the case for a more personalised approach that takes into account the gut, nutrition, metabolism and individual biology alongside psychological and psychiatric care. In this way he brings together  psychiatry, therapy and what he calls psychonutrigenomics together as three complementary pillars of mental health care. In this episode, you'll learn: How gut health and mental health are interconnected and how the microbiome can influence inflammation, nutrient metabolism and neurotransmitter pathways. Why anaerobic keystone bacteria such as Akkermansia, Roseburia and Faecalibacterium prausnitzii are receiving increasing attention. How the loss of beneficial anaerobic bacteria may allow opportunistic, LPS-producing bacteria to proliferate and contribute to inflammation and neuroinflammation. How psychological, physiological and environmental stress can trigger the body's stress response and how chronic activation can deplete nutrients and impair digestion. How information overload and constant digital stimulation are underrecognised drivers of anxiety. How amino acids including tryptophan interact with blood sugar regulation, B vitamins and magnesium in pathways involved in neurotransmitter production. Why simply taking nutrients may not solve the problem if the gut cannot digest, absorb and assimilate them effectively. Why Dr. Coetzee believes mental healthcare should integrate psychiatry, therapy and psychonutrigenomics rather than considering them in isolation. How functional testing may help clinicians investigate the microbiome, nutrient status, metabolism and genetics as part of a more personalised assessment of mental health symptoms. Take the conversation further at IMMH 2026 At the Integrative Medicine for Mental Health (IMMH) Conference 2026, Dr. Oscar Coetzee will explore these ideas in greater clinical depth in his session, The Connection Between Functional Testing and Mental Health: A New Frontier of Prevention, Causal Investigation and Treatment, sponsored by Designs for Health. Dr. Coetzee will explore how functional stool testing, organic acids, metabolomics, hormonal and genomic testing can be used to investigate neurocognitive dysfunction and mental health, including the relationships between nutrient deficiencies, the microbiome, gut inflammation, amino acids and genetic factors involved in neurotransmitter pathways. His session makes the case for what he describes as the often-overlooked "third pillar" of mental health treatment – psychonutrigenomics – sitting alongside psychiatry and therapy/counselling. Join Dr. Coetzee and more than 50 leading clinicians and researchers at IMMH 2026, October 8–11 at the Town and Country Resort, San Diego – or online.

What happens after childhood cancer changes everything?In this special episode of Game Over : c*ncer, hosts Val Solomon and Dana Nichols of Cannonball Kids' cancer Foundation revisit some of the most powerful childhood cancer survivor and family stories shared throughout the podcast.This retrospective brings together unforgettable conversations about pediatric cancer diagnosis, childhood cancer treatment, survivorship, grief, mental health, scan anxiety, life after chemotherapy, finding a new normal, losing a child, and turning pain into purpose.For many childhood cancer survivors, finishing treatment is only the beginning of another journey. Survivors may face long-term side effects, questions about identity, survivor guilt, fear of recurrence, and the challenge of figuring out what “normal” looks like after cancer. Families also carry the emotional impact long after treatment ends, from the anxiety surrounding follow-up scans and bloodwork to the lasting trauma of watching a child fight for their life. As one family explains in this episode, you don't necessarily fully exhale when treatment ends. You'll also hear from parents and loved ones who turned devastating loss into advocacy, research funding, community support, and a commitment to keeping their children's names and legacies alive. Across 50 episodes, Game Over: c*ncer has created space for pediatric cancer researchers, survivors, families, donors, and advocates to tell the stories behind the fight for better treatments and better outcomes.This milestone episode celebrates those voices while reminding us why the work continues.Learn more about Cannonball Kids' cancer Foundation and how you can help advance childhood cancer research at cannonballkidscancer.org.Subscribe to Game Over: c*ncer for more conversations about pediatric cancer research, nonprofit leadership, philanthropy, childhood cancer advocacy, innovative cancer treatments, and the people working to create meaningful change.----------------------------------Learn more about Cannonball Kids' cancer Foundation and support pediatric cancer research: cannonballkidscancer.org----------------------------------Connect with Dana: https://www.linkedin.com/in/danaknichols/Connect with Val: https://www.linkedin.com/in/valerie-solomon/Join us for the LINK conference: https://cannonballkidscancer.org/link

Malaria affects an estimated 300-600 million people a year around the world with around 2000 cases of malaria brought back to the US each year. This session will focus on the current treatment and symptom control of malaria around the world and in the US. Current research on prevention and vaccine development will also be discussed.

Hour 2 of Jake & Ben on September 30, 2026 Top 3 Stories of the Day: Jusuf Nurkic Blown Away by Darryn Peterson's maturity, TCU had a players only meeting ahead of BYU matchup, Dan Lanning is done talking about Dante Moore's Injury.  Phil Mickelson has checked into treatment WNBA Playoffs are heating up

Researchers have been investigating the impact of using RAT tests to detect influenza, Covid-19 and RSV at GP clinics, to see if they improve treatment and help curb the spread of winter illnesses. Professor Maria Stubbe co-authored the study, she's from Otago University's Department of Primary Health Care and spoke to Ingrid Hipkiss.

NB. Moderate post processing was applied to this recording due to the higher than usual ambient noise in the conference hall.Differences in Bone Mineral Density Response to Bisphosphonate Treatment by Stage in Puberty in Children with Cerebral Palsy

Injuries can interrupt the sporting and cultural careers of First Nations athletes and dancers, particularly when access to specialist treatment is limited. A Queensland-based initiative is working with health and community organisations to help address some of those barriers.

Dental implants replace missing teeth by fusing a titanium post with the jawbone, then supporting a crown, bridge, or denture, provided patients have healthy gums, adequate bone, and consistent hygiene. Learn more at https://www.smilesunlimited.com/ Smiles Unlimited Dentistry City: Rockville Centre Address: 214 Maple Avenue Website: https://www.smilesunlimited.com/ Phone: +1 516 594 2111

Os avanços da ciência transformaram o tratamento dos cânceres hematológicos,ampliando as possibilidades terapêuticas e contribuindo para o aumento da sobrevida depacientes com doenças como o mieloma múltiplo. Ainda assim, diagnóstico, recaídas,acesso ao tratamento e qualidade de vida permanecem entre os desafios da jornada.¹ ⁴Neste episódio do podcast Notícia no Seu Tempo, a jornalista Carla Fiorio conversacom os hematologistas Walter Moisés Tobias Braga, médico responsável peloAmbulatório de Mieloma Múltiplo da Universidade Federal de São Paulo (SP 114081);e Deise Almeida (SP 149683), médica e diretora médica de Oncologia e Hematologia daGSK Brasil, sobre mieloma múltiplo e mielofibrose, duas doenças que fazem parte douniverso da onco-hematologia. A conversa aborda os avanços da medicina, asnecessidades que ainda não foram atendidas e as perspectivas para o futuro do cuidado. Este episódio é uma produção do Estadão Blue Studio com patrocínio da GSK.Referências para o texto de apresentação: 1. Nooka AK, Kastritis E, Dimopoulos MA. Treatment options for relapsed andrefractory multiple myeloma. Blood. 2015;125(20).2. Hungria V, et al. Emerging Real-World Treatment Patterns and ClinicalOutcomes of Multiple Myeloma in Argentina and Brazil: Insights from theTOTEMM Study in the Private Healthcare Sector. Curr Oncol. 2026;33:16.3. Eisfeld C, et al. Time trends in survival and causes of death in multiple myeloma.BMC Cancer. 2023.4. IQVIA Institute. Global Oncology Trends 2025.Referências para o episódio: 1. Nooka AK, Kastritis E, Dimopoulos MA. Treatment options for relapsed andrefractory multiple myeloma. Blood. 2015;125(20). REF-480872. CA: A Cancer Journal for Clinicians. Vol. 70. 2020. p. 7–30. REF-724913. Kazandjian D. Multiple myeloma epidemiology and survival: A uniquemalignancy. Semin Oncol. 2016;43(6):676–81. REF-2960414. Hungria, V.; Maiolino, A.; Pessoa de Magalhães, R.J., Filho; Pitombeira deLacerda, M.; Remaggi, G.; Scibona, P.; Seehaus, C.; Brulc, E.; Savoy, N.; Fantl,D.; et al. Emerging Real-World Treatment Patterns and Clinical Outcomes ofMultiple Myeloma in Argentina and Brazil: Insights from the TOTEMM Studyin the Private Healthcare Sector. Curr. Oncol. 2026, 33, 16.https://doi.org/10.3390/curroncol33010016. REF-316596 5. Khoury JD, Solary E, Abla O, Akkari Y, Alaggio R, Apperley JF, et al. The 5thedition of the World Health Organization Classification of HaematolymphoidTumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia.2022;36:1703–1719. doi:10.1038/s41375-022-01613-1 REF-2279396. Eisfeld C. et al. Time trends in survival and causes of death in multiplemyeloma. BMC Cancer. 2023. REF-3161117. IQVIA Institute. Global Oncology Trends 2025. REF-3191028. Observatório de Oncologia. Panorama do Mieloma Múltiplo no SUS [acesso emjul2026]. https://observatoriodeoncologia.com.br/estudos/cancer-de-sangue/mieloma-multiplo/2024/panorama-do-mieloma-multiplo/ REF-2963359. International Myeloma Foundation Latin America. Mieloma múltiplo: segundotipo de câncer sanguíneo mais frequente no mundo [Internet]. São Paulo: IMFLA; 2022 jun 07 [acesso em jul2026]. https://myeloma.org.br/mieloma-multiplo-segundo-tipo-de-cancer-sanguineo-mais-frequente-no-mundo/. REF-26981910. Kumar SK et al. Multiple Myeloma. Nature Reviews Disease Primers. 2017.REF-1817111. Yu B et al. BCMA-targeted immunotherapy for multiple myeloma. Journal ofHematology & Oncology. 2020. REF-10177912. Wang R et al. Antibody–Drug Conjugates (ADCs): current and futurebiopharmaceuticals. Journal of Hematology & Oncology. 2025. REF-28457113. Scherber RM, Mesa RA. Management of challenging myelofibrosis after JAKinhibitor failure. Blood Reviews. 2020. REF-16832614. Nicolosi M et al. Sex and degree of severity influence the prognostic impact ofanemia in primary myelofibrosis. Leukemia. 2018. REF-30724015. Mughal TI et al. Myelofibrosis-associated complications. International Journalof General Medicine. 2014. REF-16520816. Naymagon L, Mascarenhas J. Myelofibrosis-Related Anemia: Current andEmerging Therapeutic Strategies. Hemasphere. 2017. REF-16521017. OJJAARA® (momelotinibe). Bula do produto; Consulta Pública ANS sobreincorporação para mielofibrose. REF-32111518. Hungria, V; et al. Belantamab mafodotin plus bortezomib and dexamethasone inpatients with relapsed or refractory multiple myeloma (DREAMM-7): updatedoverall survival analysis from a global, randomised, open-label, phase 3 trial.Lancet Oncol 2025 Published Online July 15, 2025 https://doi.org/10.1016/S1470-2045(25)00330-4. REF-24715319. Mukhopadhyay, P., Abdullah, H.A., Opalinska, J.B. et al. The clinical journey ofbelantamab mafodotin in relapsed or refractory multiple myeloma: lessons indrug development. Blood Cancer J. 15, 15 (2025).https://doi.org/10.1038/s41408-025-01212-0. REF-24715320. ABBAS, A. K.; LICHTMAN, A. H.; PILLAI, S. Cellular and molecularimmunology. 10. ed. Philadelphia: Elsevier, 2022. REF-30571621. BIRGEGARD, G. et al. Inflammatory functional iron deficiency common inmyelofibrosis, contributes to anaemia and impairs quality of life. EuropeanJournal of Haematology, 2019; 102:235–240. REF-32205922. Al Noumani I; Expert Opinion on Pharmacotherapy; 2026; 27(8), 657–668.REF-331446 Material dirigido ao público geral. Por favor, consulte o seu médico. NP-BR-MMU-WCNT-260004/SETEMBRO DE 2026See omnystudio.com/listener for privacy information.

Check out Sam's new special, "Incorrect," out today on Netflix! On this episode of First Date, Lauren Compton sits down with comedian and We Might Be Drunk co-host Sam Morril for his second date and a hilarious conversation about whether he'd make a good gay guy, influencers dying from BBLs, meeting his new girlfriend on Hinge over Terrence Malick movies, bombing a 60th birthday gig in Corfu while she laughed extra loud at the bar, why how someone fights matters more than anything, Lauren's days-long silent treatment, the rat living in his Greenwich Village apartment until three guys showed up with hockey sticks, turning 40 without kids, accidentally telling her son "I love you" before telling her, Lauren's husband's deodorant-before-bed problem, the manscaping debate, Lauren's chocolate mushroom scavenger hunt at a New York barber shop, and his new Netflix special Sam Morril: Incorrect. Follow Sam:Instagram: https://instagram.com/sammorrilTour dates: https://sammorril.com Don't forget to like, comment, and subscribe! First Date Ep. 170 https://www.tiktok.com/@iamlaurencomptonhttps://www.instagram.com/firstdateshowhttps://store.ymhstudios.com Chapters 00:00:00 - Intro00:02:44 - Dying From A BBL00:08:14 - How He Met His Girlfriend On Hinge00:13:46 - How Does Your Partner Fight?00:18:19 - Lauren's Silent Treatment00:25:23 - Is Sam Ready For Kids?00:32:47 - He Told Her Son I Love You First00:39:38 - Lauren's Husband's Deodorant Problem00:44:45 - Why Dinner On A First Date Is Risky00:54:43 - Manscaping Is Getting Out Of Control01:02:03 - Chocolate Mushrooms From A Barber Shop01:07:36 - Where To Find Sam Learn more about your ad choices. Visit megaphone.fm/adchoices

Following the death of 27-year-old Presley Gerber inside a Santa Monica sober living facility, board-certified psychiatrist and former FDA Medical Officer Dr. Josef Witt-Doerring of TaperClinic joins Dr. Drew to examine the fatal risks of overmedicating with psychiatric drugs. Dr. Witt-Doerring analyzes Gerber's disclosures of fluctuating benzodiazepine doses without daily medical oversight, the physiological hazards of unmonitored psychiatric medication tapers, and the emerging panic over gas station kratom. Dr. Mary Talley Bowden breaks down the brewing revolt within the MAHA movement, as health freedom leaders issue an ultimatum to Pres. Donald Trump and RFK Jr. demanding the removal of the mRNA vaccine platform. California Department of Public Health whistleblower Ronald Owens Jr., author of “Muzzled Truth,” exposes how state officials suppressed early COVID-19 treatment warnings from 40 million residents and examines former HHS Secretary Xavier Becerra's controversial public remarks on vaccine mortality. Dr. Mary Talley Bowden completed her residency at Stanford University and is board-certified in both Otolaryngology and Sleep Medicine. She is the author of “Dangerous Misinformation: The Virus, the Treatments, and the Lies” available at https://amzn.to/4rF16CW. Follow at https://breathemd.org Ronald F. Owens, Jr. worked at the California Department of Public Health (CDPH) as an Information Officer 2 during COVID, where he says he learned that then-HHS Secretary Xavier Becerra said COVID-19 vaccines were “killing people.” He is the author of “Muzzled Truth: How The California Dept. of Public Health Rejected COVID-19 Treatment and Vaccine Health Risks Warnings.” Find more at https://muzzledtruth.com Dr. Josef Witt-Doerring is a board-certified psychiatrist and former FDA Medical Officer who is Medical Director of TaperClinic, one of the only practices focused exclusively on helping patients safely de-prescribe from psychiatric medications. He previously worked at Janssen Pharmaceuticals and the FDA's Division of Psychiatry, and hosts the podcast Side Effects with Dr. Josef. Follow at https://taperclinic.com 「 SUPPORT OUR SPONSORS 」 • FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. Get 15% off a 90-day Starter Kit Subscription at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/fatty15⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/paleovalley⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twc.health/drew⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 「 ABOUT THE SHOW 」 This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. Executive Producers • Kaleb Nation - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://kalebnation.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • Susan Pinsky - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://x.com/firstladyoflove⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Content Producer • Emily Barsh - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://x.com/emilytvproducer⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Dentistry is most important when a patient is in the practice. As soon as they leave, there are a million other parts of their life competing for priority. Tiff and Dana discuss how to talk about dental care with your patients so it doesn't get lost under the heap of everything else.  Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Tiffanie (00:01) Hello, Dental A Team listeners. We are back again to podcast with you. To yeah, I loved that Dana. Dana's got some excitement in her veins today. I think it's nice out. Honestly, it's nice out. I had I had to close this window the last podcast. That's what you saw me do. and then I have another window open and I'm in Phoenix. We don't open our windows often, and I've only got like probably thirty minutes left of this window being open.   DAT-Dana (00:27) Right.   Tiffanie (00:29) but it's energizing. I feel like   I just need the fresh air and and it's just beautiful out. So I can imagine Dana where you are if it's this beautiful here and then Brodie's in he's forty five minutes south. So he's in Tempe and he sent a picture and it was more beautiful and I'm like, gosh, go another hour and a half past that towards Dana. It's gotta be just gorgeous down there right now.   DAT-Dana (00:51) It is. I feel like though Phoenix can just be gorgeous and be gorgeous. Further south, and there's an as you know, Tiff, because you kind of grew up in this area.   Tiffanie (00:58) Mm-hmm.   DAT-Dana (01:00) if it is sunny and beautiful, then typically it's paired with wind, right? So I feel like my windows are never   Tiffanie (01:04) This is   DAT-Dana (01:06) open because even when in the temperature is beautiful enough to have them open, the wind is going and I don't want all   Tiffanie (01:12) yeah.   DAT-Dana (01:13) the desert dust you know, sitting in my living room. So   Tiffanie (01:17) I love   what you just said. I love it. So Brodie texted me a picture and I said, Gosh, that's prettier than here. I said, This is this weather is the only thing I miss about living in Sierra Vista. And what you just said, people say, Why did you move? Like the weather was the weather is better in Sierra Vista. It literally is. The temperatures   DAT-Dana (01:33) Yeah. Yes.   Tiffanie (01:35) are better. You get a better winter, you get better seasonality. Like it is just better. And people say, Well, why did you move? And I say, Because of the wind. I legitimately   90% moved because I couldn't you just can't be in it. It whips your hair, like it hurts my hair hitting my face as a child. I remember the pain of that and the tangles and brushing my hair out at the end of the day because I had to walk home from the bus. Like legitimately, Dana, the wind. I can't handle Southern Arizona winds. Yeah. Yeah.   DAT-Dana (02:12) Yep, yep, you   hit it. You hit it right on.   Tiffanie (02:15) Spent   my I spent my whole childhood there. I lived in Sierra Vista till I was what, twenty? I think I moved up here when I was twenty. I can't I can't do it. So yeah, I love that you said that. And everyone listening, you just got a nice little taste of the Arizona weather history there. It's never changed. It's still windy. So if you want wind, go down south. If you want really cool honestly, it's it's beautiful down there. So if you haven't visited Southern Arizona, meaning   Like Phoenix is cool too. Obviously Sedona. But if you haven't been south of Phoenix, Tucson has some really cool stuff. But then you get into like Saurita, where you are, and Senoida, there's like wine country, there's Tombstone, Isbe. Like there's a lot to do down there. And I discredit it and disvalue it 'cause I grew up in it. but it is really beautiful. And   on to dental. Yeah. Yeah.   DAT-Dana (03:08) Yeah, but my windows just stay closed. So I can look at   the beauty. I just Yep. Right. Yeah.   Tiffanie (03:13) My windows stay closed because it's too hot. So in Arizona we just don't open windows. Okay.   It's just stifling in our house all the time. It's fine. So on that note, dental. Dana, we get fed podcast topics. and then you and I, I love that you and I are just like, nah, we're not gonna do that one today. I don't I didn't like the other one. So today we we already talked about kind of   Prepping for changes and and systems that work in the midst of change. That was a a podcast we just recorded. So if you haven't heard that one, go back, find it after this one. You don't need it beforehand. But they kinda go I think they kinda go hand in hand because one change that we oftentimes don't prep for because we don't know it's coming, is accepted treatment still like falling off of a schedule. And I think that happens a lot. I have a lot of practices that are like,   It's full until the day before or two days before or gosh my hygiene schedule's full six months. I can't get ab get anybody in. But then the week of it's falling apart. So we're not here to talk about hygiene. There's plenty of those podcasts. Go search it. But we are going to talk about why accepted treatment still falls off of the schedule. And Dana, right before we started this podcast, you said something and I was like, Yep, another drop mic drop moment from Dana. She'll always give them to us.   I would love for you to repeat what you said right before we got on this podcast because I think that it's true and I think that's where we start.   DAT-Dana (04:38) Yeah. I I am known for my brutal honesty tips. So what I   Tiffanie (04:42) Ha ha   DAT-Dana (04:44) said before we got on is like treatment that falls up after the fact is typically for the same reasons that we hear patients give us that they don't schedule to begin with.   Tiffanie (04:53) Yes, yes. And I got excited about that because I believe that oftentimes we work so hard in like the sales side of dentistry that or not that we work so hard on the sales side of dentistry to get a yes that they're just like, okay, yes, fine, I'll schedule it. Like, well, what about this hurdle? What about this hurdle? And yes, I wanna work objections and I wanna I wanna get over hurdles.   But I think Dana, in what you said, you said the same, they they fall off the schedule for the same reason that people don't schedule. And I wonder if not every time, but if sometimes those patients who are falling off weren't actually a yes, they were a let me out of this office right now, right? Because I I've taken a lot of   Communication courses, a lot of relationship style courses. I've done a lot of emotional intelligence and just like communication stuff. And something that is tried and true in every aspect of anything that I've done extracurricularly is the relationship comes first. And   Knowing   the person, knowing the why, knowing the reason, and speaking to that and overcoming, helping someone overcome an issue or a problem and seeing better on the other side is the most important factor. And oftentimes in our objections and our conversations of our hurdles, I wonder if that aspect of the communication gets missed because it's more about checking check boxes.   than it is about investing in the person. And maybe I'm being wild, but when you said that, that's where my brain went and I was like, gosh, it's the relationships. Dana, what are you what's your perspective? What are you seeing on your side?   DAT-Dana (06:47) Yeah, I 100% agree with you. And I feel like when because we hear it all the time when we go into park, well, it falls out because life happens, right? Well, you're right.   Tiffanie (06:55) Yeah.   DAT-Dana (06:56) Life is going to happen. and typically we will also kind of say that like dentistry is most important when the patient is in the office. So then when life happens, right, it becomes less and less important. And I think that you're absolutely right. And to me, it tells me that like   I actually didn't really listen and get to the bottom of what actually was holding the patient back or what their no actually was. And so yes, I got a yes, which great, but I didn't actually get a yes that meant I'm fully committed, I fully understand, I'm fully ready to go. and so then that's kind of why we see it fall off. And I feel like   The biggest thing is life is going to happen for your patients when they leave the practice. So if they don't know where, when, how to prioritize the dentistry that you are talking about with them in life happening, then we didn't get it right.   Right, because life is gonna happen and I need to know that if my dog chews 35 Legos, like she's been doing every week and has to have an emergency vet visit, right? That   Tiffanie (08:00) Yep.   DAT-Dana (08:01) like I know where my dentistry needs to fall in the spectrum of the things of my dog eating 35 Legos, right? Do I need   Tiffanie (08:08) Yeah.   DAT-Dana (08:08) that crown or does the dog need to so life happens, absolutely.   Tiffanie (08:12) Yeah.   DAT-Dana (08:13) But I think our biggest tool is   treatment coordinators or people that talk about treatment or even the dentists, right? Tre doing the treatment planning in the back is they need to know where to prioritize the dental work that needs done with the life things that are going to happen. And I think when we just get that artificial yes, that didn't happen.   Because they   Tiffanie (08:34) Yeah.   DAT-Dana (08:34) left and something came up in their life, or they left and were just like, I do it all the time. I go to Target, I put all these things in my cart, and as I'm walking up to the thing, I'm like, I don't really need that. Or   Tiffanie (08:44) Mm-hmm. Mm-hmm.   DAT-Dana (08:46) you know what? I don't, I don't really need my lips moisturized. That chapstick can go. Right. And so   Tiffanie (08:50) Yep. Yep.   DAT-Dana (08:51) those things start to happen. And if you think about doing that and you think about, okay, well, how   What would make someone take the dentistry out of their cart, right, and stick it back on the shelf? It's probably because we didn't get to the bottom of what is important to them. We didn't build that relationship with them. We didn't understand who they were and how they make their decisions. And we didn't get through to them where to prioritize this decision and all the other decisions they're going to make the second they leave the office.   Tiffanie (09:21) Absolutely agree. Absolutely agree. And that's not something that I think people innately know how to do, especially in the workplace, because in my opinion, we think of work as transactional, right? You go it work, the word work is transactional, right? You do something for something. you work out at the gym to get stronger, right? To get healthier. You do something for something. So it's always transactional.   And transactional doesn't always translate to the emotional side of it. And we miss that mark. And in in dentistry, dentistry is weird, right? Because d medical, like med they don't have to think about this very often, right? One, they've got a million people walking through the door all day. They don't it's a rare occasion that someone's really concerned if you're coming back or not. So if you have a provider like that, please by all means share it on all the platforms because we all need one.   In dentistry, one, it's that's not how it happens. We don't have a million people coming through the doors. And two, we actually literally are more invested in the people that are coming to our practices. Dentists in general sought out dentistry for a different reason than many medical professionals at least are practicing now, right? I think that they probably had a good reason to get into it, but throughout the years something shifted and changed for for many people. My point of that.   is that we discredit that emotional side of it and we become more transactional where it's like, okay, the next step in the in the flow is schedule. And so we're like, okay, great. I reviewed the estimate. You've got that estimate. No questions. Great. Let's schedule. Right. And then they're like, I'll call you. And we're like, well, what difference is let me get you on the schedule now. So that I would hate for you to forget. Let me put you on the schedule now. We'll block out the time. And then if if there's you get to work and there's a work   Event in the way, give me a call. Right? I've done that a million times. Like, no, no. Now I'm supposed to say, Well, let's get it on the schedule, because now it's on the schedule, it's accepted. Right? But then that patient is like laxadaisy about the appointment or what have you. Because I didn't I didn't ask what's holding you back. Like, great, tell me more about this. Tell me when I would sit patients down for a treatment plan, I've I've done this for a long time. And in the same practice I had   the   awesome opportunity of testing out a million things over the almost 13 years I was at this practice and I've watched myself evolve. I can look back now and see like how I evolved from the transactional to the they sit down in front of me and I'm like, hey, they said you need a crown. Wha how what do you think about that? And sometimes patients were like they would just cry. They're like, I don't even I don't have anything like this. Or sometimes patients are like, I knew it was coming or can't they just pull it?   Like now I'm in a conversation and now I can learn more about the patient, their thought process, their priorities, right? Like can't you just pull it? Well, tell me why that's where you jump. From a crown to a pull, for me, that's a massive, that's a massive jump. Let me tell you why. And then you tell me why you took that leap. What's the priority there for you so that I can understand more? But instead we're so transactional, we're like, no, that would be wild. You need a crown.   And it's gonna be this much. And we stick to that transactional checklist instead of being like, Well, let me be curious, like what makes you wanna just pull out the tooth? Because to me, in dentistry, you blew my mind with that statement. So tell me why you want to pull that tooth out. But we don't always think to ask those questions. So Dana, like this is all very Kiera would be like, Yes, Tiff, this is great, but like what's the track like what's the action item, right? So like   This is all great. How do we train? And I know you and I both work on this with practices, but how do we train a treatment coordinator or a doctor, right? A dentist diagnosing can do these things too. So what   DAT-Dana (13:30) Yeah.   Tiffanie (13:30) are some like tips that you give practices to say, hey, get more relational and less transactional without saying those words?   DAT-Dana (13:38) Yeah. I   I think one, it is just just like you said, it's kind of shifting your mindset. I always teach teams at the end of the day, we want the yes, right? But we want a yes that is good for both of you, right? Like you as a treatment coordinator and them as the patient. And just getting a yes, like you said, is super transactional. So to me, how I train teams is we have to just ask more questions. We have to ask what's holding them back. We have to ask.   what would a budget be that they're comfortable with? We have to ask like if they feel like third party financing is an option for them. We have to ask if they even want to save the tooth. We have   Tiffanie (14:14) Yeah.   DAT-Dana (14:14) to just ask more questions. And I feel like   It's again, I like gonna highlight the podcast we did before. Please go find it. It was a good one, but like it comes down to communication and it comes down to just asking more questions because every question that you ask is going to break down a barrier in some way. And it might present a new one that we have to work through, but it's getting treatment coordinators to understand that your job is to partner with the patient and figure out a way. There is   always away. And I like I say this all the time. There's no financial barrier that you like really can't truly overcome. You can break down treatment, you can break down payments, you can pay ahead of time and then add third party. You can like there are you have to get super creative sometimes, absolutely. But you have to really feel in your bones that it is so important for this patient to have done what is needed to be done and you have to be willing to ask whatever question it takes.   to get to the point where you can both feel really good about a yes. Not just you, because you got the yes. You both have to feel really good about the yes.   Tiffanie (15:23) I totally agree. Yeah, that was beautiful. And then get some pre-collect.   DAT-Dana (15:28) Yes.   Tiffanie (15:29) I the money mindset is far overlooked. there's a statement I wanted to remember to say. One of the things that I learned in all of the training that I've done is to be more interested than interesting. And I think about that all the time because human nature is to talk about ourselves, right? Or to be right or to have the the   most information and in dentistry, especially my treatment coordinators, my office managers, my billing reps. Like we I think sometimes feel like we have something to prove, right? That we're we do know what we're talking about because there isn't a formal you don't get to go to school to be a treatment coordinator and you come out with a certificate or a degree in treatment planning. Like you just don't we learn it on the job. We learn it by going to CE. We learn it because we hired a consultant, the Dental A Team and they were wonderful. Like   We learn these things through doing it. And so I think sometimes we wanna make sure that people know what we know what we're doing. So we can get a little transactional in it and a little dry. So making sure that we're being more interested, meaning to Dana's point, like asking more questions. Be be in the why, be in the why is it that way? What do you feel about that? Tell me more, right? So the one aspect. And then the the   like hurdle of the collecting in advance or something you've already paid for, right? Everybody, it's all over Instagram. You guys just look up like girl math, right? But this is one majority of your patients are probably female. I'm just gonna point that out there. Okay. So girl math works. Two, I don't think it's just women who think this way 99.9% of the time, right? Money out, money spent is already gone. You're likely not going to have someone call you and it it does happen. I'm not gonna say it won't.   It does happen, especially for large sums, but it is going to be very rare that someone calls and says, Hey, my dog ate 35 Legos yesterday and I need that $600 that I put towards that crown back so I can take him to the vet. They're gonna find another way to pay for the vet bill because they've already paid the $600 or whatever towards the treatment that they're getting done at your practice. So whether they're paying full in advance, they're paying partial, having some skin in the game.   And   having committed financially locks it in place. And it is a psychological proven skill that works every single time. Money is already gone. We've already accounted for that money to be gone. We've already formulated a plan to get it back. And we're we've moved forward. So Dana, do you I do you still this is a real question? Do you still find that you   Have pushback from teams to collect in advance. I feel like for me, it's like less and less over time. It's 2026 now, and the time of recording this, I can tell you five years ago it was much different than it is today. What are you seeing? you see more new clients than I do. I don't, I don't   DAT-Dana (18:38) Do   Tiffanie (18:38) take on new clients, so you're gonna have a better pool to choose from. Are you still seeing pushback from teams when it comes to pre collecting?   DAT-Dana (18:48) Feel like I do still see some because it's an uncomfortable space. It's a new space. And I think anytime we're putting people in a new space, you do get a little bit of resistance, but it is nowhere near what I used to get because honestly and truly Tiff, teams are exhausted in trying to   Tiffanie (19:03) Yeah.   DAT-Dana (19:03) build and rebuild and refill and backfill and replace what they've already replaced in their schedule. And and I think that.   For so long, like yes, cancellation policies are great. Yes, all those pieces we wanna have them in place, but I think   Pre-collecting, I think, works wonders in that area. And I think that team members are willing to do things or try things like just to keep their schedule solid. So   I agree with you. I think that more and more team members are open to it. More and more team members also just understand, like I think sometimes just put your patient hat on and yeah, I'm probably not gonna miss an appointment that I've already paid for. And so I do feel like   A lot of my calls are around like just schedule changes and then the process of that. And then, you know, we're trying to chase down patients because they're working the same hours we're working and and all of that. And I think teams are exhausted from trying to fill and backfill their schedule. And so I do think that like pre-collecting in those pieces, because again, it's like a yes that you can be super confident is a yes.   Like I   Tiffanie (20:17) Yeah.   DAT-Dana (20:18) said before, I yes, it feels good for both of you. I think when it's yes and there's a financial commitment that feels really good for me because I know that patient is invested, is going to come. And that's probably not a spot unless there's a super rare thing that pops up that I'm gonna have to then do that extra behind the scenes work to fill. And so I   Tiffanie (20:39) Yeah.   DAT-Dana (20:40) agree with you. I think teams are a little bit more open to it. I think teams are a little bit   more willing to kind of see the benefits of it because honestly and truly schedule changes I think are still just a really big highlight in a practice. And anything that's going to lighten that load, I think is massive for teams.   Tiffanie (21:02) I   completely agree. Thank you. I hope that the dentists who are listening today heard that. The office managers who are listening. Because I I think, Dana, from what I've seen, I agree with you. I think teams are exhausted and they're like, I'll do it, I'll try it. Right. And I think we have to we're so used to paying for things these days before we get it. It used to be like, Well, I can't get like I don't get my stuff from Target. Like I walk out and I pay for it at the same time. But now   It's an Amazon Prime culture. We're paying for things before it ever ships to our door. And I'm gonna tell you right now, there are times that that thing never even comes. Right? It never gets here. And I'm like, it's lost in someone's trunk and they're sending me a new one. massage therapists, right? I booked a massage for a surprise massage for Aaron a couple months ago. I had to pay online, I had to pay on the app to before I could schedule the appointment for him. So I'm like, well, he's he better freaking go because I already paid for it.   concert tickets, there's nothing there's not a lot right now that we pay for that we're not paying before we get the thing. And we're paying pretty far in advance for something. So it's that culture, that mindset has shifted. But I think that business owners, it's it's personal. Right? They're paying for your treatment, for your business, for you to provide them with something. So it's more personal. And I say this because to   To everything that Dana said, I want you to take that to heart because I think it's more often a dentist and a business owner that says, my team's not going to like that, than the team saying no, we won't do that. And so I want you to give them the chance, the shot, the opportunity to make their lives easier and get the actual yes. Because in my opinion, case acceptance is scheduled and paid for. Treatment that is scheduled and paid for.   Is accepted, right? And I don't hold that, I don't, that's not my like standard bar for everyone. You guys get to decide what that looks like, but to Dana's point, scheduled and paid for is less likely to fall off the schedule. So if that's where you can set your bar, you're gonna have a more full schedule. So I love that, Dana. So I would say one, I loved your ask more questions, so B   Be invested in the person, be interested in who they are and why they're making decisions the way that they do. And I think Dana, something you said was how are they making the decisions? Like how, what is their priority in the decision making? If you can get to that point in just asking more questions and being interested in them, you're gonna get your yes. And then I would say if you don't do some sort of prepayments, if your schedule is falling apart, even if it's not, I think it's smart. But if you're someone who's here because that title said   accept a treatment is still falling off your schedule, put in those pre-collects. At least collect a portion, I would say 50% to 60% down holds the appointment. Dana, thank you so much. I knew this one would go I knew it would go well. We didn't super prep for it. And I feel like the ones that we don't super prep for are the ones where our minds really start getting on a a good track. So Dana, thank you for your time today. Thank you for your nuggets as always. And   On behalf of everyone, Dana, thank you for your brutal honesty. Always a pleasure. Thank you. It's   DAT-Dana (24:25) Anytime   Tiffanie (24:27) always accepted. I love brutal honesty. and with that, that is a wrap for today's podcast. You guys go re-listen. There were some gems in here. Like Dana, thank you so much. You you dropped some massive gems, and business owners, try it, just try it out, see if it works, see how it works, see how you can manipulate it to work best for you guys. If you guys need help with it, Hello@TheDentalATeam.com.   Also TheDentalATeam.com, you can sign up for a live like video call session with our team, and they'll help you figure out the gaps and figure out a way to fill those gaps. And so Hello@TheDentalATeam.com and TheDentalATeam.com as always. Thank you for listening. Drop us a five-star review below. We love to hear from you. And we'll catch you next time.  

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Host: Darryl S. Chutka, M.D.  Guest: Erick Bothun, M.D.  Normally, our eyes work together, providing us with one single image and providing accurate depth perception. However, when there's misalignment of the eyes and they don't point in the same direction, that's known as strabismus. It's much more than a cosmetic issue; a variety of complications can develop if strabismus isn't treated. Primary care clinicians are usually the first healthcare contact of those with strabismus, and it becomes important for us to recognize it and arrange proper referral for management. Does strabismus only occur in children? How does it differ from amblyopia? What is the treatment and how effective is it? I'll get answers to these questions and more as we discuss “Strabismus: Symptoms, Causes and Treatment” with my guest Dr. Erick Bothun, a pediatric ophthalmologist at the Mayo Clinic. 

When should conversations about puberty and mental health start, and what should your child know before leaving pediatric care?In this episode of our What Good Care Looks Like for Kids with Sickle Cell series, pediatric hematologist Dr. Jacob talks about growing up with sickle cell disease, from delayed puberty and early sexual and reproductive health conversations, to how mental health is screened in kids and teens, to the key things every young adult should know before transitioning to adult care (genotype, baseline hemoglobin and medications). She also shares her advice for parents raising a child with sickle cell, and a message for the young people living with it.Dr. Jacob is the Director of the Pediatric Sickle Cell Program at Riley Pediatric Cancer and Blood Disorders and Co-Director of the Lifespan Sickle Cell Program at Indiana University.This episode is part of Sickle Cell 101's Care and Treatment 101 Educational Initiative, a community resource dedicated to making care information accessible and actionable for the sickle cell community.Thank you to our Care and Treatment 101 sponsors: Agios, Beam Therapeutics, and Pfizer.

Currently, there are three treatments currently available for the treatment of pulmonary hypertension, which all work to slow the rate of loss of lung function. However, the treatment landscape is likely to evolve with the positive TETON trials demonstrating that inhaled treprostinil has independent antifibrotic properties. Expert Steven Nathan, MD, Inova, looks ahead to the future of disease-modifying therapies and what these advances mean for patients and pulmonologists, with host Ugo Ezema, MD, Tulane. 

Clement Manyathela speaks to Prof Helen Rees, Executive Director of Wits RHI and co-chair of South Africa’s Mpox NDOH Incident Management who shares on what MPOX is, its symptoms and how to treat it. The Clement Manyathela Show is broadcast on 702, a Johannesburg based talk radio station, weekdays from 09:00 to 12:00 (SA Time). Clement Manyathela starts his show each weekday on 702 at 9 am taking your calls and voice notes on his Open Line. In the second hour of his show, he unpacks, explains, and makes sense of the news of the day. Clement has several features in his third hour from 11 am that provide you with information to help and guide you through your daily life. As your morning friend, he tackles the serious as well as the light-hearted, on your behalf. Thank you for listening to a podcast from The Clement Manyathela Show. Listen live on Primedia+ weekdays from 09:00 and 12:00 (SA Time) to The Clement Manyathela Show broadcast on 702 https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/XijPLtJ or find all the catch-up podcasts here https://buff.ly/p0gWuPE Subscribe to the 702 Daily and Weekly Newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook https://www.facebook.com/TalkRadio702 702 on TikTok https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702 See omnystudio.com/listener for privacy information.

A new Kiwi charity launched this morning is taking on one of the biggest challenges in cancer care: how to make new treatments more affordable and accessible to the people who need them. 

Late Season Control Options for Sericea Being Prepared for Wheat Pests Will Kansas be a Top 10 Milk Producing State?   00:01:05 – Late Season Control Options for Sericea: K-State Extension rangeland management specialist Molly Reichenborn starts today's show as she explains late season control for sericea lespedeza and what options are available. Options for Late Season Sericea Control   00:12:05 – Being Prepared for Wheat Pests: Jeff Whitworth, K-State crop entomologist, keeps the show going as he discusses insecticide seed treatments for wheat and what pests growers should keep an eye out for as wheat gets established.   00:23:05 – Will Kansas be a Top 10 Milk Producing State?: Ending the show is K-State dairy specialist Mike Brouk saying Kansas is well positioned to break into the Top 10 as one of the top milk producing states.      Send comments, questions or requests for copies of past programs to ksrenews@ksu.edu.   Agriculture Today is a daily program featuring Kansas State University agricultural specialists and other experts examining ag issues facing Kansas and the nation. It is hosted by Shelby Varner and distributed to radio stations throughout Kansas and as a daily podcast.   K‑State Extension is a short name for the Kansas State University Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well‑being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices statewide. Its headquarters is on the K‑State campus in Manhattan. For more information, visit Extension.ksu.edu. K-State Extension is an equal opportunity provider and employer.

Belt Treatment to Cockroaches Begin | Shehzad vs Swara in Rise & Fall | UGC Trap | Karan Verma

Beyond the Digest are bonus episodes to the DermSurgery Digest that include reviews of interesting and relevant articles from JAMA Dermatology, Journal of the American Academy of Dermatology (JAAD) and Plastic and Reconstructive Surgery (ASPS).Articles featured in this episode include: ·        “Public Discourse on Menopausal Skin Management: A YouTube Infodemiology Study of Treatment Perceptions, Sentiment, and Unmet Needs Across 43 954 Viewer Comments” Journal of Cosmetic Dermatology·        “Tissue Micro-Coring Is a Safe and Effective Option for the Treatment of the Nasolabial Fold, Marionette, and Perioral Rhytids” Lasers in Surgery and Medicine·        “Topical Carboxytherapy for Skin Rejuvenation” Journal of Clinical and Aesthetic Dermatology“A Dermatologist's Guide to Nonsurgical Rejuvenation of the Neck and Jawline” Journal of Clinical and Aesthetic DermatologyBeyond the Digest Contributors include Naomi Lawrence, MD, Dermatologic Surgery Digital Content Editor; Yesul Kim, MD, Beyond the Digest Co-host and features Payvand Kamrani, DO and Kavita Darji, MD for the September episode.Your feedback is encouraged. Please contact communicationstaff@asds.net.

Dr. Neil Inhaber, VP and Head of Global Medical Affairs at Takeda,  highlights the complexities of cytomegalovirus (CMV) infection following organ transplantation when a patient's immune system is suppressed. Managing post-transplant CMV is particularly challenging because treatments must balance the risk of organ rejection and the need for immunosuppressive and anti-CMV therapies. Neil explains, "Takeda has been involved in the development of anti-infectives that target post-transplant cytomegalovirus or CMV infection. And this is an area that really has been a challenge for clinicians for as long as I've been in practice. When I first entered practice 40 years ago, I was taking care of lung transplant patients, and then I joined industry about 20 years ago to focus on the industry side. And this is something that's been present even since I was in practice."   "When you think about cytomegalovirus in general, this is not a problem in the general population because about 50% of the population is infected is a strong word, but certainly is colonized with cytomegalovirus. So, for example, I might be carrying it, and I might be one of those 50%. For me, it's no problem at all because my immune system can keep it under control. If I were in a situation where I would need to have my immune system suppressed following an organ transplantation, that is when there is the possibility for the cytomegalovirus to activate."  #Takeda #Maribavir #TransplantID #CMVAwareness #TransplantMedicine #CMV #InfectiousDisease #OrganTransplant #RealWorldEvidence #TransplantInfectiousDisease #MedicalAffairs #HealthcareInnovation Takeda.com Download the transcript here

Dr. Neil Inhaber, VP and Head of Global Medical Affairs at Takeda,  highlights the complexities of cytomegalovirus (CMV) infection following organ transplantation when a patient's immune system is suppressed. Managing post-transplant CMV is particularly challenging because treatments must balance the risk of organ rejection and the need for immunosuppressive and anti-CMV therapies.  Neil explains, "Takeda has been involved in the development of anti-infectives that target post-transplant cytomegalovirus or CMV infection. And this is an area that really has been a challenge for clinicians for as long as I've been in practice. When I first entered practice 40 years ago, I was taking care of lung transplant patients, and then I joined industry about 20 years ago to focus on the industry side. And this is something that's been present even since I was in practice."   "When you think about cytomegalovirus in general, this is not a problem in the general population because about 50% of the population is infected is a strong word, but certainly is colonized with cytomegalovirus. So, for example, I might be carrying it, and I might be one of those 50%. For me, it's no problem at all because my immune system can keep it under control. If I were in a situation where I would need to have my immune system suppressed following an organ transplantation, that is when there is the possibility for the cytomegalovirus to activate."  #Takeda #Maribavir #TransplantID #CMVAwareness #TransplantMedicine #CMV #InfectiousDisease #OrganTransplant #RealWorldEvidence #TransplantInfectiousDisease #MedicalAffairs #HealthcareInnovation Takeda.com Listen to the podcast here

Send us Fan MailWhat happens when a dream job turns into a nightmare after a cancer diagnosis? Join Mark Carey and his co-host as they unravel the shocking case of Leah Lando, a veteran news anchor who faced brutal discrimination and retaliation while undergoing cancer treatment. Leah's story is not just a personal battle; it highlights a toxic work culture that can exist in even the most prestigious organizations. After being heavily recruited by Scripps Media, Leah uprooted her life for what she thought was a golden opportunity, only to find herself in a hostile work environment marked by exclusion and interrogation about her medical condition. This episode dives deep into the systemic issues of discrimination that plague workplaces, particularly focusing on gender and age discrimination, as well as the devastating impact of retaliation when employees are vulnerable. Leah's experience serves as a crucial reminder of the importance of employee rights and the need for companies to foster a supportive culture, especially for those undergoing serious health challenges like cancer treatment. The hosts dissect how management, particularly the station manager, not only failed to provide reasonable accommodation but actively worked to build a case for Leah's termination while she was undergoing treatment. As they navigate the legal implications of Leah's firing, the discussion also sheds light on broader patterns of workplace discrimination that affect older women and individuals with disabilities. The court found Leah's claims plausible, emphasizing the critical need for employee advocacy and awareness around workplace rights. This episode is a must-listen for anyone navigating employment disputes, especially those dealing with cancer treatment or similar challenges. Tune in for insider tips on negotiating severance, understanding employment contracts, and recognizing the signs of a toxic workplace culture. Whether you're an employee fighting for your rights, an advocate for workplace change, or simply someone interested in the intersection of health and employment law, this episode of the Employee Survival Guide® is packed with essential insights. Discover how to empower yourself in the face of adversity, understand your legal rights, and learn how to navigate the complexities of employment law. Don't let discrimination define your career—join us as we explore the vital steps to ensuring a healthier work environment for everyone.  If you enjoyed this episode of the Employee Survival Guide please like us on Facebook, X and LinkedIn.  We would really appreciate if you could leave a review of this podcast on your favorite podcast player such as Apple Podcasts and Spotify. Leaving a review will help other employees find the Employee Survival Guide.  For more information, please contact our employment attorneys at Carey & Associates, P.C. at 203-255-4150, www.capclaw.com.Disclaimer:  For educational use only, not intended to be legal advice. 

Starting Fertility Treatment? What I Wish I Knew Before I Walked Into a Fertility Clinic. Entering your Two Week Wait Window?? THIS WEEK ONLY Grab my 14 Day Audio Devotional - Peace in the Wait for $27 instead of $49 - If you're in the middle of the two week wait right now, I created the Two Week Wait Audio Devotional to walk with you day-by-day—from ovulation to testing—with Scripture, prayer, worship, and steady truth; you can find it here: https://stan.store/coduinker/p/peace-in-the-wait   Try Inito — the fertility tool I've personally started using as Josh and I prepare to TTC baby #3 after navigating both infertility and now secondary infertility.

Contributor: Aaron Lessen, MD Educational Pearls: Case review of a patient with recurrent episodes of syncope and shortness of breath, during which she is found to have intermittent runs of polymorphic ventricular tachycardia Torsades de pointes is polymorphic ventricular tachycardia occurring in the setting of a prolonged QT/QTc Risk of torsades increases substantially when QTc exceeds 500ms Causes: Common reversible causes include QT-prolonging medications, hypokalemia, hypomagnesemia, hypocalcemia, bradycardia, and structural heart disease Congenital causes of a prolonged QT interval are primarily inherited genetic mutations affecting cardiac myocyte ion channels leading to delayed ventricular repolarization Treatment:  Stop any QT-prolonging medications and correct electrolytes IV magnesium to suppress recurrent torsades Increasing the heart rate with isoproterenol or temporary pacing can prevent the pauses that trigger recurrent episodes If the rhythm degenerates into ventricular fibrillation → defibrillate   References Wigginton JG, Agarwal S, Bartos JA, Coute RA, Drennan IR, Haamid A, Kudenchuk PJ, Link MS, Panchal AR, Pelter MM, Del Rios M, Rodriguez AJ, Perman SM, Sanko S, Kotini-Shah P, Kurz MC. Part 9: Adult Advanced Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025 Oct 21;152(16_suppl_2):S538-S577. doi: 10.1161/CIR.0000000000001376. Epub 2025 Oct 22. PMID: 41122884.   Summarized by Meg Joyce, MS3 | Edited by Meg Joyce & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/ Golf Fundraiser: https://www.zeffy.com/en-US/ticketing/emergency-medical-minute-charity-golf--2026

Dr. Tesha Monteith talks with Dr. Tamara Pringsheim about the updated American Academy of Neurology (AAN) and American Headache Society (AHS) guidelines on pharmacologic treatment for migraine prevention in adults.  Read the related article in Neurology®. Disclosures can be found at Neurology.org.  Show transcript:  Dr. Jose Merino (00:08): This is Jose Merino, editor-in-chief of the Neurology Family of Journals. The Neurology Podcast provides practical information to neurologists and other clinicians to help them provide better care for their patients. Thanks for listening and have a great week. Dr. Tesha Monteith (00:23): Hi, this is Tesha Monteith with the Neurology Podcast. I'm excited to talk to you today about the update in Migraine Guideline: Pharmacologic Treatment for Migraine Prevention in Adults: Practice Guideline Recommendations, a report of the American Academy Neurology Guidelines Subcommittee, and the American Headache Society. Since the last guideline in 2012, there's been a lot of new advances, including the introduction of CGRP inhibitors for acute and preventive treatment. (00:53): With me to discuss is the lead author, Tamara Pringsheim, a neurologist at the Department of Clinical Neurosciences, Psychiatry, Pediatrics, and Community Health Sciences at the University of Calgary. How are you, Tamara? Dr. Tamara Pringsheim (01:06): Great. Thank you for asking me to talk to you about this. Dr. Tesha Monteith (01:09): Why don't you tell me a little bit about yourself and how you got involved in this work? Dr. Tamara Pringsheim (01:14): Sure. I've been working as a methodologist for the American Academy of Neurology Guidelines Subcommittee for a number of years, since 2015. Prior to that, I was a member of the guideline development subcommittee from 2011. I've worked on a number of different guidelines across neurological conditions. Dr. Tesha Monteith (01:36): Great. So how do these new guidelines compare, just broadly speaking, with the older guidelines? Dr. Tamara Pringsheim (01:43): I guess since the last guidelines were published more than 10 years ago, we've had changes to our methodological process. We had a major update to our guideline process manual in 2017, and guideline methodology has continued to evolve over that time period. And as well, a number of targeted treatments for migraine have come out. So there's been an explosion of evidence, particularly in the last five to seven years. And so we have a whole new class of medications available for migraine prevention, which really target our underlying understanding of the condition, whereas most of the other medications were discovered through serendipity. Dr. Tesha Monteith (02:33): So I know that you reviewed over 200 randomized controlled trials. And so how was the quality or confidence of the evidence determined? Dr. Tamara Pringsheim (02:47): With our process, we start by rating risk of bias for every article. This basically gets at a number of different features related to the clinical trial methodology and reporting, and it helps us determine how confident we are in the evidence. In order for us to be highly confident that the results that we are seeing reflect the truth, we typically need to have at least two Class 1 studies for any intervention outcome pair. The effect size estimate also has to meet a certain threshold in terms of the effect size and the precision surrounding that estimate. So if we feel that based on what the panel decides in terms of what is the minimal clinically important difference between an intervention and placebo, that will help us determine our confidence in the evidence. (03:51): So there's this critical coming together of the number of studies, the quality of studies, the effect size, and the precision of the evidence that helps us determine our confidence in the evidence. And all of this is done behind the scenes using a very algorithmic approach so that these rules are faithfully applied across the different interventions we're looking at. This complexity makes it hard for people to understand why certain drugs land in a certain area, but it's one of the things that we do to make this process standardized and rigorous. Dr. Tesha Monteith (04:37): So I do want to talk to you about that, where drugs have landed. One newer thing was that the review was not just episodic migraine, but also chronic migraine. Dr. Tamara Pringsheim (04:47): Yes. Dr. Tesha Monteith (04:48): Were there important differences in the strength of evidence between these populations? Dr. Tamara Pringsheim (04:53): One thing that's really important to remember is that the use of the term chronic migraine is fairly new. So a lot of the trials of the older headache preventive medications were done in the 80s and the 90s. And at this time, there wasn't a definition which distinguished chronic migraine in particular. So a lot of the trials for amitriptyline, for example, were not done in a purely episodic or chronic migraine population. And so this really contrasts with the newer studies where these populations were well-defined. And so we're going to have higher quality evidence or evidence specifically for chronic migraine with the new drugs, whereas for the old drugs, we won't have that. Dr. Tesha Monteith (05:50): Let's get into the preventive treatments that had the strongest level of evidence for episodic migraine. Dr. Tamara Pringsheim (05:57): We had high confidence in the evidence for two of the CGRP medications, erenumab and galcanezumab. Again, these high confidence in the evidence statements are based on the fact that for both these drugs, there were multiple Class 1 studies showing that they were efficacious. And the effect size was in the range that was pre-specified. So the lower level of the 95% confidence interval was clearly higher than what we decided was the minimal clinically important difference. Both these drugs, one had two Class 1 studies, one had three Class 1 studies, so we could be very highly confident that these two medications were efficacious. (06:50): Now for the moderate confidence drugs, we have a longer list for episodic migraines. So it includes atogepant, eptinezumab, fremanezumab, propranolol, rimegepant, topiramate, and valproate, and then a slightly longer list for the low confidence drugs. So amitriptyline, bisoprolol, flunarizine, fluoxetine, levetiracetam, metoprolol, nifedipine, pizotifen, and telmisartan. (07:18): And for this outcome, I'm specifically talking about episodic migraine headache days. Now, one of the layers of complexity, again for this guideline, is that we had a few different outcomes that we were looking at. So the two main outcomes we were looking at were the headache frequency, the change in the number of headache days, but also the 50% responder rate. That's the proportion of people in the treatment group who had at least a 50% reduction in their headache frequency. And some drugs would make it for one endpoint, but not the other. And this is an important nuance that, again, adds complexity to our data synthesis. Dr. Tesha Monteith (08:06): And what about for chronic migraine? Dr. Tamara Pringsheim (08:08): So for chronic migraine, for the number of headache days, we had high confidence for fremanezumab, galcanezumab and onabotulinumtoxinA, and moderate confidence for atogepant, eptinezumab, erenumab, topiramate, rimegepant, and valproate. We didn't have any medications that were in the low confidence in the evidence category. Dr. Tesha Monteith (08:33): Oftentimes in the newer clinical trials, we're looking at change in monthly migraine days, but interesting that you looked at headache days. Dr. Tamara Pringsheim (08:42): Yeah. So another difficulty is that there's not always consistency in what's reported. So some trials would report headache days and some trials would report migraine days per month. Wherever possible, we use the change in the number of days with migraine. And where this was not present, we would use headache days. Dr. Tesha Monteith (09:08): Now, a drug that we use very often in clinical practice is rimegepant, which has a dual benefit of acute attack treatment as well as prevention. And that was rated as low confidence, but in a recent International Headache Society, Italian guidelines, that was noted as moderate quality evidence, strongly in favor of. What do you think that discrepancy was about? Is that a matter of outcomes or? Dr. Tamara Pringsheim (09:38): This guideline includes clinical trials that were published up until June of 2024. And so at that time, the only trial of rimegepant versus placebo that was published was in a population of patients that had episodic or chronic migraine. The population was combined. And so we only have one study. And as I was explaining at the beginning, in order for us to have high confidence in the evidence, we have to have at least two Class 1 studies and the minimal clinically important difference has to meet a certain threshold. So for rimegepant in June of 2024, there's only one study published versus placebo. So the highest possible confidence in the evidence we could have for rimegepant based on the fact that just one study would be moderate. (10:38): The reason why it's not listed in recommendation 3A as high or moderate confidence is because while we had moderate confidence in the evidence for rimegepant on the number of headache days, we had low confidence in the evidence for the 50% responder rate. And that's because for the 50% responder rate, it did not meet the pre-specified cutoff with respect to the minimally clinically important difference. (11:11): So again, it's a small nuance in the evidence, but for an evidence-based guideline, we really pay attention to these things. I know it makes it complex and hard for people who are not immersed in the evidence to understand. This is part of the rigor. There's a temptation to oversimplify things so that it's easy to understand, but that's really one of the strengths of the AAN process is that we take the evidence very seriously. We are truly evidence-based. We are going through every data point very carefully, and so that you should feel confident when you see that we've rated these medications as a higher moderate confidence, that we've really looked and evaluated these data points very carefully. Dr. Tesha Monteith (12:01): We can say that different guidelines have different outcomes. And to your point, it's more than just the data. It's your pre-specified process that then led to those recommendations, right? Dr. Tamara Pringsheim (12:14): Yeah. And I feel pretty confident that if we were to update the evidence, including the last two years, that rimegepant would move up, right? Because just looking even quickly now, we can see that since 2024, there have been several additional studies published. So now we wouldn't just be basing our evidence review on one placebo controlled study. There have been several more, the medications FDA approved. Dr. Tesha Monteith (12:44): Right. Dr. Tamara Pringsheim (12:45): I don't think anyone should change their practice based on this and people should be using rimegepant. That's not the message that we're trying to send. Dr. Tesha Monteith (12:54): That's really important. Dr. Tamara Pringsheim (12:55): Yes. We are not on a campaign to say that rimegepant is not a treatment option. As you can see, it is listed and it is in the guidelines. It's just based on the data we had available, we had low confidence in one of the outcomes, the 50% responder rate. So I hope that makes sense. Dr. Tesha Monteith (13:14): Yeah, I think it makes sense. It's the processes, it's a 2017 guideline manual, and that does make sense. So thank you for that clarification because a lot of our clinicians will be asking questions about this. Dr. Tamara Pringsheim (13:26): I mean, the same goes for another drug, candesartan is the other one. Dr. Tesha Monteith (13:30): Yeah. Candesartan recently had a paper published in the Lancet. Dr. Tamara Pringsheim (13:33): Yes. Dr. Tesha Monteith (13:33): And it did well, and people are using candesartan. Dr. Tamara Pringsheim (13:38): Yes. Yes, exactly. I prescribe candesartan for migraine prevention. At the time we did the evidence review, we had a couple of positive studies, a couple of negative studies. And when we put the data together, it came out as very low confidence because there's a discrepancy. And then we have a huge trial published that is a positive study, but it came out in 2026. It was not part of our evidence review. We don't say anywhere in the guideline, don't use candesartan, right? We don't say that. We highlight the drugs for which we have the confidence in the evidence and put them in there. But we need to remember that new drugs are coming out all the time and that they didn't factor into our decision making. (14:26): So again, I hope that people don't read the guideline and say, "Oh my God, I can't use candesartan." That's not true. Dr. Tesha Monteith (14:33): So one thing I want to look at is quality of life outcomes. That was something also not seen in the first or the 2012 guidelines. And so how did you look at quality of life outcomes and how should we consider them? Dr. Tamara Pringsheim (14:47): Yeah, so we wanted to make sure that we incorporated patient reported quality of life outcomes in the guideline, recognizing that this is very important. And the newer trials of the more recent medications have been incorporating patient reported quality of life outcomes in their clinical trials. This adds overall credibility that we are incorporating into our decision-making evidence that not only are patients' number of headache days decreasing, but their quality of life is improving because that's important to patients and hence is important to us. (15:31): So we used outcomes from validated measures of migraine related quality of life. So there's the MIDAS, there's the HIT-6, and there's something called the migraine specific questionnaire, which has three subscales. One is emotional function, one is role function preventive, and one is role function restriction. And then a few studies use something called the migraine physical function impact diary. So those were the main instruments that we looked at. And again, we had a pre-specified minimally clinically important difference on these instruments that we looked at. (16:19): And we had a reasonable amount of data, not as much data as we had for headache days or the responder rate, but certainly again, for the CGRP antagonists, we had high confidence in the evidence for galcanezumab, for example, in episodic migraine. And for chronic migraine, we had moderate confidence in the evidence for a number of medications including topiramate and onabotulinumtoxinA. So these quality of life measurements seem to be increasingly used in our modern clinical trial era. Dr. Tesha Monteith (17:07): Great. Another question is just thinking about some of the limitations of this work. There were very few high quality head-to-head trials. How does that limit your comparative effectiveness data? Dr. Tamara Pringsheim (17:19): This is a major issue that most, but not all of the head-to-head trials were investigator-led. Many were done a very long time ago before the modern clinical trial era, and so the quality of these studies was low. And also they were not non-inferiority studies. So basically the only question they could answer is whether drug A is better than drug B based on their trial protocol and methodology. And for most of the comparisons, we have very low quality evidence, so we really cannot support or refute that drug A is better or worse than drug B. So we can't really say anything. There were a few instances where we could say that drug A is better than drug B, but it's low confidence evidence, very few comparisons. (18:17): Some evidence is emerging so that some of the CGRP drugs are being compared to some of the older drugs now with the hope that we can prescribe these sooner to migraine patients. That evidence will probably emerge in the coming years. Dr. Tesha Monteith (18:31): And another question is how should these guidelines be incorporated in clinical practice also while balancing tolerability, comorbidities, patient preference, reproductive considerations, access, and costs? Dr. Tamara Pringsheim (18:47): So we have the evidence synthesis. So you can say, okay, this is the evidence. These are the effect sizes. This is the number of studies to support this outcome, that outcomes. You have the details in the systematic review, right? And then how do you take those details and apply them in the practice? And that's the art of medicine. And we don't make decisions without our patients. All of our decisions are collaborative. I say to my patients, "It's my job to tell you what your options are. It's your job to discuss these options with me and for us to make a decision together regarding which one is the best for you in your situation." (19:30): And that's what we're trying to do in the recommendations. In the recommendation statements, you'll see that in this specific situation, this might be a better choice. We talk a lot about when you're going to decide to even start a preventive and the importance of shared decision making, that those are our first two sets of recommendations. Recommendations one and two are about those things. (19:56): And then our recommendation three statements just tries to gently offer some advice on when you should think about which medication, where efficacy is the priority, tolerability is the priority, long-term harms, cost. Cost is a really tricky one because cost really depends on the person's specific pharmaceutical formulary plan and healthcare insurance. I know that for some patients, their insurance plans require a certain number of oral medications to be tried before an injectable like a botulinum toxin or a subcutaneous medication or one of the newer medications can be prescribed. Dr. Tesha Monteith (20:41): So you put a lot of work in this, your team, the American Academy of Neurology, the American Headache Society, outstanding work. What should we take away from this? Dr. Tamara Pringsheim (20:52): I think that we should take away that a lot of work is being done by headache neurologists and neuroscientists who are interested in headache to develop new treatments for people with migraine. I think that the CGRP drugs are a major advance and that now we have many new medications that are specifically designed for migraine treatment and these treatments are changing people's lives for the better. I think it's brought new hope to people with migraine and it's an exciting time to be a clinician who treats patients with migraine when you have several new medications where the companies have invested the time to do the research, do well-designed clinical studies, and that we can feel confident that these medications are helping our patients. Dr. Tesha Monteith (21:51): Excellent. I couldn't have said that better. Thank you again for your work and your time and for being on our podcast. Dr. Stacey Clardy (22:00): This is Stacey Clardy, your podcast editor. If you've enjoyed the podcast, please take a few moments to subscribe, rate, and review the Neurology Podcast through Apple Podcasts, Google Podcasts, Spotify, or wherever you listen. And remember, you can always head to neurology.org/podcast for our full list of past episodes, or you can also search by keyword on the podcast app for any neurology specific topics.