Podcasts about treatments

Bacterial Skin InfectionsThese three are often tested against each other. The win is recognizing depth, borders, and systemic features, then choosing topical vs oral vs IV. Cellulitis Clinical Presentation Rash / Skin Findings Systemic Symptoms The question stem will likely include Physical Exam & Labs Treatment Exam Keys Erysipelas Clinical Presentation Rash / Skin Findings […] The post 150 Skin Infections, Bites & Infestations – Pattern Recognition, Treatment Buckets, and Easy PANCE Points appeared first on Physician Assistant Exam Review.

Nearly half of U.S. adults have undiagnosed hypertension, which increases risks for stroke, heart attack, and early brain impairment due to reduced oxygen and nutrient delivery to neural tissue Early hypertension triggers rapid cellular damage, including endothelial aging, neuronal energy loss, myelin disruption, and blood-brain barrier leakage, all of which accelerate inflammation and cognitive decline even before symptoms appear Long-term high blood pressure leads to changes such as white matter hyperintensities, microbleeds, and brain volume loss. These findings are strongly linked to slower processing, stroke risk, and dementia Dementia risk rises with midlife hypertension, and older adults with high blood pressure show accelerated brain aging; regular monitoring beginning around age 40 helps reduce long-term cognitive decline Treatment can reverse some early damage, while lifestyle strategies such as diet changes, exercise, and better sleep significantly lower blood pressure and help protect long-term brain health

PREVIEW FOR LATER TODAY: Behnam Ben Taleblu reports on the dire state of Iran, where security forces target hospitals, forcing protesters to forego medical treatment. Beyond the brutal crackdown, political dissatisfaction is fueled by insane inflation rates, with foodstuff prices rising between 60 to 73 percent, driving sustained unrest.1900 PERSIA

Send us a textThe badge asks for everything, then hands you a shift change and a smile. We sat down with returning guest,  licensed clinical social worker Alexis Silva, to dig into the quiet realities behind the uniform: why trust is scarce, why stigma is sticky, and how substance use becomes a steady companion long before it becomes a crisis. Alexis works almost exclusively with first responders, military, and veterans, and brings her own sobriety and family experience to the table. That honesty opens a door many are afraid to touch—because careers are on the line, documentation feels risky, and walking into a room where you don't have to translate the language of the job can be the difference between shutting down and speaking up.We break apart common myths: not every struggle is trauma from the job; for many, it starts with childhood adversity, genetics, and family patterns. Alcohol, THC, and benzos promise relief and steal sleep, fueling irritability, poor decisions, and conflict at home. We unpack the tipping point where use shifts from choice to maintenance—when your body drives the next drink—and why matching care to risk matters. Sometimes inpatient comes first, then outpatient therapy and groups, so progress isn't crushed by daily stress. We also go beyond substances to behavioral addictions like gambling, tracing how the chase hooks into the same adrenaline circuits that make first responders so good under pressure.Across the hour, we map practical steps you can use today: how to assess risk without shame, how to reset routines every few career years, what honest partner check-ins sound like, and how peer support and culturally competent clinicians reduce fear of being “the problem” at the station. If you've wondered whether your coping is helping or hiding, this conversation offers a clear path forward—grounded, direct, and built for people who don't have time for fluff.If this resonates, follow the show, share it with a teammate, and leave a quick review to help other first responders find it. Your story isn't a liability—it's a starting point.If you want to reach Alexa, please go to https://www.psychologytoday.com/us/therapists/alexa-silva-chelmsford-ma/1140390Freed.ai: We'll Do Your SOAP Notes!Freed AI converts conversations into SOAP note.Use code Steve50 for $50 off the 1st month!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showYouTube Channel For The Podcast

In today's episode of Reddit Stories Podcast, a wild Karen completely loses it. You won't believe how this one ends! Sit back, relax, and enjoy this binge-worthy Reddit Stories Podcast, featuring Karen freakouts, entitled people stories, and pro revenge tales.

In this episode, I'm thrilled to welcome Dr. Anna Glezer, a renowned reproductive psychiatrist and founder of Women's Wellness Psychiatry to the Egg Whisperer Show. Dr. Glezer has dedicated her career to supporting fertility patients, many of whom I've had the privilege to care for, through some of the most emotionally challenging moments of their reproductive journeys. With training from Harvard Medical School and UCSF, she brings a compassionate, integrative approach to helping people manage stress, anxiety, and depression during fertility treatment, pregnancy, and beyond. Get the full show notes on my website. Our conversation dives deep into the unique emotional landscape of fertility and pregnancy. Together, we explore how hormonal changes, societal pressures, and the ups and downs of the fertility journey can impact mental health. Dr. Glezer shares her expertise on building a strong foundation for emotional wellbeing, the importance of individualized care, and practical strategies for navigating grief, loss, and the rollercoaster of hope and disappointment. In this episode, we cover: The unique ways stress, anxiety, and depression manifest during fertility treatment and pregnancy How to build a strong support system and foundation for mental health The role of lifestyle medicine, nutrition, and supplements in emotional wellbeing Coping with grief and loss after unsuccessful fertility treatments or pregnancy loss Strategies for managing anxiety and "what if" thinking during subsequent pregnancies How Dr. Glezer tailors her integrative approach to each patient's needs Advice for loved ones and fertility teams on providing meaningful support Resources: Women's Wellness Psychiatry: https://annaglezermd.com/ Resolve: The National Infertility Association: resolve.org Do you have questions about IVF, and what to expect? Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, February 9th, 2026 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org  where you can schedule a consultation. Other ways to connect: Subscribe to my YouTube channel for more fertility tips Join Egg Whisperer School Subscribe to the newsletter to get updates 

Send us a textBen and Daphna review the ICAF randomized clinical trial evaluating extended caffeine therapy in preterm infants and its impact on intermittent hypoxia through 41 weeks postmenstrual age. They discuss the study design, oximetry outcomes across multiple saturation thresholds, inflammatory biomarkers including TNF-α, and clinically relevant safety signals such as oxygen restart rates, length of stay, and weight gain. The conversation focuses on what intermittent hypoxia may mean for ongoing risk, and whether a targeted subgroup of infants might benefit from extending caffeine beyond traditional stopping points.----Intermittent hypoxia and caffeine in infants born preterm: the ICAF Randomized Clinical Trial. Eichenwald E, Corwin M, McEntire B, Knoblach S, Limperopoulos C, Kapse K, Kerr S, Heeren TC, Ikponmwonba C, Hunt CE; ICAF Study Group.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 24:fetalneonatal-2025-329230. doi: 10.1136/archdischild-2025-329230. Online ahead of print.PMID: 41285561Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In part one of this two-part series, Dr. Neishay Ayub discusses the history of a novel anti-epileptic drug, levetiracetam.  Show citations:  Abou-Khalil B. Levetiracetam in the treatment of epilepsy. Neuropsychiatr Dis Treat. 2008;4(3):507-523. doi:10.2147/ndt.s2937  Löscher W, Gillard M, Sands ZA, Kaminski RM, Klitgaard H. Synaptic Vesicle Glycoprotein 2A Ligands in the Treatment of Epilepsy and Beyond. CNS Drugs. 2016;30(11):1055-1077. doi:10.1007/s40263-016-0384-x Rogawski MA. Brivaracetam: a rational drug discovery success story. Br J Pharmacol. 2008;154(8):1555-1557. doi:10.1038/bjp.2008.221 Ulloa CM, Towfigh A, Safdieh J. Review of levetiracetam, with a focus on the extended release formulation, as adjuvant therapy in controlling partial-onset seizures. Neuropsychiatr Dis Treat. 2009;5:467-476. doi:10.2147/ndt.s4844 Wu PP, Cao BR, Tian FY, Gao ZB. Development of SV2A Ligands for Epilepsy Treatment: A Review of Levetiracetam, Brivaracetam, and Padsevonil. Neurosci Bull. 2024;40(5):594-608. doi:10.1007/s12264-023-01138-2 Mahmoud A, Tabassum S, Al Enazi S, et al. Amelioration of Levetiracetam-Induced Behavioral Side Effects by Pyridoxine. A Randomized Double Blind Controlled Study. Pediatr Neurol. 2021;119:15-21. doi:10.1016/j.pediatrneurol.2021.02.010 Major P, Greenberg E, Khan A, Thiele EA. Pyridoxine supplementation for the treatment of levetiracetam-induced behavior side effects in children: preliminary results. Epilepsy Behav. 2008;13(3):557-559. doi:10.1016/j.yebeh.2008.07.004 Romoli M, Perucca E, Sen A. Pyridoxine supplementation for levetiracetam-related neuropsychiatric adverse events: A systematic review. Epilepsy Behav. 2020;103(Pt A):106861. doi:10.1016/j.yebeh.2019.106861 Show transcript:  Dr. Neishay Ayub: Hello, my name is Neishay Ayub, and today we are discussing the history of a novel anti-epileptic drug, levetiracetam. It's a story of a scientific dead end, a radical new testing method, and a mystery that took years to unravel. To set the scene, let's go back to 1974. The pharmaceutical company, UCB Pharma, was working on compounds to boost cognitive function. They were looking for a successor to their drug piracetam. During this research, levetiracetam was first synthesized, but the compound didn't show any significant brain-boosting effects. With no discernible purpose, it was filed away and largely forgotten. For nearly two decades, this medicine sat on a shelf an anonymous entry in a long list of failed drug candidates. The story could have ended there, but in the early 1990s, researchers took a different approach to drug discovery. Researchers screened their entire library of forgotten compounds against audiogenic seizure-susceptible mice. These are mice prone to seizures triggered by sound. Levetiracetam was incredibly ineffective in chronic epileptic mice. Interestingly, levetiracetam had previously failed traditional screening tests which was to prevent acute seizures in normal animals subjected to maximal electroshock or pentylenetetrazole. Levetiracetam was pushed forward to human clinical trials and was found to be efficacious in three placebo-controlled, randomized, blinded clinical trials for adults with refractory focal epilepsy. Two of the clinical trials reviewed levetiracetam three grams per day compared to placebo. They found the responder rate, i.e., 50% reduction in seizure frequency, was 39% to 42% for patients on three grams per day versus placebo at 10% to 16% when used as adjunctive therapy. One of these trials also used levetiracetam as monotherapy, noting a median percent reduction in focal seizure frequency of 73%, a responder rate of 59%, and 18% of patients achieving seizure freedom. In November 1999, the FDA gave its approval for adjunctive treatment of partial onset seizures. While levetiracetam was effective, how it worked was still unclear. It didn't affect the ion channels and neurotransmitter receptors that older, more traditional anti-epileptic drugs targeted. Eventually in 2004, scientists made another breakthrough. They identified the drug's primary molecular target, a protein called SV2A. This protein is involved in regulating the release of neurotransmitters. Instead of suppressing all neurologic activity, levetiracetam appears to bind to SV2A and selectively modulate neurotransmitter release in overactive seizing neurons. This precise mechanism is why it has such a favorable side effect profile. With the mystery solved and a novel mechanism understood, levetiracetam continues to be a popular anti-seizure medication to this day, and its use has been expanded. Further clinical trials led to FDA approvals for use in adult and pediatric patients with myoclonic epilepsy for myoclonic seizures as well as adult and pediatric patients with idiopathic generalized epilepsy for primary generalized tonic-clonic seizures. There is an off-label use for status epilepticus and seizure prophylaxis in TBI, in traumatic brain injury, subarachnoid hemorrhage, and neurosurgical cases. Formulations have also expanded to include tablets and liquid formulations for immediate release, extended-release tablets, and intravenous formulations. Today, with the original patent expired, generic versions are available, making this treatment accessible to millions. The journey of levetiracetam from an abandoned compound to a frontline treatment is a powerful reminder that in science, a failure might just be a success waiting to be tested in a different way.

Text Dr. Lenz any feedback or questions Understanding the Link Between ADHD and Trauma with Dr. Iris ManorJoin us as we explore the intricate connections between ADHD, PTSD, and trauma with Dr. Iris Manor, a renowned child and adolescent psychiatrist and director of the lifespan ADHD clinic at Gaha Mental Health Clinic. In this in-depth discussion, Dr. Manor sheds light on why individuals with ADHD are more prone to developing traumatic stress disorders and PTSD, backed by research and case studies. We delve into the biological, behavioral, and environmental factors contributing to these conditions, as well as the essential treatment and management strategies. Dr. Manor also emphasizes the importance of treating ADHD to mitigate the impact of trauma and provides valuable insights into the role of family dynamics in recovery. Whether you're a clinician, a parent, or someone living with ADHD and trauma, this episode offers vital information and practical advice.Watch on YouTube Here00:00 Introduction to the Podcast and Special Guest01:19 Understanding the Link Between ADHD and Trauma03:20 Behavioral and Biological Explanations05:22 Genetic and Environmental Factors07:53 Impact of Trauma on ADHD14:16 COVID-19 as a Trauma and Its Effects19:23 Treatment and Resilience Strategies26:05 Positive Magic Circle for PTSD and ADHD26:31 Screening Parents for ADHD and PTSD26:49 Diagnosing and Treating Families29:22 Challenges in Treating ADHD and PTSD31:36 Emotional Dysregulation and ADHD33:48 Medications for Emotional Dysregulation36:23 Autism, ADHD, and Trauma39:07 The Impact of Trauma on ADHD44:48 ADHD Awareness and Treatment Click here for the YouTube channel International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers. Joy LenzFibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start. Support the showWhen I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That's why I created this space: to offer education, validation, and hope. If you've been told fibromyalgia “isn't real” or that it's “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you'll find trusted, evidence-based insights here, drawn from my 29+ years as an MD. Please remember to talk with your doctor about your symptoms and care. This content doesn't replace per...

Guest: Gregory Copley. King Charles III is demonstrating resilience by outworking other royals and returning to full duties despite his ongoing cancer treatment, while steadfastly ignoring the distraction of gossip surrounding Prince Harry and Prince Andrew. The King faces a challenging year managing a relationship with Prime Minister Keir Starmer, whose government Copley describes as hostile to the monarchy and struggling with a tattered economy and a severe illegal migration crisis.1828 BANK OF ENGLAND

Plus: Meta delays roll out of smartglasses to countries outside the U.S. amid high American demand. And a Bill Gates-backed nuclear fusion company has teamed up with Nvidia and Siemens. Julie Chang hosts. Learn more about your ad choices. Visit megaphone.fm/adchoices

We begin the new calendar year with a new book, the book of Exodus. The Jewish nation – still a family – is in Egypt, and things go from bad to worse. Pharaoh torments the people, enslaves them, and embitters their lives with back breaking labor. He then implements a policy of infanticide. But a […]

On episode #97 of the Infectious Disease Puscast, Daniel reviews the infectious disease literature for the weeks of 12/18/25 – 12/31/25. Host: Daniel Griffin Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Outcomes Related to Bacterial Co-Infection and Antibiotic Use in Adults Hospitalized With Respiratory Syncytial Virus Compared with Influenza (OFID) Once-Weekly Oral Islatravir Plus Lenacapavir Versus Daily Oral Bictegravir, Emtricitabine, and Tenofovir Alafenamide in Persons With HIV-1 (Annals of Internal Medicine) Bacterial GeoSentinel Analysis of Travelers' Diarrhea Antimicrobial Resistance Patterns (JAMA Open Network) Rapid direct disk diffusion testing for antibiotic resistance in urinary tract infections: a bacterial concentration-adjusted approach (Microbiology Spectrum) Impact of an Educational Leaflet About Asymptomatic Bacteriuria and Urinary Tract Infection on Antibiotic Preferences Among US Adults ≥65 Years: An Online Randomized Controlled Survey Experiment (OFID) Fungal The Last of US Season 2 (YouTube) Real-world Evaluation of Histoplasmosis Diagnosis and Treatment in Patients From a Michigan Health System (OFID) Parasitic Progress Toward Eradication of Dracunculiasis (Guinea Worm Disease) — Worldwide, January 2024–June 2025 (CDC: MMWR) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Astaxanthin (Asta-zan-than) is a powerful compound found on a humble algae that has been scientifically proven to treat cancer, reverse Parkinson's symptoms (and stop its progression), and reverse all chronic inflammatory diseases. Samuel Shepherd, a biochemical engineer who was faced with the diagnosis of an untreatable cancer, decided death was not going to take him just yet and used every tool at his disposal to become cancer-free. Now his research can help you with your chronic illness, whether it's autoimmune, mold, histamine, leaky gut, heavy metal toxicity, heart disease, dementia, or cancer.  He shares with us in a truly easy to understand form the biochemical reason we develop disease and how astaxanthin treats the root cause. I truly loved this interview and I'm thrilled that it's the first episode of the year.    Learn more: Website: https://valasta.net/  Youtube: https://www.youtube.com/@ValAsta   Marian's Programs:  https://www.roadtolivingwhole.com/meal-plans/ coaching: https://www.roadtolivingwhole.com/meal-plans-for-therapeutic-diets/   Disclaimer: The goal of this podcast is to help you take control of your health and feel the best you possibly can! These episodes are not meant to take the place of working with a qualified healthcare professional and are not designed to diagnose or treat any diseases or medical conditions. Any advice provided is not a medical diagnosis or medical treatment plan.  

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This episode reviews recent evidence on microwave and radiofrequency ablation as minimally invasive treatments for primary and secondary hyperparathyroidism, highlighting efficacy, safety, and complication profiles compared with surgery. Focusing on a multicenter prospective Radiology study in older patients, the discussion shows that both ablation techniques achieve meaningful biochemical improvement with acceptable risk, particularly as alternatives for patients who may not be ideal surgical candidates. Efficacy and Safety of Microwave and Radiofrequency Ablationin the Treatment of Hyperparathyroidism in Older Individuals:A Multicenter Prospective Study. Zhang and Liu et al. Radiology 2025; 317(1):e243359. 

Dan & Billy welcome back longtime friend & Nostalgia Test Podcast Allstar Jeremy Madson to put Metallica's Saint Anger & Some Kind of Monster to the ultimate test—THE NOSTALGIA TEST!   “I think we all went through that period where you tried to convince yourself that you liked [Saint Anger] before you eventually came to the point where like, oh, f***, it sucks.” -Billy   We're starting 2026 with an episode that's been 23 years in the making. Ever since Metallica dropped Saint Anger and Some Kind of Monster in 2003 Dan, Billy, & Jeremy have been on a serendipitous nostalgic road to this conversation, this nostalgia test, this very moment where they unpack the total disillusionment they endured when this album came out. This is that moment. They talk about the impact of the documentary, the ego that is Lars, how James Hetfiled's time in rehab, and the cool demeanor of Kirk Hammett. they also talk about the unceremonious way Jason Newstead was treated and the dumpster fire Rob Trujillo walked into when he was hired. So, grab your best metalhead friends, put on your favorite band shirt, and crack open a Bud heavy, because this one is for the real Metallica fans who aren't trying to rewrite the history that's the Saint Anger album. Email us (thenostalgiatest@gmail.com) your thoughts, opinions, & episode idea for The Wheel of Nostalgia! Suggest A Test & Be Our Guest! We're always looking for a fun new topic for The Nostalgia Test. Hit the link above, tell us what you'd like to see tested, and be our guest for that episode!   Approximate Rundown 00:00 Introduction to the Metallica Eras Journey 01:13 Welcoming the Hosts and Guests 01:51 Discussing the Impact of Saint Anger 03:11 Personal Recollections of the Album Release 07:01 Analyzing the Album's Reception and Documentary 09:11 Reflecting on Metallica's Evolution and Challenges 11:52 Critiquing the Album's Musical Choices 14:58 The Band's Internal Struggles and Dynamics 26:54 The Infamous Dave Mustaine Scene 28:11 Anthrax and Metallica: A Tense History 28:51 Dave Mustaine's Trolling and Lars' Indifference 29:16 The Big Four Reunion and Lars' Ego 29:55 Jason Newsted's Treatment and Icon Performance Controversy 31:45 Lars' Hair and James' Vocals: A Documentary Analysis 32:08 Saint Anger: A Musical and Critical Failure 37:01 Napster Lawsuit and Fan Betrayal 38:14 The Metal Scene in the Early 2000s 42:11 Rob Trujillo's Entry and Band Dynamics 45:45 Summer Sanitarium Tour and Metallica's Struggles 47:05 Saint Anger: Final Verdict and Documentary Reflection 52:29 Closing Thoughts and Future Episodes   Book The Nostalgia Test Podcast Bring The Nostalgia Test Podcast's high energy fun and comedy on your podcast, to host your themed parties & special events!  The Nostalgia Test Podcast will create an unforgettable Nostalgic experience for any occasion because we are the party! We bring it 100% of the time! Email us at thenostalgiatest@gmail.com or fill out the form at this link. LET'S GET NOSTALGIC!       Keep up with all things The Nostalgia Test Podcast on Instagram | Substack | Discord | TikTok | Bluesky | YouTube | Facebook   The intro and outro music ('Neon Attack 80s') is by Emanmusic. The Lithology Brewing ad music ("Red, White, Black, & Blue") is by PEG and the Rejected

There is a new initiative in northern Utah that is taking a different approach to Veterans facing legal issues. Judge Craig Hall of the 2nd District Court of Ogden joins to discuss the Veteran Treatment Court and how this program is designed to help Veterans get the help they need.

Dr. Jim Dunlap discusses one of the honorable mention articles of 2024, titled “Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults—An Exploratory Analysis From the DREAM Trial,” which was originally published in the Journal of Orthopaedic & Sports Physical Therapy in April 2024. Dr. Jeremy Schroeder serves as the series host. Dr. Dunlap is a member of the Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2024, as selected for the 2025 AMSSM Annual Meeting. Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults—An Exploratory Analysis From the DREAM Trial: https://www.jospt.org/doi/full/10.2519/jospt.2024.12245

Dr. Lisa Hicks and Dr. Joseph Mikhael discuss the updated guideline from ASCO and Ontario Health (Cancer Care Ontario) on the treatment of multiple myeloma. They cover recommendations for therapeutic options across smoldering multiple myeloma, transplant eligible multiple myeloma, transplant ineligible multiple myeloma, and relapsed or refractory multiple myeloma. They highlight the importance of shared decision making and patient-centric care. They comment on the explosion of new treatment options in this space and the impetus for this guideline becoming a living guideline, which will be updated on an ongoing, regular basis. Read the full guideline, "Treatment of Multiple Myeloma: ASCO-Ontario Health (Cancer Care Ontario) Living Guideline" at www.asco.org/hematologic-malignancies-guidelines. TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/hematologic-malignancies-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02587   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I am interviewing Dr. Lisa Hicks from St. Michael's Hospital and University of Toronto, and Dr. Joseph Mikhael from the Translational Genomics Research Institute, an affiliate of City of Hope Cancer Center, co-chairs on "Treatment of Multiple Myeloma: American Society of Clinical Oncology-Ontario Health (Cancer Care Ontario) Living Guideline." Thank you for being here today, Dr. Hicks and Dr. Mikhael. Dr. Lisa Hicks: Thanks so much. Dr. Joseph Mikhael: It is a pleasure to be with you, Brittany. Thank you. Brittany Harvey: Before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Hicks and Dr. Mikhael who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into what we are here today to talk about, Dr. Mikhael, I would like to start by recognizing that this guideline updates the 2019 ASCO-CCO Guideline on the Treatment of Multiple Myeloma. So what prompted this update and what is the scope of this updated guideline? Dr. Joseph Mikhael: It is amazing when we think back in myeloma years, 2019 actually seems a very, very long time ago because really so much has changed in myeloma over these last six to seven years. Indeed, there have been over 150 randomized controlled trials that we didn't have at the prior guideline that we reviewed for this. Myeloma is a disease that has really changed so dramatically over these last several years. Multiple new agents have been introduced. We now have CAR-T cell therapy, bispecific antibodies, and multiple other agents that were not available at the time. Furthermore, with this growing complexity, it is becoming more important than ever to be able to provide practical advice and guidelines to the oncology community. For most oncologists, they have less than 5% of their time dedicated to multiple myeloma. It is important to bring a clarity to them that allows them to care for their patients. And the scope of these guidelines, furthermore, really cover the whole spectrum of myeloma. They go further than our prior guideline where now we have included smoldering multiple myeloma along with frontline therapy and relapsed multiple myeloma. So, we have really tried to provide the full spectrum to our colleagues in oncology to ensure that they have the tools they need to provide the best care possible for their patients. Dr. Lisa Hicks: That is a really terrific summary. And maybe one thing I will just add is it is really unique to have this much literature. I can't think of another guideline that I have ever been involved with that has seen a field move so quickly and develop so many advancements in a period of just over four or five years. Brittany Harvey: Certainly, there is a large volume of evidence that you all had to review for this guideline update. I think to your point probably one of the greater volumes of literature for a guideline update that you both mentioned. Based on that, I would like to review the key recommendations that are updated in this guideline. So Dr. Hicks, that new patient population that Dr. Mikhael mentioned earlier, what are the key recommendations for patients with smoldering multiple myeloma? Dr. Lisa Hicks: So this is the first time that an ASCO guideline is addressing this branch of multiple myeloma care. It is an area where I think some guidance is needed, and smoldering myeloma is not an active cancer. And so one thing that I really want to highlight is that the panel felt very strongly that to recommend any therapy in this space we needed a higher level of evidentiary certainty, of evidentiary confidence, to make recommendations for active therapy. The panel really made two very important recommendations. First of all, the panel did not recommend treatment for low or intermediate risk smoldering myeloma. That is important. And then the area where I think for the first time we have recommended consideration of treatment is patients with high risk smoldering myeloma. And for patients with high risk smoldering myeloma, the panel recommended that it was appropriate to consider either treatment with daratumumab or careful observation. Dr. Joseph Mikhael: And I think that move forward as you have mentioned, Dr. Hicks, is particularly important because it is an area to some degree still of equipoise and many trials are going on in the area. But we do now have a strong phase III trial that supports the use of daratumumab monotherapy for three years when compared to close observation. But of course, that is not for everyone. And one of the key themes of all of our recommendations are going to be now that more and more choices are available, that we have discussions with our patients to ensure that we match the right treatment with the preference of the patient. And I think that is particularly important here in smoldering myeloma. Dr. Lisa Hicks: Multiple myeloma care and the multiple myeloma evidence is really so nuanced, and one of the nuances that readers will appreciate if they read the guideline is that how smoldering myeloma is risk stratified has been different across different trials. And that really adds to the complexity of this recommendation and is one of the reasons that the panel felt that it was appropriate to recommend either observation or treatment. Brittany Harvey: It is great to have these new recommendations for this unique patient population. And as you both mentioned, that individualized patient care is really important across this entire guideline. So then following those recommendations, Dr. Mikhael, what is recommended for initial therapy, autologous stem cell transplantation, post transplant therapy, and measurement of response for patients with transplant eligible multiple myeloma? Dr. Joseph Mikhael: Well, that is an area that has really considerably also grown since the last guideline. Obviously one would have to consult the guidelines to get every last detail, but in essence, we want to assess whether or not patients are transplant eligible or ineligible. And that assessment is not based on age or renal function alone, but indeed on a careful assessment of that patient. When that assessment is made and deemed that a patient is transplant eligible, our recommendation is that a patient typically would receive a quadruplet. That is to say, a monoclonal antibody directed against CD38, a proteasome inhibitor, an immunomodulatory drug, and dexamethasone to be given for approximately four to six cycles followed by the stem cell transplant, followed by potentially another two cycles of consolidation, and then maintenance therapy. A couple of important caveats. One, we do have two different CD38 antibodies that can be used, either daratumumab or isatuximab. Although typically bortezomib is the preferred proteasome inhibitor, consideration can be given to carfilzomib by virtue of the potential toxicity from bortezomib. And then lastly in the maintenance setting, we are typically recommending at least lenalidomide alone, but consideration can be given to dual maintenance therapy as the data is emerging to either add to that daratumumab or carfilzomib. All the while using the IMWG criteria for response. The goal of course is to achieve the deepest response possible and to maintain that response until such time as patients would relapse. Finally, the length of maintenance therapy continues to be an area of equipoise and study in multiple myeloma. And so at minimum, patients would receive two to three years of maintenance therapy, and based on risk status and depth of response it can be considered that patients would potentially come off maintenance therapy, of course always with the caveat that toxicity would influence length of therapy as well. Brittany Harvey: Yes, as you mentioned, evaluating which patients are eligible is extremely important for considering what is recommended in the guideline for both transplant eligible and transplant ineligible patients. So then Dr. Hicks, following those recommendations for transplant eligible multiple myeloma, what are the recommended treatments, goals of therapy, and measurement of response for patients with transplant ineligible multiple myeloma? Dr. Lisa Hicks: You know, I really can't emphasize enough how important an individualized patient assessment is. When we are thinking about the range of patients that are included in this category of transplant ineligible patients, it is a huge range. You may have fairly fit patients in their late 70s all the way to patients in their 90s. And we really want to see that treatments are tailored both to the fitness of the patient, their individual circumstances, and their preferences. And it is a wonderful thing to have lots of options for patients in this circumstance. What the guidelines have recommended for most patients who are transplant ineligible but fit enough for a stronger therapy is quadruplet therapy. So actually therapy that is very similar to what is being recommended in the transplant eligible population but for a longer period of time. And then for those patients who for whatever reason, be it their fitness or their preference, are not appropriate for that quadruplet therapy, the recommendation is for triplet therapy with a combination of lenalidomide, bortezomib, dexamethasone, or very often, more often in most cases, an antibody based approach with an anti-CD38 plus lenalidomide plus dexamethasone. Dr. Joseph Mikhael: The only thing I would add to that, I think we have to also, as we do mention in our recommendations, be particularly cautious with the dosing of these medications. Because even though we think of them as a single agent or a particular class, there can be quite a variation within the dosing regimen that can affect a patient's side effects and their quality of life. And so being very careful with dose modifications, and particularly in the transplant ineligible patient, is an important part of the recommendation as well. Dr. Lisa Hicks: Yeah, this is a podcast so no one can see me nodding vigorously that dose modification is so important particularly with those older and frailer patients, and with particular attention to trying to reduce dexamethasone doses and favoring weekly administration of bortezomib when that drug is used. Brittany Harvey: Absolutely. Considering the risks and benefits and patient preferences is really key to selecting therapy for these patients. So then Dr. Mikhael, for the final overarching patient population addressed in this guideline, for patients with relapsed or refractory multiple myeloma, what treatment options are recommended? Dr. Joseph Mikhael: This of course is, if you will, the biggest part of the guideline because there has been so much done in the relapse setting. And I think we start the guideline by saying a decision has to be made as to when to institute therapy. That there may be some patients with slow biochemical relapse that may be monitored for a period of time. But when the decision is made to initiate treatment, instead of a simple algorithm, the guideline emphasizes the fact that there are multiple choices that can be given to a patient that are going to match what comorbidities the patient has, what they have been treated with before, and of course what their preferences are. I think we highlight two particular areas. That now that CAR-T cell therapy is available as early as first relapse, it should be a consideration by virtue of the fact that it has resulted in such deep and durable responses. But that triplets should also be considered in that earlier relapse setting because we do have multiple classes of agents that can be used. We know that in later relapse options exist including bispecific antibodies for which we have four different choices. And that in general, patients will ultimately receive either a triplet or CAR-T cell therapy in earlier relapse, but there are some patients who may be eligible only for a doublet by virtue of their comorbidities and of their prior therapies. Lastly, it really does emphasize the point as we have mentioned a few times in this podcast, and I am so glad it keeps coming up, is that as I often say we don't treat myeloma, we treat people. And engaging the patient in that conversation to ensure that the right treatment gets matched to the right patients is particularly important because with all the new classes that we have with antibody drug conjugates, with XPO1 inhibitors, the traditional three classes of proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, along with as we have already mentioned CAR-T and bispecific antibodies, it really is an incredible laundry list of choice. And making that choice specific to the patient becomes absolutely critical. I should also lastly note that there are patients who may defer their initial transplant. There may be patients who may be eligible for a second transplant. So autologous stem cell transplant, although primarily used in the frontline setting, may still be a consideration for a smaller subset of patients in the relapse setting. Dr. Lisa Hicks: I think maybe one thing that I would add is an overarching principle which is actually similar to a principle in the first guideline, and that is that in the relapsed or refractory setting, there are many different treatment options. And in fact, the number of treatment options feels like it is evolving every day. But an overarching principle for clinicians to consider is to try and choose combinations of drugs that the patient has either not been exposed to in the past or certainly that they are not refractory to. We really want to be pulling new options out of the toolbox as much as we can. Dr. Joseph Mikhael: Very often we do see where someone may be on a triplet and they are progressing on it and someone just changes out one drug. We have suggested not to take that approach but to take the approach of completely introducing a new therapy when someone is progressing on their current therapy. I think that point is particularly important and the consensus panel was very clear. Brittany Harvey: Understood. That is very helpful when thinking about what options to offer to patients in the relapsed and refractory setting. And as you mentioned earlier, the figures in this guideline provide an outline of options and then the tables really go into some of the details and outcomes of the trials, and those are very helpful for clinicians to refer to. So then Dr. Hicks, we have talked a little bit about some of the nuances of the guideline, but what should clinicians know as they implement these new and updated recommendations? Dr. Lisa Hicks: I think they should feel comfortable that these are trustworthy guidelines. So these are evidence-based guidelines that have been rigorously developed after a very thorough evidence review and put together by a panel of experts who were extremely thoughtful in their review of the evidence. And so all of this contributes to the trustworthiness of the guidance. And then I would also encourage people to take a deep look at the guidelines because of the importance of nuance that is addressed in them, and then to also explore some of the tools that ASCO is developing that helps with implementation including the flow charts that are contained within the guidelines and some additional tools that are available online. Brittany Harvey: Absolutely. The tools and resources for this guideline are available online with the publication and we will provide links to that in the show notes of the episode. So then following that, Dr. Mikhael, how does this guideline update affect patients with multiple myeloma? Dr. Joseph Mikhael: As we sort of intimated earlier, I like to say I don't treat myeloma, I treat people. I think we should always be patient-centric and patient-focused. And I think in the discussion we always were. We always wanted to ensure that multiple factors go into a decision-making process. We are not just looking at the biology of the disease, we are looking at patient factors. Those patient factors include their frailty as we commented in a frailty assessment, their preferences, their comorbidities. And I think, in a day where we have so many choices, we emphasize in the guideline the importance of that conversation with the patient. That, if you will, shared decision-making model where options are laid out and based on the patient factors and the treatment factors they can then be meshed together in the best way so that patients can make the right choice. And of course in conjunction with the guidelines, we have patient friendly summaries of them. And we involved, of course, patients in the development of these guidelines. And I think that is one of the greatest strengths of the ASCO guidelines is that there is a patient with us at the table who is giving their perspective on the guideline as we go forward. So I am very thankful that we have created a product that is, if you will, not only for the providers, the practitioners that are prescribing these agents and that are directly giving the care, but indeed for the very patients who of course have the most at stake here. Dr. Lisa Hicks: Yeah Joe, I am so glad you called out the participation of patient partners in the guideline. It is such an important part and they were really- the patient partner was such an important part of this panel in helping us understand the patient perspective as we developed this guidance. Brittany Harvey: Definitely. It is a hugely important role for the panel and for all of the panel including the patient partners and the experts in the disease to review the evidence and come up with comprehensive recommendations. And yes, as you mentioned, the individualized treatment and the shared decision-making is really paramount to this guideline. Finally, Dr. Hicks, you alluded to earlier the vast number of treatment options that is really exploding in multiple myeloma. And so this guideline is becoming a living guideline continuously updated by ASCO. So what are the outstanding questions regarding this topic and what evidence is the panel looking forward to for future updates? Dr. Lisa Hicks: I am really excited about this. This is one of the first guidelines that will be a living guideline for ASCO and it is such a good fit. You have heard Joe and I say a few times how quickly this field is moving, how complex the field is. I think everyone on the panel knew that no matter how quickly we did it and how deeply we reviewed the evidence, it was inevitable that more evidence would be generated as we were putting out the guideline. In a field like that, it is really important that we find a way to provide evidence-based guidelines quickly to the community. You know, waiting another five years, letting another 150 trials accrue before we do another guideline is not what the community needs. And so ASCO has really risen to this challenge and is committed to living guidelines. And so a living guideline is a guideline that commits to reviewing the evolving evidence on an ongoing basis, watching for practice changing trials, and having a standing panel that will review evidence and update recommendations on a regularly scheduled basis. So that is what a living guideline is, and that is what this guideline is becoming. That is just the first thing in terms of what a living guideline is. And then what are we watching? Well, honestly what aren't we watching? There is so much happening in multiple myeloma. We knew as we put the guideline out that there were trials in process, some trials that had been released at conferences but not yet published. We will be waiting for those and if they are practice changing they will be addressed in upcoming updates. There is new evidence just recently presented around combined anti-CD38 and bispecific antibodies. I don't know yet whether that will be addressed but I wouldn't be surprised if it was. There are so many things coming down the pipeline and it is just wonderful that there is going to be a way to try and address them in a robust fashion. Dr. Joseph Mikhael: Yeah I agree with you, Lisa. I can't think of another disease that would be more relevant for a living guideline. I mean we had difficulty because new data kept coming in as we were making recommendations. And so at some point we had to draw a line and say this is where we will stop and produce this guideline and have it ongoing. And I really look forward to seeing the updates because we know as you mentioned that there are so many things that are on the verge of approval and on the verge of changing the way we manage this terrible disease. And before I close, I would love to remind all of our listeners that as we commented from the start, patient engagement is critical at ASCO and in our guidelines process. Unfortunately we lost a very dear patient during the guidelines process, and that is Jack Aiello. Jack Aiello had been a patient and a patient advocate for many, many years in the myeloma community. And indeed we have actually dedicated these guidelines to his honor. And so I thought it would be valuable for us to mention that today. And we miss you Jack, but we are very grateful that we have been able to dedicate this excellent body of work to your memory. Brittany Harvey: Absolutely. This guideline and your dedication to him is an honor to his memory and we really recognize him in thinking about this guideline. We will look forward to those future trial results that you mentioned, Dr. Hicks, to update this guideline and continue to provide options for patients with multiple myeloma and improve upon those options and shared decision-making with patients. So I want to thank you both for all of your work to develop this guideline and for your time today, Dr. Hicks and Dr. Mikhael. Dr. Lisa Hicks: You are so welcome. Thanks for featuring this guideline. Dr. Joseph Mikhael: Thank you so much, Brittany. It has been a privilege. Brittany Harvey: Finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/hematologic-malignancies-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines App, which is available in the  Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Can adults really expand their maxilla? Is treating sleep apnea with a CPAP or mandibular advancement device only MASKING the problem? How does craniofacial anatomy influence airway health, and what should dentists look for? Dr. Dave Singh joins us to dive into CranioFacial Sleep Medicine. He breaks down how structural issues—like a narrow maxilla, high-arched palate, or limited tongue space—can be root causes of sleep-disordered breathing, rather than just treating symptoms.  The episode also touches on controversies in orthodontics and presents evidence supporting interventions once thought impossible in adults. https://youtu.be/WUyeOjKquJU Watch PDP253 on Youtube Protrusive Dental Pearl: Obstructive Sleep Apnea is NOT just a “fat old man disease.” If you're not screening every patient for sleep and airway issues, you're missing a huge piece of their overall health. Snoring, bruxism, and craniofacial anatomy are all connected, and understanding these links can transform the way you approach patient care. Key Takeaways: Mandibular advancement appliances are not a universal solution. While effective for some patients, they often fail to address the underlying causes of airway collapse. Craniofacial sleep medicine focuses on airway etiology, not just symptom control, by identifying why the mandible, tongue, and airway behave as they do during sleep. The cranial base plays a foundational role in facial growth, jaw position, and airway size, directly influencing sleep apnea risk. A retruded mandible is frequently due to developmental and epigenetic factors, rather than being an isolated mandibular issue. Sleep apnea has multiple endotypes—including craniofacial, neurologic, metabolic, and myopathic—requiring individualized treatment planning. Bruxism is not a reliable airway-opening mechanism and may be a primitive physiological response to hypoxia rather than a protective behavior. Tooth wear can be an early indicator of sleep-disordered breathing, and should prompt clinicians to screen beyond restorative concerns. Upper Airway Resistance Syndrome (UARS) can occur even when the apnea-hypopnea index (AHI) is low, particularly in non-obese patients with fatigue, pain, and poor sleep quality. Palatal expansion should be understood as a 3D craniofacial intervention, aimed at improving nasal airflow and airway function—not merely widening the dental arch. Effective care depends on an integrated, multidisciplinary approach, involving dentists, orthodontists, sleep physicians, ENTs, and myofunctional therapists. Youtube Highlights: 00:00 Teaser 01:01 Introduction 02:56 Pearl: Debunking Myths About Sleep Apnea 04:27 Interview with Professor Dave Singh: Journey and Insights 13:23 Craniofacial Development 18:53 Epigenetics and Orthodontic Controversies 25:52 Diagnosis and Treatment of Sleep Apnea 32:49 Understanding Upper Airway Resistance Syndrome 34:17 Midroll 37:38 Understanding Upper Airway Resistance Syndrome 39:45 Diagnosing Sleep Disorders and Treatment Modalities 43:58 Exploring Bruxism and Its Hypotheses 45:19 CPAP and Alternative Treatments for Sleep Apnea 48:12 Managing Upper Airway Resistance Syndrome 55:11 Integrative Approach to Sleep Disorder Management 57:17 Diagnostic Protocols and Imaging Techniques 01:02:25 The Importance of Proper Device Fit and Function 01:07:16 Upcoming Events and Further Learning Opportunities 01:09:56 Outro ✨ Don't Miss Out: Practical, anatomy-based approaches to sleep and airway management for dentists and specialists

Luis Hernandez, M.D., FACC, fellowship-trained Cardiologist and Medical Director of the Advanced Heart Failure Program at Monument Health Heart and Vascular Institute, gives insight on how devices like defibrillators, pacemakers and pulmonary pressure sensors manage heart failure and help prevent hospital readmissions. He also outlines the importance of medication and patient monitoring in improving heart failure outcomes. Dr. Hernandez brings plenty of visual aides in this episode so be sure to check out the video version on YouTube! Hosted on Acast. See acast.com/privacy for more information.

Noninterventional studies in clinical research are underutilized in clinical research and inefficient. Dan Drozd, CMO of PicnicHealth, knows we can do better. With host Deborah Borfitz, Drozd discusses the issues and ramifications researchers face from the lack of noninterventional studies, offers tactics for raising the bar for evidence generation, and shares what he expects in the clinical research space in 2026 in this episode of the Scope of Things. Plus, Borfitz shares the latest news on an expanding good pharma score card, an entirely telehealth-based cancer trial, a novel online platform for bowel cancer research, improving patient-reported outcomes in cancer trials, a virtual clinical trial for psychedelics, and identifying Type 1 diabetes in the symptom-less window stage. Show Notes   News Roundup Good Pharma Scorecard Study in JAMA Internal Medicine News on the Yale Scool of Medicine website  Nationwide telehealth trial for cancer News on The Ohio State University website Online platform for bowel cancer research News on the Newcastle University website Patient-reported outcomes in cancer clinical trials Paper in The Lancet Oncology News on the European Organisation for Research and Treatment of Cancer website Virtual clinical trial of psychedelics Research article in Advanced Science Type 1 diabetes risk prediction testing Study in The Lancet News on the University of Exeter website Guest Dan Drozd, M.D., CMO of PicnicHealth The Scope of Things podcast explores clinical research and its possibilities, promise, and pitfalls. Clinical Research News senior writer, Deborah Borfitz, welcomes guests who are visionaries closest to the topics, but who can still see past their piece of the puzzle. Focusing on game-changing trends and out-of-the-box operational approaches in the clinical research field, the Scope of Things podcast is your no-nonsense, insider's look at clinical research today.

Prostate cancer that spreads to the bone does not automatically mean surrendering vitality or choice.In this episode, Dr. Stephen Petteruti explains why standard treatments for prostate cancer bone metastasis often miss the mark. He breaks down how aggressive testosterone suppression can ease symptoms in the short term, yet frequently leads to fatigue, weakness, and limited long-term benefit. Dr. Stephen presents a more intentional path forward, one that prioritizes quality of life alongside disease control. He discusses why repeated biopsies and invasive interventions may do more harm than good, and how strategies such as symptom-guided care, intermittent therapy, and carefully considered testosterone approaches may help preserve energy, cognition, and sexual health.Rethink what effective treatment means and engage with an approach centered on living well, not simply enduring. Watch the full episode of Prostate Cancer Bone Metastasis: Why Standard Treatment Fails Men and What to Do Instead.Enjoy the podcast? Subscribe and leave a 5-star.Dr. Stephen Petteruti is a leading Functional Medicine Physician dedicated to enhancing vitality by addressing health at a cellular level. Combining the best of conventional medicine with advancements in cellular biology, he offers a patient-centered approach through his practice, Intellectual Medicine 120. A seasoned speaker and educator, he has lectured at prestigious conferences like A4M and ACAM, sharing his expertise on anti-aging. His innovative methods include concierge medicine and non-invasive anti-aging treatments, empowering patients to live longer, healthier lives.Website: www.intellectualmedicine.com Website: https://www.theprostateprotocol.com/ YouTube: https://www.youtube.com/@intellectualmedicine LinkedIn: https://www.linkedin.com/in/drstephenpetteruti/ Instagram: instagram.com/intellectualmedine Consultation: https://www.theprostateprotocol.com/book-a-consultation Store: https://www.theprostateprotocol.com/store Community: https://www.theprostateprotocol.com/products/communities/v2/fightcancerlikeaman/home    Disclaimer:  The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.Produced by https://www.BroadcastYourAuthority.com 

The CHALLENGE trial found that a three-year, structured exercise program after chemotherapy for stage III colon cancer reduced the risk of the cancer coming back (recurrence risk) and also led to people living longer overall. Dr. Kerry Courneya, the lead researcher, thinks the results can be applied to people with other types of cancer, including breast cancer. Listen to the episode to hear Dr. Courneya explain: why the study asked people to exercise for three years why he thinks the results may spur insurance companies to cover exercise-related costs, like equipment and gym memberships the reasons why the results also could apply to people diagnosed with breast cancer

In this episode of the JIMD Podcast, we explore manganese transporter disorders with Dr Karin Tuschl, Dr Suvasini Sharma and Prof John Spencer, covering clinical red flags, MRI clues, EDTA chelation, and the urgent search for safer, oral treatments for hypermanganesemia with dystonia. Consensus of Expert Opinion for the Diagnosis and Management of Hypermanganesaemia With Dystonia 1 and 2 Sherry Fang, et al https://doi.org/10.1002/jimd.70031 Removal of Toxic Metabolites—Chelation: Manganese Disorders Hendrik Vogt, et al https://doi.org/10.1002/jimd.70107

In this captivating episode host Myrna Young discusses a groundbreaking advancement in cancer treatment with Dr. Jeffrey Gross, founder of ReCelebrate. The episode dives deep into the innovative use of Natural Killer (NK) cells as a promising non-toxic alternative to chemotherapy and radiation. Dr. Gross, a renowned expert in regenerative medicine and immunotherapy, explains how NK cell-derived exosomes are reshaping cancer treatment by selectively targeting cancer cells without harming healthy tissue. This conversation promises to shed light on emerging cancer therapies that evoke hope and potential for more humane cancer treatments.With a strong focus on NK cell-derived exosomes, Dr. Gross elaborates on how these natural remedies can boost the immune system, effectively contributing to cancer prevention and management. The episode further explores how current advancements in regenerative medicine are becoming accessible and offer substantial benefits to patients undergoing or at risk of cancer, while possibly enriching the lives of those with genetic predispositions to cancer. This episode provides vital insights into the future of cancer treatment, marking a pivotal moment for patients seeking comprehensive care options that could potentially enhance longevity and overall well-being.Key Takeaways:Revolutionary Cancer Treatment: NK cell-derived exosomes represent a new frontier in cancer treatment, offering a targeted and non-toxic alternative to chemotherapy and radiation therapy.Selective Targeting: These NK exosomes can naturally identify and attack cancer cells while bypassing healthy cells, minimizing collateral damage.Broad Application: Suitable for a variety of cancers, including blood cancers like leukemia and lymphoma, offering diverse treatment possibilities.Preventative Potential: Beyond treatment, NK exosome therapy might reduce cancer recurrence risk and serve as a preventative measure for high-risk patients.Evolving Alternative Medicine: Reflective of the broader trends in regenerative medicine, Dr. Gross and ReCelebrate are at the forefront of offering innovative therapies that prioritize patient well-being with fewer side effects.Notable Quotes:To advertise on our podcast, visit https://advertising.libsyn.com/TransformyourMindor email kriti@youngandprofiting.com See this video on The Transform Your Mind YouTube Channel https://www.youtube.com/@MyhelpsUs/videosTo see a transcripts of this audio as well as links to all the advertisers on the show page https://myhelps.us/Follow Transform Your Mind on Instagram https://www.instagram.com/myrnamyoung/Follow Transform Your mind on Facebookhttps://www.facebook.com/profile.php?id=100063738390977Please leave a rating and review on iTunes https://podcasts.apple.com/us/podcast/transform-your-mind/id1144973094 https://podcast.feedspot.com/personal_development_podcasts/

What does comprehensive treatment planning look like, and how can specialists and general dentists design it together? In this episode, Dr. Grant Stucki sits down with Florida general dentist and educator Dr. Vic Martel to unpack the ins and outs of comprehensive treatment planning. Dr. Martel explains why many dentists were never taught comprehensive planning in dental school, how this leads to a reactive mindset, and why slowing down to assess occlusion, periodontal health, joints, and restorative needs as a whole improves outcomes for patients and practices. Together, they explore real-world barriers and practical solutions to comprehensive treatment planning and the importance of surgeon-led education and interdisciplinary planning. Dr. Martel shares how he runs new-patient exams and builds trust with patients while coordinating with specialists. He also explains how investing in your referral network can help a practice grow and how a thoughtful, comprehensive treatment plan makes life easier for everyone on the team. Tune in now!Key Points From This Episode:Comprehensive treatment planning and why many dentists are underprepared.The difference between “tooth fixer” dentistry and being a “physician of the mouth.”Learn how comprehensive treatment planning benefits patients and practices.Find out about the biggest barriers to comprehensive treatment planning. How comprehensive planning impacts case acceptance, treatment, and patient outcomes.Hear how generalists and specialists can work together to design a comprehensive plan. Explore the history behind grand rounds and why it is an effective educational tool.Important considerations around implant solutions and the risk of removal. He shares his comprehensive dental exam setup and his overall approach. Discover how shared plans improve coordination, referrals, and patient confidence.Final takeaways and why dentists should focus on educating their referral network.Links Mentioned in Today's Episode:Dr. Victor Martel on LinkedIn — https://www.linkedin.com/in/victor-martel-dmd-91431922/ Dr. Victor Martel on Instagram — https://www.instagram.com/drvicmartel/ Dr. Victor Martel Email Address — martelacademy@gmail.com Dr. Victor Martel Phone Number — 561 602 7222 Martel Academy — https://martelacademy.com/ Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Send us a textIn this Journal Club episode, Ben and Daphna review a major randomized clinical trial published in JAMA comparing expectant management with active pharmacologic treatment of patent ductus arteriosus in preterm infants. They walk through the trial design, inclusion criteria, and outcomes, highlighting the unexpected survival difference favoring expectant management despite similar rates of bronchopulmonary dysplasia. The discussion explores the implications for bedside decision-making, the limitations of PDA-focused strategies, and the need for a more physiologic, patient-centered approach to ductal management in extremely preterm infants.----Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants: The PDA Randomized Clinical Trial. Laughon MM, Thomas SM, Watterberg KL, Kennedy KA, Keszler M, Ambalavanan N, Davis AS, Slaughter JL, Guillet R, Colaizy TT, Cotten CM, Dhawan MA, Bose CL, Talbert J, Smucny S, Benitz WE, Rysavy MA, Ohls RK, Baserga MC, DeMauro SB, Jaleel M, Jackson WM, Carlo WA, Puopolo KM, Hibbs AM, Katheria A, Sánchez PJ, D'Angio CT, Patel RM, Johnson BA, Chock VY, Bhatt AJ, Merhar SL, Moore R, Laptook AR, Ghavam S, Fuller J, Vyas-Read S, Kicklighter SD, Steinbrekera B, Anderson K, Reynolds AM, Wyckoff MH, Montoya C, Das A, Do B, Chang S, Higgins RD, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA. 2025 Dec 9:e2523330. doi: 10.1001/jama.2025.23330. Online ahead of print.PMID: 41364689Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

(00:00) Zolak & Bertrand start the hour with calls on the Patriots and whether kickers need to be booted from the NFL.(8:59) We dive into the Sounds of Sunday from Week 18.(21:03) The crew finishes the day with calls on everything.(31:26) Today's Takeaway.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Parents!Listen to this podcast, audiobooks and more on Storybutton, without your kids needing to use a screened device or your phone. Listen with no fees or subscriptions.—> Order Storybutton Today The Spy Starter Pack

What does a low heart rate really mean in athletes? When is it a normal adaptation to training, and when is it a sign that something is medically wrong? In this interview, Dr. Marianne Miller speaks with Megan Hellner, RD and Katherine Hill, MD, co-founders of AthleatMD, about one of the most misunderstood issues in athlete health. Together, they unpack how low heart rate, underfueling, and performance pressure can intersect in ways that are often minimized or missed entirely in both sports medicine and eating disorder care. Content Caution This episode includes discussion of eating disorders, Relative Energy Deficiency in Sport (REDS), medical instability, low heart rate, weight loss, body image pressure, and athletic injury. Listener discretion is encouraged. What Is Relative Energy Deficiency in Sport (REDS)? Relative Energy Deficiency in Sport occurs when an athlete's energy intake does not meet the demands of training, daily functioning, and, for young athletes, growth and development. Dr. Hill explains that REDS can occur with or without an eating disorder and that many athletes develop REDS unintentionally due to intense schedules, high training loads, or lack of accurate nutrition guidance. Although REDS is a relatively new diagnostic framework, its medical consequences are not new. Energy deficiency affects nearly every system in the body, including the heart, bones, hormones, digestion, immune function, and mental health. Importantly, many athletes with REDS do not appear thin, which contributes to how frequently the condition is overlooked. Low Heart Rate in Athletes: Fitness or Medical Red Flag? A low resting heart rate is often praised as evidence of elite fitness, yet this episode challenges that assumption. Dr. Hill and Dr. Hellner explain the difference between mild athletic bradycardia and dangerous cardiac suppression related to undernutrition. They discuss why heart rates in the low 40s or 30s should never be automatically dismissed as “normal for athletes,” particularly when fatigue, injury, missed periods, or hormonal suppression are present. The conversation highlights how REDS and malnutrition can compound athletic adaptations, leading to serious medical risk while athletes are reassured that nothing is wrong. Where Eating Disorder Care and Sports Medicine Fall Short Athletes often exist in a gray area where eating disorder treatment programs and sports medicine settings fail to fully meet their needs. Drs. Hellner and Hill describe how eating disorder programs may underestimate the importance of athletic identity, while sports environments frequently minimize eating disorders and REDS altogether. This disconnect can result in rigid activity bans, delayed diagnosis, or false reassurance that prolongs harm. The episode emphasizes the need for individualized, multidisciplinary decision-making that considers medical stability, psychological safety, and the athlete's relationship with sport. Body Image Pressure and the Athletic Aesthetic Myth The conversation also explores how appearance-based expectations shape athlete health. Dr. Hellner introduces the concept of the athletic aesthetic myth, which falsely assumes that performance requires a specific body type. Dr. Marianne and her guests discuss how coaching culture, social media trends, and gendered body ideals increase risk for REDS and disordered eating. They also highlight the growing visibility of elite athletes across a wide range of body sizes, challenging the belief that leanness equals success. How AthleatMD Supports Athletes With REDS and Eating Disorders AthleatMD provides virtual medical and nutrition care for athletes across many states, serving competitive, recreational, and former athletes. Dr. Hellner explains how assessment focuses on weight history, growth patterns, labs, training load, injury history, and relationship with food and sport, without assuming intentional restriction. Treatment centers on nutrition restoration, medical stabilization, and education, with approaches tailored to the athlete's sport, goals, and developmental stage. For many athletes, restoring adequate energy intake improves both health and performance in ways they did not expect. Who This Episode Is For This episode is especially relevant for athletes experiencing fatigue, injury, or declining performance, as well as parents of young athletes, coaches, therapists, dietitians, and medical providers. It is also an important listen for anyone questioning whether “fit” always means healthy in sport. Related Episode Eating Disorders & Athletes: The Pressure to Perform on Apple & Spotify. About Today's Guests Dr. Megan Hellner and Dr. Katherine Hill are the co-founders of AthleatMD (@athleatmd), a virtual, multidisciplinary practice specializing in medical and nutrition care for athletes with eating disorders and Relative Energy Deficiency in Sport (REDS). Their work focuses on bridging the long-standing gap between sports performance and eating disorder treatment. About the Host Dr. Marianne Miller is a Licensed Marriage and Family Therapist and the host of Dr. Marianne-Land: An Eating Disorder Recovery Podcast. She provides neurodivergent-affirming, trauma-informed care for eating disorders, including anorexia, bulimia, binge eating disorder, and ARFID, and works with clients in California, Texas, and Washington, D.C. Learn more about working with Dr. Marianne and explore her courses and podcast at drmariannemiller.com.

In this episode of the JEMS Report, Mike Brown sits down with EMS advocates David Blevins and Sam Magill to discuss groundbreaking federal legislation introduced by Senators Collins and Welch that aims to expand treat-in-place programs and establish sustainable funding models for Mobile Integrated Health (MIH). They explore how this legislation could shift EMS from the traditional transport-focused model to one centered on delivering appropriate care at the right place and time—often right in the patient's home. The conversation highlights the critical role of EMS providers in advocacy, the implications for liability and medical direction, and the potential to reduce hospital overcrowding and healthcare costs. Listeners will also hear about the real-world benefits of MIH programs, including improved patient outcomes and new career pathways within EMS.

Dr Karan Desai discusses the article "Autologous Fat Grafting and Neurolysis for Treatment of Recalcitrant Carpal Tunnel Syndrome" that appears in the January 2026 issue of The Journal of Hand Surgery.

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How Exercise Really Boosts Cancer Treatment Recovery with guest Scott Capozza January 4, 2026 Yale Cancer Center visit: https://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095

Featuring perspectives from Dr Harry Paul Erba, Dr Amir Fathi, Dr Tara L Lin, Dr Alexander Perl and Dr Eytan M Stein, including the following topics:  Introduction (0:00) Up-Front Therapy for Older Patients with Acute Myeloid Leukemia (AML) — Dr Lin (1:46) Selection of Therapy for Younger Patients with AML without a Targetable Mutation; Promising Investigational Strategies — Dr Perl (25:38) Role of FLT3 Inhibitors in AML Management — Dr Erba (48:27) Incorporation of IDH Inhibitors into the Care of Patients with AML — Dr Fathi (1:10:28) Current and Future Role of Menin Inhibitors in the Treatment of AML — Dr Stein (1:37:29) CME information and select publications

Dr. DebWhat if I told you that the stomach acid medication you’re taking for heartburn is actually causing the problem it’s supposed to solve that your doctor learned virtually nothing about nutrition, despite spending 8 years in medical school. That the very system claiming to heal you was deliberately designed over a hundred years ago by an oil tycoon, John D. Rockefeller, to create lifelong customers, not healthy people. Last week a patient spent thousands of dollars on tests and treatments for acid reflux, only to discover she needed more stomach acid, not less. The medication keeping her sick was designed to do exactly that. Today we’re exposing the greatest medical deception in modern history, how a petroleum empire systematically destroyed natural healing wisdom turned medicine into a profit machine. And why the treatments, keeping millions sick were engineered that way from the beginning. This isn’t about conspiracy theories. This is a documented history that explains why you feel so lost about your own body’s needs welcome back to let’s talk wellness. Now the show where we uncover the root causes of chronic illness, explore cutting edge regenerative medicine, and empower you with the tools to heal. I’m Dr. Deb. And today we’re diving into how the Rockefeller Medical Empire systematically destroyed natural healing wisdom and replaced it with profit driven systems that keeps you dependent on treatments instead of achieving true health. If you or someone you love has been running to the doctor for every minor ailment, taking acid blockers that seem to make digestive problems worse, or feeling confused about basic body functions that our ancestors understood instinctively. This episode is for you. So, as usual, grab a cup of coffee, tea, or whatever helps you unwind. Settle in and let’s get started on your journey to reclaiming your health sovereignty all right. So here we are talking about the Rockefeller Medical Revolution. Now, what if your symptoms aren’t true diagnosis, but rather the predictable result of a medical system designed over a hundred years ago to create lifelong customers instead of healthy people. Now I learned this when I was in naturopathic school over 20 years ago. And it hasn’t been talked about a lot until recently. Recently. People are exposing the truth about what actually happened in our medical system. And today I want to take you back to the early 19 hundreds to understand how we lost the basic health wisdom that sustained humanity for thousands of years. Yes, I said that thousands of years. This isn’t conspiracy theory. This is documented history. That explains why you feel so lost when it comes to your own body’s needs. You know by the turn of the 20th century. According to meridian health Clinic’s documentation. Rockefeller controlled 90% of all petroleum refineries in America and through ownership of the Standard Oil Corporation. But Rockefeller saw an opportunity that went far beyond oil. He recognized that petrochemicals could be the foundation for a completely new medical system. And here’s what most people don’t know. Natural and herbal medicines were very popular in America during the early 19 hundreds. According to Staywell, Copper’s historical analysis, almost one half of medical colleges and doctors in America were practicing holistic medicine, using extensive knowledge from Europe and native American traditions. People understood that food was medicine, that the body had natural healing mechanisms, and that supporting these mechanisms was the key to health. But there was a problem with the Rockefeller’s business plan. Natural medicines couldn’t be patented. They couldn’t make a lot of money off of them, because they couldn’t hold a patent. Petrochemicals, however, could be patented, could be owned, and could be sold for high profits. So Rockefeller and Andrew Carnegie devised a systematic plan to eliminate natural medicine and replace it with petrochemical based pharmaceuticals and according to E. Richard Brown’s comprehensive academic documentation in Rockefeller, medicine men. Medicine, and capitalism in America. They employed the services of Abraham Flexner, who proceeded to visit and assess every single medical school in us and in Canada. Within a very short time of this development, medical schools all around the us began to collapse or consolidate. The numbers are staggering. By 1910 30 schools had merged, and 21 had closed their doors of the 166 medical colleges operating in 19 0, 4, a hundred 33 had survived by 1910 and a hundred 4 by 1915, 15 years later, only 76 schools of medicine existed in the Us. And they all followed the same curriculum. This wasn’t just about changing medical education. According to Staywell’s copper historical analysis. Rockefeller and Carnegie influenced insurance companies to stop covering holistic treatments. Medical professionals were trained in the new pharmaceutical model and natural solutions became outdated or forgotten. Not only that alternative healthcare practitioners who wanted to stay practicing in alternative medicine were imprisoned for doing so as documented by the potency number 710. The goal was clear, create a system where scientists would study how plants cure disease, identify which chemicals in the plants were effective and then recreate a similar but not identical chemical in the laboratory that would be patented. E. Richard Brown’s documents. The story of how a powerful professional elite gained virtual homogeny in the western theater of healing by effectively taking control of the ethos and practice of Western medicine. The result, according to the healthcare spending data, the United States now spends 17.6% of its Gdp on health care 4.9 trillion dollars in 2023, or 14,570 per person nearly twice as much as the average Oecd country. But it doesn’t focus on cure. But on symptoms, and thus creating recurring clients. This systematic destruction of natural medicine explains why today’s healthcare providers often seem baffled by simple questions about nutrition why they immediately reach for a prescription medication for minor ailments, and why so many people feel disconnected from their own body’s wisdom. We’ve been trained over 4 generations to believe that our bodies are broken, and that symptoms are diseases rather than messages, and that external interventions are always superior to supporting natural healing processes. But here’s what they couldn’t eliminate your body’s innate wisdom. Your digestive system still functions the same way it did a hundred years ago. Your immune system still follows the same patterns. The principles of nutrition, movement and stress management haven’t changed. We’ve just forgotten how to listen and respond. We’re gonna take a small break here and hear from our sponsor. When we come back. We’re gonna talk about the acid reflux deception, and why your cure is making you sicker, so don’t go away all right, welcome back. So I want to give you a perfect example of how Rockefeller medicine has turned natural body wisdom upside down, the treatment of acid, reflux, and heartburn. Every single day in my practice I see patients who’ve been taking acid blocker medications, proton pump inhibitors like prilosec nexium or prevacid for years, not for weeks, years, and sometimes even decades. They come to me because their digestive problems are getting worse, not better. They have bloating and gas and nutrition deficiencies. And we’re seeing many more increased food sensitivities. And here’s what’s happening in the Us. Most people often attribute their digestive problems to too much stomach acid. And they use medications to suppress the stomach acid, but, in fact symptoms of chronic acid, reflux, heartburn, or gerd, can also be caused by too little stomach acid, a condition called hyper. Sorry hypochlorhydria normal stomach acid has a Ph level of one to 2, which is highly acidic. Hydrochloric acid plays an important role in your digestion and your immunity. It helps to break down proteins and absorb essential nutrients, and it helps control viruses and bacteria that might otherwise infect your stomach. But here’s the crucial part that most people don’t understand, and, according to Cleveland clinic, your stomach secretes lower amounts of hydrochloric acid. As you age. Hypochlorhydria is more common in people over the age of 40, and even more common over the age of 65. Webmd states that the stomach acid can produce less acid as a result of aging and being 65 or older is a risk factor for developing hypochlorhydria. We’ve been treating this in my practice for a long time. It’s 1 of the main foundations that we learn as naturopathic practitioners and as naturopathic doctors, and there are times where people need these medications, but they were designed to be used short term not long term in a 2,013 review published in Medical News today, they found that hypochlorhydria is the main change in the stomach acid of older adults. and when you have hypochlorydria, poor digestion from the lack of stomach, acid can create gas bubbles that rise into your esophagus or throat, carrying stomach acid with them. You experience heartburn and assume that you have too much acid. So you take acid blockers which makes the underlying problem worse. Now, here’s something that will shock you. PPI’s protein pump inhibitors were originally studied and approved by the FDA for short-term use only according to research published in us pharmacists, most cases of peptic ulcers resolve in 6 to 8 weeks with PPI therapy, which is what these medications were created for. Originally the American family physician reports that for erosive esophagitis. Omeprazole is indicated for short term 4 to 8 weeks. That’s it. Treatment and healing and done if needed. An additional 4 to 8 weeks of therapy may be considered and the University of Minnesota College of Pharmacy, States. Guidelines recommended a treatment duration of 8 weeks with standard once a day dosing for a PPI for Gerd. The Canadian family physician, published guidelines where a team of healthcare professionals recommended prescribing Ppis in adults who suffer from heartburn and who have completed a minimum treatment of 4 weeks in which symptoms were relieved. Yet people are taking these medications for years, even decades far beyond their intended duration of use and a study published in Pmc. Found that the threshold for defining long-term PPI use varied from 2 weeks to 7 years of PPI use. But the most common definition was greater than one year or 6 months, according to the research in clinical context, use of Ppis for more than 8 weeks could be reasonably defined as long-term use. Now let’s talk about what these acid blocker medications are actually doing to your body when used. Long term. The research on long term PPI use is absolutely alarming. According to the comprehensive review published in pubmed central Pmc. Long-term use of ppis have been associated with serious adverse effects, including kidney disease, cardiovascular disease fractures because you’re not absorbing your nutrients, and you’re being depleted. Infections, including C. Diff pneumonia, micronutrient deficiencies and hypomagnesium a low level of magnesium anemia, vitamin, b, deficiency, hypocalcemia, low calcium, low potassium. and even cancers, including gastric cancer, pancreatic cancer, colorectal cancer. And hepatic cancer and we are seeing all of these cancers on a rise, and we are now linking them back to some of these medications. Mayo clinic proceedings published research showing that recent studies regarding long-term use of PPI medication have noted potential adverse effects, including risks of fracture, pneumonia, C diff, which is a diarrhea. It’s a bacteria, low magnesium, low b 12 chronic kidney disease and even dementia. And a 2024 study published in nature communications, analyzing over 2 million participants from 5 cohorts found that PPI use correlated with increased risk of 15 leading global diseases, such as ischemic heart disease. Diabetes, respiratory infections, chronic kidney disease. And these associations showed dose response relationships and consistency across different PPI types. Now think about this. You take a medication for heartburn that was designed for 4 to 8 weeks of use, and when used long term, it actually increases your risk of life, threatening infections, kidney disease, and dementia. This is the predictable result of suppressing a natural body function that exists for important reasons. Hci plays a key role in many physiological processes. It triggers, intestinal hormones, prepares folate and B 12 for absorption, and it’s essential for absorption of minerals, including calcium, magnesium, potassium, zinc, and iron. And when you block acid production, you create a cascade of nutritional deficiencies and immune system problems that often manifest as seemingly unrelated health issues. So what’s the natural approach? Instead of suppressing stomach acid, we need to support healthy acid production and address the root cause of reflux healthcare. Providers may prescribe hcl supplements like betaine, hydrochloric acid. Bhcl is what it’s called. Sometimes it’s called betaine it’s often combined with enzymes like pepsin or amylase or lipase, and it’s used to treat hydrochloric acid deficiency, hypochlorhydria. These supplements can help your digestion and sometimes help your stomach acid gradually return back to normal levels where you may not need to use them all the time. Simple strategies include consuming protein at the beginning of the meal to stimulate Hcl production, consume fluids separately at least 30 min away from meals, if you can, and address the underlying cause like chronic stress and H. Pylori infections. This is such a sore subject for me. So many people walk around with an H. Pylori infection. It’s a bacterial infection in the stomach that can cause stomach ulcers, causes a lot of stomach pain and burning. and nobody is treating the infection. It’s a bacterial infection. We don’t treat this anymore with antibiotics or antimicrobials. We treat it with Ppis. But, Ppis don’t fix the problem. You have to get rid of the bacteria once the bacteria is gone, the gut lining can heal. Now it is a common bacteria. It can reoccur quite frequently. It’s highly contagious, so you can pick it up from other people, and it may need multiple courses of treatment over a person’s lifetime. But you’re actually treating the problem. You’re getting rid of the bacteria that’s creating the issue instead of suppressing the acid. That’s not fixing the bacteria which then leads to a whole host of other problems that we just talked about. There are natural approaches to increase stomach acid, including addressing zinc deficiency. And since the stomach uses zinc to produce Hcl. Taking probiotics to help support healthy gut bacteria and using digestive bitters before meals can be really helpful. This is exactly what I mean about reclaiming the body’s wisdom. Instead of suppressing natural functions, we support them instead of creating drug dependency, we restore normal physiology. Instead of treating symptoms indefinitely, we address the root cause and help the body heal itself. In many cultures. Bitters is a common thing to use before or after a meal. But yet in the American culture we don’t do that anymore. We’ve not passed on that tradition. So very few people understand how to use bitters, or what bitters are, or why they’re important. And these basic things that can be used in your food and cooking and taking could replace thousands of dollars of medication that you don’t really need. That can create many more problems along the way. Now, why does your doctor know nothing about nutrition. Well, I want to address something that might shock you all. The reason your doctor seems baffled when you ask about nutrition isn’t because they’re not intelligent. It’s because they literally never learned this in medical school statistics on nutritional education in medical schools are staggering and help explain why we have such a health literacy crisis in America. According to recent research published in multiple academic journals, only 27% of Us. Medical schools actually offer students. The recommended 25 h of nutritional training across 4 years of medical school. That means 73% of the medical schools don’t even meet the minimum standards set in 1985. But wait, it gets worse. A 2021 survey of medical schools in the Us. And the Uk. Found that most students receive an average of only 11 h of nutritional training throughout their entire medical program. and another recent study showed that in 2023 a survey of more than a thousand Us. Medical students. About 58% of these respondents said they received no formal nutritional education while in medical school. For 4 years those who did averaged only 3 h. I’m going to say this again because it’s it’s huge 3 h of nutritional education per year. So let me put this in perspective during 4 years of medical school most students spend fewer than 20 h on nutrition that’s completely disproportionate to its health benefits for patients to compare. They’ll spend hundreds of hours learning about pharmaceutical interventions, but virtually no time learning how food affects health and disease. Now, could this be? Why, when we talk about nutrition to lower cholesterol levels or control your diabetes, they blow you off, and they don’t answer you. It’s because they don’t understand. But yet what they’ll say is, people won’t change their diet. That’s why you have to take medication. That’s not true. I will tell you. I work with people every single day who are willing to change their diet. They’re just confused by all the information that’s out there today about nutrition. And what diet is the right diet to follow? Do I do, Paleo? Do I do? Aip? Do I do carnivore? Do I do, Keto? Do I do? Low carb? There’s so many diets out there today? It’s confusing people. So I digress. But let’s go back. So here’s the kicker. The limited time medical students do spend on nutrition office often focuses on nutrients think proteins and carbohydrates rather than training in topics such as motivational interviewing or meal planning, and as one Stanford researcher noted, we physicians often sound like chemists rather than counselors who can speak with patients about diet. Isn’t that true? We can speak super high level up here, but we can’t talk basics about nutrition. And this explains why only 14% of the physicians believe they were adequately trained in nutritional counseling. Once they entered practice and without foundational concepts of nutrition in undergrad work. Graduate medical education unsurprisingly falls short of meeting patients, needs for nutritional guidance in clinical practice, and meanwhile diet, sensitive chronic diseases continue to escalate. Although they are largely preventable and treatable by nutritional therapies and dietary. Lifestyle changes. Now think about this. Diet. Related diseases are the number one cause of death in the Us. The number one cause. Yet many doctors receive little to no nutritional education in medical school, and according to current health statistics from 2017 to march of 2020. Obesity prevalence was 19.7% among us children and adolescents affecting approximately 14.7 million young people. About 352,000 Americans, under the age of 20, have been diagnosed with diabetes. Let me say this again, because these numbers are astounding to me. 352,000 Americans, under the age of 20, have been diagnosed with diabetes with 5,300 youth diagnosed with type, 2 diabetes annually. Yet the very professionals we turn to for health. Guidance were never taught how food affects these conditions and what drug has come to the rescue Glp. One S. Ozempic wegovy. They’re great for weight loss. They’re great for treating diabetes. But why are they here? Well, these numbers are. Why, they’re here. This is staggering to put 352,000 Americans under the age of 20 on a glp, one that they’re going to be on for the rest of their lives at a minimum of $1,200 per month. All we have to do is do the math, you guys, and we can see exactly what’s happening to our country, and who is getting rich, and who is getting the short end of the stick. You’ve become a moneymaker to the pharmaceutical industry because nobody has taught you how to eat properly, how to live, how to have a healthy lifestyle, and how to prevent disease, or how to actually reverse type 2 diabetes, because it’s reversible in many cases, especially young people. And we do none of that. All we do is prescribe medications. Metformin. Glp, one for the rest of your life from 20 years old to 75, or 80, you’re going to be taking medications that are making the pharmaceutical companies more wealth and creating a disease on top of a disease on top of a disease. These deficiencies in nutritional education happen at all levels of medical training, and there’s been little improvement, despite decades of calls for reform. In 1985, the National Academy of Sciences report that they recommended at least 25 h of nutritional education in medical school. But a 2015 study showed only 29% of medical schools met this goal, and a 2023 study suggests the problem has become even worse. Only 7.8% of medical students reported 20 or more hours of nutritional education across all 4 years of medical school. This systemic lack of nutrition, nutritional education has been attributed to several factors a dearth of qualified instructors for nutritional courses, since most physicians do not understand nutrition well enough to teach it competition for curriculum time, with schools focusing on pharmaceutical interventions rather than lifestyle medicine and a lack of external incentives that support schools, teaching nutrition. And ironically, many medical schools are part of universities that have nutrition departments with Phd. Trained professors who could fill this gap by teaching nutrition in medical schools but those classes are often taught by physicians who may not have adequate nutritional training themselves. This explains so much about what I see in my practice. Patients come to me confused and frustrated because their primary care doctors can’t answer basic questions about how food affects their health conditions. And these doctors aren’t incompetent. They simply were never taught this information. And the result is that these physicians graduate, knowing how to prescribe medications for diabetes, but not how dietary changes can prevent or reverse it. They can treat high blood pressure with pharmaceuticals, but they may not know that specific nutritional approaches can be equally or more effective. This isn’t the doctor’s fault. It’s the predictable result of medical education systems that was deliberately designed to focus on patentable treatments rather than natural healing approaches. And remember this traces back to the Rockefeller influence on medical education. You can’t patent an apple or a vegetable. But you can patent a drug now. Why can’t we trust most medical studies? Well this just gets even better. I need to address something that’s crucial for you to understand as you navigate health information. Why so much of the medical research you hear about in the news is biased, and why peer Review isn’t the gold standard of truth you’ve been told it is. The corruption in medical research by pharmaceutical companies is not a conspiracy theory. It’s well documented scientific fact, according to research, published in frontiers, in research, metrics and analytics. When pharmaceutical and other companies sponsor research, there is a bias. A systematic tendency towards results serving their interests. But the bias is not seen in the formal factors routinely associated with low quality science. A Cochrane Review analyzed 75 studies of the association between industry, funding, and trial results, and these authors concluded that trials funded by a drug or device company were more likely to have positive conclusions and statistically significant results, and that this association could not be explained by differences in risk of bias between industry and non-industry funded trials. So think about that. According to the Cochrane collaboration, industry funding itself should be considered a standard risk of bias, a factor in clinical trials. Studies published in science and engineering ethics show that industry supported research is much more likely to yield positive outcomes than research with any other sponsorship. And here’s how the bias gets introduced through choice of compartor agents, multiple publications of positive trials and non-publication of negative trials reinterpreting data submitted to regulatory agencies, discordance between results and conclusions, conflict of interest leading to more positive conclusions, ghostwriting and the use of seating trials. Research, published in the American Journal of Medicine. Found that a result favorable to drug study was reported by all industry, supported studies compared with two-thirds of studies, not industry, supported all industry, supported studies showed favorable results. That’s not science that’s marketing, masquerading as research. And according to research, published in sciencedirect the peer review system which we’re told ensures quality. Science has a major limitation. It has proved to be unable to deal with conflicts of interest, especially in big science contexts where prestigious scientists may have similar biases and conflicts of interest are widely shared among peer reviewers. Even government funded research can have conflicts of interest. Research published in pubmed States that there are significant benefits to authors and investigators in participating in government funded research and to journals in publishing it, which creates potentially biased information that are rarely acknowledged. And, according to research, published in frontiers in research, metrics, and analytics, the pharmaceutical industry has essentially co-opted medical knowledge systems for their particular interests. Using its very substantial resources. Pharmaceutical companies take their own research and smoothly integrate it into medical science. Taking advantage of the legitimacy of medical institutions. And this corruption means that much of what passes for medical science is actually influenced by commercial interests rather than pursuant of truth. Research published in Pmc. Shows that industry funding affects the results of clinical trials in predictable directions, serving the interests of the funders rather than the patients. So where can we get this reliable, unbiased Health information, because this is critically important, because your health decisions should be based on the best available evidence, not marketing disguised as science. And so here are some sources that I recommend for trustworthy health and nutritional information. They’re independent academic sources. According to Harvard Chan School of public health their nutritional, sourced, implicitly states their content is free from industry, influence, or support. The Linus Pauling Institute, Micronutrient Information Center at Oregon State University, which, according to the Glendale Community college Research Guide provides scientifically accurate information about vitamins, minerals, and other dietary factors. This Institute has been around for decades. I’ve used it a lot. I’ve gotten a lot of great information from them. Very, very trustworthy. According to the Glendale Community College of Nutrition Resource guide Tufts, University of Human Nutritional Research Center on aging is one of 6 human nutrition research centers supported by the United States Department of Agriculture, the Usda. Their peer reviewed journals with strong editorial independence though you must still check funding resources. And how do you evaluate this information? Online? Well, according to medlineplus and various health literacy guides when evaluating health information medical schools and large professional or nonprofit organizations are generally reliable sources, but remember, it is tainted by the Rockefeller method. So, for example, the American College of cardiology. Excuse me. Professional organization and the American Heart Institute a nonprofit are both reliable sources. Sorry about that of information on heart health and watch out for ads designed to look like neutral health information. If the site is funded by ads they should be clearly marked as advertisements. Excuse me, I guess I’m talking just a little too much now. So when the fear of medicine becomes deadly. Now, I want to address something critically important that often gets lost in conversations about health, sovereignty, and questioning the medical establishment. And while I’ve spent most of this episode explaining how the Rockefeller medical system has created dependency and suppressed natural healing wisdom. There’s a dangerous pendulum swing happening that I see in my practice. People becoming so fearful of pharmaceutical interventions that they refuse lifesaving treatments when they’re genuinely needed. This is where balance and clinical judgment become absolutely essential. Yes, we need to reclaim our basic health literacy and reduce our dependency on unnecessary medical interventions. But there are serious bacterial infections that require immediate antibiotic treatment, and the consequences of avoiding treatment can be devastating or even fatal. So let me share some examples from research that illustrate when antibiotic fear becomes dangerous. Let’s talk about Lyme disease, and when natural approaches might not be enough. The International Lyme Disease Association ilads has conducted extensive research on chronic lyme disease, and their findings are sobering. Ileds defines chronic lyme disease as a multi-system illness that results from an active and ongoing infection of pathogenic members of the Borrelia Brdorferi complex. And, according to ilads research published in their treatment guidelines, the consequences of untreated persistent lyme infection far outweigh the potential consequences of long-term antibiotic therapy in well-designed trials of antibiotic retreatment in patients with severe fatigue, 64% in the treatment arm obtained clinically significant and sustained benefit from additional antibiotic therapy. Ilas emphasizes that cases of chronic borrelia require individualized treatment plans, and when necessary antibiotic therapy should be extended their research demonstrates that 20 days of prophylactic antibiotic treatment may be highly effective for preventing the onset of lyme disease. After known tick bites and patients with early Lyme disease may be best served by receiving 4 to 6 weeks of antibiotic therapy. Research published in Pmc. Shows that patients with untreated infections may go on to develop chronic, debilitating, multisystem illnesses that is difficult to manage, and numerous studies have documented persistent Borrelia, burgdorferi infection in patients with persistent symptoms of neurological lyme disease following short course. Antibiotic treatment and animal models have demonstrated that short course. Antibiotic therapy may fail to eradicate lyme spirochetes short course is a 1 day. One pill treatment of doxycycline. Or less than 20 days of antibiotics, is considered a short course. It’s not long enough to kill the bacteria. The bacteria’s life cycle is about 21 days, so if you don’t treat the infection long enough, the likelihood of that infection returning is significant. They’ve also done studies in the petri dish, where they show doxycycline being put into a petri dish with active lyme and doxycycline does not kill the infection, it just slows the replication of it. Therefore, using only doxycycline, which is common practice in lyme disease may not completely eradicate that infection for you. So let’s talk about another life threatening emergency. C. Diff clostridia difficile infection, which represents another example where antibiotic treatment is absolutely essential, despite the fact that C diff itself is often triggered by antibiotic use. According to Cleveland clinic C. Diff is estimated to cause almost half a million infections in the United States each year, with 500,000 infections, causing 15,000 deaths each year. Studies reported by Pmc. Found thirty-day Cdi. Mortality rates ranging from 6 to 11% and hospitalized Cdi patients have significantly increased the risk of mortality and complications. Research published in Pmc shows that 16.5% of Cdi patients experience sepsis and that this increases with reoccurrences 27.3% of patients with their 1st reoccurrence experience sepsis. While 33.1% with 2 reoccurrences and 43.2% with 3 or more reoccurrences. Mortality associated with sepsis is very high within hospital 30 days and 12 month mortality rates of 24%, 30% and 58% respectively. According to the Cdc treatment for C diff infection usually involves taking a specific antibiotic, such as vancomycin for at least 10 days, and while this seems counterintuitive, treating an antibiotic associated infection with more antibiotics. It’s often lifesaving. Now let’s talk about preventing devastating complications. Strep throat infections. Provide perhaps the clearest example of when antibiotic treatment prevents serious long-term consequences, and, according to Mayo clinic, if untreated strep throat can cause complications such as kidney inflammation and rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, and a specific type of rash of heart valve damage. We also know that strep can cause pans pandas, which is a systemic infection, often causing problems with severe Ocd. And anxiety and affecting mostly young people. The research is unambiguous. According to the Cleveland clinic. Rheumatic fever is a rare complication of untreated strep, throat, or scarlet fever that most commonly affects children and teens, and in severe cases it can lead to serious health problems that can affect your child’s heart. Joints and organs. And research also shows that the rate of development of rheumatic fever in individuals with untreated strep infections is estimated to be 3%. The incidence of reoccurrence with a subsequent untreated infection is substantially greater. About 50% the rate of development is far lower in individuals who have received antibiotic treatment. And according to the World health organization, rheumatic heart disease results from the inflammation and scarring of the heart valves caused by rheumatic fever, and if rheumatic fever is not treated promptly, rheumatic heart disease may occur, and rheumatic heart disease weakens the valves between the chambers of the heart, and severe rheumatic heart disease can require heart surgery and result in death. The who states that rheumatic heart disease remains the leading cause of maternal cardiac complications during pregnancy. And additionally, according to the National Kidney foundation. After your child has either had throat or skin strep infection, they can develop post strep glomerial nephritis. The Strep bacteria travels to the kidneys and makes the filtering units of the kidneys inflamed, causing the kidneys to be able to unable or less able to fill and filter urine. This can develop one to 2 weeks after an untreated throat infection, or 3 to 4 weeks after an untreated skin infection. We need to find balance. And here’s what I want you to understand. Questioning the medical establishment and developing health literacy doesn’t mean rejecting all medical interventions. It means developing the wisdom to know when they’re necessary and lifesaving versus when they’re unnecessary and potentially harmful. When I see patients with confirmed lyme disease, serious strep infections or life. Threatening conditions like C diff. I don’t hesitate to recommend appropriate therapy but I also work to support their overall health address, root causes, protect and restore their gut microbiome and help them recover their natural resilience. The goal isn’t to avoid all medical interventions. It’s to use them wisely when truly needed, while simultaneously supporting your body’s inherent healing capacity and addressing the lifestyle factors that created the vulnerability. In the 1st place. All of this can be extremely overwhelming, and it can be frightening to understand or learn. But remember, the power that you have is knowledge. The more you learn about what’s actually happening in your health, in understanding nutrition. in learning what your body wants to be fed, and how it feels, and working with practitioners who are holistic in nature, natural, integrative, functional, whatever we want to call that these days. The more you can learn from them, the more control you have over your own health and what I would urge you to do is to teach your children what you’re learning. Teach them how to live a healthy lifestyle, teach them how to keep a clean environment. This is how we take back our own health. So thank you for joining me today on, let’s talk wellness. Now, if this episode resonated with you. Please share it with someone who could benefit from understanding how the Rockefeller medical system has shaped our approach to health, and how to reclaim your body’s wisdom while using medical care appropriately when truly needed. Remember, wellness isn’t just about feeling good. It’s about understanding your body, trusting its wisdom, supporting its natural healing capacity, and knowing when to seek appropriate medical intervention. If you’re ready to explore how functional medicine can help you develop this deeper health knowledge while addressing root causes rather than just managing symptoms. You can get more information from serenityhealthcarecenter.com, or reach out directly to us through our social media channels until next time. I’m Dr. Dab, reminding you that your body is your wisest teacher. Learn to listen, trust the process, use medical care wisely when needed, and take care of your body, mind, and spirit. Be well, and we’ll see you on the next episode.The post Episode 250 -The Great Medical Deception first appeared on Let's Talk Wellness Now.

Bipolar depression and mixed episodes remain among the most difficult—and highest-risk—conditions in psychiatry. Even when mood symptoms improve, many patients continue to experience significant cognitive and functional impairment.On NYU Insights on Psychiatry, Dan Iosifescu, MD, explains why standard treatment approaches so often fall short. Dr. Iosifescu argues that symptom suppression is frequently mistaken for recovery, that short-term improvement does not equal durable treatment, and that bipolar mixed episodes expose the limits of one-size-fits-all care.The discussion focuses on the clinical dangers of mixed episodes, the challenge of recognizing them, and the importance of acute stabilization followed by a deliberate transition to sustainable long-term treatment. Dr. Iosifescu also explores how emerging biological research—including metabolic interventions and personalized experimental models—may eventually help clinicians better match patients to treatments.Rather than offering quick fixes, this conversation reframes how clinicians think about success, recovery, and personalization in the treatment of bipolar depression.Guest: Dan Iosifescu, MD, Director of Clinical Research at the Nathan Kline Institute and Director of the Mood Disorders Clinical and Research Program at NYU Langone Health.Watch Insights on Psychiatry on YouTubeSenior Producer: Jon Earle

Staff Picks from recent stories:With a new year starting, many of us are trying to change our habits. An Alberta company is interested in shaking up Canadian currency by creating a digital coin, backed by the loonie.And: Canada is trying to cash in on a shift to renewables and EV technology. One of the metals essential to those industries is copper. It's needed to build batteries, military equipment, and big tech. Two copper mines are on the prime minister's list of major infrastructure projects.Also: Hundreds of Canadians are diagnosed with dementia every day. It is expected to become an even more pressing health problem as Canada's population ages. Now researchers are studying a treatment built around sunshine, fresh air and farm animals.Plus: Infusion centres, technology to remember Vimy Ridge, a year of environmental policy changes, and more.

In this episode, we explore a head-to-head comparison of lithium versus quetiapine augmentation for treatment-resistant depression. When patients have failed multiple antidepressants, which augmentation strategy offers the best balance of efficacy and tolerability? We examine real-world data tracking symptom burden and side effects over an entire year. Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 76 Treatment-Resistant Depression: Lithium vs. Quetiapine for Augmentation?

What are your thoughts on Alpha-ketoglutarate for healthy aging?A treatment for warts?Am I destined to develop diabetes given my strong family history of diabetes and high blood pressure?

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THE GORE AND GLORY OF BATTLE Colleague Professor Emily Wilson. Wilson discusses translating the Iliad'svivid violence, drawing on insights from combat veterans regarding the trauma of battlefield death. A central theme is the treatment of corpses; possessing and stripping a dead enemy's armor is the ultimate sign of dominance. The conversation touches on the physical nature of the gods, who bleed "ichor" when wounded, and Poseidon's support for the Greeks in contrast to his brother Zeus. NUMBER 6 500 AD. ACHILLES TENT. ALEXANDRIA ORIGIN

Rest is the worst thing for your back pain. Common advice from doctors can actually make your disc issues and sciatica worse by ignoring the power of specific movement to heal your spine. In episode 845 of the Savage Perspective Podcast, host Robert Sikes talks with renowned lower back pain expert Grant Elliot about the real cause of flexion intolerant pain and how to build a bulletproof back. Grant explains why most treatments fail and shares simple, effective exercises and daily habits to strengthen your spine, improve mobility, and live pain free, even if you have scoliosis or a sedentary job. He provides clear, evidence based strategies for safe lifting, choosing the right mattress, and understanding why movement is the true medicine for long term spinal health.Ready to build a stronger, more resilient body? Join Robert's FREE Bodybuilding Masterclass and learn the foundational principles of building muscle and optimizing your health. Get started here: https://www.ketobodybuilding.com/registration-2Follow Grant on IG: https://www.instagram.com/rehabfix/Get Keto Brick: https://www.ketobrick.com/Subscribe to the podcast: https://open.spotify.com/show/42cjJssghqD01bdWBxRYEg?si=1XYKmPXmR4eKw2O9gGCEuQChapters:0:00 - Why General Doctors Give Bad Advice for Back Pain 1:15 - How a Cycling Injury Created a Back Pain Expert 3:05 - The Flaw in Traditional Chiropractic & PT Models 5:41 - Becoming the Expert He Never Had 6:33 - Why Your Doctor Shouldn't Give You Lifting Advice 8:16 - The #1 Myth: Why Resting Makes Back Pain WORSE 9:21 - What Is Flexion Intolerant Back Pain? (The Most Common Type) 10:50 - What's Happening Inside Your Spine When It Hurts to Bend Over? 13:20 - Is Sitting Really That Bad For You? The Truth About Posture 14:42 - The Single Best Exercise to Reverse a Sedentary Lifestyle 17:14 - How Often Should You Take Movement Breaks? (A Simple Routine) 19:46 - The Myth of the "Perfect" Ergonomic Office Chair 21:00 - How to Choose the Best Mattress for Back Pain & Sleep Quality 22:50 - The Dangers of Fear-Mongering in Healthcare 25:26 - The Truth About Uneven Hips, Weak Core & Bad Posture 27:06 - Does Scoliosis Actually Cause Back Pain? 29:52 - Are Some Exercises Inherently Bad for Your Spine? 30:02 - How to Properly Prepare Your Body for Heavy Lifts 33:03 - Why You SHOULD Deadlift With a Rounded Back 36:46 - Who is the Typical Person That Needs Back Rehab? 37:35 - A Guide to Footwear: Are Barefoot Shoes Worth It? 40:44 - Is It Too Late for Adults to Benefit from Barefoot Shoes? 42:58 - A Day in the Life: An Expert's Daily Movement Routine 45:32 - How Long Should Your Warm-Up Really Be? 47:28 - The Worst Time of Day to Deadlift for Spine Safety 51:03 - Are Stem Cells & PRP Injections a Waste of Money? 54:04 - The 80/20 Rule for an Effective Pain Recovery Plan 55:45 - The Next Chapter: Restructuring the Business 57:10 - How Entrepreneurial Stress Physically Manifests in the Body 1:01:06 - The Addictive Drug of Passionate Work vs. Optimal Health 1:03:19 - Where to Find Grant & Get a Free Self-Diagnosis Training

In the final episode of 2025, Brad sits down with Brian, who share's a raw and honest sobriety story that spans decades. Brian opens up about growing up in Spokane, Washington surrounded by alcoholism, violence, and instability — and how hockey became his escape. As a teenager, alcohol quickly became more than “weekend fun,” turning into blackout drinking, fights, arrests, and a dangerous spiral that ended in a moment that forced everything to change. Brian shares what finally made him ask for help, why leaving his environment was a key part of getting sober, and what it took to rebuild identity, friendships, and confidence without alcohol. Brian's last drink was December 28th, 1991 — and today he reflects on 34 years sober, life in Germany, and the mindset that helped him protect his recovery for the long haul. In this episode, we cover: •Childhood trauma, absent father, and growing up around addiction •Hockey as an outlet for anger, pain, and survival •Early drinking, escalation, blackouts, and legal consequences •The turning point that forced Brian to choose recovery •Treatment, relocating, and why “new environment” mattered •Rebuilding identity without alcohol (social life, confidence, dating) •Long-term sobriety tools: honesty, boundaries, and an exit plan •What 34 years sober has taught Brian about freedom and control   Join the Sober Motivation Community: Click here for 30 Days free Brian on Instagram: https://www.instagram.com/mrbrianpiper/  

In this episode of More Than A Pretty Face, Dr. Azi speaks with two leading dermatology experts about modern aesthetic and hair restoration treatments. First, Beverly Hills cosmetic dermatologist Dr. Ardalan Minokadeh shares how neuromodulators, fillers, and facial contouring should be approached differently in men. Then, New York–based dermatologist Dr. Marc Avram breaks down evidence-based hair loss treatments, from medications and PRP to at-home and in-office laser therapies. The episode wraps with practical insights on confidence, aging, and personalized care. Timeline of what was discussed: 00:00 – Intro 00:18 – Submit questions 00:34 – Meet Dr. Ardalan 01:05 – Conference context 01:40 – Men & aesthetics 02:25 – Botox dosing in men 03:10 – Brow positioning 03:45 – Crow's feet focus 04:20 – Dosing approach 05:05 – Icing & comfort 06:05 – Lip filler in men 07:15 – Neck & lower face 08:10 – Trap tox 08:55 – Jawline trends 09:35 – Chin projection 10:25 – Rapid-fire Q&A 11:55 – Where to find Dr. Ardalan 12:30 – Transition 12:51 – Meet Dr. Avram 13:05 – Hair restoration overview 13:35 – PP405 discussion 14:25 – Diagnosing hair loss 15:05 – Medical therapy 15:50 – PRP & regeneration 16:35 – Treatment timelines 17:20 – Combination therapy 18:00 – At-home laser caps 18:45 – In-office lasers 19:35 – Laser mechanism 20:20 – Emerging treatments 21:05 – Choosing a laser cap 21:45 – Supplements 22:50 – Where to find Dr. Avram 23:14 – End   ______________________________________________________________ Follow Ardalan Minokadeh on Instagram: @doctor.ardalan Dr. Ardalan Minokadeh is a board-certified, cosmetic fellowship–trained dermatologist based in Beverly Hills. He specializes in advanced injectable treatments, aesthetic dermatology, and facial balancing for both men and women. Known for his precise, anatomy-driven approach, Dr. Minokadeh is an expert in neuromodulators and dermal fillers, with a strong focus on natural, tailored results and patient-centered care.   Follow Marc Avram on Instagram: @drmarcavram Dr. Marc Avram is a board-certified dermatologist and internationally recognized leader in hair restoration and cosmetic dermatology, based on New York City's Upper East Side. He is the author of multiple textbooks and peer-reviewed publications and is widely regarded for his expertise in medical, regenerative, and laser-based hair loss treatments. Dr. Avram is known for his evidence-based approach, clinical innovation, and dedication to personalized patient care. ______________________________________________________________ Submit your questions for the podcast to Dr. Azi on Instagram @morethanaprettyfacepodcast, @skinbydrazi, on YouTube, and TikTok @skinbydrazi. Email morethanaprettyfacepodcast@gmail.com. Shop skincare at https://azimdskincare.com and learn more about the practice at https://www.lajollalaserderm.com/ The content of this podcast is for entertainment, educational, and informational purposes and does not constitute formal medical advice. © Azadeh Shirazi, MD FAAD.