Podcasts about usual care

Does having an injury or pain mean you need to stop moving? In this episode of The Body Nerd Show, I'm joined by Dana Jones, host of The Pain Free Athlete Podcast, for a myth-busting conversation about pain, injury, and movement. Together, we debunk some of the most common and harmful fitness myths that keep you stuck. If you've ever wondered what to do when you're in pain, why rest isn't always the best solution, or how to stay active safely, this episode is for you. Dana and I also dive into the mindset shifts that help you navigate workouts and life — even when you're in pain. You'll learn: Why no pain, no gain is not true (especially if you're already in pain Why pain doesn't have to be a normal part of aging How to navigate your workouts when you're injured or in pain All the links: Pain Free Athlete Podcast @painfreeathletepodcast on Instagram Dana's journaling prompts for pain Boulder Back Pain Study - Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial Nicole Sachs - Break Awake 30 days to more strength + flexibility with the Mobility Mastery Toolkit www.aewellness.com/podcast - Show notes, links and more. Come hang out with me on Instagram @hollaformala : https://instagram.com/hollaformala/ TikTok @ aewellness Bodywork Starter Guide - learn the 6 places you need to roll right now for quick relief, plus the reason why what you've tried so far has only given you a temporary fix. Download the guide for free now at www.aewellness.com/bodywork 818-396-6501 is the Body Nerd Hotline - how do you build consistency and/or where are you getting stuck? Drop me a line and let me know your body nerd hacks - you might just hear your voice on a future episode!   Today's episode of The Body Nerd Show is brought to you by Movement Mavens™ Therapy Balls—the official mobility tool of the show and the best way to keep your body moving pain-free. Tight hips? Stiff back? Movement Mavens Therapy Balls are designed to mimic the feel of a massage therapist's hands, helping you release tension, improve flexibility, and move better—every single day. Because let's be real—foam rollers are meh, and tennis balls? Not even close. Get the best. Your body deserves it. And right now, you can save 25% on all therapy balls, kits, and workshops with code BODYNERD25. Shop now at www.aewellness.com/shop-now/  

Dr. Aziz Gazipura explains the dangers of people-pleasing tendencies and shares actionable steps for overcoming it. — YOU'LL LEARN — 1) The massive costs of being a people-pleaser2) How to not feel guilty when saying no3) A surprising strategy to build your discomfort tolerance Subscribe or visit AwesomeAtYourJob.com/ep925 for clickable versions of the links below. — ABOUT AZIZ — Dr. Aziz is a clinical psychologist and one of the world's leading experts on social confidence. In 2011, Dr. Aziz started The Center For Social Confidence, which is dedicated to helping everyone break through their shyness and social anxiety.Through confidence coaching, audio and video programs, podcasts, a detailed blog, and intensive weekend workshops, Dr. Aziz has helped thousands of people all over the world increase their confidence and lives out his mission: To help every person who is stuck in shyness liberate themselves to pursue the relationship, career, and life they have always dreamed of.He lives in Portland, Oregon with his wife Candace and son Zaim.• Book: Not Nice: Stop People Pleasing, Staying Silent, & Feeling Guilty... And Start Speaking Up, Saying No, Asking Boldly, And Unapologetically Being Yourself (site) • Book: Less Nice, More You: Stop Hiding & Become The Most Bold, Authentic Version Of You Now • Mini course: “5 Steps to Unleash Your Inner Confidence” • Organization: Social Confidence Center • Website: DrAziz.com — RESOURCES MENTIONED IN THE SHOW — • Study: Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain - A Randomized Clinical Trial• Book: Free to Focus: A Total Productivity System to Achieve More by Doing Less by Michael Hyatt • Book: The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain by Alan Gordon, Alon Ziv• Previous episode: 830: Lessons Learned from the World's Longest Scientific Study on Happiness with Dr. Robert Waldinger See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode, Dr. Valentin Fuster reviews a groundbreaking study comparing metabolic surgery to traditional care for patients with obesity and obstructive sleep apnea. The research shows that metabolic surgery significantly lowers the risk of major cardiovascular events and mortality, highlighting the need for a multifaceted approach to treating these interlinked conditions.

Interview with Philip R. de Reuver, MD, PhD, and Daan J. Comes, MD, authors of Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Gallstones and Abdominal Pain: 5-Year Follow-Up of the SECURE Randomized Clinical Trial. Hosted by Amalia Cochran, MD. Related Content: Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Abdominal Pain and Gallstones

Interview with Philip R. de Reuver, MD, PhD, and Daan J. Comes, MD, authors of Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Gallstones and Abdominal Pain: 5-Year Follow-Up of the SECURE Randomized Clinical Trial. Hosted by Amalia Cochran, MD. Related Content: Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Abdominal Pain and Gallstones

We sit down to discuss the RESTORE trial, the biggest RCT to date looking at cognitive functional therapy for back pain! Please note, this podcast does not constitute medical advice.

Commentary by Dr. Valentin Fuster

ACC.24: VICTORION-INITIATE trial - An “Inclisiran First” Strategy vs Usual Care in Patients With Atherosclerotic Cardiovascular Disease

Jana hat eine kanadische Arbeit ausgegraben, die die Effekte einer kontinuierlichen primärmedizinischen Versorgung anhand vorhandener Evidenz beleuchtet. Ilja referiert eine nicht ganz neue Studie aus Großbritannien zur Versorgung von Gicht-Patienten durch speziell geschulte nichtärztliche Praxisassistent*Innen. Außerdem wird noch mal das Faß der vaccine efficacy aufgemacht. Achtung: Relative Risikoreduktion.

Dr. Aziz Gazipura explains the dangers of people-pleasing tendencies and shares actionable steps for overcoming it. — YOU'LL LEARN — 1) The massive costs of being a people-pleaser 2) How to not feel guilty when saying no 3) A surprising strategy to build your discomfort tolerance Subscribe or visit AwesomeAtYourJob.com/ep925 for clickable versions of the links below. — ABOUT AZIZ — Dr. Aziz is a clinical psychologist and one of the world's leading experts on social confidence. In 2011, Dr. Aziz started The Center For Social Confidence, which is dedicated to helping everyone break through their shyness and social anxiety. Through confidence coaching, audio and video programs, podcasts, a detailed blog, and intensive weekend workshops, Dr. Aziz has helped thousands of people all over the world increase their confidence and lives out his mission: To help every person who is stuck in shyness liberate themselves to pursue the relationship, career, and life they have always dreamed of.He lives in Portland, Oregon with his wife Candace and son Zaim. • Book: Not Nice: Stop People Pleasing, Staying Silent, & Feeling Guilty... And Start Speaking Up, Saying No, Asking Boldly, And Unapologetically Being Yourself (site) • Book: Less Nice, More You: Stop Hiding & Become The Most Bold, Authentic Version Of You Now • Mini course: “5 Steps to Unleash Your Inner Confidence” • Organization: Social Confidence Center • Website: DrAziz.com — RESOURCES MENTIONED IN THE SHOW — • Study: Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain - A Randomized Clinical Trial • Book: Free to Focus: A Total Productivity System to Achieve More by Doing Less by Michael Hyatt • Book: The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain by Alan Gordon, Alon Ziv • Previous episode: 830: Lessons Learned from the World's Longest Scientific Study on Happiness with Dr. Robert Waldinger See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome to the second part of our captivating two-part podcast series. In this episode, we draw our exploration of the groundbreaking realm of pain reprocessing therapy to a close and its potential to be a life-changing solution for those enduring chronic back pain. As we delve deep into the study, we take you on a fascinating journey through the human brain's reaction to pain, utilizing MRI scans to compare the responses of those undergoing therapy with those who received placebos. This objective data provides solid evidence of the therapy's effectiveness. We wholeheartedly invite you to engage with us, sharing your thoughts, questions, and reflections on the topics we've delved into. Your input is invaluable, so please reach out, share your insights, and embark on this enlightening journey of discovery alongside us.Ashar YK, Gordon A, Schubiner H, Uipi C, Knight K, Anderson Z, Carlisle J, Polisky L, Geuter S, Flood TF, Kragel PA, Dimidjian S, Lumley MA, Wager TD. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022 Jan 1;79(1):13-23. doi: 10.1001/jamapsychiatry.2021.2669. PMID: 34586357; PMCID: PMC8482298.Learn more and become a member at www.DrJournalClub.comCheck out our complete offerings of NANCEAC-approved Continuing Education Courses.

If you care about AF you will love this conversation. Soren has some interesting ideas about what AF is now vs what AF was in the past. Here are some links:The LOOP Study (which was non-significant). Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP StudySeverity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke: A Post Hoc Analysis of the LOOP Randomized Clinical TrialSensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.BTW: This is the kind of content we aim to bring you at Sensible Medicine. Thanks for your support. I have some great ideas for future conversations. Feel free to let me know your interests, too. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

In this unique two part podcast series, we'll start with Josh's firsthand account of successfully completing his inaugural triathlon, we will then shift our focus where we'll guide you through the intricate world of a randomized control trial of PRT, from the meticulous process of participant selection to the intricacies of statistical analysis. Plus, we'll delve into the ethical considerations, power analysis, and the three arms of the trial.  Stay tuned for Part 2, where we'll continue to uncover the mysteries of the randomized control trial of PRT.  It's a rollercoaster of knowledge, laughter, and experiences - so buckle up and join us on this enlightening ride! Ashar YK, Gordon A, Schubiner H, Uipi C, Knight K, Anderson Z, Carlisle J, Polisky L, Geuter S, Flood TF, Kragel PA, Dimidjian S, Lumley MA, Wager TD. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022 Jan 1;79(1):13-23. doi: 10.1001/jamapsychiatry.2021.2669. PMID: 34586357; PMCID: PMC8482298. Learn more and become a member at www.DrJournalClub.comCheck out our complete offerings of NANCEAC-approved Continuing Education Courses.

Quick summaries of Episodes 21-30. 21. SOAT for OUD: Short-Acting Opioid Agonists for Opioid Use Disorder: Safety and preliminary outcomes of short-acting opioid agonist treatment (sOAT) for hospitalized patients with opioid use disorder  22. Contingency Management for Coronary Artery Disease: High-risk Coronary Plaque Regression in Cash-based Contingency Management Intervention Among Cocaine Users With HIV-associated Subclinical Coronary Atherosclerosis 23. Eat-Sleep-Console: ACT NOW Collaborative. Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal 24. Smoking Cessation and Mortality: Association Between Smoking, Smoking Cessation, and Mortality by Race, Ethnicity, and Sex Among US Adults 25. High-dose Buprenorphine Induction: High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder 26. Addiction Survivors: Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment 27. The First Opioid Prescription: Risk factors for the development of opioid use disorder after first opioid prescription: A Swedish national study 28. Pain and Recovery: Persistence of significant pain interference following substance use disorder remission: Negative association with psychosocial and physical recovery 29. Vaping Cessation: Varenicline and counseling for vaping cessation: a double-blind, randomized, parallel-group, placebo-controlled trial 30. Race and MOUD: Racial Inequality in Receipt of Medications for Opioid Use Disorder ---------- Episode Credits: Original theme music: composed and performed by Benjamin Kennedy Audio production: Erin McCue Executive Producer: Dr. Patrick Beeman A podcast from Ars Longa Media ---------- The best part of any journal club is the conversation. Send us your comments on Twitter, Facebook, YouTube, Spotify, email, or join our Facebook group. Email: addictionmedicinejournalclub@gmail.com  Twitter: @AddictionMedJC  Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club YouTube: addictionmedicinejournalclub Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.

Pain reprosessing therapy er en metode som går på å behandle kroniske smertelidelser, da mesteparten av de kroniske smertelidelsene er nevroplastiske. Jeg har benyttet denne metoden en stund, men Pål og hans kolleger skal snart i gang med å replisere en RCT studie gjort av et forskerteam i USA, som har vist veldig gode resultater. Han har begynt å bruke metoden på sine pasienter, og opplever at han endelig har et verktøy som kan brukes til å kurere kroniske smertelidelser. Som vi snakker om her i denne episoden er det på tide med et paradigmeskifte i hvordan vi behandler kroniske smerter, så jeg blir så glad av at det nå skal gjøres studier i Norge på akkurat dette.Link til bouler back pain study:Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial | Pain Medicine | JAMA Psychiatry | JAMA NetworkFølg meg gjerne påDoktor Laila Five (@doktorfive) • Instagram-bilder og -videoerSmerte | Doktorfivelailafive (@doktorfive) | TikTokmail: laila@doktorfive.comDisclamer: innholdet i podcasten er ment som generell helseopplysning og erstatter ikke medisinske råd eller behandling. Har du spørsmål om din medisinske tilstand må du kontakte egen lege. Selv om mange alvorlige symptomer som deles i denne podcasten er nevroplastiske, så bør annen fysisk sykdom alltid utelukkes av lege, før legen din kan vurdere om tilstanden er nevroplastisk Hosted on Acast. See acast.com/privacy for more information.

23. We discuss an article about the Eat-Sleep-Console approach to treat neonatal opioid withdrawal syndrome. Young LW, Ounpraseuth ST, et. al. ACT NOW Collaborative. Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal. N Engl J Med. 2023 Apr 30. doi: 10.1056/NEJMoa2214470. Epub ahead of print. PMID: 37125831. We also share how even nematodes get the endocannabinoid munchies, and semaglutide helps rats with their binge-drinking. The conserved endocannabinoid anandamide modulates olfactory sensitivity to induce hedonic feeding in C. elegans Semaglutide reduces alcohol intake and relapse-like drinking in male and female rats What Ozempic Reveals About Desire --------- Episode 23 Credits: Original theme music: composed and performed by Benjamin Kennedy Audio production: Erin McCue Video production: Spencer Kennedy Executive Producer: Dr. Partick Beeman A podcast from Ars Longa Media ---------- This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.  The best part of any journal club is the conversation. Send us your comments on Twitter, Facebook, YouTube, Spotify, email, or join our Facebook group. Email: addictionmedicinejournalclub@gmail.com  Twitter: @AddictionMedJC  Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club YouTube: addictionmedicinejournalclub Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.

AF screening, BNP, a new SGLT2 inhibitor, a sky-is-blue study, and the UK Mini Mitral surgical trial are discussed in this week's podcast This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I AF Screening - Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064361 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 - Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders https://www.jacc.org/doi/full/10.1016/j.jacc.2019.09.050 - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 - Stepwise mass screening for atrial fibrillation using N-terminal pro b-type natriuretic peptide: the STROKESTOP II study design https://doi.org/10.1093/europace/euw319 - Current misconception 3: that subgroup-specific trial mortality results often provide a good basis for individualising patient care https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068511/ II Frailty and GDMT of HFrEF Frailty Linked to Lower Use of Guideline Treatments in HFrEF https://www.medscape.com/viewarticle/993218 - Physical Frailty and Use of Guideline‐Recommended Drugs in Patients With Heart Failure and Reduced Ejection Fraction https://www.ahajournals.org/doi/10.1161/JAHA.122.026844 III Sotagliflozin FDA Approves New Drug, Sotagliflozin, for Heart Failure https://www.medscape.com/viewarticle/992518 - Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease https://www.nejm.org/doi/full/10.1056/NEJMoa2030186 - Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2030183 IV Mini-Mitral Support for Minimally Invasive Mitral Valve Repair: Mini Mitral Published https://www.medscape.com/viewarticle/993191 - Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair https://jamanetwork.com/journals/jama/article-abstract/2805908 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: news@medscape.net

Impella, digital health, low-value processes, are tricuspid valve interventions with pacing leads are the topics Dr. John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Impella Class I Recall FDA Class I Recall for Some Abiomed Impella Heart Pumps https://www.medscape.com/viewarticle/992845 - A Prospective, Randomized Clinical Trial of Hemodynamic Support With Impella 2.5 Versus Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Percutaneous Coronary Intervention https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.112.098194 - Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction https://doi.org/10.1016/j.jacc.2016.10.022 https://www.sciencedirect.com/science/article/pii/S0735109716367675?via%3Dihub - The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.044007 - Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock https://jamanetwork.com/journals/jama/fullarticle/2761003 - Danish Cardiogenic Shock Trial (DanShock) https://clinicaltrials.gov/ct2/show/NCT01633502 II. Wearable Devices - Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805753 doi:10.1001/jamanetworkopen.2023.16634 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 III. The Cost of Quality Measures - The Volume and Cost of Quality Metric Reporting https://jamanetwork.com/journals/jama/fullarticle/2805705 - Goodhart's law https://en.wikipedia.org/wiki/Goodhart%27s_law IV. Tricuspid Valve Interventions and Pacing Leads Leadless Dual-Chamber Pacemaker Clears Early Safety, Performance Hurdles https://www.medscape.com/viewarticle/992464 - Transcatheter Tricuspid Valve Replacement With the EVOQUE System: 1-Year Outcomes of a Multicenter, First-in-Human Experience https://www.jacc.org/doi/10.1016/j.jcin.2022.01.280 - Effects of Implantable Cardioverter-Defibrillator Leads on the Tricuspid Valve and Right Ventricle: A Randomized Comparison of Transvenous versus Subcutaneous Leads https://eppro01.ativ.me/src/EventPilot/php/express/web/planner.php?id=HRS23&utm_source=heartrhythm&utm_medium=nav-button&utm_campaign=hr23-webtracking - Management and Outcomes of Transvenous Pacing Leads in Patients Undergoing Transcatheter Tricuspid Valve Replacement https://www.jacc.org/doi/10.1016/j.jcin.2020.04.054 - TRILUMINATE trial -- Transcatheter Repair for Patients with Tricuspid Regurgitation https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Lead Story:  Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal The New England Journal of Medicine This multicenter randomized controlled trial was undertaken to evaluate the the Eat, Sleep, Console Care Tool vs usual care for neonatal opioid withdrawal with the primary outcome being medically ready for hospital discharge. The Eat, Sleep, Console Care Tool relies on an assessment of withdrawal severity focused on an infant's ability to eat, sleep, and be consoled, along with the use of nonpharmacologic interventions as first line of treatment. The Eat, Sleep, Console care approach decreased the time until infants with opioid withdrawal were medically ready for discharge by a mean of 6.7 days, and the proportion of infants receiving pharmacologic treatment by 32.5%. Hence, this approach facilitates more judicious use of medication for these infants.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Reporting on potential fraud in medicine, AF, stroke, a possible new cholesterol-lowering drug, and the tone of debate in medical science are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Potential Fraud in Medicine Inside the Big Business of Clogged Arteries https://www.medscape.com/viewarticle/988448 II. AF Screening and Stroke STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Severity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke https://jamanetwork.com/journals/jamaneurology/fullarticle/2795865 III. Bempedoic Acid New Studies Give Bempedoic Acid a Bump as Lipid-Lowering Agent https://www.medscape.com/viewarticle/911100 - Rationale and design of the CLEAR-outcomes trial: Evaluating the effect of bempedoic acid on cardiovascular events in patients with statin intolerance https://doi.org/10.1016/j.ahj.2020.10.060 - Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol https://www.nejm.org/doi/full/10.1056/NEJMoa1803917 - Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease https://jamanetwork.com/journals/jama/fullarticle/2754792 - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 - Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022 IV. The Technique of Critical Appraisal Why Evidence-Based Medicine Enthusiasts Could Use a Lesson in Persuasion https://www.medscape.com/viewarticle/988227 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Bradyarrhythmia during AF screening, thrombolysis in stroke, NP vs MD care, and the most biased paper this year — on LAAO — are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Screening with ILR - Ade Adamson Tweet https://twitter.com/AdeAdamson/status/1625878856820482048?s=20 - The Rapid Rise in Cutaneous Melanoma Diagnoses https://www.nejm.org/doi/full/10.1056/NEJMsb2019760 - Loop Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01698-6/fulltext - Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care https://jamanetwork.com/journals/jamacardiology/fullarticle/2801362 II. Thrombolysis in Mild Stroke Thrombolysis Not Necessary in Mild Nondisabling Stroke: ARAMIS https://www.medscape.com/viewarticle/988381 - PRISMS Trial https://jamanetwork.com/journals/jama/fullarticle/2687354 - Risk of selection bias assessment in the NINDS rt-PA stroke study https://pubmed.ncbi.nlm.nih.gov/35705913/ - Tissue Plasminogen Activator for Acute Ischemic Stroke https://www.nejm.org/doi/full/10.1056/NEJM199512143332401 - Effects of alteplase for acute stroke; Hacke et al meta-analysis https://journals.sagepub.com/doi/10.1177/1747493017744464 - Methodological survey of missing outcome data in an alteplase for ischemic stroke meta-analysis https://onlinelibrary.wiley.com/doi/full/10.1111/ane.13656 - ECASS; Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke https://www.nejm.org/doi/full/10.1056/nejmoa0804656 - Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances https://pubmed.ncbi.nlm.nih.gov/32430395/ III. NP vs MD Care This Doc Still Supports NP/PA Led Care ... With Caveats https://www.medscape.com/viewarticle/967073 - The Productivity of Professions: Evidence from the Emergency Department https://www.nber.org/papers/w30608 - Independent Nurse Practitioners and Physician Assistants: A Doc's View https://www.medscape.com/viewarticle/924047 IV. LAAO vs OAC - Comparative Effectiveness of Left Atrial Appendage Occlusio Versus Oral Anticoagulation by Sex https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062765 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Interview with Søren Zöga Diederichsen, MD, PhD, author of Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care: Post Hoc Analysis of the LOOP Randomized Clinical Trial, and Mark Schoenfeld, MD, author of Incidental Detection of Bradycardia by Implantable Loop Recorders—Unintended Consequences. Hosted by Kristen K. Patton, MD. Related Content: Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care Incidental Detection of Bradycardia by Implantable Loop Recorders—Unintended Consequences

Interview with Søren Zöga Diederichsen, MD, PhD, author of Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care: Post Hoc Analysis of the LOOP Randomized Clinical Trial, and Mark Schoenfeld, MD, author of Incidental Detection of Bradycardia by Implantable Loop Recorders—Unintended Consequences. Hosted by Kristen K. Patton, MD. Related Content: Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care Incidental Detection of Bradycardia by Implantable Loop Recorders—Unintended Consequences

Drug and non-drug therapies for HFpEF, the search for AF, and exercise as medicine are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. SGLT2 Inhibitors in HFpEF Dapagliflozin Gets Expanded Heart Failure Indication in Europe https://www.medscape.com/viewarticle/988034 Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2206286 II. HFpEF and Heart Rate Accelerated Pacing a Possible Strategy for Preserved-EF Heart Failure? https://www.medscape.com/viewarticle/987815 III. Stroke and AF STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease https://jamanetwork.com/journals/jama/fullarticle/2780490 Cryptogenic Stroke and Underlying Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa1313600 Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT https://pubmed.ncbi.nlm.nih.gov/28329139/ Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke https://www.nejm.org/doi/full/10.1056/NEJMoa2101897 IV. Exercise as Medicine Trending Clinical Topic: Exercise Prescription https://reference.medscape.com/viewarticle/985373 Effect of Moderate and Vigorous Aerobic Exercise on Incident Diabetes in Adults With Obesityhttps://pubmed.ncbi.nlm.nih.gov/36716009/ Features Could a Breakthrough in Heart Failure With Preserved Ejection Fraction Just Take a Change of Pace? https://www.medscape.com/viewarticle/988088 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Drs John Kane and Jose Rubio-Lorente discuss relapse in schizophrenia — why it occurs, how often it occurs, and what we can do about it. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969531). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals. Resources Schizophrenia https://www.medscape.com/resource/schizophrenia Schizophrenia Clinical Presentation https://emedicine.medscape.com/article/288259-clinical Natural Course of Schizophrenic Disorders: A 15-Year Follow-up of a Dutch Incidence Cohort https://academic.oup.com/schizophreniabulletin/article/24/1/75/1878027 Predictors of Relapse Following Response From a First Episode of Schizophrenia or Schizoaffective Disorder https://jamanetwork.com/journals/jamapsychiatry/fullarticle/204795 Five-Fold Increased Risk of Relapse Following Breaks in Antipsychotic Treatment of First Episode Psychosis https://www.sciencedirect.com/science/article/abs/pii/S0920996416304376?via%3Dihub Long-term Continuity of Antipsychotic Treatment for Schizophrenia: A Nationwide Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530382/ Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29,823 Patients With Schizophrenia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710250 Long-Acting Injectable Versus Oral Antipsychotics for the Maintenance Treatment of Schizophrenia: A Systematic Review and Comparative Meta-analysis of Randomised, Cohort, and Pre-Post Studies https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00039-0/fulltext Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364341/ Psychosis Relapse During Treatment With Long-Acting Injectable Antipsychotics in Individuals With Schizophrenia-Spectrum Disorders: An Individual Participant Data Meta-analysis https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30264-9/fulltext The Pharmacological Treatment of Schizophrenia: How Far Have We Come? https://onlinelibrary.wiley.com/doi/full/10.1002/pcn5.13 Striatal Functional Connectivity in Psychosis Relapse: A Hypothesis Generating Study https://www.sciencedirect.com/science/article/pii/S092099642100222X?via%3Dihub

CHEST October 2022, Volume 162, Issue 4 Garrett Rampon, MD, and Nicholas A Bosch, MD, joins CHEST Podcast Moderator, Gretchen Winter, MD, to discuss the effectiveness of smartphone-guided self-prone positioning recommendations. DOI: https://doi.org/10.1016/j.chest.2022.05.009

V dnešnom podcaste budeme hovoriť o tom, čo s chronickou bolesťou chrbta, o "kvantových" nálepkách proti údajným škodlivým účinkom všakovakého žiarenia a o závadzajúcom titulku, ktorý tvrdil, že AI sa naučilo dekódovať mozgové vlny. Pseudocast 573 na YouTube Zdroje Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic PopulationsIt's Time To Rethink the Origins of PainLong-term outcomes of lumbar fusion among workers' compensation subjects: a historical cohort studyThe Emotional Brain as a Predictor and Amplifier of Chronic PainEffect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back PainAn AI can decode speech from brain activity with surprising accuracy Image by Arpit from Pixabay

While there have been scientific advances in the understanding of the neurophysiology of pain, we need to recognise that this has largely been based on a biomedical concept that struggles with the subjective and psychosocial nature of chronic pain.The scientific forces that have driven our understanding of pain since the early 19th Century have largely viewed pain as an expression of an identifiable disease process resulting from tissue injury, nerve injury or a sensitised nervous system. The biomedical model of pain has given rise to a massive global pain management drug market which includes non-steroidal anti-inflammatories, corticosteroids, acetaminophen and opioids. The global opioids market size alone was valued at $4.4 billion in 2020 and, with a current surge in demand, is projected to reach $6.1 billion by 2030.A recent US study from May 2021 found that the prevalence of chronic pain is increasing for all demographics of adults, but especially for people from lower socioeconomic backgrounds. The research also found associations between people's mental and physical health and a higher prevalence of chronic pain.This finding supports the biopsychosocial model of pain which recognises physical symptoms as the outcome of a dynamic relationship, not only between mind and body, but among mind, body, and society. Most research supports the effectiveness of a biopsychosocial approach and frequently finds that multi-disciplinary, multi-modal treatments give good outcomes in the treatment of chronic pain. And, while its effectiveness is becoming more widely accepted, its incorporation into clinical practice is still limited.To provide us with a better understanding we asked Ananda Mahony to join us on the podcast.Ananda is a naturopath with post-graduate qualifications in Nutrition and a Masters in Pain Management. She is experienced in all areas of general naturopathic practice however, over the last 6 years Ananda has been working extensively with clients experiencing persistent pain. Her interest in pain management stemmed from the observation that patients were not getting good results using standard naturopathic and medical approaches, as well as an innate curiosity about what underpinned their pain and how to work more effectively with it. Ananda incorporates aspects of pain education, nutrition, naturopathy, lifestyle and self-care, working in with patients' existing persistent pain health care team.References:Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13–23. doi:10.1001/jamapsychiatry.2021.2669https://www.vox.com/science-and-health/2018/5/17/17276452/chronic-pain-treatment-psychology-cbt-mindfulness-evidenceThe Lancet. Rethinking chronic pain. Lancet. 2021;397(10289):2023. doi:10.1016/S0140-6736(21)01194-6

Podcast 27: Deprescribing Education v. Usual Care: The OPTIMIZE Pragmatic Cluster Randomized Trial by NIA IMPACT Collaboratory

“All of us need that ability to put ourselves on the list of people we take care of.” -Dr. David Clarke   In episode 164, we hear part two of Dr. Jen Barna's fascinating interview with Dr. David Clarke. In the second part of this interview, Dr. Clarke explains why self care is so very important in our lives. He also highlights the importance of processing our feelings in order to prevent and/or treat stress induced illness. Then, he answers Dr. Barna's question on how to explain the Boulder Back Pain Study to people who have questions about it. He speaks about the paradigm shift in pain management due to the effectiveness of Pain Reprocessing Therapy and its implications in healthcare.    Dr. Clarke is a gastroenterologist, President of the Psychophysiologic Disorders Association and author of They Can't Find Anything Wrong! Psychophysiologic disorders are somatic illness symptoms induced by hidden stressors. When he began his practice as a GI doctor, Dr. Clarke noticed a large number of his patients had symptoms, some so severe they resulted in multiple hospitalizations, with no identifiable underlying cause. This observation was the beginning of his journey toward identifying these patients and connecting their physical illness with hidden stressors, and then treating them with what is known as Emotional Awareness and Expression Therapy with tremendously successful results. David D. Clarke, MD is President of the Psychophysiologic Disorders Association. He is also Assistant Director at the Center for Ethics and Clinical Assistant Professor of Gastroenterology Emeritus both at Oregon Health & Science University (OHSU) in Portland, Oregon, USA.  As Faculty Associate at Arizona State University and at the Cummings Graduate Institute for Behavioral Health Studies, he teaches graduate courses on Psychophysiologic Medicine. His book for patients, They Can't Find Anything Wrong!,(Sentient Publications, 2007) was praised by a president of the American Psychosomatic Society as “truly remarkable.”  He was also the lead editor for the professional textbook Psychophysiologic Disorders (KDP Publishing, 2019) which has sixteen contributors from five countries.   He is board-certified in Gastroenterology and Internal Medicine and practiced Gastroenterology in Portland from 1984 to 2009.  During that time he diagnosed and treated over 7000 patients whose symptoms were not explained by diagnostic testing.   Dr. Clarke is a graduate of Williams College (Phi Beta Kappa) and the University of Connecticut School of Medicine where he received the Mosby Award for Clinical Excellence.  He completed internship and residency in Internal Medicine and fellowship in Gastroenterology at Harbor/UCLA Medical Center in Los Angeles.  He has been a Visiting Professor at the Royal Children's Hospital in Brisbane, Australia and at Oxford University in England.  Dr. Clarke has lectured extensively on Psychophysiologic Disorders to health care professionals and the public across North America and in Europe. He has appeared on over 100 television and radio broadcasts throughout the U.S. Dr. Clarke's websites are Stressillness.com and PPDAssociation.org.   If you are interested in learning to diagnose and treat PPD patients, here is Dr. Clarke's advice: There are numerous options now for any physician (even a psychiatrist) to become skilled at PPD diagnosis and treatment including books, online courses and recorded or live conference presentations.  The http://EndChronicPain.org/ website has access to many of these. As one Family Physician put it, "these ideas put the joy back into my practice."  Some references related to Emotional Awareness and Expression Therapy and Pain Reprocessing Therapy:   They Can't Find Anything Wrong!,(Sentient Publications, 2007)    Psychophysiologic Disorders (KDP Publishing, 2019)    Stressillness.com    PPDAssociation.org   http://EndChronicPain.org/   The Curable App: https://www.curablehealth.com/   A documentary film about a radical cure for chronic pain THIS MIGHT HURT https://www.thismighthurtfilm.com/   How therapy, not pills, can nix chronic pain and change the brain https://www.colorado.edu/today/2021/09/29/how-therapy-not-pills-can-nix-chronic-pain-and-change-brain   Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial Yoni K Ashar et al. JAMA Psychiatry. 2022. https://pubmed.ncbi.nlm.nih.gov/34586357/ Find full transcripts of DocWorking: The Whole Physician Podcast episodes on the DocWorking Blog    DocWorking empowers physicians and entire health care teams to get on the path to achieving their dreams, both in and outside of work, with programs designed to help you maximize life with minimal time.   Are you a physician who would like to tell your story? Please email Amanda Taran, our producer, at Amanda@docworking.com to be considered.   And if you like our podcast and would like to subscribe and leave us a 5 star review, we would be extremely grateful!   We're everywhere you like to get your podcasts! Apple iTunes, Spotify, iHeart Radio, Google, Pandora, Stitcher, PlayerFM, ListenNotes, Amazon, YouTube, Podbean   You can also find us on Instagram, Facebook, LinkedIn and Twitter.    Some links in our blogs and show notes are affiliate links, and purchases made via those links may result in payments to DocWorking. These help toward our production costs. Thank you for supporting DocWorking: The Whole Physician Podcast!   Occasionally, we discuss financial and legal topics. We are not financial or legal professionals. Please consult a licensed professional for financial or legal advice regarding your specific situation.   Podcast produced by: Amanda Taran

“One physician who learned these ideas told me at a conference that it had put the joy back into her work. So, it really can turn a practice around to learn how to do this.” -Dr. David Clarke In episode 163, Dr. Jen Barna welcomes Dr. David Clarke to the podcast! Dr. Clarke is a gastroenterologist, President of the Psychophysiologic Disorders Association and author of They Can't Find Anything Wrong! Psychophysiologic disorders are somatic illness symptoms induced by hidden stressors. When he began his practice as a GI doctor, Dr. Clarke noticed a large number of his patients had symptoms, some so severe they resulted in multiple hospitalizations, with no identifiable underlying cause. This observation was the beginning of his journey toward identifying these patients and connecting their physical illness with hidden stressors, and then treating them with what is known as Pain Reprocessing Therapy with tremendously successful results.    In the first half of this episode, Dr. Clarke shares the reasons that psychophysiologic disorders can be common in healthcare workers, and how they are also very common among patients. He tells us the five different types of stress he looks for in the systematic process he uses to evaluate patients, to identify the different kinds of stresses that can commonly produce physical symptoms. He also shares success stories of patients he has treated. This is a fascinating field and according to Dr. Clarke, “When you are aware of it and know to look for it, that is how you achieve the best outcomes.” This is a two-part interview, so please join us for Episode 164 on Thursday for the continuation of this conversation!  David D. Clarke, MD is President of the Psychophysiologic Disorders Association. He is also Assistant Director at the Center for Ethics and Clinical Assistant Professor of Gastroenterology Emeritus both at Oregon Health & Science University (OHSU) in Portland, Oregon, USA.  As Faculty Associate at Arizona State University and at the Cummings Graduate Institute for Behavioral Health Studies, he teaches graduate courses on Psychophysiologic Medicine. His book for patients, They Can't Find Anything Wrong!,(Sentient Publications, 2007) was praised by a president of the American Psychosomatic Society as “truly remarkable.”  He was also the lead editor for the professional textbook Psychophysiologic Disorders (KDP Publishing, 2019) which has sixteen contributors from five countries.   He is board-certified in Gastroenterology and Internal Medicine and practiced Gastroenterology in Portland from 1984 to 2009.  During that time he diagnosed and treated over 7000 patients whose symptoms were not explained by diagnostic testing.   Dr. Clarke is a graduate of Williams College (Phi Beta Kappa) and the University of Connecticut School of Medicine where he received the Mosby Award for Clinical Excellence.  He completed internship and residency in Internal Medicine and fellowship in Gastroenterology at Harbor/UCLA Medical Center in Los Angeles.  He has been a Visiting Professor at the Royal Children's Hospital in Brisbane, Australia and at Oxford University in England.  Dr. Clarke has lectured extensively on Psychophysiologic Disorders to health care professionals and the public across North America and in Europe. He has appeared on over 100 television and radio broadcasts throughout the U.S. Websites are Stressillness.com and PPDAssociation.org.   Some additional references related to Pain Reprocessing Therapy:   A film about a radical cure for chronic pain THIS MIGHT HURT https://www.thismighthurtfilm.com/   How therapy, not pills, can nix chronic pain and change the brain https://www.colorado.edu/today/2021/09/29/how-therapy-not-pills-can-nix-chronic-pain-and-change-brain   Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial Yoni K Ashar et al. JAMA Psychiatry. 2022. https://pubmed.ncbi.nlm.nih.gov/34586357/ Find full transcripts of DocWorking: The Whole Physician Podcast episodes on the DocWorking Blog    DocWorking empowers physicians and entire health care teams to get on the path to achieving their dreams, both in and outside of work, with programs designed to help you maximize life with minimal time.   Are you a physician who would like to tell your story? Please email Amanda Taran, our producer, at Amanda@docworking.com to be considered.   And if you like our podcast and would like to subscribe and leave us a 5 star review, we would be extremely grateful!   We're everywhere you like to get your podcasts! Apple iTunes, Spotify, iHeart Radio, Google, Pandora, Stitcher, PlayerFM, ListenNotes, Amazon, YouTube, Podbean   You can also find us on Instagram, Facebook, LinkedIn and Twitter.    Some links in our blogs and show notes are affiliate links, and purchases made via those links may result in payments to DocWorking. These help toward our production costs. Thank you for supporting DocWorking: The Whole Physician Podcast!   Occasionally, we discuss financial and legal topics. We are not financial or legal professionals. Please consult a licensed professional for financial or legal advice regarding your specific situation.   Podcast produced by: Amanda Taran

*The information in this podcast is intended for Healthcare Practitioners. Dr Howard Schubiner is board-certified in paediatrics, adolescent medicine, and internal medicine. He was a full Professor at Wayne State University for 18 years and now works at Providence Hospital in Southfield, MI, USA. He has authored over 60 scientific publications and has given over 250 lectures to scientific audiences regionally, nationally and internationally on topics related to adolescent medicine, ADHD, and stress reduction. Importantly, Dr Schubiner is the founder and director of the Mind Body Medicine Program at Providence Hospital. This program uses the most current research methodologies to treat individuals who suffer from the Mind Body Syndrome (MBS) or Tension Myositis Syndrome (TMS) as described by Dr John Sarno. Dr Schubiner has created a program that uses both meditative and cutting edge psychological techniques to help individuals with chronic conditions, such as fibromyalgia, whiplash, back and neck pain, myofascial pain, TMJ syndrome, tension and migraine headaches, irritable bowel syndrome, irritable bladder syndrome, insomnia, anxiety, and other related conditions. Tune into this episode to hear more about this program and its potential to resolve chronic pain. *Highlights * About neural circuits (8:00) The value in simplifying information (15:00) How conditioning influences pain (20:00) Symbolic pain (26:00) Pain reprocessing therapy (34:00) How to reappraise pain sensations (40:00) Useful links: Websites mentioned: https://www.unlearnyourpain.com/ https://www.freedomfromchronicpain.com/ https://ppdassociation.org/ https://www.tmswiki.org/w/index.php?page=TheTensionMyositisSyndromeWiki Film Dr Howard mentions: https://www.thismighthurtfilm.com/ Link to paper: Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial - https://pubmed.ncbi.nlm.nih.gov/34586357/ Link to paper: Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial – https://pubmed.ncbi.nlm.nih.gov/28643436/ Link to paper: Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: a cluster-randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/28796118/ Link to paper: Emotional Awareness and Expression Therapy Achieves Greater Pain Reduction than Cognitive Behavioral Therapy in Older Adults with Chronic Musculoskeletal Pain: A Preliminary Randomized Comparison Trial https://pubmed.ncbi.nlm.nih.gov/32451528/ Break Through With Healing Chronic Pain (Talks at Google) https://www.youtube.com/watch?v=0VyH1laOd2M Dr Howard's email – hschubiner@gmail.com

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-258   Overview: Chronic pain affects 20% of people in the United States, and chronic low back pain is the most common cause of chronic pain. Although some treatments can reduce the severity of the pain, the persistence of chronic low back pain is a source of frustration for both patients and clinicians. Join us to discuss how behavioral and psychological therapy should be part of the treatment for chronic low back pain and how new approaches may be much more effective than existing therapies.   Episode resource links: Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. Published online September 29, 2021. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-258   Overview: Chronic pain affects 20% of people in the United States, and chronic low back pain is the most common cause of chronic pain. Although some treatments can reduce the severity of the pain, the persistence of chronic low back pain is a source of frustration for both patients and clinicians. Join us to discuss how behavioral and psychological therapy should be part of the treatment for chronic low back pain and how new approaches may be much more effective than existing therapies.   Episode resource links: Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. Published online September 29, 2021. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato

Welcome back to Chat Sh*t Get Fit. This week in the recovery series we explore the "ancient" medicine of cupping and acupuncture. Both have been around for some time and we've seen them used on many occasion. Especially in regards to cupping where we see high profile athletes such as Michael Phelps the most decorated Olympian of all time partake in the service. We come onto the various reasons why for top athletes there may be some benefit. Our friend placebo is often mentioned in this episode. Remember you can listen to a full episode on placebo and nocebo here.   So what are cupping and acupuncture? The NHS in the UK classes both CAM (Complimentary and alternative medicines.  Cupping therapy is an ancient form of alternative medicine in which a therapist puts special cups on your skin for a few minutes to create suction. People get it for many purposes, including to help with pain, inflammation, blood flow, relaxation and well-being, and as a type of deep-tissue massage. The cups may be made of, Glass, Bamboo, Earthenware, and Silicone. There's also wet and dry cupping. Wet cupping is often associated with the "removal of toxins" some people also get “needle cupping,” in which the therapist first inserts acupuncture needles and then puts cups over them. Dry cupping is the safest due to wet cupping requiring an incision in the skin to draw blood.   Acupuncture is a treatment derived from ancient Chinese medicine. Fine needles are inserted at certain sites in the body for therapeutic or preventive purposes. Acupuncture is used mainly to relieve discomfort associated with a variety of diseases and conditions, including: Chemotherapy-induced and postoperative nausea and vomiting Dental pain Headaches, including tension headaches and migraines Labour pain Low back pain Neck pain Osteoarthritis Menstrual cramps Respiratory disorders, such as allergic rhinitis   So, some big claims here on benefits. We aren't so sure! Don't just take our word for it take a look at all the data linked down below!   Want to support the Podcast? We have a discount code (PRIMAL10) for a fantastic coffee brand. Cannonball Coffee. Great tasting and super powerful which WILL give you a boost in the gym. We spoke to Cannonball Coffee on a previous podcast and you can listen to that here to see why we are such fans. So if you want to support us in some small way and get some great coffee head to cannonballcoffee.co.uk and use code PRIMAL10 for 10% off any order.   New to the show? Head back to episode 1 "Let's Chat, Covid & Fitness" where we give an introduction into who we are and talk about the current state of ourselves and the fitness industry during this covid pandemic   If you need some help with your fitness journey in 2021 head to trainprimal.co/signup where we offer a variety of fitness packages to suit your goal. You'll also have access to our Facebook community where you can talk to all of us daily whether that's for more advice or just a chat. So, to enjoy a 7-day free trial head to trainprimal.co/signup   Find us on Instagram @bill_primal @coachtomreardon @andy_primal   Website: www.chatshitgetfit.com Emai: csgfpodcast@gmail.com   Studies Mentioned Cupping therapy: An analysis of the effects of suction on skin and the possible influence on human health Mode of action of cupping  (Pain) Could Cupping Therapy Be Used to Improve Sports Performance? Effects of Cupping Therapy in Amateur and Professional Athletes Cupping for Treating Pain: A Systematic Review Acupuncture for the Relief of Chronic Pain A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain Can we finally just say that acupuncture is nothing more than an elaborate placebo? In the tradition of Chairman Mao, traditional Chinese medicine gets a new boost by the Chinese government Chinese medical practice and the thoughts of Chairman Mao Acupuncture Is Theatrical Placebo The Many Faces of the 'Doctor' during the Cultural Revolution

In this episode, part of our series on nutrition and immunity, we discuss Vit C! Our topics include: • What Vitamin C is and what it does for your body • How much Vitamin C you need • What foods provide Vitamin C • Signs of deficiency and toxicity • What about using Vitamin C for prevention or healing of disease or illness? Recommended reading: • [WEBINAR] Nutrition and Immunity - https://www.cancerdietitian.com/2021/02/webinar-nutrition-and-immunity.html • The Truth About Immunity Supporting Foods - https://www.cancerdietitian.com/immunity • NIH Vit C Info: https://ods.od.nih.gov/factsheets/VitaminC-Consumer/ • Academy of Nutrition and Dietetics - How Vitamin C Supports A Healthy Immune System: https://www.eatright.org/food/vitamins-and-supplements/types-of-vitamins-and-nutrients/how-vitamin-c-supports-a-healthy-immune-system • Vitamin C for preventing and treating the common cold: https://pubmed.ncbi.nlm.nih.gov/23440782/ • Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 InfectionThe COVID A to Z Randomized Clinical Trial - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776305

Caryn Hartglass and Gary De Mattei discuss their Valentine’s Day menu and how to celebrate Mardi Gras virtually. They comment on the recent On Being Podcast with Alain de Botton entitled The True Hard Work of Love and Relationship‪s‬. They also cover a recent report on high dose Vitamin C and Zinc supplementation’s impact on COVID-19.  Links mentioned in the program:Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 InfectionAlain de Botton, The True Hard Work of Love and Relationship‪s Recipes:French Onion SoupLa BaguetteAlmond Mozzarella Cheese

Join TIffany and Rick as they address the challenges involved as Treat 2 Target has emerged from aggressive treatments for a larger population to treating per the individual and based on the complexity of each disease.  Now, if you are a patient or parent of a juvenile patient - are you ready to join the conversation? It's your turn to pull up a seat! Join Tiffany and Patrice to continue this conversation inside our new, coordinating AiArthritis Voices ONLINE COMMUNITY - where patients unite with others around the world to talk, learn, and connect.  JOIN TODAY! Other stakeholders - are you a doctor, nurse, researcher, industry representative, or other health services person who wants to join us "at the table", too?  Then message your comments or questions about this show to podcast@aiarthritis.org OR message us on any of our social media accounts at @IFAiArthritis.   AiArthritis Voices 360 is the official talk show for the International Foundation for Autoimmune & Autoinflammatory Arthritis (AiArthritis). You can find us on the web at www.aiarthritis.org.  Show Notes: Episode 42 – “Treat to Target Today with Complex Diseases - Is it possible?” 00:53 - Tiffany welcomes listeners01:22 - Tiffany introduces Rick, a fellow patient who has Ankylosing Spondylitis and attended a virtual EULAR conference with Tiffany3:00 - Rick really enjoyed the opportunity to participate in EULAR virtually since he might not have had the opportunity to attend in person otherwise03:44 - Rick and Tiffany both attended a hot topic session at EULAR called Treat to Target in AxSpa:  Myth or Reality? 04:49 - Tiffany and Rick explain the history of “Treat to Target” as a research initiative within the realm of AiArthritis Disease research10:22 - Tiffany and Rick share key takeaway points that they learned during the Treat to Target session16:34 - The study presented in the session had some problems in its design that may have impacted the quality of the results19:58 - Rick discusses his appreciation for the researchers’ ability to recognize and address the limitations of their own study21:56 - With “Treat to Target” doctors were given specific criteria for treatment and followed up with patients every 4 weeks whereas the “Usual Care” group included doctors who treated their patients however they wanted to treat them and followed up every 3 months. Doctors within the Usual Care group may have been AxSpa experts who were using the same treatments as the other group.23:24 - Rick discusses the experience of patients who are never even treated by a rheumatologist 25:49 - Tiffany gives an overview of the second portion of the seminar which covered controversies and myths in Treat to Target discussions28:46 - Accurate disease diagnosis and identification of co-morbidities is essential to implement a treat to target strategy 29:03 - Remission and removal of treatments is the ultimate goal of treat to target strategies, which is a relatively novel goal in rheumatology, but early diagnosis and aggressive treatment is usually necessary to achieve remission30:26 - The target of treatment may change over time as co-morbidities develop, as the disease progresses or as treatment becomes more effective32:06 - The second study presented in the seminar lasted 12 years, and researchers had a difficult time keeping participants enrolled in the study for the full duration36:07 - Forms that patients fill out at rheumatology appointments to measure disease activity are important for clinical researchers, yet doctors are not implementing these forms correctly (or at all) so researchers aren’t able to collect the data they need41:55 - Numeric pain scales may not be the best way to track AiArthritis pain as a disease management tool46:34 - It is important to ensure that patient data collection forms are never used by private health insurance companies or public health officials to penalize rheumatologists for the quality of service they are providing to their patients as that is not the purpose of those forms48:10 - The ideal goal of treat to target is precision medicine48:30 - The lack of definitive diagnostic measurements like bloodwork or imagine with AxSpa complicates any treatment and research50:01 - Tiffany thanks Rick for co-hosting this episode50:12 - Rick is a contributor to rheumatoidarthritis.net, ankylosingspondylitis.net, and radiabetes.com50:51 - Check out the sister site to this podcast at aiarthritisvoices.org and meet any of the Voices 360 co-hosts51:38 - If you would like to take a seat at the table, visit us on the web at aiarthritis.org/podcast, on social medias @IfAiArthritis on all platforms, or email us @ podcast@aiarthritis.org

Since 1991-1992, competing sepsis definitions have--with varying degrees of success--attempted to capture the difference between normal and abnormal host responses in order to help researchers and clinicians improve care. The most crucial basis of "usual care" in sepsis treatment is, simply, who is deemed fit to receive it. codachange.org/podcasts

This episode features Emel Yorganci (Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK).  Usual care provided to patients is rarely described in detail in randomised controlled trials (RCTs) of a complex intervention in palliative care. To interpret the effectiveness of interventions tested within RCTs, the care provided in the comparison arm must be described. Approaches including the use of open-ended questions and observations have been used in trials to understand care provided but lack convergent validity. Usual care provided in an RCT was characterised using a multi-method approach at different time points and from different professional perspectives. Similarities and variations in the care provided to patients within and across study sites and over time were identified refuting the assumption that all control participants received the same usual care. This paper provides a method for the classification of the usual care that should be embedded within RCTs of complex interventions. Assumptions made about the usual care delivered to patients during intervention development may not always remain valid at the testing stage. Characterising usual care ensures that interpretation of findings of the effectiveness of the tested intervention is more valid.To avoid incorrect interpretations of complex interventions in palliative care, usual care is best characterised using a multi-method approach embedded within the design of RCTs.

Since 1991-1992, competing for sepsis definitions have--with varying degrees of success--attempted to capture the difference between normal and abnormal host responses in order to help researchers and clinicians improve care. The most crucial basis of "usual care" in sepsis treatment is, simply, who is deemed fit to receive it.

Interesting trial this week pitting an elaborate nurse led group against suboptimal usual care.  Suboptimal usual care lost pretty badly, but what to make of this?  And does it support the rheumatologist side of the treat to target controversy?  Listen to find out and be sure to follow on @EBRheum if you have your own thoughts! 

En el episodio de esta semana discutimos el tratamiento de la bacteriemia por estafilococo, a proposito de un articulo sobre el tema recientemente publicado en la revista JAMA.   Referencia:  Thomas L Holland y colaboradores. Effect of Algorithm-Based Therapy vs Usual Care on Clinical Success and Serious Adverse Events in Patients with Staphylococcal Bacteremia. A Randomized Clinical Trial.  JAMA 2018;320(12):1249-1258. doi:10.1001/jama.2018.13155.   Frase de la Semana:   Esta semana la tomamos del poeta y ensayista venezolano Rafael Cadenas, nacido el 8 de abril de 1930 en Barquisimeto, Edo. Lara. Ganador, entre otros, del Premio Nacional de Literatura en Venezuela en 1985 y merecedor del Premio Reina Sofía de Poesía Iberoamericana en el 2018. La Frase dice: “La palabra no es el sitio del resplandor, pero insistimos, insistimos, nadie sabe porque”

Interview with Barbara H. Stanley, author of Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department

Vets With Low Back Pain: Usual Care + Chiropractic vs. Usual Care Alone Today we're going to talk about our vets with low back pain. We have already shown how chiropractic is backed completely by research for low back pain. For us, that's not even in question. But, this week, there's brand new research out... The post CF 025: Vets With Low Back Pain. Usual Care + Chiropractic vs. Usual Care Alone appeared first on Chiropractic Forward.

This episode features Professor Miriam Johnson (Director, Wolfson Palliative Care Research Centre, Hull York Medical School). The aim of this study was to: establish cardiology led palliative care versus usual care was feasible, to assess quality of data capture, to facilitate future sample size calculation and to assess survival.  Study design was a feasibility, non-randomised trial, which recruited unmatched symptomatic heart failure patients who were receiving maximal therapy for their disease. The study recruited 77 participants (43 in palliative cardiology and 34 usual care). The study concluded that a future trial is feasible. No difference in survival was noted between the intervention and control groups. This study concludes that cardiology led palliative care may improve care delivery, but further research is required to test this hypothesis further. Full paper available from:https://doi.org/10.1177/0269216318763225

Show Notes In Sepsis Episode 5, we brought on Craig Patterson, MD. One of our intensivists who is passionate about this topic (among many) in an attempt to bring it all together. We take the lessons learned over the course of the last 4 episodes and try to distill it into cohesive message about how to deal with Sepsis in modern times. For more information check out the shownotes at Pulmcast.com.

In this new segment, we are doing a brief rundown of the recent JAMA article discussing mindfulness-based stress reduction vs. CBT for chronic low back pain. Follow us on Twitter @PMRBlast or facebook facebook.com/PMRBlast Host: Ben Abramoff Co-Host: Erin McCarty Intro Music: Music By Longzijun Outro: Drankin' Song by Kevin Macleod Today's Article: Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA.2016;315(12):1240-1249. doi:10.1001/jama.2016.2323

Interview with Daniel C. Cherkin, PhD, author of Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial

Interview with Gaëtan Deslée, MD, PhD, author of Lung Volume Reduction Coil Treatment vs Usual Care in Patients With Severe Emphysema: The REVOLENS Randomized Clinical Trial

Pediatric Grand Rounds with Martha A. Q. Curley RN PhD FAAN