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The Accelerators Podcast co-host Dr. Simul Parikh is heading back around the globe, this time to discuss breast cancer! He hosts Drs. Anna Kirby (Royal Marsden Hospital & Institute of Cancer Research), Sushil Beriwal (Allegheny Health Network, Varian Medical Systems), and Revathy Krishnamurthy (Tata Memorial Centre), Radiation/Clinical Oncologists from the UK, US, and India.The group kicks off it's discussion by comparing and contrasting breast cancer screening processes in their respective countries. Then they run cases, examining varied cases of breast cancer and techniques: early stage, locally advanced, triple negative, PMRT, VMAT and SIB, and the oligometastatic state.Here are other things that were discussed in the show:The PRIMETIME Trial (UK)SOUND Trial Findings and Discussion, American Society of Breast SurgeonsOmission of Sentinal Lymph Node Biopsy, American College of Surgeons]Hypo-G Breast Abstract, ESTRO 2024FAST-Forward Boost Trial (UK, PI Anna Kirby)The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.
In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the KEYNOTE A18 clinical trial. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field. Highlights: - Concurrent chemoradiation plus brachiterapy represent the standard of care treatment in locally advanced cervical cancer providing up to 70% 5 years OS - Modern radiotherapy technique (IMRT and VMAT) has reported to further increase OS and reduce toxicity - Immunotherapy has reported to increase OS in advanced or recurrent cervical cancer when compared to standard treatment - Immunotherapy in combination with concurrent high quality chemoradiation in the treatment of locally advanced high risk cervical cancer further increase PFS and OS with respect to standard chemoradiotherapy and should be considered the new standard of care - The combination appears manageable and no substanciad additional toxicity has been reported
APTTMH
Unreal Results for Physical Therapists and Athletic Trainers
In this episode I share my experience attending the Tongue Mojo webcast from Stop Chasing Pain. After years of symptoms related to issues with my esophagus, trachea, stomach, and mouth, I am realizing how important the tongue is! I took Dr. Perry's course in hopes to see how he practically integrated the tongue with the rest of the body and to learn some exercises to start on before deciding to go the route of a potential tongue tie release (frenectomy). In this episode I share a bit about the anatomy, why the tongue is so important, and what my progress has been after just a few days of practicing what I learned. Resources mentioned in the episode:Stop Chasing Pain: https://www.stopchasingpain.com/Dr. Perry's IG: https://www.instagram.com/stopchasingpain/Tongue Mojo webcast: https://www.stopchasingpain.com/tongue-mojo/Barral Institute: https://www.barralinstitute.com/ (relevant courses: NM4, NM5, VM4, VMAT, be sure to mention Anna Hartman as referral)The Tongue Therapist (OMT): https://www.instagram.com/thetonguetherapist/YouTube Videos-Neck Pain and GERD home treatment: https://youtu.be/nxIENMEz-g4Crazy Link between Neck Pain and GERD: https://youtu.be/HFiProhhrcwHyoid bone and the Brachial Plexus: https://youtu.be/fG6E93pAZlUReflux, Neck and Shoulder Pain: https://youtu.be/kDf-Ii6ZvDwConsidering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com=================================================Watch the podcast on YouTube and subscribe!Join the MovementREV email list to stay up to date on the Unreal Results Podcast and MovementREV education. Be social and follow me:Instagram | Facebook | Twitter | YouTube
In this thrilling episode, we're joined by Fister, an elite Weapons and Tactics Instructor with an incredible story to share. Get ready to soar through the skies as he takes us on a pulse-pounding journey inside the cockpit of the AV-8B Harrier jump-jet. But that's not all! Fister was the last Commanding Officer of VMAT-203, the legendary squadron where aspiring Harrier pilots learn to master this formidable aircraft. Brace yourself for a rollercoaster of hijinks and hilarious anecdotes that'll have you on the edge of your seat... including the details of the time they once tried to land a Harrier with its gear up on a mattress! Spoiler alert: It DIDN'T go well! Don't miss out on this exhilarating episode, and be sure to SHARE this show with a friend—it's a wild ride you won't want to keep to yourself! https://www.youtube.com/watch?v=1iU31W2hfJQ&t=28s
While radiation is a common cancer treatment, few people actually know what it is and how it affects patients. In this episode, Dr. Richard Pearlman shares with listeners his expertise in radiation oncology. Episode At A Glance: Whether we battle it ourselves or walk through it with friends and family, cancer touches almost everyone. This week, Dr. Richard Pearlman joins The SavvyCast to educate listeners on radiation oncology. Dr. Pearlman is a radiation oncologist with Alliance Cancer Care. In this episode, he shares what radiation oncology is, who can benefit from it, as well as what treatment looks like. Who is Dr. Richard Pearlman? Dr. Pearlman was born and raised in Birmingham, Alabama. He attended Birmingham-Southern College in Birmingham, Alabama. He received his medical doctorate from the University of South Alabama College of Medicine in Mobile, Alabama. Following medical school, he completed his internship at Brookwood Baptist Health in Birmingham, Alabama. Additionally, he completed his residency in radiation oncology at Wayne State University in Detroit, Michigan, where he served as Chief Resident in his final year. Dr. Pearlman has experience in several radiation therapy treatments, including stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS), intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), and high dose-rate brachytherapy (HDR brachytherapy). In addition to his education and medical training, Dr. Pearlman has been awarded numerous honors and has authored several articles in peer-reviewed medical publications. He is married to Dr. Hailey Park, who is a dentist in Muscle Shoals, Alabama. Questions Answered In This Episode: How did Dr. Pearlman get into radiation oncology? What is the difference between radiology and radiation oncology? When is radiation the best option? What is radiation oncology? How does radiation treat breast cancer? What are some of the differences between radiation treatment and chemotherapy? Does insurance typically cover radiation treatment? What diseases does Dr. Pearlman treat the most? What are the side effects of radiation, especially for head and neck cancer patients? How many treatments a week are typical? What are most radiation treatments like? I hope you enjoyed this episode! As always, if you have time to rate, review, and subscribe to The SavvyCast on Apple Podcasts, it would be SO appreciated!!! If you like this podcast, be sure to check these out: Men can get Breast Cancer Too: Talking with a Male Breast Cancer Survivor Let's Talk: Surviving Cancer When You're Given Two Months To Live
An interview with Dr. Valeria Mercadante from University College London, Dr. Siri Beier Jensen from Aarhus University, and Dr. Douglas Peterson from UConn Health, authors on “Salivary Gland Hypofunction and/or Xerostomia Induced by Non-Surgical Cancer Therapies: ISOO/MASCC/ASCO Guideline.” This guideline provides evidence-based recommendations for interventions to prevent, minimize, and manage salivary gland hypofunction and xerostomia in patients receiving nonsurgical cancer therapy. Read the full guideline at www.asco.org/supportive-care-guidelines. Suggest a topic for guideline development at www.surveymonkey.com/r/ascoguidelinesurvey. TRANSCRIPT [MUSIC PLAYING] SPEAKER: 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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] BRITTANY HARVEY: Hello, and welcome to the ASCO Guidelines Podcast Series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at podcasts.asco.org. My name is Brittany Harvey, and today I'm interviewing Dr. Valeria Mercadante from University College London and University College London Hospitals Trust in London, United Kingdom, Dr. Siri Beier Jensen from Aarhus University in Aarhus, Denmark, and Dr. Douglas Peterson from the School of Dental Medicine and Neag Comprehensive Cancer Center UConn Health in Farmington, Connecticut, authors on salivary gland hypofunction and/or xerostomia induced by non-surgical cancer therapies, International Society of Oral Oncology, Multinational Association of Supportive Care in Cancer, and American Society of Clinical Oncology Guideline. Thank you for being here, Dr. Mercadante, Dr. Beier Jensen, and Dr. Petersen. VALERIA MERCADANTE: Thank you. It's a pleasure to be here. DOUGLAS PETERSON: Thank you. SIRI BEIER JENSEN: Thank you. BRITTANY HARVEY: First, I'd 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 full conflict of interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Mercadante, do you have any relevant disclosures that are directly related to this guideline topic? VALERIA MERCADANTE: No, I do not have any relevant disclosure. BRITTANY HARVEY: Thank you. And Dr. Beier Jensen, do you have any relevant disclosures that are directly related to this guideline? SIRI BEIER JENSEN: No, I have no conflicts to declare related to this guideline topic. BRITTANY HARVEY: Thank you. And finally, Dr. Peterson, do you have any relevant disclosures that are related to this guideline topic? DOUGLAS PETERSON: No. No related conflicts to declare. BRITTANY HARVEY: Thank you. Then let's delve into some of the content of the guideline. First, Dr. Mercadante, can you give us an overview of this guideline's scope and purpose? VALERIA MERCADANTE: Of course. These clinical practice guidelines focus on the prevention and management of salivary gland hypofunction and xerostomia due to non-surgical cancer therapies. This is something we are deeply passionate about because nonsurgical cancer therapies, including all type of radiation regimens, chemotherapy, and biological cancer therapy, can damage the glands in our mouth that produce saliva, resulting in xerostomia, which we define as patient-reported subjective sensation of dryness and salivary gland hypofunction, which we define as reduced salivary flow rate as measured objectively. And this condition may last for several months or may become permanent. And because saliva serves so many important function, xerostomia may lead to a range of other symptoms that can impact patient quality of life. And therefore, ASCO, MASCC, and ISOO decided to update the findings of their two previous systematic reviews published in 2010 and provide a practical, evidence-based approach in a multidisciplinary testing to address this important topic. BRITTANY HARVEY: Great. Thank you for that background. So then I'd like to review the key recommendations of this guideline. This guideline covers two clinical questions, one on prevention and one on management. So Dr. Peterson, starting with prevention, what are the key recommendations regarding pharmacologic and non-pharmacologic interventions for the prevention of salivary gland hypofunction and/or xerostomia induced by non-surgical cancer therapies? DOUGLAS PETERSON: Thank you, Brittany. As you've noted, the guideline is framed in the context of two clinical questions, prevention and then followed by the management once the condition has occurred. Relative to prevention, there were eight recommendations, all of which were directed to reducing the risk of salivary gland hypofunction and/or xerostomia in patients with head and neck cancer. And as with other ASCO guidelines, each of these recommendations was in turn supported by text directed to literature review and analysis and clinical interpretation. So let me just briefly highlight the eight recommendations on prevention. Recommendation 1.1 was that intensity-modulated radiation therapy, IMRT, should be used to spare major and minor salivary glands from a higher dose of radiation. This was a very strong, well-evidenced recommendation. The evidence quality was high. The strength of the recommendation was strong. Recommendation 1.2 is that other radiation modalities that limit cumulative dose to an irradiated volume of major and minor salivary glands as one or more effectively than IMRT may be offered. Recommendation 1.3 reads that acupuncture may be offered during radiation therapy for head and neck cancer to reduce the risk of developing the symptom of xerostomia. Recommendation 1.4, systemic administration of the sialogogue bethanechol may be offered during radiation therapy for head and neck cancer. Recommendation 1.5-- and this is an important different type of recommendation-- vitamin E or other antioxidants should not be used to reduce the risk of chemoradiation-induced salivary gland hypofunction and xerostomia. And this is because of the potential adverse impact of these antioxidants on cancer-related outcomes and the lack of evidence of benefit. In addition to those five recommendations, there were three recommendations for which the evidence was insufficient. In the panel's view, it was important to delineate these three recommendations in the context of current clinical practice as well as opportunities for future research that we'll talk about in a little bit. The three recommendations for which there was insufficient evidence are 1.6. The panel was unable to make a recommendation for or against the use of submandibular gland transfer administered before head and neck cancer treatment. This limitation is due to the current amount of evidence associated with this surgical intervention, submandibular gland transfer, in relation to ever-evolving contemporary radiation modalities. Recommendation 1.7-- evidence remains insufficient for a recommendation for or against use of the following three interventions during radiotherapy for head and neck cancer. The three interventions are oral pilocarpine, amifostine in association with contemporary radiation modalities, and low-level laser therapy. And then, finally, recommendation 1.8-- the evidence remains insufficient for or against the use of several interventions, including selected radiation technology, for example, boost radiation or hyper or hypofractionated radiation therapy, Transcutaneous Electrical Nerve Stimulation or TENS, human epidermal growth factor, and selected complementary medicines. And again, the evidence is insufficient in the panel's view for a recommendation for or against these and several other interventions that are listed in the guideline. So I'll now turn the microphone back to Brittany. BRITTANY HARVEY: Great. Thank you for reviewing those prevention recommendations and explaining the evidence that supported those as well. That's very helpful. So following that, Dr. Beier Jensen, what are the key recommendations on pharmacologic and non-pharmacologic interventions for the management of salivary gland hypofunction and/or xerostomia induced by non-surgical cancer therapies? SIRI BEIER JENSEN: The key recommendations for the management of salivary gland hypofunction and xerostomia induced by cancer therapies are based on the principles of stimulation of the salivary reflex and lubrication of the oral tissues of, say, the mucosa and the teeth. The recommendations 2.2, 2.3, 2.4, and 2.5 address this stimulatory approach. If there is residual secretory capacity of the salivary glands, stimulation of natural saliva secretion may be provided by chewing or taste stimuli. This can be regular use of sugar-free lozenges, sugar-free candies, or sugar-free non-acidic chewing gum. In patients who has their natural teeth, it's important to be aware that if acidic candies are used to stimulate saliva secretion, then it should be a special nonerosive preparation for dentate patients that will say that they do not dissolve the tooth substance. Pharmacological stimulation is also an option by prescription medication such as oral pilocarpine and cevimeline in countries where this is available. This may result in systemic adverse effects that limit use in some patients. So the gustatory and masticatory salivary reflex stimulation, recommendation 2.2, the evidence-based quality was intermediate, and the strength of the recommendation was moderate. And for the pharmacological stimulation by pilocarpine and cevimeline, it was evidence-based, high-quality, and strong recommendation strength. For patients who have salivary gland hypofunction or xerostomia induced by radiation therapy for head and neck cancer, stimulation of saliva secretion may also be provided by acupuncture, transcutaneous electricity stimulation, or acupuncture-like transcutaneous electricity stimulation, although the evidence base here is less strong than for the other stimulatory management options mentioned. This is addressed in recommendation 2.4 and 2.5. If the residual secretory capacity of the salivary glands is low or maybe even nonexistent, then regular lubrication of the oral mucosa and teeth is of relevance. This is addressed in recommendation 2.1. Such lubrication may be provided by topical application of mucosal lubricants and saliva substitutes, which are agents directed at ameliorating xerostomia and other salivary gland hypofunction-related symptoms. It is important to notice that available stimulatory and lubricating options all provide transitory increased salivary flow rates and transitory relief from xerostomia. If you would like to review the specific recommendations, they can be found in the manuscript. BRITTANY HARVEY: Great. Thank you for reviewing those recommendations on the management of salivary gland hypofunction and/or xerostomia. So Dr. Peterson, you mentioned this earlier, but there are some cases in the guideline in which evidence was insufficient to make recommendations. And you went through a few of these areas. So what areas of future research did the panel discuss? DOUGLAS PETERSON: Thanks, Brittany. The panel worked very carefully to relate the quality of evidence to strength of each of the recommendations. In addition to providing important context regarding clinical prevention and treatment of xerostomia salivary hypofunction, novel directions for future research were therefore identified. And I'll just briefly delineate these future directions. Studies directed to the continued, rapidly-evolving radiation technology such as proton therapy and volumetric modulated art therapy or VMAT, as well as the length of time after this treatment is completed, for example, one to five years after completion of treatment, these studies are needed to assess the relationship of this rapidly-evolving technology to the long-term adverse oral events such as salivary gland hypofunction and xerostomia as well as advanced dental disease and osteoradionecrosis as well. Importantly, and the panel spent quite a bit of time deliberating this, ethical considerations must continue to be paramount in the study designs. And this is pertinent relative to this guideline. An important issue is that implementation of randomized clinical trials comparing current and novel radiation therapy modalities is typically precluded for ethical reasons. So this is a barrier to address, and the panel wanted to call attention to the scientific and clinical community. In addition to the radiation technology itself, two additional future research directions also represent potential strategic advances in the field as well. First, radiosensitivity of parotid gland stem cells. For example, it has been recently shown that not all constituents of the parotid gland are equally radiosensitive because of an unequal distribution of the stem cells within the gland. This and related biologic concepts should be incorporated in future randomized controlled trials of head and neck cancer patients. Secondly, novel regenerative medicine options may be used to spare, optimize, or restore salivary gland function after treatment. The guideline addresses these innovative treatment approaches in the context of both the current state of the science as well as opportunities for future research. I'll turn the microphone back to Brittany. BRITTANY HARVEY: Great. Thank you, Dr. Peterson, for reviewing those areas where additional research would be helpful. So next, in your view, Dr. Mercadante, what is this guideline's importance and how will it affect clinicians? VALERIA MERCADANTE: Thank you for this question. We believe these guidelines offers an opportunity for any clinician involved in non-surgical cancer therapies-- oncologists, dentists, dental specialist, dental hygienists, oncology nurses, clinical researchers, advanced practitioner. We all have an essential role in supporting our patient for the entire journey by optimizing symptoms management and improve our patient quality of life. These guidelines thus suggest a preventative and treatment course, but we've also delineated what we feel is common practice between expert and what areas would need further research to provide, as Dr. Peterson beautifully described, an ethical framework for future studies in this field. BRITTANY HARVEY: Great. Thank you so much. So finally, Dr. Beier Jensen, how will these guideline recommendations impact patients? SIRI BEIER JENSEN: Well, for patients who live with these complications during cancer treatment or as [INAUDIBLE] of cancer therapies, these guideline recommendations on prevention and management of salivary gland hypofunction and xerostomia will enable them evidence-based and with the help of professional health care providers to support the natural functions of saliva and promote their oral comfort and health. BRITTANY HARVEY: Great. Well, thank you all, Dr. Mercadante, Dr. Beier Jensen, and Dr. Peterson for taking the time to work on this guideline and produce evidence-based recommendations for clinicians and patients. And thank you for taking the time to speak with me today. VALERIA MERCADANTE: Thank you. DOUGLAS PETERSON: Thank you. BRITTANY HARVEY: And thank you to all of our listeners for tuning into the ASCO Guidelines podcast series. To read the full guideline, go to www.asco.org/supportive care guidelines. Additionally, our annual survey for guideline topics is open for submissions. Suggest a topic for guideline development at SurveyMonkey.com /r/ascoguidelinesurvey by August 1st. The link is also available in the episode notes of this podcast. If you've enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode. [MUSIC PLAYING]
- V@c Info Episode 11 - "Independence Day" Link to yesterday's Livestream: https://youtu.be/I51erS5p4hM - Muchmore News (Backup Channel) Link to yesterday's Livestream via Bitchute: https://www.bitchute.com/video/U4xnUieaToTy/ What do the kings of the earth have planned possibly for this July 4th? Is "Freedom" actually "Lawlessness?" Last year the Beast wanted to identify the Seed of Abraham, this year he wants to eliminate the Seed of Abraham through the VMat 2 Gene. "Independence Day" but from who? Revelation 17:12-14, Revelation 16:12-14 Daniel 12:1 - Matthew 24:21 2 Thess 2 Jude 1:6 - Psalm 2:3 - G1199 2 Peter 2:4-6 Genesis 11:6
"Independence Day" What do the kings of the earth have planned possibly for this July 4th? Is "Freedom" actually "Lawlessness?" Last year the Beast wanted to identify the Seed of Abraham, this year he wants to eliminate the Seed of Abraham through the VMAT 2 Gene. "Independence Day" but from who? Revelation 17:12-14, Revelation 16:12-14, Daniel 12:1 - Matthew 24:21, 2 Thess 2, Jude 1:6 - Psalm 2:3 - G1199, 2 Peter 2:4-6 and Genesis 11:6
Thank you so much for tuning in for another another episode of Tin Foil Hat with Sam Tripoli. This episode I welcome True Ott to discuss Project Highjump and what Klaus Schwab and 5th Column have planned for the future of humanity. Thank you for your support.Austin: April 9th-10- Romo Roomhttps://www.tix.com/ticket-sales/theromoroom/6543/event/1211527Phoenix AZ: April 22nd-23rd- The House of Comedy Azhttps://www.showclix.com/event/sam-tripoli-9999998ix6KDGCdPlease check out Sam Tripoli's new podcast: Cash Daddies with Sam Tripoli and Howie Dewey Youtube: Youtube.com/SamtripolicomedyAudio: https://podcasts.apple.com/us/podcast/cash-daddies/id1551870411Tin Foil Hat Social Media:Tin Foil Hat Podcast:Instagram: Instagram.com/TinFoilHatCastSam Tripoli:Insta: @SamTripoliTwitter: @RoninSamTripoliXG:Twitter: twitter.com/xgmarksthespotInstagram: instagram.com/xgmarksthespot/Podcast: George Perez Stories podcasts.apple.com/us/podcast/geor…es/id1517740242We Don't Smoke The Same: https://www.youtube.com/channel/UCt2REu6BgMyEtk1OLiXWzPQJohnny Woodard:twitter: twitter.com/JohnnyWoodardinstagram: instagram.com/johnnyawoodardPodcast: Broken Simulationpodcasts.apple.com/us/podcast/brok…li/id1506303807Patreon:Patreon.com/TinFoilHatPatreon.com/BryanCallenCheck out my new spiritual podcast called Zero on Rokfin:Rokfin.com/zeroTshirts:TinFoilHattshirts.comCoffee Cups:TinFoilHatswag.comSUBSCRIBE: https://bit.ly/2Sr53bTPlease Check Out The New Union Of The Unwanted Podcast: The Union of The Unwanted is an Alt-Media round-table hangout show hosted by Ricky Varandas, Sam Tripoli, Midnight Mike, and Charlie Robinson.Youtube: https://www.youtube.com/channel/UC2u1QUbVpglxRGA-NUSO3vA?view_as=subscriberFLOTE: https://flote.app/uotuwInstagram: https://instagram.com/tuotuw/Thank you to our sponsors:Athleticgreens.com: Athleticgreens daily all-in-one superfood powder is your nutritional essential. It is by far the easiest and most delicious nutritional habit that you can add to your health routine today and empower you to take ownership of your health.Simply visit athleticgreens.com/TINFOIL and join health experts, athletes and health conscious go-getters around the world who make a daily commitment to their health every day. Again, simply visit athleticgreens.com/TINFOIL and get your FREE year supply of Vitamin D and 5 free travel packs today. CBDLion.com: With a wide variety of award winning CBD products. For all the Tin Foil Hat listeners goto CBDLion.com and type the word "Tinfoil" to 20% off for every order.Superspeciosa.com: If you’re feeling unwell, physically or mentally—try kratom. As of now, it’s still considered a legal alternative to controlled substances, and it’s safe.SUPER SPECIOSA offers the purest, highest quality, and highest strength kratom on the market.SUPER SPECIOSA’s kratom is backed by a money back guarantee. Go to GetSuperLeaf.com/SAM, promocode SAM for 20% off.JoinHoney.com: Honey is the FREE browser extension that scours the internet for promo codes and applies the best one it finds to your cart. Honey supports over 30,000 stores online. Get Honey for FREE at Join Honey dot com slash TINFOILHAT. That’s Join Honey dot com slash TINFOILHAT.IP... Frequently Podcast: If you are looking for a funny business podcast with solid business advice, 80’s music and headline news than check the IP... Frequently podcast. Subscribe to IP... Frequently and stay up-to-date on their weekly stream of episodes wherever you get your podcasts..Lucy.Co: LUCY Nicotine is a company founded by CalTech scientists and former smokers looking for a better and cleaner nicotine alternative. Finally, tobacco alternatives that don’t suck! Lucy has created a nicotine gum with 4 milligrams of nicotine that comes in three flavors: Tin Foil Hat Listeners - Go to LUCY dot C O and use Promo Code TINFOIL to get 20% off all products, including gum or lozenges!MANSCAPED Refined Cologne: Get 20% Off and Free Shipping with the code TINFOILHAT at Manscaped.com. That’s 20% off with free shipping at manscaped.com, and use code TINFOILHATProactive: Right now is a great time to try Proactiv! For our podcast listeners, you can get a SPECIAL LIMITED TIME OFFER by going to Proactiv.com/SAM! Subscribe today and you will receive Proactiv’s Hydrating Duo as a FREE GIFT. That includes four Hydrogel Masks AND the Green Tea Moisturizer! Best of all, you get FREE SHIPPING!HelixSleep.com: Just go to Helix Sleep dot com slash tinfoil, take their two-minute sleep quiz, and they’ll match you to a customized mattress that will give you the best sleep of your life. Helix is offering up to 200 dollars off all mattress orders AND two free pillows for our listeners at Helix Sleep dot com slash tinfoil.
Today's episode is about the management of tardive dyskinesia. Here are some questions we cover in this episode: What is the best way to approach tardive dyskinesia? This episode will discuss an algorithm with levels of evidence for each treatment option. What is the evidence level for second-generation VMAT-2 inhibitors, such as deutetrabenazine and valbenazine? Is there evidence for prescribing anticholinergics in tardive dyskinesia? Should you use them? What options do you have if a VMAT inhibitor is not effective or well tolerated? Faculty: Greg Pontone, M.D. Learn more about Premium Membership here Earn 1.25 CMEs: "Drug-Induced Movement Disorders: The Clinical Essentials" Treating Tardive Dyskinesia: A Clinical Conundrum and New Approaches
We have been very excited about releasing our discussion with Dr Dianne Crellin for some time now. Di is an emergency nurse practitioner at the Royal Children's Hospital (RCH) and senior lecturer coordinating the nurse practitioner program at Melbourne University's Department of Nursing, and as you will hear she has an incredibly broad reach to her clinical and research interests. A past Executive Director of the College of Emergency Nursing Australasia who has received the Julie Finucane AOM Medal for Leadership in Emergency Nursing, Di has way too many strings to her emergency nursing bow to cover in this brief introduction.During this episode, John and Cliff cover a lot of ground with Di about pain assessment and management in children, distraction techniques, her experiences with AUSMAT and VMAT responding to disasters in South East Asia and Pacific regions as well as the ENP team at RCH ED. Luckily for us, Di is a self-described person who loves to chat and we hope you enjoy listening to her insights as much as we did.
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.02.324095v1?rss=1 Authors: bradner, j., Kalia, V., Lau, F., Sharma, M., Bucher, M., Johnson, M., Chen, M., Walker, D., Jones, D., Miller, G. Abstract: The proper storage and release of monoamines contributes to a wide range of neuronal activity. Here, we examine the effects of altered vesicular monoamine transport in the nematode C. elegans. The gene cat-1 is responsible for the encoding of the vesicular monoamine transporter (VMAT) in C. elegans and is analogous to the mammalian vesicular monoamine transporter 2 (VMAT2). Our laboratory has previously shown that reduced VMAT2 activity confers vulnerability on catecholamine neurons in mice. The purpose of this paper was to determine whether this function is conserved and to determine the impact of reduced VMAT activity in C. elegans. Here we show that deletion of cat-1/VMAT increases sensitivity to the neurotoxicant 1-methyl-4-phenylpyridinium (MPP+) as measured by enhanced degeneration of dopamine neurons. Reduced cat-1/VMAT also induces changes in dopamine-mediated behaviors. High-resolution mass spectrometry-based metabolomics in the whole organism reveals changes in amino acid metabolism, including tyrosine metabolism in the cat-1/VMAT mutants. Treatment with MPP+ disrupted tryptophan metabolism. Both conditions altered glycerophospholipid metabolism, suggesting a convergent pathway of neuronal dysfunction. Our results demonstrate the evolutionarily conserved nature of monoamine function in C. elegans and further suggest that HRMS-based metabolomics can be used in this model to study environmental and genetic contributors to complex human disease Copy rights belong to original authors. Visit the link for more info
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.24.312264v1?rss=1 Authors: Sanders, T. H. Abstract: Epigenetic modulation of neural circuits facilitates learning and memory. Here, we examined specific inhibition of histone deacetylase 2 (HDAC2) expression in rats receiving a single intracerebroventricular injection of HDAC2-targeted anti-sense oligonucleotides (ASOs) one month prior to cognitive testing. The HDAC2 ASO-injected rats displayed increased novelty preference, decreased cortical and hippocampal HDAC2 mRNA and protein, and upregulated gene expression that persisted 1-month post-injection. Cortical RNA-seq revealed strongly increased transcription of a subset of cyclic adenosine monophosphate (cAMP)-response element binding (CREB) genes known to influence synaptic plasticity, along with dopamine (DRD1, DRD2) and adenosine (ADORA2A) G-protein-coupled receptors (GPCRs). Our analysis identified evidence of a positive-feedback loop that amplified expression of CREB-regulated Gs GPCRs and genes in cAMP/Gs/Gi signaling pathways. Additionally, we found differential expression of enzymes that shift neurotransmitter biosynthesis away from norepinephrine and toward dopamine and acetylcholine (DBH, CHAT). We also observed increased expression of genes important for neurotransmitter packaging (SV2C, VMAT) and release (SYT9). The data indicate that persistent inhibition of HDAC2 expression enables long-lived enhancement of aspects of cognition through increased cortical transcription of a subset of CREB-regulated genes amplified by a positive-feedback mechanism that increases synaptic plasticity and shifts neurotransmitter balance toward increased dopaminergic and cholinergic signaling. Copy rights belong to original authors. Visit the link for more info
Dr Vishruta Dumane, Icahn School of Medicine at Mount Sinai, New York, is working on improving breast cancer treatments with the goal of delivering the most effective radiotherapy dose to the tumour, while limiting the risk treatment poses to other parts of the body. Her recent research looks at the use of deep inspiration breath holds (DIBH) during volumetric modulated arc therapy (VMAT) to reduce exposure of critical organs, such as the heart and lungs.For more on Dr Dumanes research, read her article in Research Outreach: https://researchoutreach.org/articles/breath-hold-techniques-during-volumetric-modulated-arc-therapy-breast-cancer-patients/Read the original paper this episode is based on in Radiation Oncology: https://ro-journal.biomedcentral.com/articles/10.1186/s13014-018-1132-9
Dr. Vivek Mehta, Radiation Oncologist at Swedish Cancer Institute in Seattle, WA, describes new technologies that are improving the accuracy and safety of radiation for stage non-small cell lung cancer (NSCLC).
Dr. Vivek Mehta, Radiation Oncologist at Swedish Cancer Institute in Seattle, WA, describes new technologies that are improving the accuracy and safety of radiation for stage non-small cell lung cancer (NSCLC).
Purpose: Ileal carcinoids are gut epithelial tumors originating from serotonin-containing enterochromaffin (EC) cells. Therapeutic options for effectively inhibiting the growth and spread of metastatic carcinoids are still limited. We aimed to identify the role of matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) during tumor development and metastasis. Patients and Methods: Tissue samples were obtained from surgically treated patients. Expression of the EC-cell marker, vesicular monoamine transporter-1 (VMAT-1), was used to verify ileal carcinoids. We investigated the differential expression of MMP-2, 7, 9, 11, and 13 and their endogenous inhibitors (TIMP-1, 2, and 3) by quantitative real-time RT-PCR in 25 primary tumors, their corresponding lymph node metastases and/or liver metastases and matched normal mucosa. Results: Significantly increased expression of VMAT-1, MMP-2, MMP-11, TIMP-1 and TIMP-3 was determined by quantitative RT-PCR in EC-cell carcinoids compared to normal intestinal mucosa (p < 0.05). In contrast, MMP-2 and MMP-9 as well as TIMP-1, TIMP-2, and TIMP-3 expression in primary tumors of patients with liver metastases (M1) was significantly lower than in patients lacking liver metastases (M0). EC-cell tumors were significantly larger in the M1 group of tumors, while VMAT-1 expression was significantly decreased. We found an inverse correlation between tumor size and prognosis. Univariate analysis further revealed that decreased expression of VMAT-1, MMP-2 and TIMP-3 in primary tumors was significantly associated with a reduced survival time of the patients. Conclusion: Our data reveal that MMP-2 and TIMP-3 expression together with VMAT-1 expression are of potential prognostic and clinical value in ileal carcinoids. Copyright (C) 2008 S. Karger AG, Basel