On Medical Grounds

“Because what happens is that the symptoms in men are presumed to be the gold standard. And the symptoms in women are considered atypical. Well, they’re not atypical. They’re typical for women. And we then have to define what is specific to women.” - Dr. Nanette Wenger

Today On Medical Grounds, we will be speaking with Dr. Nanette Wenger about heart disease in women, differences in risks, and how women talk about symptoms of heart disease differently than men. Dr. Wenger is Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine. Her career is a series of firsts. She received her medical degree from Harvard Medical School in 1954 as one of their first female graduates. During her postgraduate work at Mount Sinai Hospital in New York City, she became the first woman to be chief resident in the cardiology department. Throughout her career, Dr. Wenger has focused on heart disease in women, despite the consensus in the medical community that this was a disease found primarily in men. In 1993, Dr. Wenger co-wrote a landmark review article that demonstrated that cardiovascular disease affects women as much as men. Prior to this point in time, women were more likely to die from the disease because their symptoms were not recognized. She also helped write the 2007 guidelines for preventing cardiovascular disease in women. As a pioneer in gender disparities in medicine, Dr. Wenger has devoted her career to understanding how coronary artery disease affects women.

For additional show notes including an infographic on the state of women in hart disease, please visit OnMedicalGrounds.com.

(00:47) Introducing Dr. Wenger
(02:23) Why cardiology?
(03:30) When did Dr. Wenger discover heart disease was different in women?
(07:41) How is heart disease different for women?
(12:36) How are we falling behind on awareness and care?

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Dr. Curtis Schreiber is the medical director at the Missouri Memory Center and was a principal investigator of a Phase III  study for donanemab for patients with Alzheimer’s Disease.  Many of his patients were enrolled in the trial and the encouraging results were recently released.  Dr. Schreiber is with us today to discuss his work and the findings from this  important study.  The full read-out of the top line results for donanemab will be coming out on July 17 at an international Alzheimer’s conference followed by a publication in the Journal of the American Medical Association (JAMA) which will be linked here on release.

MISSOURI MEMORY CENTER STUDY SUMMARY:

In the phase III study, donanemab significantly slowed cognitive and functional decline in patients with early symptomatic Alzheimer’s. Results reported by 
 Eli Lilly & Co. include:

•  47% of participants on donanemab showed no decline based on a key measure of disease severity at one year compared to 29% of participants on placebo.

•  Participants on donanemab had a 40% less decline in their ability to perform activities of daily living at 18 months.

•  Participants on donanemab experienced a 39% lower risk of progressing to the next stage of disease compared to placebo.

Another Alzheimer's drug, lecanemab is expected to receive full FDA approval on July 6th. Phase III trial results showed that lecanemab slowed cognitive decline by 27%.

(00:48) Introducing Dr. Curtis Schreiber
(01:43) Optimizm for Alzheimer's treatment
(03:03) Statistical findings from phase III donanemab trial
(05:50) Participant recruitment and selection
(07:07) What is donanemab?
(08:05) Why does it work and how is it administered?
(09:19) Donanemab side effects
(13:58) How does donanemab compare to other drugs?
(15:14) Lifestyle of study participants
(16:30) Lifestyle modifications for Alzheimer's risk
(17:49) Alzheimer's genetics
(21:05) Why Dr. Schreiber switched from engineering to neurology
(22:30) His personal reason for studying Alzheimer's 
(23:54) Hope for Alzheimer's

https://jamanetwork.com/journals/jama/article-abstract/2807533

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Today On Medical Grounds, we will be speaking with Dr. Jeffrey Weber of Isaac Perlmutter Cancer Center at NYU Langone Health. He is senior investigator of a phase two clinical trial for an mRNA melanoma vaccine. This vaccine has significantly reduced the recurrence of tumors in patients when combined with an immunotherapy drug. 

(00:48) Introducing Dr. Weber
(01:38) Melanoma mRNA vaccine
(04:14) How does an the vaccine work?
(06:34) First randomized trial
(07:38) Personalized medicine
(09:28) Side effects
(11:19) How is this vaccine similar to mRNA COVID vaccine?
(12:52) Bedside to bench to bedside approach
(14:34) How do patients get involved in clinical trials?
(16:23) Definition of "cure"
(17:52) Clinically meaningful endpoints
(18:49) What's next for mRNA cancer vaccines?
(19:38) Dr. Weber's personal cancer connection
(20:22) What keeps Dr. Weber up at night?

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Free CME/CE credits for physicians, nurses, and lab professionals! Click here to get your certificate.

Join us as Jane talks with Dr. Jay Shubrook, a diabetes specialist from Touro University, about diabetes, why we must diagnose earlier and how to screen. 

(00:22) Introducing Dr. Jay Shubrook
(01:57) Why is diabetes moving to younger populations?
(03:13) How do you screen?
(04:16) Are patients proactive?
(05:32) Lifestyle modifications
(07:24) Benefits of excercise
(08:56) Alcohol and diabetes
(10:00) Other drinks and sodas
(11:24) Medications and FDA approvals
(12:55) Role of urgent care
(14:15) Racial disparities
(17:08) Reactive vs. proactive

Visit us at OnMedicalGrounds.com for more podcasts or download our app! You can subscribe through your podcast platform, our website, or follow us on social media for podcast updates and medical news. Some of our podcasts offer FREE CME/CE credits.
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One in three people in the U.S. have prediabetes and 17% don't know it. Dr. Whitley is a clinical professor and certified diabetes specialist and educator. She is with us to talk about screening and diagnosis of prediabetes and diabetes, who should be screened, and how. 

(00:14) Introducing Dr. Heather Whitley
(01:59) Dr. Whitley's research
(03:48) Bridge the gap with screening
(05:06) Screening methods for prediabetes and diabetes
(09:13) Benefits of point-of-care HbA1c
(10:40) Guidelines for community and urgent care
(13:11) Cost savings and efficiency with point-of-care HbA1c
(15:01) Dr. Whitley's point-of-care experience
(16:10) Racial and sex disparity in HbA1c, statistical vs. clinical relevance
(17:58) Use of point-of-care HbA1c in community settings to improve outcomes

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Dr. Yukari Manabe of Johns Hopkins and OMG host Dr. Jane Caldwell discuss the alarming rise in sexually transmitted infections (STIs) since the beginning of the COVID pandemic, and innovative ways to improve STI testing. 

(00:22) Introduction: Dr. Yukari Manabe
(01:20) STIs vs STDs
(01:35) Major drivers for increases in STIs
(02:23) Social distancing and STIs
(03:40) Classic STIs of concern
(05:29) STI diagnosis
(06:39) Rapid testing
(09:03) Multiplex testing
(10:09) Point-of-care testing
(12:01) Near-patient testing success
(12:25) STI treatments
(13:36) STI prevention
(15:42) STI screening recommendations
(16:35) Filling the gaps
(17:19) Importance of education
(18:08) Monkeypox...is it an STI?
(19:06) Syndromic management
(20:02) Dr. Manabe's concerns for global health
(20:57) Dr. Manabe's public health wish

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A stressed lawyer collapses in court. Not a heart attack...not COVID. Come and test your diagnostic skills with us as we get his lab results and learn more clues to the mystery.

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A college football player has an old shoulder injury and could need another surgery, but that may not be his only problem. Tune in to test your pain management skills. For additional related information and FREE CME, visit www.OnMedicalGrounds.com, listen to the podcast, and click on the CME/CE button for your certificate.

Visit us at OnMedicalGrounds.com for more podcasts or download our app! You can subscribe through your podcast platform, our website, or follow us on social media for podcast updates and medical news. Some of our podcasts offer FREE CME/CE credits.
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Dr. O’Leary is a pediatric infectious disease specialist and professor of Pediatrics at the University of Colorado. As director of the Colorado Children Outcomes Network (COCONet), a practice-based research consortium, he and his colleagues focus on identifying barriers to vaccination. Dr. O’Leary is with us today to talk about developing and testing interventions to address barriers to vaccinations.

(00:23) Introduction to Dr. Sean O'Leary
(00:58) August is National Immunization Month
(01:32) Reduction in vaccine orders
(02:23) Catching up children on vaccinations
(03:39) Polio cases have been reported
(05:52) Are there concerns for smallpox?
(07:27) Vaccine misinformation
(08:20) Are children missing boosters?
(09:18) Colorado Childrens Outcomes Network (COCONet)
(10:40) Barriers to vaccinations
(12:41) Vaccine interventions
(17:42) Vaccine hesitancy resources
(19:03) COVID-19 and pandemic effects on vaccination rates

Visit us at OnMedicalGrounds.com for more podcasts or download our app! You can subscribe through your podcast platform, our website, or follow us on social media for podcast updates and medical news. Some of our podcasts offer FREE CME/CE credits.
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Free CME/CE CREDITS (ACCME, ANCC, ACPE)! For credit visit https://www.onmedicalgrounds.com/PremiumContent/Osteomyelitis, view the additional material, click the CME/CE button, and get your certificate.

Dr. Adam Bressler is an infectious disease specialist affiliated with Emory Hillandale Hospital and Emory Decatur Hospital. He will be joining us to discuss the role of antibiotic-resistance and other complications in current treatment regimens for osteomyelitis, developments in novel glycopeptide antibiotic treatments for Gram-positive and antibiotic-resistant osteomyelitis, and the multidisciplinary approach to the diagnosis and treatment of osteomyelitis. 

(00:22) CME/CE information
(01:57) What is osteomyelitis and why is it tough to treat
(02:53) Role of antibiotic or antimicrobial resistance
(03:37) Challenges of bone tissue
(04:45) Role of biofilms in osteomyelitis
(06:30) First line treatments often fail
(07:28) New antibiotics showing promise
(09:15) Need for guidelines for osteomyelitis treatment
(10:35) Glycopeptide antibiotics
(11:08) Glycopeptide antibiotic mechanisms
(11:55) Telavancin Observational Use Registry (TOUR) study
(13:03) TOUR methods
(14:04) TOUR results
(16:46) Infusion centers and pumps
(17:58) TOUR demographics
(20:20) Immunocompromised patients and other risk factors
(24:18) Multidisciplinary approach

Visit us at OnMedicalGrounds.com for more podcasts or download our app! You can subscribe through your podcast platform, our website, or follow us on social media for podcast updates and medical news. Some of our podcasts offer FREE CME/CE credits.
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