Standard Podcast [27:04m]: Play Now | Play in Popup | Download (1185)

Part 2 of 4: Uncertainties and controversies in neurology and medicine - with focus on cardio and cerebrovascular disease, stroke and TIAs. Future Rife with Strife series will focus on controversies in other areas of neurology.

Today’s focus: EDTA (ethyline diamine tetra acetate) for the treatment of cardiac, peripheral and cerebral atherosclerosis.

Reports:

• Basics of EDTA pharmacology
• History of EDTA as a treatment for atherosclerosis
• Trial to Assess Chelation Therapy (TACT)
• Controversies of EDTA chelation for treating atherosclerosis. E.g. U.S. vs. Evers.

Resources for learning more:

• www.drcranton.com/chelation.htm
• www.acam.org
• Saunders textbook: Cardiovascular Drug Therapy - with chapter and many references on EDTA chelation therapy.

Who are the ‘Quackbusters‘? We didn’t have time to cover this question during the show, but this group remains a mystery. It publishes opinions against so-called ‘integrative medicine’ (previously called ‘alternative medicine’), including attacks against the use of EDTA chelation for atherosclerosis. We on the STAT editorial team would appreciate learning who funds this organization. It is not clear from their website.
Next week’s show: We’ll address testosterone for stroke care and the controversial area of bio-identical hormone therapy (versus the use of synthetic/derivatized hormones).

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

 

 Standard Podcast: Play Now | Play in Popup | Download (699)

Uncertainties and controversies in neurology and medicine - with focus on stroke and TIAs.

Part 1 of 4. This 4-part series focuses on controversies in the area of strokes and TIAs. Future Rife with Strife series will focus on controversies in other areas of neurology.

Hear these reports:

The Role Of Controversies In The Advancement Of Medicine: medical controversies, with criticism and debates, are the way that optimal medical therapies crystallize.

TIA and Stroke Admissions: a study on primary care physicians last year in the journal Stroke showed that even when strokes and TIAs were well recognized as medical emergencies by the PCPs, essentially 30% of them would not admit the TIA patients as a medical emergency.

Immediate Treatment of TIAs: the PROFESS trial is underway comparing clopidogrel (Plavix) with ASA/dipyridamole (Aggrenox) for secondary stroke prevention. Until those results are available, which drug is best to use for the prevention of stroke in TIA patients? Or is Aspirin alone adequate ?

Carotid Stenting Versus Carotid Endarterectomy: Which do you recommend for your patients and why?

Intra-Arterial Thrombolytics for the Treatment of Acute Stroke: You may recall the “Lazarus phenomenon” from STAT episode #61. Dramatic improvement after intra-arterial thrombolytic occurred in twenty-five percent of the patients. Might this ‘emerging therapy’ someday take the place of IV infusions of thrombolytics?

Percutaneous Closure of Patent Foramen Ovales for Stroke Prevention: The relative risk of any thromboembolic event is 4-fold in patients with a PFO. A study in the New England Journal of Medicine 4 months ago support that PFOs and resulting paradoxical emboli are a cause of stroke in both older patients and younger patients. How about this proposition: the large-scale procedural intervention - percutaneous PFO closure - for the prevention of strokes (and migraines)? Now there’s a controversy that society is probably not quite ready to grapple with.

Next week’s show: Controversies about neuroprotection before or after acute ischemic stroke, and EDTA chelation therapy as a preventive and treatment for cerebrovascular and cardiovascular disease.

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

 

 Standard Podcast [23:08m]: Play Now | Play in Popup | Download (564)

Harnessing information power for your patients and your practice. Part 2 of 2.

Special title for this installment: Information power forming the future of neurology and medicine.

Hear these reports:

Elsevier’s WiserWiki Allows Physicians To Update Evidence-Based Medical Information With Experience-Based Practice Insights: WiserWiki potentially creates a virtual, living, continually updated medical manual – possibly much more useful and ‘in the now’ – than a periodically updated, edition-based textbook (which only a handful of ‘experts’ edit)!

Illumin8 research tool to help researchers answer complex R&D questions faster and more accurately: The first web-based research tool that integrates ‘natural language search technology’ with the large amounts of content from Elsevier’s scientific articles and web sources.

Education in the third dimension: Enactive learning - ‘learning by doing’ - may be poised for a big comeback because now, thanks to the large, active European Union-funded research network called Enactive.

Med Schools Adjusting to Millennial Students: Medical educators are looking into a variety of different ideas on how to best teach this new tech-savvy, team-oriented generation. We predict that collaborative approaches - including wiki technology - and audio and video podcasting, and the use of iTunes U - will be important parts of their modern teaching approaches!

Thoughts on the ‘Global Brain’: Medical ideas here on Earth (thanks to information technology) are now well interconnected by a web of ‘synapses’ - the billions of nodes of the world wide web. It’s like a ‘global brain.’ Stored information on blogs and wikis - like WiserWiki – are analogous to stored memory in the brain’s synapses. And podcasting (‘audioblogging’) is like the ‘voice’ for the global brain!

Next week’s show will be the first of a new series of STAT special-topic installments: Rife with Strife – uncertainties and controversies in neurology and medicine. The focus will be on the cerebral vascular disorders and stroke.

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

 

 Standard Podcast [26:35m]: Play Now | Play in Popup | Download (446)

Harnessing information power for your patients and your practice

This week’s show: The I.T. Sword has Two Edges: benefits and Risks of I.T. for neurology

Hear these reports:

Double-edged Sword of I.T.: It’s reaching into physician practices whether they’re ready for it or not. The government’s seeing to that. Is it a ‘brave new world’ for neurology and medicine? One possibly with significant risks and benefits: clinical practice guidelines and electronic medical records. Ninety (90)% of authors of clinical practice guidelines had financial relationships with the pharmaceutical industry (according to JAMA back in 2002). See the Association of American Physicians and Surgeons (AAPS) website.

Will you recommend that your patients put their health records in the hands of Google, Microsoft or Wal-Mart? You may soon be getting requests to do so. See this Newsweek story.

The National ePrescribing Patient Safety Initiative (NEPSI): This software is available to equip every physician in the US with electronic prescribing software. Created by a coalition of health insurers and software companies, it’s compatible with the software in 99% of the nation’s pharmacies. It’s easy to learn and free of charge. Could there be future privacy and control-related risks with this technology as well?

CaringBridge.org: Patients or their families easily create - for free - their own private website so that family and friends can provide the patients and caregivers with support through guest book messages and photos.

I.T. for Autism: This is a must-see video produced by Amanda Baggs who has autism. We became aware of the video thanks to Wired Magazine. Ms. Baggs might otherwise be considered mute and retarted, if not for technology. She shares amazing insights with us from her valuable and intelligent perspective using her computer and synthetic voice technology from Dynavox. Dr. Mike Merzenich, neuroscientist at UC San Francisco is quoted: the idea that 75 percent of autistic people are mentally retarded is “incredibly wrong and destructive.” Let’s see if many more autistics start ’speaking out’ through information technology.

Next week’s show: It’s the second part of this two-part series on Information Technology for Neurology: new learning enhancements available through I-T, the use of ‘Wikis’ for the establishment of independently developed clinical practice guidelines, and more.

 

 Standard Podcast [17:39m]: Play Now | Play in Popup | Download (220)

Insights into sleep, and sleep disorders - whether lack of, excessive or disturbed sleep. Part 4 of a 4-part series.

On this show: You’ll hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of his obstructive sleep apnea (OSA) - especially the use of continuous positive airway pressure (CPAP) during sleep - has dramatically changed his life for the better. There’s a good chance that Mr. Frank (prior to his treatment) typifies numerous OSA sufferers in your practice for whom sleep apnea remains undiagnosed and untreated.

Next week: The installment topic will be a surprise. We’re sure you’ll find that it’s interesting, timely and important neurology and medical news information. Hint: information technology (IT) for neurology reigns supreme.

Thanks for staying subscribed to STAT! — The Podcast of Neurology News and Medicine.

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

 

 Standard Podcast [18:49m]: Play Now | Play in Popup | Download (213)

Insights into sleep, and sleep disorders - whether lack of, excessive or disturbed sleep. Part 3 of a 4-part series.

On this show: We conclude the 3 interviews with Sleep Medicine experts Dr. Michael Littner and Dr. Jay Puangco. How important is sleep medicine in the practice of neurology? Might we expect significant increases - or decreases - in the use of sleep labs, what with Medicare’s likely reimbursement for home sleep apnea studies? And finally: Dr. Littner and Dr. Puangco provide us with take-to-the-office clinical pearls we may be able to use to help our patients.

Next week: Part 4 of the 4-part series. Hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of his OSA - especially the use of continuous positive airway pressure (CPAP) during his sleep - has dramatically changed life for the better. PS: There’s a good chance that Mr. Frank (prior to his diagnosis and treatment) exemplifies numerous people in your practice who’s OSA remains undiagnosed and untreated.

Thanks for staying subscribed to STAT! — The Podcast of Neurology News and Medicine.

Sponsor: Flow Productions. Flow will be producing additional lines of podcasts based on cutting medical news and information. If you are interested in sponsoring one of the shows please contact info@flowproductions.org. Click here to see and hear an example of our next-generation video podcasts.

 

 Standard Podcast [21:22m]: Play Now | Play in Popup | Download (205)

Insights into sleep, and sleep disorders - whether lack of, excessive or disturbed sleep. Part 2 of a 4-part series.

On this show: We continue our interviews with Sleep Medicine experts Dr. Michael Littner and Dr. Jay Puangco. Cardiologists regularly use home testing for arrhythmia detection on a relatively large scale. Is it time for neurologists and other physicians to do likewise for testing sleep apnea? If Medicare completes the final approval of payment for home testing for sleep apnea, this may provide access (to this extremely important testing) to a huge number of patients. But do you think you can become a sleep apnea expert - employing home apnea testing for your patients - after just a weekend certification course? Think again!

Upcoming 2 shows: On Part 3 and 4 (next two weeks) we’ll complete our 3 interviews with Dr. Littner and Dr. Puangco, and hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of his OSA - especially the use of continuous positive airway pressure (CPAP) during sleep - has dramatically changed his life for the better.

 

 Standard Podcast [22:33m]: Play Now | Play in Popup | Download (205)

Insights into sleep, and sleep disorders - whether lack of, excessive or disturbed sleep. Part 1 of a 4-part series.

On this show: Interview with Sleep Medicine experts Dr. Michael Littner and Dr. Jay Puangco. We’ll have an overview of Sleep Medicine, and highlight the importance Sleep Medicine as a medical specialty. Also: what percent of the population is estimated to have sleep apnea? And what fraction of those may remain undiagnosed? Is ’snoring’ and ‘excessive daytime sleepiness” (EDS) on your history intake form? If not, maybe it should be! Would you be eligible for a sleep medicine fellowship? And finally: insights into formal training in Sleep Medicine, from neurologist Dr. Puangco who’s in the Sleep Medicine fellowship at UCLA.

Upcoming 3 shows: On Part 2 and 3 (next two weeks) we continue our interviews with Dr. Littner and Dr. Puangco discussing the new and revolutionary home testing technologies for sleep apnea. And we’ll address what’s probably the current hottest topic in Sleep Medicine. Hint: the topic is ‘hot’ because of potential for significant reimbursement for efficient diagnostics coming soon.

On Part 4 we’ll hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of OSA has changed his life for the better.

 

 #108: Imagery for Neurology, Installment #3 [15:53m]: Play Now | Play in Popup | Download (190)

Imagery and images for neurology professionals: part 2 of a 2-part mini series.

Today’s show: Second part of the interview with Dr. Daniel Amen, MD and Dr. Douglass. They discuss the accuracy of SPECT images for ‘imaging human behavior,’ and the accuracy of SPECT scans for diagnosing preclinical and clinical Alzheimer’s disease. They’ll also touch upon the potential quagmire of neuroethical issues related to the health insurance industry, particularly when insurance companies may discriminate against patients who test positive for Alzheimer’s based on SPECT neuroimaging, or based on positive tests for the APO E-4 allele (the Alzheimer’s ‘risk gene’).

For more information about SPECT scanning and the Amen Clinics: www.AmenClinics.com.

Next week’s show: It will be the first of a four-part Reap the Sleep series on Sleep Medicine - with focus on sleep apnea. We’ll interview sleep medicine experts Drs. Michael Littner and Jay Puangco.

 

 #107: Imagery for Neurology, Installment #107 [23:08m]: Play Now | Play in Popup | Download (188)

Imagery and images for neurology professionals.

Today’s show: Interview with Dr. Daniel Amen, MD. SPECT scanning has dramatically changed the way Dr. Amen looks at and sees (and treats) his patients.

Psychiatrists remain the only doctors who never look at the ‘organ’ they treat (the human brain). We make psychiatric diagnoses today essentially like our predecessors did back in 1840. Might SPECT scanning change that?

‘Imaging human behavior’ with SPECT is considered a new frontier for the entire field of neuropsychiatry since we can now literally see functional imbalances in the brain, and then do what we can to try to correct those imbalances.

According to Dr. Amen, SPECT neuroimaging opens the minds of doctors who employ it, and it opens many doors for possible therapeutic options for neurobehavioral disorders (not just medications). SPECT can apparently document brain changes (improvements) from treatments like acupuncture/acupressure, hyperbaric oxygen, dietary supplements and even transcranial magnetic stimulation.

For more information about SPECT scanning and the Amen Clinics: www.AmenClinics.com.

Next week’s show: Part 2 of the interview with Dr. Daniel Amen (and Dr. William Campbell Douglass). The doctors will discuss the accuracy of SPECT images of the brain, and their accuracy for diagnosing pre-clinical Alzheimer’s disease. They’ll also discuss the potential quagmire of issues related to likely discrimination by health insurance companies after people test positive for Alzheimer’s based on SPECT neuroimaging (or based on positive tests for APO E4, the Alzheimer’s risk gene).