Category Archives: Internal Medicine

Internal Medicine

Studying the effects of probiotics for idiopathic epilepsy – DVM 360

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Canine idiopathic epilepsy (IE) is one of the most commonly diagnosed and treated chronic neurological conditions, according to Zoe Bailey, DVM, neurology/neurosurgery resident at the University of Wisconsin-Madison.1 The cause of this epilepsy type is unknown, but a higher prevalence has been seen in purebred dogs vs mixed breed dogs, and male dogs are more commonly affected than females.2

To treat IE, starting an antiepileptic drug (AED) is the most common route and usually the first line therapy. However, this is not always the best option for every patient and client. Bailey explained in her lecture at the 2024 American College of Veterinary Internal Medicine Forum in Minneapolis, Minnesota, that adverse effects of this medication can negatively impact the clients perception of their dogs quality of life. Additionally, approximately 30% of dogs will be drug resistant to this specific treatment.1 Bailey noted some other therapies for this condition can include dietary changes, use of cannabidiol products, neurostimulation, and more.

Bailey participated in a study aimed at investigating the microbiota-gut-brain axis and its impact on epilepsy. In humans, probiotics have been found to decrease seizure frequency and severity,3 however, there has yet to be a large-scale study on dogs with IE. Bailey and other researchers used a probiotic (Visbiome Vet) with 42-client owned dogs previously diagnosed with IE and already taking a prescription AED. Dogs in this study were between the ages of 1 and 9 years and had a seizure history of at least 6 months, with a frequency of at least 1 every 3 months. Dogs were enrolled on a rolling basis from January 2022 through May of 2023. So we did a prospective, placebo controlled, masked, crossover clinical trial, both with a 9- or 12-month period, there was a total of 3 or 4 phases, each of which was 3 months in duration, Bailey explained during the ACVIM session.1

The first phase was used as an observational period, also to have some control data as a basis before moving forward in the study. The second phase administered a daily placebo capsule provided by Visbiome Vet to the enrolled dogs. A daily dose of the probiotic from Visbiome Vet was given during phase 3 and adjusted based on the dogs body weight. The study concluded with phase 4 in which dogs were observed again, now evaluating any changes in data with the introduction of a regular dose of probiotics.

By the end of the study, only 21 dogs had completed all 4 phases. The other 21 dogs were excluded at various time points throughout the study due to the development of new diseases, the need for additional non-AED medications, dietary modifications, owner compliance, and death due to other circumstances, said Bailey.

Seizure logs were maintained by owners and every seizure was documented. At the start of the study, 17 of the 21 completed dogs were on 2 or more AEDs and 12 of 21 dogs had their AED prescription adjusted by their veterinarian.

The study results revealed the following:

Bailey concluded that, although there was some improvement discovered, the measurement of seizure frequency was not statistically significant enough to prove the use of probiotics improves the outcomes of dogs with IE. Some of the limitations of this particular study was a small population size and reliance on owners for seizure detection and documentation. So really, the next steps that we're still in progress with are evaluating the microbiome of this population of dogs with refractory idiopathic epilepsy. And then [also] to determine if this biome alters their microbiome, Bailey said.

References

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Studying the effects of probiotics for idiopathic epilepsy - DVM 360

Internal Medicine

Pride Celebrated at UConn Health – UConn Today – University of Connecticut

UConn Health believes in health care for all and provides equitable and inclusive care to lesbian, gay, bisexual, transgender, and queer/questioning+ members of our community.

Students from Reach Out, a student organization at UConn Health dedicated to LGBTQIA+ awareness, education, and activism in the UConn medical and dental communities, proudly raised the flag. The UConn School of Medicine students were fourth-year medical students Cailyn Regan, Sarah Hartmann, and Ryan Hannon.

Reach Out aims to bring students of any gender or sexual identity together, make an impact through service in the greater Hartford community, and provide education amongst the next generation of clinicians who strive for excellence in well-rounded patient care.

The students were supported by the newly appointed UConn Health CEO Dr. Andy Agwunobi, Chief Diversity Officer Dr. Jeffrey Hines, and their Reach Out faculty advisor Zita Lazzarini, JD, MPH.

Also, in attendance were Internal Medicine Resident Dr. Nicholas Harriel, who will be entering his third year of graduate medical education training (GME) at UConn Health and Ian Shick, assistant director of the Rainbow Center at UConn.

A special thanks to UConn Fire Departments Captain Anthony Ruggiero and Deputy Chief Christopher Renshaw for their special assistance of the UConn Health students with the flag raising, along with UConn Police Officer Nolan Hurst.

This month UConn Healths campus is also being illuminated in rainbow.

Learn more about UConn Health and its LGBTQIA+ Services.

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Pride Celebrated at UConn Health - UConn Today - University of Connecticut

Internal Medicine

Residents and Faculty Shine at Internal Medicine Annual Meeting – Washington State University

Residents and faculty from the WSU College of Medicine and Internal Medicine Residency Program in Everett were showcased via multiple posters, oral presentations, and workshops at the highly competitive Society of General Internal Medicine annual meeting in Boston. The conference was attended by approximately 2700 clinicians.

The list of presentations and leadership roles by WSU colleagues represents an incredible level of engagement and highlights WSU COMs growing national reputation.

Meeting proceedings will be published in a supplemental issue of the Journal of General Internal Medicine.

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Residents and Faculty Shine at Internal Medicine Annual Meeting - Washington State University

Internal Medicine

Opinion | Smoking Isn’t the Only Source of Nicotine Addiction in Town – Medpage Today

Benowitz is a professor of medicine, and a nicotine and tobacco researcher.

E-cigarettes were introduced in the early 2000s as a way for smokers to manage their nicotine addiction without exposing themselves to the well-documented harms associated with the toxins and carcinogens in combustible cigarette smoke. These harms include increased risks of cancer, cardiovascular disease, chronic lung disease, and a number of other debilitating or life-threatening diseases. While many people have used e-cigarettes to quit smoking, other non-smokers have taken up e-cigarette use, particularly young adults.

However, the use of e-cigarettes, commonly known as vaping, is not without harm. Based on a review of the published data available at the time, an expert committee of the National Academies of Sciences, Engineering, and Medicine issued a report in 2018 finding conclusive evidence that although substituting e-cigarettes for combustible cigarettes reduced exposure to numerous toxins and carcinogens, e-cigarette use is not risk-free.

What are some of the harms? People who vape continue to be exposed to nicotine, which is highly addictive, making quitting e-cigarettes difficult for some. In addition, vapers may be subject to social stigma, and they incur expenses for purchasing vaping devices and liquids. Many people who have taken up vaping, either to help themselves quit smoking or as a primary form of recreational drug use, would like to quit. Furthermore, some healthcare professionals are supportive of the use of e-cigarettes to quit smoking but would like their patients to stop use when they are confident they will not relapse to smoking, due to the possible risks of nicotine use.

A study recently published in JAMA Internal Medicine is the first randomized, placebo-controlled trial to report a successful e-cigarette cessation benefit with pharmacological treatment. As a member of the Data and Safety Monitoring Committee for this study and an author on the publication, I believe the findings are an important step in addressing a relatively new source of nicotine addiction. This publication provides an opportunity for clinicians and the public health community to revisit how we think and talk about the harms associated with smoking, vaping, and nicotine addiction, and to reconsider how we can best take action to help reduce these harms.

Help or Harm: How Do We Discuss Vaping With Patients?

The fact that vaping can be associated with a high degree of dependence and a possible risk to health creates a challenge in counseling patients about their use of e-cigarettes. Given the extreme dangers associated with cigarette smoking, I believe that vaping can be a useful tool for harm reduction. I also believe that overcoming nicotine addiction -- in any form -- provides health, social, and economic benefits to those who can quit.

Healthcare professionals are solutions-oriented, and we strive to help patients set and achieve goals that can improve their physical and mental health and their quality of life. The lack of effective vaping cessation medications is an important missing piece of the puzzle when discussing the relative risks and benefits of smoking, vaping, and overcoming nicotine dependence. Survey data show that more than half of adults vaping nicotine plan to quit using e-cigarettes, and approximately 15% had already tried to quit in the prior year. Some succeeded, but additional tools are likely needed to help others. Is it realistic to counsel patients to quit vaping without addressing the very real biochemical basis of their nicotine addiction?

Hope for an Effective Vaping Cessation Therapy

Our data in JAMA Internal Medicine suggest we may be moving closer to finding an important intervention for e-cigarette-related nicotine dependence. The Phase II randomized clinical trial ORCA-V1 found that e-cigarette cessation rates were significantly higher for participants receiving 12 weeks of cytisinicline plus behavioral support compared with those receiving behavioral support alone. Cytisinicline is a partial agonist at 42 nicotinic acetylcholine receptors that mediate nicotine dependence and has shown efficacy for cigarette smoking cessation.

In the study, 160 participants were randomized 2:1 to 3 mg cytisinicline taken three times daily or placebo for 12 weeks. All participants received weekly behavioral support. The primary endpoint was biochemically verified continuous abstinence from nicotine e-cigarette use, measured during the last 4 weeks of treatment. Participants receiving 12 weeks of cytisinicline treatment had 2.6 times higher odds of having quit vaping during the last 4 weeks of treatment compared with subjects who received placebo, with vaping cessation rates during weeks 9-12 of 31.8% and 15.1%, respectively. No treatment-related serious adverse events were reported, and rates of adverse events were similar between the cytisinicline (50.9%) and placebo (54.7%) arms.

Acting Today While Awaiting Tomorrow's Advances

Although additional studies are needed to confirm the efficacy and safety of cytisinicline as a vaping cessation therapy, the ORCA-V1 results show that pharmacological tools may help to address the complex role that vaping plays in the continuum of reducing harms from cigarette smoking while sustaining nicotine addiction. These findings are particularly encouraging given the increasing prevalence of e-cigarette use among adults -- especially young adults -- in the U.S. Moreover, as a plant-based alkaloid, cytisinicline may appeal to those who prefer natural products as well as those who have tried and failed to quit smoking or vaping using other pharmacologic agents.

As we await additional data supporting the use of cytisinicline as a vaping cessation therapy, those of us who counsel patients who smoke cigarettes or vape nicotine should not shy away from having candid discussions about smoking, vaping, and overcoming nicotine addiction. We should be able to explain the risks and benefits of vaping and our patients' ability to make decisions that meet their personal health and lifestyle goals. With additional research, I hope those discussions will one day soon include the availability of safe and effective vaping cessation therapy.

Neal L. Benowitz, MD, is professor emeritus in the Department of Medicine at the University of California San Francisco.

Disclosures

Benowitz reported personal fees from Achieve Life Sciences while the JAMA Internal Medicine study was being conducted, as well as personal fees as a tobacco litigation expert witness in litigation against tobacco companies.

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Opinion | Smoking Isn't the Only Source of Nicotine Addiction in Town - Medpage Today

Internal Medicine

Benefis gets approval for Internal Medicine residency program – KRTV NEWS Great Falls

Benefis Health System recently earned approval for its new Internal Medicine Residency Program from the Accreditation Council for Graduate Medical Education, bringing more health care professionals to the central Montana area.

Physicians coming out of medical school become residents to further learn their specialty. It works like an apprenticeship with gradually escalating responsibilities and autonomy. Internal medicine providers for adult patients over time, treating chronic illness and monitoring wellness. Residents in the program will learn to take care of hospitalized patients and learn preventative medicine.

Internal Medicine Residency Program Director Michael Sheffield says, Statistics say that when you finish your training, wherever you are, 60 to 70% of those residents will remain in the area. So if we train them here, we have a good chance of keeping about two thirds of them in the area to provide care for the future patient, future generations in this area.

After the three year program, most residents will become internal medicine providers and later move on to a speciality like cardiology or critical care. Program leaders hope to gear residents towards relevant specialities like geriatrics and addiction medicine. With the new residency, patients will be interacting with students and residents which may take more time, but all care and decisions will be supervised by medical professionals.

Sheffield describes, as patients become accustomed to it, the nursing staff, respiratory therapy, all of the staff will begin to work with residents more directly and change the way they work, and so forth in the way patients receive their care.

Sheffield explains he is most excited for the residents energy, curiosity are things that are refreshing every day. And so looking forward to having them here to have those discussions, to remember back when and what it was like when I started and what it's like now, to make sure they get the same sort of joy and excitement that we all had when we were training.

The first graduates from Touro College of Osteopathic Medicine in Great Falls, as well as will be eligible to apply for the Internal Medicine Residency in Fall 2025, in the programs second year.

Benefis will be accepting applications this fall, with the first ten Internal Medicine Residents starting in July 2025.

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Benefis gets approval for Internal Medicine residency program - KRTV NEWS Great Falls

Internal Medicine

Clinical Score Predicts Recovery From Dialysis Dependent Acute Kidney Injury – MedicalResearch.com

MedicalResearch.com Interview with:

Silvi Shah, MD,MS,FASN,FACP Associate Professor Internal Medicine | College of Medicine University of Cincinnati College of Medicine

MedicalResearch.com: What is the background for this study?

Response: AKI (Acute Kidney Injury) is a major contributor to end-stage kidney disease (ESKD).

About a third of patients with ESKD recover kidney function due to AKI. The study looked at the health outcomes of 22,922 patients from the U.S. Renal Data System from 2005 to 2014 to construct a clinical scoring system to predict kidney recovery within 90 days and 12 months after the start of dialysis for kidney failure patients due to acute kidney injury (AKI)

MedicalResearch.com: What should readers take away from your report?

Response: Our results indicate that about one-fourth of patients with dialysis-dependent AKI will recover within 90 days, and around one-third of those patients will recover within 1 year. Several factors can predict recovery. If you have a lower body mass index, are Black, have congestive heart failure, or have a history of amputation, you have lower chances of recovery. The clinical score developed by our team helps us to do a risk prediction and, at the same time, allows us to tell patients and healthcare providers what percentage of recovery may be expected. If you fall in the high score category, dialysis-dependent AKI patients have a 57% chance of recovery in 90 days. This is very encouraging for both patients and physicians.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Future research should focus on guidelines and protocols for monitoring kidney function recovery in dialysis-dependent AKI patients and developing interventions to promote kidney function recovery.

Disclosures: Dr. Silvi Shah is supported by a K23 career development award from the National Institutes of Health.

Citation: Silvi Shah, Jia H Ng, Anthony C Leonard, Kathleen Harrison, Karthikeyan Meganathan, Annette L Christianson, Charuhas V Thakar, A clinical score to predict recovery in end-stage kidney disease due to acute kidney injury,Clinical Kidney Journal, Volume 17, Issue 5, May 2024, sfae085,https://doi.org/10.1093/ckj/sfae085

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Last Updated on May 30, 2024 by Marie Benz MD FAAD

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Clinical Score Predicts Recovery From Dialysis Dependent Acute Kidney Injury - MedicalResearch.com

Internal Medicine

A Mother’s Encouragement and a Husband-Wife Doctor Team Set the Stage for a Career in Hematologic Oncology – The ASCO Post

Lymphoma expert Jane N. Winter, MD, grew up on the south shore of Long Island in New York. My dad sold cars in my great uncles dealership after a failed foray into business after World War II. My mom graduated high school at 16 to go to work to help support her family. When my younger brother went off to kindergarten, she went back to school to take college prerequisites, then to a community college, then to college, and ultimately to graduate school, where she completed a masters degree in learning disabilities. I think my mom was the driving force in my decision to become a physician; when I told her I wanted to be a nurse, having read the Cherry Ames book series, she said, No, youll be a doctor, which was pretty forward-thinking for a woman in the 1950s, she related. I have two brothers who have been amazing in terms of their successes, both executives at Fortune 500 companies, and have always been very supportive.

TITLE

Professor of Medicine, Division of Hematology/Oncology; a member of the Robert H. Lurie Comprehensive Cancer Center at Northwestern University; and a hematologist at Northwestern Medicine

MEDICAL DEGREE

University of Pennsylvania School of Medicine, Philadelphia

ADVICE FOR YOUNG WOMEN CONSIDERING A CAREER IN ONCOLOGY

We have certainly made progress in closing the gender gap, but its definitely challenging for young women who want to balance a career and a family. Its never going to be easy, because there is never enough time for everything we want to do. However, being persistent and confident in yourself is key. In short, join societies such as ASH and ASCO, and when you have an opportunity, seize it.

Dr. Winter continued: I also had a very unusual set of pediatricians, a husband-wife team, who influenced my perception of medicine. Their office was on the first floor of their home, and their children would play in the yard while one of them saw patients, and the other made house calls. If I was sick, my mom would say, Dr. Bea is in the office, and Dr. Philip is making house calls. Who do you want to see? I didnt think twice that Dr. Beatrice was a physician.

On the Cusp of the Womens Movement

It was totally serendipitous that I wound up at a womens college, the same college Dr. Bea had attended. I was recruited to Bryn Mawr by friends of my parents who really wanted me to date their son, who was applying to nearby Haverford. As it happened, I was invited to a Bryn Mawr Alumnae Association reception where I met the most amazing group of professional women. That just sealed the deal for me as to which college I wanted to attend. Bryn Mawr was a very intellectually challenging place, which, in many ways, laid the foundation for my career path and my world view, she said. I majored in philosophy and spent a year at the London School of Economics studying Philosophy of Science, a field I keep hoping to revisit.

Valued Early Mentors

During her undergraduate years at Bryn Mawr, Dr. Winter spent free time in Philadelphia, which influenced her next step. I loved Philadelphia, so the University of Pennsylvania School of Medicine seemed like a natural transition. It was career-shaping in many ways. For example, I encountered Dr. John Glick, who later became Penns Cancer Center Director but also my housemates beloved hematologist-oncologist. I also spent an invaluable month rotating at Fox Chase, where I had amazing experiences caring for patients with all types of malignancies but particularly patients with leukemia and lymphoma, she explained.

Asked what sealed the deal for her decision to pursue blood malignancies, Dr. Winter replied: Its fairly common for important experiences during medical school to impact a students career choice. I had some very engaging rotations as a medical student, particularly with hematologists who impressed me. I also had a close childhood friend who developed Hodgkin lymphoma and underwent treatment with Dr. Glick while living with me during my second year of medical school. In retrospect, that experience in addition to the role models I encountered during medical school and residency likely determined my direction.

Dr. Winter added: I loved looking under the microscope at blood smears, bone marrow, and lymph node biopsies, and I especially enjoyed integrating the pathology with the clinical picture. Some of my best mentors were hematopathologists.

Brief Indecision

After attaining her medical degree in 1977 from the University of Pennsylvania School of Medicine, Dr. Winter decided on another big city experience for her internship and internal medicine residency at the University of Chicago, where her interest in the hematologic malignancies was further encouraged by rotations with Dr. John Ultmann and Dr. Harvey Golomb, both of whom played major roles at ASCO. But I also liked bedside cardiology and found myself being strong-armed by the Chief of Cardiology to stay on as a cardiology fellow. Did I really want to be an interventionalist, passing catheters all day and wearing a lead apron?

Dr. Winter continued: Luckily, I had a good friendthe other Jane from collegewho was an internal medicine resident at Columbia, where Dr. Rose Ruth Ellison was the new head of oncology and the attending on Janes General Medicine rotation. Jane told Dr. Ellison that she had a friend who might be interested in hematology/oncology and Rose Ruth said, Bring her tomorrow. So, I showed up and signed on. Truth be told, my goal in life at that time was a subscription to the New York City Ballet, a passion Jane and I share. So, thats how I wound up at Columbia, she related.

As it turned out, Dr. Winters fellowship at Columbia was cut short by unforeseen circumstances. Within the first weeks of my fellowship, the head of the cancer center, Dr. Paul Marks, left to become President of Memorial Sloan Kettering Cancer Center and took with him the Division Chief of Hematology, Dr. -Richard Rifkind. Soon thereafter, one of Columbias best -hematologists, Dr. Hymie Nossel, had a massive heart attack. The place seemed to be decimated.

At the same time, Dr. Winter had become increasingly committed to her soon-to-be husband, Dr. Richard Larson, a then budding leukemia expert. He had been a resident with me and had stayed at the University of Chicago for fellowship, Dr. Winter explained. Fortunately, a second-year position in the fellowship program at Northwestern became available unexpectedly and I had the opportunity to work in Dr. Alan Epsteins lab making monoclonal antibodiesthen very new and excitingto the diffuse large B-cell lymphoma cell lines that Alan had developed while a graduate student at Stanford.

An Opportunity to Grow

Dr. Winter took the faculty position at Northwestern University. Asked whether there were other reasons for her decision besides a serendipitous job opening, she commented: Actually, there was an opportunity at the University of Chicago, but I needed my own space, separate from my husband, which Northwestern offered. Moreover, I was attracted to Alans work in large cell lymphoma and the opportunity to focus on lymphoma clinically.

Dr. Winter shared how this opportunity started small but grew. When I came to Northwestern, the clinical trials office was the size of a closet. It was very much a private practice kind of place, with a very small, full-time, academic faculty. However, soon after arriving as a second-year fellow, I saw that I could be part of a team that was building something for the future. When offered the opportunity to stay on as a faculty member, I seized the opportunity and have been here ever since. Over the years, we have turned the institution into a real powerhouse, which has been immensely rewarding. I work with absolutely terrific scientists and clinicians, with a top-notch support system from the top down.

In addition to her many accomplishments, Dr. -Winter also served as President of the American Society of Hematology (ASH) for a year-long term (20212022). She has been a member of ASH for -nearly 40 years, and during that time, she has served in various leadership roles representing the Society.

A Busy Schedule

Asked to briefly describe the focus of her current work, Dr. Winter replied: My path has been anything but linear. My work making monoclonal antibodies to diffuse large B-cell lymphoma cell lines led me to bone marrow purging with my own antibodies to remove malignant lymphoma cells from bone marrow harvests for patients undergoing stem cell transplants. Early on, I had collaborations with faculty on Northwesterns Evanston campus expanding hematopoietic progenitors ex vivo for use in bone marrow transplant patients. And, similarly with another project here on the Chicago campus in megakaryocytopoiesis. We had funding from the Department of Defense to support these projects. I had a period where I was very involved in transplantation and even ran our fledgling bone marrow transplant program, but eventually focused on clinical and translational investigation in lymphoma.

Dr. Winter had a long career looking at prognostic markers in diffuse large B-cell lymphoma. That grew out of my initial laboratory experience in Alans lab. My goal from the start was to sort out the clinical and biologic heterogeneity of the diffuse large B-cell lymphomas. And 40 years later, it remains an elusive goal. Over time, that work became more molecularly based at a level I was not prepared to lead. So, Ive been fortunate to collaborate with folks who are much better equipped to address those kinds of questions at a genetic level. My clinical investigation has focused in recent years on Hodgkin lymphoma, more specifically on the use of checkpoint inhibition in both previously untreated and relapsed patients. We just launched a new clinical trial in patients with newly diagnosed Hodgkin lymphoma, building on our prior trials, further shifting from chemotherapy to immunotherapy. This trial will also compare circulating tumor DNA and imaging with FDG-PET. Like all my recent projects, Ive partnered with one of my fellows, Megan Melody. Its my greatest pleasure to see my mentees develop and succeed.

Challenges Ahead

Given that Dr. Winters career began contemporaneously with the womens rights movement, she reflected on the difference between now and then for a young woman entering the field. We have certainly made progress in closing the gender gap, she noted, but its definitely challenging for young women who want to balance a career and a family. Its never going to be easy, because there is never enough time in the day for everything we want to do. However, being persistent and confident in yourself is key. In short, join societies such as ASH and ASCO, and when you have an opportunity, seize it.

Dr. Winter shared some thoughts on mentorship relationships: I didnt have an easy time of it early on; mentorship wasnt what it is today. Today, young trainees are very aggressive about seeking out mentorship relationships. When I was coming up, I had a career development award where my mentor met with me only to put his signature on the grant but never sat down or communicated with me. Members of the current generation know what they need to get from a mentorship relationship. Choose wisely, I always say, in your collaborators, mentors, and spouses; be careful about how you invest your precious time and energy and who you look to for help

Decompression Time

What does a super-busy oncology leader do to decompress? I have a 19th-century house, so theres always a project underway, and I live in an amazing city, where theres so much to discover and experience. I have two wonderful sons and daughters-in-law and two beautiful grandchildren to spoil. I still go to the ballet, and Im actually making it a bigger priority recently. My husband and I walk and ride the lakefront, which is a great way to keep centered and relax. And I love my work. Ive had a long and rewarding career and still fully enjoy my patients, my colleagues, and my trainees, commented Dr. Winter.

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A Mother's Encouragement and a Husband-Wife Doctor Team Set the Stage for a Career in Hematologic Oncology - The ASCO Post

Internal Medicine

Local doctor to share new lifestyle health techniques with Longboaters – Your Observer

Dr. Coeurlida Ashby loved working as a doctor at her internal medicine practice until she realized how little time it gives for patients to heal.

There were a lot of patients that needed time and the system isn't really set up for giving them that kind of time, said Ashby. I realized very early on in my career that I was practicing medicine in a way that I knew wasn't sustainable for me as a healer.

Dr. Coeurlida Ashby

This led to an existential crisis. Ashby didnt know if traditional medicine was the best outlet for her healing art. So, she went to the only thing that made her feel better: health and fitness.

Ashby poured most of her free time into bodybuilding and learning about nutrition. She started teaching her health techniques to clients after hours and saw a significant difference in her mood. She also noticed that implementing a healthy lifestyle reversed chronic diseases for most of her clients.

In 2017, Ashby discovered the lifestyle medicine concept and immediately knew it was her calling.

The Paradise Center will host Ashby for an exclusive presentation on lifestyle medicine from 1:30 to 3:30 p.m. on June 3.

Lifestyle medicine focuses on implementing lifestyle changes that promote healthy fitness and nutrition to prevent chronic diseases. Ashby said that lifestyle medicine is based on six pillars from ancient Chinese tradition. The pillars include sleep, nutrition, fitness, social connections, mental health and toxins you put in your body.

Ashbys presentation will serve as an introduction to lifestyle medicine for Longboaters. It will provide an interactive discussion for participants to understand and see the benefits of incorporating these lifestyle changes.

She will cover how it improves overall health, boosts energy and vitality, manages stress and prevents and reverses chronic diseases. She will mainly focus on heart disease and metabolic health.

Ashby earned her medical degree in internal medicine from Yale University School of Medicine. She completed her residency training at Yale New Haven Hospital where she served as chief resident of the Yale Internal Medicine Primary Care Program.

Ashby got a lifestyle medicine certificate in 2020 and has become a leader in the field through her recognition in the American Board of Lifestyle Medicine. She now runs her own practice, Conscious Health, in Sarasota.

Ashby hopes the presentation will interest Longboaters to start thinking about their everyday habits and how their lifestyle affects their health. She is open to giving consultations at The Paradise Centers Medical Suite if people are interested.

I think lifestyle medicine is a missing resource right now on Longboat, said Ashby. It is incredible the potential impact it could have on reducing suffering and disease burden. I love the atmosphere of having a space for movement at The Paradise Center, having a physical therapist in the same building and having potential other providers. It is just the type of setting that lifestyle lends itself to. They're definitely on the right track and this would be adding right in the mix.

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Local doctor to share new lifestyle health techniques with Longboaters - Your Observer

Internal Medicine

Marquis Who’s Who Honors H. Kenneth Fisher, MD, for Expertise in Medicine – 24-7 Press Release

He became a Diplomate of the American Boards of Sleep Medicine, Pulmonary Medicine, and Internal Medicine, all after the age of 65.

LOS ANGELES, CA, May 31, 2024 /24-7PressRelease/ -- H. Kenneth Fisher, MD, has been recognized for inclusion in Marquis Who's Who. As in all Marquis Who's Who biographical volumes, individuals profiled are selected on the basis of current reference value. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process.

Dr. Fisher's distinguished medical career, particularly in pulmonary and sleep medicine, illustrates his dedication and expertise in the field. After completing his formal training to become a specialist in internal medicine and pulmonary disorders, he was a medical school professor for a decade. In this role he guided the education of doctors-in-training, conducted original research, and supervised care of patients with severe lung disorders.

For 30 years after that, he served the communities of West Los Angeles and Beverly Hills in private practice, applying his extensive knowledge and experience directly to patient care. His role was as a specialist in Internal Medicine and as a consultant to other physicians for patients with pulmonary disorders and sleep problems. He became a Diplomate of the American Boards of Sleep Medicine, Pulmonary Medicine, and Internal Medicine, all after the age of 65. He was named by The Consumers Research Council of America as one of America's Top Physicians and named as a Southern California Super-Doctor by Los Angeles Magazine. In addition to his Los Angeles practice, he helped identify and treat sleep disorders with Cardiopulmonary Services of Casper, WY, and with Sleep Medicine Consultants of Central Texas, Austin.

Before entering private practice, Dr. Fisher's academic career included faculty posts at the University of Washington, the University of Arizona, and the University of California, Los Angeles. Throughout his career, Dr. Fisher has been recognized as an expert in his field. His voluntary work included serving as Chairman of the Research Review for the American Thoracic Society and as a member of the Scientific Advisory Board of the Sjogrens Syndrome Foundation. His formal teaching earned the highest rankings from medical students at the University of California. In early 2024 he completed a book titled: Sleep: A Users Guide, which will be published in the second half of this year. The book highlights Dr. Fisher's expertise and his ability to communicate complex medical concepts understandably.

Dr. Fisher's previous academic background is equally impressive. He earned a Bachelor of Arts degree in Chemistry from Carleton College in 1955 and a second degree in Chemistry from the University of Oxford in 1957 as a Rhodes Scholar. Dr. Fisher pursued coursework in industrial management at the Massachusetts Institute of Technology. He then completed his medical training with an MD from Washington University School of Medicine in 1962, followed by two years' residency at Barnes Hospital, and another two years of specialty training at Albert Einstein College of Medicine in New York. His research training was at the Cardio Vascular Research Institute, University of California, San Francisco.

Beyond his professional endeavors, Dr. Fisher has engaged with various civic organizations and contributed to academia through gifts and volunteer work for Carleton College, Washington University, Oxford University, and MIT. His scholarly achievements have been recognized with such awards as the Baker Scholarship, the Rhodes Scholarship, and the John Hay Whitney Fellowship of the Institute at MIT.

In his personal life, Dr. Fisher is a father to three sons. He enjoys tennis, photography, overseas travel, and reading. During the Covid Pandemic, he practiced internal medicine and sleep medicine remotely, demonstrating his ongoing commitment to advancing health care to the very edge of retirement.

About Marquis Who's Who: Since 1899, when A. N. Marquis printed the First Edition of Who's Who in America, Marquis Who's Who has chronicled the lives of the most accomplished individuals and innovators from every significant field of endeavor, including politics, business, medicine, law, education, art, religion and entertainment. Marquis celebrates its 125th anniversary in 2023, and Who's Who in America remains an essential biographical source for thousands of researchers, journalists, librarians and executive search firms around the world. Marquis publications may be visited at the official Marquis Who's Who website at http://www.marquiswhoswho.com.

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Marquis Who's Who Honors H. Kenneth Fisher, MD, for Expertise in Medicine - 24-7 Press Release

Internal Medicine

Interdisciplinary Curriculum Boosts Women’s Health and Gender-Affirming Care in Internal Medicine Residency – Yale School of Medicine

A novel interdisciplinary curriculum has been successfully implemented in Internal Medicine residency programs to enhance education in women's health, gender-affirming care, and health disparities. Led by Janet Henrich, MD, and created by a collaborative team of faculty from various disciplines, including Internal Medicine; Obstetrics, Gynecology & Reproductive Sciences; Surgery; and community experts, this curriculum comprises half-day modules on interrelated topics, emphasizing health equity and interactive learning.

Implemented since 2015 for about 175 residents annually, the curriculum's impact was evaluated through anonymous surveys. The 2022-2023 data showed that 90% of the 131 resident respondents felt adequately prepared to apply the skills learned. A consistent trend of increased comfort with the material was observed across previous years. The curriculum was particularly commended for its interactive teaching methods and direct learning experiences from community members and peers.

This innovative educational approach has proven effective in increasing resident learning and readiness. The team hopes this success can be replicated for other medical training programs, addressing vital issues in women's and gender-affirming care education, and fostering an equitable healthcare environment.

To learn more, read It Takes a Village: An Interdisciplinary Approach to Preparing Internal Medicine Residents to Care for Patients at the Intersection of Women's Health, Gender-Affirming Care, and Health Disparities in the Journal of Womens Health.

Henrich JB, Richman I, Rabin TL, Gielissen KA, Dhond M, Canarie JX, Hirschman AF, Windham MR, Maya S, McNamara C, Pathy S, Bernstein P, Smith R, Vasquez L. It Takes a Village: An Interdisciplinary Approach to Preparing Internal Medicine Residents to Care for Patients at the Intersection of Women's Health, Gender-Affirming Care, and Health Disparities. J Womens Health (Larchmt). 2024 Feb;33(2):152-162. doi: 10.1089/jwh.2023.0217. Epub 2024 Jan 8. PMID: 38190490.

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Interdisciplinary Curriculum Boosts Women's Health and Gender-Affirming Care in Internal Medicine Residency - Yale School of Medicine