Newsletter

The Essential Guide to Medical & Video News

Volume 2 #5 June 1, 2025

President, the Medicine Information Institute, creator of The Essential Guide to Medical News--giving KOLs & medicines a clear voice. Chief Pharmacy Officer- CITI trained researcher, Speaker, Senior consultant, Author, Editor, EssentialGuideToPrescriptionDrugs.com and EGPD eBooks and the Essential Guide to Medical News at 

Where does the time go? My Newsletter publication cycle was interrupted by an interim hospital leadership engagement. I’ve got to tell you Tennessee is beautiful and I was fortunate to work with a wonderful medical staff, enlightened Pharmacy leadership and super administration. Did you know that Ballad Health is on the cutting edge of using a central fill process and robotics to get medicine distribution remarkably automated? I was in the middle of an amazing Ai application development and clinical team all wrapped around a Be Excellent program with super colleagues. Unfortunately, the Health Care Gods stepped in and I had to end an outstanding leadership engagement at Ballad Health in order to take care of not one, but two family members. I didn’t see that coming, but I think it might be a good example for you and your family of how things can suddenly change so I’d like to talk a little about that.

One family member gave me permission and asked me to work to help you in your struggle with a chronic disease using her information as an example! The second family member doesn’t think she actually had a heart attack, yet her main measure of heart function (Ejection Fraction) is far lower than it should be. Let’s take a closer look at these difficult situations in the hope that it may help you and your family work through health problems that you are facing.

Please remember, it’s always best to PREVENT a disease or condition than to have to treat it. Many of you might have heard of pre-diabetes, or could have even been told by your doctor that you HAVE pre-diabetes. This is especially challenging IF you are overweight and have a family history of diabetes and heart disease. Did you know that these problems are linked? It’s true. Diabetes is the great damager. I can’t tell you how many patients have told me that they really don’t think they need to take their medicines cause its just a little sugar.

It's NOT just a little damn sugar. It’s a sequence/cascade of errors in metabolism and inflammation and resistance to insulin and cells in your pancreas that die and bad chemicals that your body makes with that excess sugar and the clogging of your small and then larger arteries. Are you starting to see the potential linkages and bad chain of events? I’m also going to make a video called the death train that diabetes really is in July. Once you get on that train of abnormal sugar trends and God forbid, poor management that, the changes may be so subtle, they may lead you to think, hell, it is just a little sugar, that doctor was wrong. Let me tell you what my sister has had happen and it is because she fought that mountain of sugar and tried to climb that mountain of sugar too long.

Your blood sugar should be controlled in a pretty narrow range. A cool organ called the pancreas, and some other organs help regulate this. It’s just like a thermostat in your home. Instead of keeping the heat at 70, your body tries to keep the sugar between 70 and 120 (in the funny units of mg/DL instead of degrees Fahrenheit like your home thermostat). IF the blood sugar (what your doctor calls glucose) gets too low, you get dizzy, shaky and can pass out or even die. Your doctor calls this problem hypoglycemia. Some people struggle with this because their thermostat (islet cells in the pancreas that make insulin) and the other regulatory organs don’t work well and too much insulin (the hormone that controls blood sugar) gets released.

The other end of the sugar shift is hyperglycemia, or too high a blood sugar. The signs and  symptoms of this can be similar to too low a blood sugar. You get shaky, sweat, feel dizzy and  pass out and can actually die. Part of the problem is the way that your body reacts to this excess  of sugar. It makes bad chemicals, it changes the Ph, it gives you ketoacidosis and things just  don’t work right. Your liver actually changes the sugar into other chemicals like sorbitol.  Inflammatory chemicals called leukotrienes get released. Your confused body tries to store the  sugar…this is where the overweight and diabetes comes in. Your body also tries to get rid of it.  Your great kidneys that usually try to conserve sugar and protein just get overwhelmed and pee it  out. Tired of being on this train yet? 

It gets worse. Your body makes lipid (fat) from the sugar and stores it—giving you that belly  and when it doesn’t transport the fat well, it deposits it in your small blood vessels and then your  larger ones—you know, like the ones in your heart? This is why people who don’t manage their  diabetes well get heart attacks (2-4 times as often as those without diabetes) AND this is why  they get kidney failure, because they damage the working parts of the kidney (parenchyma)  AND this is why people living with badly managed diabetes clog up their leg arteries and require  amputations AND this is why they clog up their crucial arteries that supply the brain and they get  strokes. Feel that diabetes death train accelerating? What’s wrong with your eyes? The  inflammatory chemicals and abnormal lipids are bothering your retina. You might have retinitis  like my sister. 

Where else does that fat go? Beyond your belly, the fat gets stored in your liver. Damn…usually  no symptoms here early on, but fatty liver (what your doctor used to call NASH or non Alcoholic Steato Hepatitis and now calls MASH or Metabolic dysfunction Associated  StreatoHepatitis). Your liver gets clogged up with fat and doesn’t work right. Your liver helps  you remove toxins, metabolize (change) medicines into non-toxic chemicals that can be easily  eliminated, makes albumin—a critical protein that keeps water where it should be in our body  and much more. Without a liver, you die. Without blood flow to your heart, you get a heart  attack and may die. Without blood flow to your brain, you get a stroke and may lose the ability  to walk or talk and you may die.  

Those nasty inflammatory chemicals (interleukins and others) also damage your nerves. My  sister can’t feel her feet (diabetic peripheral neuropathy). I remember her being young and active.  She now requires a walker just to get around Myers Grocery store. She has had a triple bypass  and now a 4th stent. That diabetes death train is heading to that sad station. She asked me to tell  you that you can slow or even get off that train IF you start early and keep up the regular  exercise, get to best weight, smart diet and low alcohol use. Some people have even been able to  come off their diabetes medicines after they have started them if they work closely with their  doctor and clinical pharmacist. 

What about your children? There are recent data about children and impaired glucose tolerance  from Diabetes Care. The May 19th 2025 study, reported by Monostra in Healio showed that sugar  (glucose) in the prediabetes range or higher and worsening insulin resistance during adolescence  and young adulthood are tied to higher risk of heart (cardiac) damage. The authors advocate  having health care professionals think of prediabetes in children/adolescents as an emergency  requiring aggressive clinical management! 

Stopping the diabetes death train:

What did my sister mean by start early? She got a warning from her body when  her fasting blood sugar went above 126. Her doctor told her she was now a type 2  diabetic and she needed to start metformin. What if she had started to exercise, got  her weight back down to 130, watched her diet, and took the other steps? Can I say  that she wouldn’t have become a type one or insulin dependent diabetic?  Reasonably, I can say probably. Reasonably, I can say that her brother, me,  ballooned up to 236 pounds. My blood sugar was in the pre-diabetes range. My  blood pressure was up, I clogged up my right coronary artery and had a small heart  attack and I started metformin.  

Damn, was I on the train? Was I losing that blood sugar chess match?

Yup. Getting a stent scared me (well—actually two stents  were placed in my RCA at Johns Hopkins in 2005). The history is interesting, and I  feel blessed to be alive. I had written a book called Medicines and Your Family,  national treatment guidelines in conjunction with an excellent 10-person writing  committee/editorial board. The focus was the continuum from high blood pressure  and abnormal cholesterol to unstable angina and heart attacks and strokes and the  plan was to distribute it to 100,000 US heart patients via Mended Hearts.  

A physician named John Rumberger was on the board and late in the production  calendar, he advised me to include the major and minor symptoms of heart attacks  in men and women. I was tired and resisted including the information, but I  relented. I was frankly amazed that not everyone gets that classic crushing chest pain, and pain in the left arm or jaw that I had seen in the movies. Additionally,  men and women may get signs and symptoms that are different (perhaps usually  are). Some women may only have a feeling that something is wrong and  indigestion. Men may have major symptoms or only minor symptoms like I would  soon have.  

Haven written a book where I because acutely aware of heart attack symptoms,  God has a sense of irony in that shortly after I finished the book, our family cat  jumped on the bed at 4:15 AM March 24th, 2005. I wondered what we had eaten for dinner to give me what I thought was heartburn. I got up. My back hurt a little as I stretched. I went downstairs to the home office and was going to check email  when I felt my forehead and noticed that I was sweating. I started to type, and my  fingers felt tingly. OMG. I had just written about this in the Mended Hearts book. Damn. I recognized my own minor symptoms of a heart attack (indigestion,  tingling in the fingers, back pain and sweating). What followed was a trip to the  local hospital, some medicines and a rushed trip to John’s Hopkins and an  extremely lucky, stunned myocardium result. More on that later.

When God taps you on the shoulder, you have to listen. I decided to get off the pre diabetes, diabetes, heart attack death train. I started that free medicine---you know- --exercise 5 days a week. I changed my diet—smaller portions and better food,  limited dessert, cut down from the 2 glasses of red wine a day to 2 a week. Stopped  buying larger pant waist sizes. It was uncomfortable, but I went from a 42 to a 38- inch waist in 2 years. I made a video for  www.EssentialGuideToPrescriptionDrugs.com EssentialGuideToPrescriptionDrugs.com where I showed my weight. I will  follow up in July 2025 and reveal my total weight loss. I started lifting weights 3  times a week and coupled that with an hour of exercise the other 4 days of the  week. I am no longer pre-diabetic. 

When I started writing this morning, I didn’t intend to focus so tightly on diabetes,  but the challenges my sister is facing are terrible, have impacted me and her greatly and since she gave me permission to talk about what happened to her, I decided to run with it. At the start of this EGMN edition, I mentioned the second family  member. While it is an undecided dilemma, this is a good example of what can  happen in women and can show you that some heart attacks can actually NOT  HAVE SYMPTOMS. Indeed, the symptoms of a heart attack in women are often  very very different than heart attacks in men. Let’s take a closer look. Please  remember that if you are a female in her 20s with a family history of heart disease,  talk to your doctor during your next visit and ask how you can limit heart disease  risk factors, if a baseline lipid panel makes sense and of course, get your Lp(a)  checked because it is an independent risk factor for heart attack. 

Women and silent heart attacks

The signs and symptoms of a heart attack can be  different in women and men. It’s true—women tend to have more “minor” signs  and symptoms (vague feeling that something is wrong, vague feeling of impending  doom and heart burn) and men tend to have more major signs and symptoms  (crushing chest pain, left arm pain and/or jaw pain). This is NOT a guarantee, and  men may have minor symptoms and women may present with major symptoms.  Location and severity of the attack may also impact what the patient feels (my  symptoms were very very minor). Pay attention to your body and ask your doctor  what he or she wants you to do if you start to have any symptoms—especially if  you are already a heart patient or are living with diabetes!

Did you make some health-related New Year’s resolutions?  

Should we make our own unique health recognition Day in January? Live in the  present, but plan for a healthy future by living a healthy today. Take a look  below…this is what I am going to do. I weigh 199 today. My target is 194 by April  and 188 (my high school football playing days weight) by September. I’ll make a  video on this and will show you my progress. IF you want to keep me honest, I’ll  post it on my website too. Losing weight and maintaining a healthy diet certainly  isn’t as easy as when I was 18 and had much more muscle mass. That is also  something I am working on. Please join me and just do better than you did in 2024.  You can do this. I used to be the fat, smart kid that a lot of people picked on in 6th grade. That wasn’t fun. Thanks to Mr. Sparocco for Judo lessons and my Mom for  scraping together money for tennis lessons, and then football double training in the  summer. Things changed. You can change your stars too. Small, achievable  incremental steps!

I hope you are making the most of PREVENTIVE approaches to living the longest,  healthiest life you can lead.  

Some of you may remember an early video where January 24 was declared National Dr. Rybacki was going to start to lose 5 pounds  and keep it off, then another 6 pounds by the Fall and get his A1C to  5.4 Day. It’s a mouthful for a recognition day and I know it’s silly,  but the core principles are good. You can make your own  recognition day and celebrate those successes. Pull together your  own individualized team, find a coach to help you. Go get it done ! 

I hope you are making the most of proactive approaches to living the longest,  healthiest life you can lead. Yes, I just repeated this, because it IS that important. I  can’t count the times that people suffering in the hospital have told me that they  wished they had taken better care of themselves. You and I know that today is the  day to start walking down that road toward better health. Don’t let perfect get in  the way of better. Small steps, achievable steps, make the most sense. You don’t  have to run a marathon tomorrow. Start with some achievable walks with a friend  on some regular basis. Lift some soup cans for 10 reps three times a day. There  was a super article that Eric Topol, MD posted on LinkedIn: https://lnkd.in/gZYFb6Dp

Don’t forget--Even a small amount of physical activity does a lot of good for  promoting health, as supported by wearable sensor data in large studies

https://lnkd.in/gZYFb6Dp

The first human had their genome edited????

I was lucky to have had some oversight and interacted with the gene therapy team  at Hackensack University Medical Center. HUMC was one of the early adopters of a gene therapy for Spinal Muscular Atrophy (SMA) called Zolgensma. I know  what you are thinking. Gene therapy is radical, feels like we may be challenging  the limits of what we were meant to do, but what if your child had a gene defect  and just needed that one gene? This is the case with SMA and Zolgensma. A virus  is used to insert the gene for the patient and remarkably, the patient may have been  cured. 

The New England Journal of Medicine posted an article that many people missed  this week. It has a long title: Patient-Specific In Vivo Gene Editing to Treat a Rare  Genetic Disease. Musunuru, SA Grandinette and BS Wang et al Published May 15,  2025 DOI: 10.1056/NEJM0a250747 the article that we will long remember. The  summary says that “Base editors can correct disease-causing genetic variants.”  They then describe a neonate diagnosed with severe carbamoyl-phosphate  synthetase 1 deficiency. Half of the infants with this disease die early. This child  got two intravenous infusions at 7 and 8 months of age. The child benefitted  greatly and the doctors caring for the infant were able to cut the medicine treating  the childs’ problem in half, while increasing crucial protein in the diet that they  were not previously able to tolerate! The future benefits of this are astounding.

Do it yourself flu shot follow up

In the last newsletter of 2024, I mentioned the “do it yourself” Flu shot is coming  in early 2025. The nasal spray form will give you and some of your family control  over the shot, but first, a little more about the flu that we take for granted. Put a note to get the current flu shot this coming September—put it in your healthy  reminder calendar as part of that “Better Health in 2025 set of Goals! 

Remember, the flu kills 21,000 Americans in an average flu season and we often  forget this grim fact. Largely PREVENTABLE deaths. Many of us get a flu shot  although no one likes it and for some, it generalizes to overall vaccine hesitancy.  FluMist has been available for about 20 years for people up to 49 years old.  SOON, in 2025 for the 2025-2026 flu season, it will be available without a  prescription (but will require that you fill out a drug information and history form)  and will be known as FluMist Home! I have the details for you. Rent the video for  a buck at DIY-Flushot and get the latest info on an excellent new access to care  approach! Look below for additional details from my phone call with the company  in late May. 

You can reach out to the manufacturer of FluMist (AstraZeneca) by calling 800- 236-9933. I expect that they will formulate the spray for the 2025-2026 season  based on the expected most prevalent virus groups (usually 3 of them) that the  CDC identifies. Flumist for the past season was: trivalent (had 3 virus  components. The guidance from the vaccine gurus at ACIP is that the vaccine can  be given to people from 2-49 years old. 

The wonderful news is that this FlumistHome product HAS indeed continued to be  envisioned and the availability date (per AstraZeneca Drug Information) will be  2025. Find out more www.flumisthcp.com if you are a health care practitioner and  just plain folks can visit www.flumist.com and can sign up for product information  to be emailed to you once it becomes available. The Price? The wholesale  Acquisition Cost or WAC is not yet known. 

Do you like medicine and health videos? Click the link

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Summer—Hit the beach, go to the lake, take a much needed  vacation. Get that work-life balance. June is Alzheimer’s and brain  awareness month, Men’s health month, world blood donor day and  the ASCO oncology meeting. Yeah, we’ve got some videos for that!  For $4.77, less than a beer in a bar, you get everything from  donating blood to top tips for facing cancer. Make yourself or your  friends smarter all summer long—Give the Summer video bundle as  a gift and oh yeah…always wear sun screen! 

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Newsletters I read and subscribe to

Innovation Where is it, how is it generated? Is there an organized, structured approach? I’ve met someone who is asking the questions, seeding the Centers of Excellence and has even woven science into her newsletter. Her name is Kasia Hein-Peters, MD and I think she is someone with a lot to say!

Subscribe to her Monthly newsletter, Academy for SciencePreneures where she helps you “Discover How Life Science Entrepreneurs Innovate, Scale Up and Create the Future:

https://www.linkedin.com/newsletters/academy-for-sciencepreneurs-7003460755048079362/.

Head to our EssentialGuideToPrescriptionDrugs.com web site or take a look on my YouTube channel for our viewers video guide VVG- for updates on breaking conference coverage news, the new EGMN from the office or additional articles and an email list or two—you might even get a free video if you join one of our lists (only an email or at most 2 a month with updates you might like).

I hate prostate exams, but will get one again  this year. You may have heard that former  President Biden has been diagnosed with an  aggressive form of prostate cancer in May.

 Men hate prostate exams but they are so needed. Prostate cancer, like other  cancers is best when diagnosed (caught) early. There are many kinds of prostate  cancer and while most are slow growing, some are aggressive. Some kinds of  prostate cancer respond to various treatments and some are more resistant to  treatment. Unfortunately, former President Biden has a more aggressive kind of  prostate cancer, but fortunately, it does appear to be responsive to one kind of  treatment. 

Think of cancer as a village of cells that do not listen to normal restraints on  growth. The village is made up of people with various personalities and ethnicity  and immune systems, treatment susceptibility, etc. The tumor/cancer is made up  of millions of cells that all were once normal cells and then changed. Some may  be more responsive to a treatment while others not so much. This is why some  cancer patients get better, have tumors shrink, then have the cancer come back  or even worse, spread (metastasize) to other places. If you look at any kind of  cancer, you will see that it will have a general rate of growth, place or places  where it “likes to spread” as well as various recurrence characteristics.

If you fail to get a prostate exam or if a somewhat hidden (occult) cancer grows, it  may become more likely to spread. Damn cancer. Prostate cancer tends to spread  to the bones, liver and lymph nodes. Bone cancer is difficult to treat and can be  painful. Always remember that a prostate cancer that has spread to the bone is still prostate cancer.  

Controversy has arisen regarding  the timing of the diagnosis and whether or not the former president had cancer  while he was president, or if he was screened. The Wall Street Journal (not a  medical journal) reported on May 20th that the last known prostate cancer blood  

screening test was performed in 2014. There is uncertainty as to Biden being  screened for prostate cancer while he was president. Talk to your doctor to see if  PSA or other screening makes sense for you. After you reach a certain age, and in  some situations PSA screening isn’t recommended. 

The reality is that roughly 1 in 8 men are estimated to be diagnosed with prostate  cancer according to the National Cancer Institute (NCI). Most are diagnosed  between 65-74. NCI further estimates that in 2025, there will be 313,780 prostate  cancer cases—roughly 15.4% of cancers and prostate cancer will lead to 35,770  deaths. 

Staging and scoring of cancers is always critical. You may have heard of a Gleason  score by now. It ranges from 6-10 and a lower score is better. When a Gleason  score is low, it means that the cells in the cancer resemble more normal cells. Mr.  Biden has a score of 9 which falls into the range of more aggressive prostate  cancer. From my perspective, anyone with this level of Gleason score is facing a  very serious health challenge. Give former president Biden and his family their privacy. The fundamental truths regarding cancer is that an early diagnosis is always better and diagnosis BEFORE any metastasis or spread has happened is the  best situation possible. Healing thoughts and prayers to President Biden and his  family. 

What to do when your prescription transfer doesn’t transfer

 ...or a perfect storm leading to missed doses of my prescription.

 Have you ever transferred a prescription? Because of the consulting that  I do around the country, I’ve had to take these steps a few times and I  hope I can give both the pharmacies involved, you and your family and  even me some pointers on what might have been done better. Suffice to  say that I left the Pharmacy angry, felt like I wasted an hour of my time,  my wife was pissed off, the pharmacy staff was not happy and a saving  grace for the store was a delightful check out clerk who had the best  guest relations, service recovery and was the bright spot in a bad  customer experience. 

I’ve been lucky to often be in leadership positions and have the benefit  of Lean Six Sigma, Patient Experience training, FEMA training, Quality  management training, Patient engagement, Patient education, Adherence  compliance, Service Recovery, Patient Satisfaction (Press Ganey),  Corporate Compliance and other trainings/enlightenment over my 30  years of experience. In a nutshell, the customer is always right, you take  them as you find them, you never know what THEY are facing in their  own or family life, everyone must respected and excellence and optimal  communication is the goal of every encounter.

I tried to transfer a life-sustaining prescription from a major Pharmacy  chain—might have been CVS, Walgreens or Rite Aid (the store name doesn’t matter). At the delightful initial encounter with a Pharmacy  technician, I also asked to transfer any and all prescriptions from a major  chain in Florida and a major grocery store pharmacy in Tennessee and  one in Florida (yup—I had been traveling for leadership work AND had  been price-shopping). The smiling tech dutifully took down the  information that I gave, appeared to have a pre-printed fax form that she  said she would fax and I left the store confident that everything would be  done. 

Indeed, everything was done as I later learned (in the sense of the  promise to fax), but I also learned that simply sending a fax to someone  (even when the medicine to be transferred should never be stopped and  in that sense is life-sustaining—preventing a late clot in a heart stent)  does NOT guarantee that the store or pharmacy in the store where it was  dutifully faxed would actually respond.  

I returned to the store in 4 days, all out of the medicine (Plavix clopidogrel). I asked for my prescription. The tech told me that it didn’t come through. 

I didn’t have a ready response. Shouldn’t they have checked to make  sure it came through after they sent a fax request to transfer? 

The person (who I thought was a pharmacist) didn’t seem to realize how  important the drug is. I reminded her that it is a life-sustaining medicine  and asked in the state of Oregon allowed an emergency fill like some of  

the other states I had been in. I was abruptly told that “they” only did  such fills when there was a valid prescription was on file. This made me  extremely uncomfortable, and I was shocked. I explained that if I didn’t  get the medicine, I would have to go to an urgent care to get it filled. 

The staff then told me that they “could” call the store in Florida and  asked if I wanted to wait. I was surprised at the question, but said that I  would indeed like them to call. (this seemed obvious and would be a  better that me trying to find an urgent care and paying for both the  urgent care visit AND the prescription and also having to go to another  pharmacy to get a supply or the full fill of the pills I needed). 

Additional process optimization Opportunity(s) (what could have  been done better) and realities in Doctor’s offices and Pharmacies: 

The pharmacy staff, knowing how long it would take, could have given  me an estimate of the time usually required for this. 

The Patient (me) could have asked how long it might take. I instead  assumed that because the store was empty and there were no other  customers or drive ups, that the prescription would be quickly filled  since I was there, someone at the store had failed to check on the fax  result that I had been assured of 4 days earlier and of course it was  reasonable that they would be in service recovery mode. 

I was wrong. I stood in the waiting area of the pharmacy for 15 minutes.  No one said a word to me until a young man (manager) asked if I had  been helped. I thanked him, told him that I was waiting for a prescription  transfer and he continued to help what turned out to be one technician  and one pharmacist behind the counter. I stood near the Tylenol display  for another 15 minutes. No one said anything to me. 57 minutes of my  day was gone, but I finally had my prescription.

Key takeaways on prescription transfers to a new store: 

1. Always call and make certain that they have been able to get your  medicine transferred. It is NOT an automatic thing. If you haven’t signed up for text notifications, they may not call you to let you  know there was a transfer problem and you will have wasted your  valuable time by just driving there. 
2. Ask the pharmacy staff what THEY do IF there aren’t any refills  left and how they follow up with you. Because I was new, they  didn’t have me in their text service and it appears that they actually  didn’t check on the faxes that they sent to the Pharmacies in TN  and Fla to see IF my prescription was transferred. Yikes…I was  not a happy camper, but in retrospect, I owned part (a very small  part) of the problem. 
3. Ask what the transferred prescription will cost in the new store.  The price you got in the original store may NOT be the same in the  new store and it is smart to avoid financial toxicity and sticker  shock. 
4. Many Pharmacies are understaffed these days. Glitches are more  likely to happen and surprisingly, it may perceived as “on you” to  do some of the follow up. It may take a Pharmacy longer than you  or others expect to actually fax a prescription from the original  pharmacy to the new one. To her credit, the pharmacist in my new  pharmacy did call the old one (instead of just sending another fax),  but it still took more than 20 minutes for them to actually fax the  info. This really seemed like a long time as I was standing there  waiting and my wife was waiting for me without cell service. 
5. Remember, many doctor’s offices are understaffed and they may  take longer than usual for your kind Doc (well, their staff) to  respond to a fax request from your well-intended pharmacist. In  short, give yourself more “pill time”, that is, ORDER early, a week  or two BEFORE you run out. 

Upcoming Conferences & excellence/recognition Days

One of the important upcoming National medical meetings is the American  Society Of Clinical Oncology, also known as ASCO. ASCO 2025 will be at the  McCormick Center in Chicago Illinois this year. This is usually THE meeting for  cancer therapies research and updates. I’ll be updating you on the meeting on the  landing page at www.EssentialGuidetoPrescriptionDrugs.com 

ASCO is home to doctors and oncology professionals from around the world! The  meeting this year starts on May 30 and ends June 3, 2025. Asco was started in  1964 and they are committed to finding the knowledge that conquers cancer.  There may even be some sections on Cardio-Oncology since some cancer  treatments can challenge heart function. You can find out more about attending  and of course, the usual press releases at www.ASCO.org. I’m excited to review  the meeting research results as it usually crosses the lines between many many  kinds of cancer and breakthrough treatments! Think of all the people who will  probably be helped. 

Three of the breakthrough poster presentations that I am  aware of involve pancreatic cancer, T cell lymphoma and head  and neck cancer.

Pancreatic cancer is a horrible diagnosis

Roughly 66,000 people in the US will get pancreatic cancer annually. One of my  first medical rounding experiences involved a patient who was told that they had  advanced pancreatic cancer and that there was little that could be done. An 

experimental medicine called motixafortide is being studied at Columbia  University and is being supported by Regeneron and BioLine Rx. The study is  called CheMo4METPANC (clinicaltrials.gov identifier NCT04543071). What it does  is compare the benefits of motixafortide plus cemiplimab plus gemcitabine plus  nabpaclitaxel versus the standard of care (SOC) gemcitabine and nabpaclitaxel alone. This is an extension study in 108 patients after a pilot study showed that 4  of 11 patients had progression free survival and one liver lesion patient appeared  to have been cured. It is early, but this new combination appears to be a  breakthrough in a very difficult kind of cancer! 

T Cell lymphoma may have met its match

A medicine called lacutamab from a little known French company called Innate  Pharma will be on the schedule in the 2025 Chicago ASCO meeting. What will be  presented are the considerable results of the TELOMAK study. It is rare to see  “highly promising” from a principal investigator, but this exactly what the PI  (professor Pierluigi Porcu) said of the results in T-cell lymphoma (cutaneous).  More to follow when the data are released.

Head and Neck Cancer Hope  

HPV is an odd virus that clinicians think of relative to venereal warts. The odd part  is that this is one of those viruses that is KNOWN to be associated with cancer.  The ongoing phase 3 research called VERSATILE-003 is a randomized open label  trial of PDS0101 and pembrolizumab (Keytruda) compared to pembrolizumab for  First-Line treatment of Patients with HPV-positive Recurrent/Metastatic Head and  Neck Squamous Cell Carcinoma is a mouthful, but will be presented in a poster on  June 2, 2025 9-12 moon CDT. The work is being done by a small Princeton, NJ company called PDS Biotech. IF the results of VERSATILE-003 are anything like  VERSATILE -002, this will be a breakthrough medicine, giving hope and help for patients with the abysmal diagnosis of head and neck cancer. 

Thank you as always for subscribing to our newsletter and feel free to forward the  link to friends and family as well as the Summer video bundle link… 

Real world, real medicines, fantastic news and health recognition days. I’m Dr. Jim Rybacki for  EGMVM, Your Essential Guide to Medical and Video News.  

Please remember that this Newsletter represents news and information and is NOT medical  advice or a recommendation on any medicine or treatment. No claim is made that all  possible actions or effects of any medicine are included in this newsletter. Although diligent  care has been taken to help ensure that the information in this edition is accurate, the  continued accuracy and currentness are ever subject to change. Copyright The Medicine  Information Institute May 2025.

Volume 2 #1 February 17, 2025 

By Dr. James Rybacki

Did you make some health-related New Year’s resolutions? Should we make our own unique health recognition Day in January? Live in the present, but plan for a healthy future by living a healthy today. Take a look below…this is what I am going to do. I weigh 199 today. My target is 194 by April and 188 (my high school football playing days weight) by September. I’ll do a video on this and will show you my progress. IF you want to keep me honest, I’ll post it on my website too. Losing weight and maintaining a healthy diet certainly isn’t as easy as when I was 18 and had much more muscle mass. That is also something I am working on. Please join me and just do better than you did in 2024. You can do this. I used to be the fat, smart kid that lost of people picked on in 6th grade. That wasn’t fun. Thanks to Mr. Sparocco for Judo lessons and my Mom scraping together money for tennis lessons, and then football double training in the summer. Things changed. You can change your stars too. Small, achievable incremental steps!

I hope you are making the most of PREVENTIVE approaches to living the longest, healthiest life you can lead.

January 24 was National Dr. Rybacki is going to start to lose 5 pounds and keep it off, then another 6 pounds by the Fall and get his A1C to 5.4 day. It’s a mouthful for a recognition day and I know it’s silly, but the core principles are good. You can make your own recognition day and celebrate those successes. Go get it done !

I hope you are making the most of proactive approaches to living the longest, healthiest life you can lead. Yes, I just repeated this, because it IS that important. I can’t count the times that people suffering in the hospital have told me that they wished they had taken better care of themselves. You and I know that today is the day to start walking down that road toward better health. Don’t let perfect get in the way of better. Small steps, achievable steps, make the most sense. You don’t have to run a marathon, start with some achievable walks with a friend on some regular basis. There was a super article that Eric Topol, MD posted on LinkedIn recently:

Even a small amount of physical activity does a lot of good for promoting health, as supported by wearable sensor data in large studies https://lnkd.in/gZYFb6Dp

LISTEN to this… “Even a small amount of physical activity does a lot of good.” We have a choice. We can be a healthier version of ourselves in a year or we can continue to age prematurely, continue that fat attack and high blood pressure attack that will happen unless we take steps. I mean that literally. A little walking does a lot of good. Start there!

January is also National Blood Donor Month and we will have Heart Failure awareness week February 9-15th and the whole month is American Heart Month.

Have you donated blood in the last year, this year? Did you know you might actually lose some weight by donating blood? It’s true, albeit a small amount. I include that in one of our videos as a tongue in cheek was to try to get you to donate. I’m doing some consulting at a Level One Trauma center in TN and I have to tell you THERE IS ALWAYS A NEED FOR BLOOD. Many employers will actually give you time off to donate. Please ask. We have a video on this:

https://vod.essentialguidetoprescriptiondrugs.com/videos/national-blood-donation-day-mov

It’s actually amazing how many benefits blood donation brings and every 2 seconds, someone needs blood. Please help. This can virtually be the gift of life, especially if you have a rare blood type.

In the last newsletter of 2024, I mentioned the “do it yourself” Flu shot is coming in early 2025. The nasal spray form will give you and some of your family control over the shot, but first, a little more about the flu that we take for granted. Put a note to get the current flu shot this coming September—put it in your healthy reminder calendar as part of that “Better Health in 2025 set of Goals!

Remember, the flu kills 21,000 Americans in an average flu season and we often forget this grim fact. Largely PREVENTABLE deaths. Many of us get a flu shot although no one likes it and for some, it generalizes to overall vaccine hesitancy. FluMist has been available for about 20 years for people up to 49. SOON, in 2025, it will be available without a prescription and will be known as FluMist Home! I have the details for you. Rent the video for a buck at https://vod.essentialguidetoprescriptiondrugs.com/products/do-it-yourself-flu-shot and get the latest info on an excellent new access to care approach!

Newsletters I read and subscribe to

Innovation. Where is it, how is it generated? Is there an organized, structured approach? I’ve met someone who is asking the questions, seeding the Centers of Excellence and has even woven science into her newsletter. Her name is Kasia Hein-Peters, MD and I think she is someone with a lot to say!

Subscribe to her Monthly newsletter, Academy for SciencePreneures where she helps you “Discover How Life Science Entrepeneurs Innovate, Scale Up and Create the Future:

https://www.linkedin.com/newsletters/academy-for-sciencepreneurs-7003460755048079362/.

Heart Failure awareness week February 9-15th and the whole month is American Heart Month

Heart Failure or heart success? Many clinics that were previously known as heart failure clinics are now called Heart Success Clinics. We have some awesome videos and interviews with one of the brightest people on the planet, Amy Brownell. You can browse our whole catalog (including free videos) at:

https://vod.essentialguidetoprescriptiondrugs.com/browse

Patients dealing with heart compromise and a special kind of heart failure called ATTR-CM have great new hope with the approval of a new treatment which is an ATTR Stabilizer (the drug is called Attruby). There is a good review from Nature Reviews, Drug Discovery from November 2024 at: https://www.nature.com/articles/d41573-024-00188-z#:~:text=The%20FDA%20has%20approved%20BridgeBio%27s,tafamidis%20(Vyndaqel/Vyndamax)

As usual I will attend the American College of Cardiology in Chicago (see below) and I expect that the creator of this near 100 % ATTR Stabilizer (BridgeBio Pharma) will have news at ACC. More to follow as usual and I will report on this live from ACC !

Late Breakers, Upcoming Conferences and excellence

What’s next? I always wonder with hope about tomorrow and what it will bring. I’ve decided to continue the $4.99 for 12 videos holiday health bundle up to February 28, 2025- OR the first 50,000 buyers…

https://vod.essentialguidetoprescriptiondrugs.com/products/give-the-holiday-gift-of-better-health

Did you know breadfruit could be the new super fruit? Is Nitric Oxide a product you should know --PLUS 10 more of our best-selling videos as a gift of health info for yourself and your family or for your friends or BOTH! Videos give key facts on everything from details on the first RSV vaccine to A special Heart Failure Treatment, the FDA Fantastic Four new meds and Auvelity to Mounjaro. visit us at www.EssentialGuideToPrescriptionDrugs.com and find out more.

Upcoming Conferences and excellence in recognition Days

Cancer and particularly Liver Cancer saw some breakthrough progress in 2024. Some of you may remember a video I did, basically a case report of a patient with advanced liver cancer (Hepatocellular Carcinoma). This persistent patient continued to take an investigational (experimental) drug called namodenoson. Later reports show that the clearance of the cancer has persisted. This Rumanian patient is now cancer-free and has been so for 8 years after her first namodenoson dose.

Further recognition is about to be given to the drug and to the small biotech company that makes it (Can-Fite). This recognition and explanation of how the drug works will be presented at the American Society of Clinical Oncology (ASCO) in San Francisco the 23-25th. The presentation is titled, “The Liver protective Effect of the anti-Cancer Drug Candidate Namodenoson is Mediated via Adiponectin.” This medicine is being evaluated in a pivotal Phase three multinational study (the one which leads to data that is sent to the FDA for an approval decision)

World Cancer Day is coming February 4th---I will have more on this for our next newsletter.

The American College of Cardiology will be going to Chicago…

Chicago…it will be a cold place in any March, but March 29-31 2025, it will be the site of the American College of Cardiology meeting. The temp will be warmed by breaking Cardiology News and fantastic research results (Late Breakers). I will be there with my ear muffs on, taking in all the latest heart science and hopefully letting you in on news to ease those heart blues and much more! The Official link is below…

ACC.25, March 29 - 31, 2025 in Chicago, IL

Happy New Year again and feel free to pass this newsletter along to friends and family. So much is changing for the better in Health and treatments.

One quick update. Do you know what happens IF you start to scratch that itch ??? There IS a neuroimmune itch-scratch circuit. What ? Yes, it’s true. That little scratching you or your family may do can be significant. There was just a great update in Science Magazine. https://media.licdn.com/dms/image/v2/D5622AQEh_piK_-8rYA/feedshare-shrink_800/B56ZS5Mv6cGQAg-/0/1738273921940?e=1741219200&v=beta&t=eebggAFwukb-sUYJ-bh9z0R_ud8WyITFXys1ujUeJQ0 https://www.science.org/doi/10.1126/science.adn9390 Real world, real medicines, fantastic news and health recognition days. I’m Dr. Jim Rybacki for EGMVM, Your Essential Guide to Medical and Video News. Please remember that this Newsletter represents news and information and is NOT medical advice or a recommendation on any medicine or treatment. No claim is made that all possible actions or effects of any medicine are included in this newsletter. Although diligent care has been taken to help ensure that the information in this edition is accurate, the continued accuracy and currentness are ever subject to change. Copyright The Medicine Information Institute February 2025.

Volume 1 #7 December 24, 2024 

By Dr. James Rybacki

December, where does the time go and where has the year gone? I bet you are seeing Holiday Decorations and products already and before you know it you will be celebrating however you celebrate for the holidays and New Year! What a joyous time and our country has a new administration and hopefully our healthcare system will be even stronger.

Not surprisingly, December is National Safe Toys and Gifts Month. What does that mean? Let’s think this over. Remember to have age-appropriate toys around—especially if there will be a mix of children in your house visiting. Toys with small parts that are a choking risk are NOT appropriate for little ones. The last thing you want is a trip to the Emergency Room. You can find some great information at the American Public Health Association at www.APHA.org. Some key take aways are to:

• Inspect toys that your kids got as gifts. Look for the age rating for the toy that they got. Make sure that the age rating corresponds to the age of your child.
• Make sure that toys are sturdy enough to withstand the intended play. ATSM means that the toy has met the American Society for Testing and Materials standards.
• Gifts of sporting equipment should always be paired with the required helmet. For example, a helmet and knee pads should go with a skateboard!
• If you have doubts or questions, it’s OK to call Prevent Blindness America at 800-331-2020 and visit www.preventblindness.org/safe-toy-checklist.

We’ve created our best Medicine and Health video flash sale ever—ALL of our videos are just 99 cents and who knows how long it will last…Hint---it won’t last long, but I want you to be able to gift videos to your friends. Still time to send a health video stocking stuffer right into their email in box !!!!!!!!!!!!!! 12 videos for just $4.99 LESS than 50 cents a video !!! Click the link below and you can gift the bundle to anyone you want !!! OR if you want to be cheap, you can send them a 99 cent rental for, well, just 99 cents !!! Goo for it !

 vod.essentialguidetoprescriptiondrugs.com/products/give-the-holiday-gift-of-better-health

I am declaring December to be I’m Gonna Cringe if you Binge (IGCIYB) month. Many of my friends and even colleagues way overdo the celebrating with food, desert, alcohol and other risky behaviors. Could this be the year you actually eat and drink in moderation? Please don’t make me cringe…have fun, but stop before you feel like you are going to vomit (barf). Maybe just one plateful and no seconds? Maybe just one drink? Your friends will thank you for this and will invite you back next year.

December is National Impaired Driving Prevention Month.

I hope you are making the most of PREVENTIVE approaches to living the longest, healthiest life you can lead. Do you remember that sentence from our last edition? If you are the one who is hosting the holiday gathering, be that great Christmas host by making sure you don’t release a bunch of buzzed (impaired) drivers out on the road. Unfortunately states may have different standards for what is impaired or what is legally drunk. We have the classic eBook on the general concepts of alcohol on  Amazon.

One of the newer concepts that some people are trying is stacking energy drinks on top of alcohol. This approach may let you tolerate some higher alcohol levels (sugar content in some energy drinks may modify hypoglycemia), BUT, the alcohol level itself (what will show up in a Breathalyzer) will NOT change and you are heading for a hefty DUI fine and you will NOT have better reflexes if you make that potentially cataclysmic decision to try to drive. Please, please get an uber or have a trustworthy designated driver friend drive you home.

Remember that people gather together during the holidays. They head to the crowded shopping Malls, pack into crowed airports and planes and in essence, probably being exposed to more flu, RSV and Covid. I have to be realistic. This is just what happens. Uncle Bob may be the one carrying the new covid XEC, aunt Martha could be the RSV vector and Jimmy could just have the flu cause he forgot to get his flu shot. Damn. (sorry for the language), but each of these conditions could have been prevented OR might have been minor cases IF they had gotten the appropriate vaccines. YOU can still take the power away from Covid, Flu and RSV because there is still time to get the right shots.

The “do it yourself” Flu shot is coming in early 2025. The nasal spray form will give you and some of your family control over the shot, but first, a little more about the flu that we take for granted.

The flu kills 21,000 Americans in an average flu season and we often forget this grim fact. Largely PREVENTABLE deaths. Many of us get a flu shot although no one likes it and for some, it generalizes to overall vaccine hesitancy. FluMist has been available for about 20 years for people up to 49. SOON, in 2025, it will be available without a prescription and will be known as FluMist Home! I have the details for you. Rent the video for a buck at https://vod.essentialguidetoprescriptiondrugs.com/products/do-it-yourself-flu-shot and get the latest info on an excellent new access to care approach!

Remember that there have already been 4 (four) SURMOUNT studies and they have been wildly successful. SURMOUNT 5 is still continuing at the time of this Newsletter. You can find this crucial new study on www.ClinicalTrials.gov and just put in the unique trial number which is: NCT05822830. The wonderful thing about the clinical trials site is that it gives you the actual design that the study is using, tells who is the big cheese (in research land, this person is called the PI or principal investigator). I use this site often and it is my go to source for research. SURMOUNT 5 is gutsy because it is a head-to-head study. What this means is that tirzepatide (the generic name for Zepbound) is not being compared to a placebo, it is being compared to an active drug, the GLP-1 semaglutide (generic for the brand Wegovy). The study seeks to understand the results (efficacy) and safety of tirzepatide compared to semaglutide in people with obesity OR overweight who have weight related problems (comorbidities) like high blood pressure and heart disease. There are 32 sites seeing enrolled patients, the study is active, but is NOT accepting new patients (not actively recruiting).

Newsletters I read and subscribe to

Late Breakers, Upcoming Conferences and excellence

What’s next? Go for the video bundle… it will NEVER be cheaper and will go away soon

vod.essentialguidetoprescriptiondrugs.com/products/give-the-holiday-gift-of-better-health

Thank you as always for your support and for helping us keep the lights on. It always amazes me how high the cost for professional videos is, ESPECIALLY on the West Coast. Feel free to take advantage of our many video bundles when you visit www.EssentialGuidetoPrescriptionDrugs.com

Resistant bacteria and difficult to treat infections are often in the news. Remember, it’s been more than 20 years since a new antibiotic has been available to treat urinary tract infections. Sulopenam (the brand is Orlynvah) won FDA approval and now will begin to help patients and their families as the latest in the clinician arsenal against uncomplicated UTIs. More to follow on this important antibiotic!

Real world, real medicines and health recognition days. I’m Dr. Jim Rybacki for EGMVM, Your Essential Guide to Medical and Video News.

Please remember that this Newsletter represents news and information and is NOT medical advice or a recommendation on any medicine or treatment. No claim is made that all possible actions or effects of any medicine are included in this newsletter. Although diligent care has been taken to help ensure that the information in this edition is accurate, the continued accuracy and currentness are ever subject to change. Copyright The Medicine Information Institute December 2024.

Volume 1 #6 November 1, 2024 November-December

By Dr. James Rybacki

November, where does the time go? I bet you are seeing Holiday Decorations and products already! I hope you are making the most of PREVENTIVE approaches to living the longest, healthiest life you can lead. Did you get your flu shot and new Covid Vaccine? I certainly did. I just don’t have time to be sick. There will be a remarkable breakthrough in 2025. I’ve called it the “do it yourself” Flu shot. The nasal spray form is coming, but first, a little more about the flu that we take for granted.

The flu kills 21,000 Americans in an average flu season and we often forget this grim fact. Largely PREVENTABLE deaths. Many of us get a flu shot although no one likes it and for some, it generalizes to overall vaccine hesitancy. FluMist has been available for about 20 years for people up to 49. SOON, in 2025, it will be available without a prescription and will be known as FluMist Home! I have the details for you. Rent the video for a buck at https://vod.essentialguidetoprescriptiondrugs.com/products/do-it-yourself-flu-shot and get the latest info on an excellent new access to care approach!

As I’ve done for more than 20 years, I’m heading to the American Heart Association meeting in Chicago November 15-18th and will be at a meeting with more than 20,000 people from all over the world. Great science and learning opportunity, but the infectious disease specialists would also tell us that there will be a lot of flu and Covid amongst the attendees. I will be careful and will report on the breaking science!

November is our current focus and it is replete with Health awareness days, weeks and of course the month itself. The six horseman of health or hospitalization and loss are: American Diabetes month, National Alzheimer’s Awareness Month, Pancreatic Cancer Awareness Month, National Hospice and Palliative care month, US antibiotic Awareness Week & International Survivors of Suicide Loss Day. Let’s take a closer look.

November is remarkable for the sheer number of diabetes recognitions that happen. Did you know that it’s American Diabetes month, National Diabetes month, Diabetic eye disease month and November 14th is World diabetes day. They ARE trying to tell you NOT to take diabetes for granted. Let me talk plainly-It’s NOT just a little sugar! I find that many people think of it like they think of that white, sweet teaspoonful of stuff that goes in their coffee. Diabetes does indeed cause blood sugar to become poorly controlled, but it also leads to circulation problems, kidney disease, can lead to blindness, heart attacks, strokes, amputations and death.

Newer medicines are offering hope. The GLP1s like Wegovy and combined inhibitors like Zepbound work to decrease risk of progression to type two for some and help decrease weight loss and inflammation for most! These are the game changers and because it helps you in two ways, I think Zepbound is the True Breakthrough of this family. I did an interview with Dr. Steve Nissen from Cleveland Clinic at the American College of Cardiology meeting. Dr. Nissen sees GLP1s as breakthroughs and is actually studying Zepbound in a research approach called SURMOUNT. Watch our Nissen SURMOUNT video at:  vod.essentialguidetoprescriptiondrugs 

Let me make you smarter so you can surmount any doubters about your data. You may remember that there have already been 4 (four) SURMOUNT studies and they have been wildly successful. SURMOUNT 5 is still continuing at the time of this Newsletter. You can find this crucial new study on www.ClinicalTrials.gov and just put in the unique trial number which is: NCT05822830. The wonderful thing about the clinical trials site is that it gives you the actual design that the study is using, tells who is the big cheese (in research land, this person is called the PI or principal investigator). I use this site often and it is my go to source for research. SURMOUNT 5 is gutsy because it is a head-to-head study. What this means is that tirzepatide (the generic name for Zepbound) is not being compared to a placebo, it is being compared to an active drug, the GLP-1 semaglutide (generic for the brand Wegovy). The study seeks to understand the results (efficacy) and safety of tirzepatide compared to semaglutide in people with obesity OR overweight who have weight related problems (comorbidities) like high blood pressure and heart disease. There are 32 sites seeing enrolled patients, the study is active, but is NOT accepting new patients (not actively recruiting).

Continuing on, November is also National Alzheimer’s Awareness Month. It’s true. Am I SLIPPING?—have you had that thought? I TALKED WITH MY DOCTOR ABOUT THIS. Current clinical consensus tells us that it’s smart for Medicare beneficiaries to have cognitive tests as part of their Medicare annual wellness exam (30 point mental status exam). This is something that I took and fortunately am OK for now. These kind of tests are smart to undertake if YOU have a family history and/or if you notice memory slips or changes in thinking. Perhaps the gold standard is the PET scan which actually shows the tangles and Alzheimer’s associated changes. You can read more at https://www.alz.org/professionals/health-systems-medical-professionals/cognitive-assessment. Even more info can be found at https://www.alzheimers.org.uk/blog/three-promising-drugs-for-treating-alzheimers-disease-bring-fresh-hope

Treatments for Alzheimer’s include lecanemab (Brand Lecambi) approved for any kind of dementia in the UK. Two of the most recent approvals are donanemab (see Kinsula-Lilly and TRAILBLAZER ALZ4) an immunotherapy approved July 2024 in the US and the most recently approved drug is benzgalantamine (Zunveyl) which targets AD symptoms directly and provides significant benefits in thinking (cognitive) and global function (see Alpha Cognition, a Canadian company https://zunveyl.com/ ).

Looking further into November, It’s also Pancreatic Cancer Awareness Month, This was one of the first catastrophic illness diagnosis discussions I witnessed in my clinical rounding. The room was inexplicably tense and I was so new, I didn’t know why. The answer came from the sad diagnostic news that the attending physician gave. The stage was stage 4 and the cancer had already spread significantly. The problem with pancreatic cancer is that about 80 Percent of cases have virtually no symptoms. What this means is that by the time it is found, there may be little hope.

Hope for pancreatic cancer this year appears to be coming from Immunotherapy. I talked about this in edition 5 of EGMVN relative to liver cancer, but the same is true for pancreatic cancer or PDAC as it is known. Pancreatic adenocarcinoma researchers have found that RAS mutations are there is almost every case of PDAC. RAS addicted tumors rely on RAS on for survival. KRAS (Ki-ras-2 Kirsten rat sarcoma viral oncogene homolog) is the most common RAS mutation (Rat Sarcoma Virus) and simply, it promotes growth of the tumor. Inhibiting this will no doubt become part of combination therapy. More to follow as usual.

One additional interesting investigational medicine for pancreatic cancer has a strong new track record in liver cancer. It’s called namodenoson and the FDA just granted orphan drug designation October 9, 2024. Can-Fite (pronounced can fight) is the company that will start a phase 2 study shortly. This novel research will identify and define the Objective Response Rate (ORR), Progression Free Survival (PFS), Disease Control Rate (DCR), Duration of Response (DoR) and Overall Survival (OS). New medicines are always on the horizon and I am happy to let you know about them. Namodenoson (a drug that works on the A3 adenosine receptor) is currently in phase 3 study (the one that leads to data for FDA submission) of this drug in advanced liver cancer and one patient in particular stands out. Several years ago, this patient had advanced liver cancer and had a COMPLETE response to treatment! I did a video in Feb 2023. You can watch at: https://vod.essentialguidetoprescriptiondrugs.com/videos/update-on-liver-cancer-february-2023 . The remarkable thing is—the patient is STILL cancer free. Yes, cancer free. I’ll keep you updated at www.EssentialGuideToPrscriptionDrugs.com as more information becomes available

While some people mistakenly think of Hospice as giving up,

November is National Hospice and Palliative care month. Palliative care makes the patient more comfortable and Hospice provides tremendous support for patients and family members alike. Both organizations are truly about caring and Hospice also gives the caregivers respite. RESPITE. That person that someone loves becomes a patient and the patient may become a 24 hour a day obligation with NO RELIEF for the person who loves them. Often, that loving caregiver burns out. They don’t want to ask for relief because they think it means a compromise of their love and is somehow disloyal. I went through this kind of discussion with my mother as she took care of my Step-Dad and I saw it in the face of my brother-in-laws wife as she worked so hard to help her husband who had become a melanoma patient. Palliative care changes the cure landscape to a comfort landscape and Hospice changes despair into care for the living patient and the spent caregiver and family. Celebrate these days as they give the best quality of life back to the patient AND to their loved ones.

November and antibiotics? You probably never thought of this.

US antibiotic Awareness Week falls in November, it’s true.

Volume 1 #5 September 10, 2024 September- November 

By Dr. James Rybacki

President, the Medicine Information Institute, creator of The Essential Guide to Medical News-- giving KOLs & medicines a clear voice. Chief Pharmacy Officer-CITI trained researcher, Senior consultant, author September 6, to November 6, 2024 Watch the free video version here.

September and that first scent of Autumn in the air. The great circle of the seasons heading into October and Halloween. College football and falling leaves! Many of you have asked for a video edition of this newsletter. OK, I struggled with this, frankly because of the expense, but I’m willing to give it a try-will you help me by joining our members only team for just 7 bucks?  Please help-click on the link! Join our members only team 

I will do every other month in video format from the studio for 4 months. I’m going to keep the electronic version free, but have to charge for the video because it’s just that expensive. I’m hoping that we can reach 1,000 video subscribers as quickly as we did for the electronic version. Thank you as always for your support. Feel free to take advantage of our many video bundles when you visit EssentialGuidetoPrescriptionDrugs.com 

While we don’t think of cholesterol as associated with Fall- September IS National Cholesterol education month. Let me talk plainly- KNOW YOUR DAMN numbers! Then do what your doctor recommends to make them better and decrease YOUR risk and that of your family if they are implicated by your genes. 

Abnormal Cholesterol killed my Dad and is killing my sister and probably me, maybe you. It’s sneaky. No symptoms. Do you hear that sound? No sound either. Do you have that diagnostic pain? Nope, no pain either unless we are talking about leg pain from far advanced peripheral artery disease, chest pain from advanced compromise of the heart circulation or headache pain from that first TIA or God forbid, an evolving stroke. If you haven’t done this, talk with your doctor on that next visit about your numbers. Good, bad, Lp (a) and particle number. Start on that next visit—the clock may be ticking and there are a lot of things we can do to lower your risk and keep you alive with a great quality of life! Remember that Lp(a) is an independent risk factor for heart and doubles or even triples your risk of heart attack (according to Harvard Health- ) Be smart today and know your LP(a) ! 

Looking further, did you know that September is World Alzheimer’s month? It’s true. Current clinical consensus tells us that it’s smart for Medicare beneficiaries to have cognitive tests as part of their Medicare annual wellness exam (30 point mental status exam). Smart to also add people with family history and those who notice memory slips or changes in thinking. Perhaps the gold standard is the PET scan which actually shows the tangles and Alzheimer’s associated changes. You can read more at alz.org. Even more info can be found at alzheimers.org 

Treatments for Alzheimer’s include lecanemab (Brand Lecambi) approved for any kind of dementia in the UK. Two of the most recent approvals are donanemab (see Kinsula-Lilly and TRAILBLAZER ALZ4) an immunotherapy approved July 2024 in the US and the most recently approved drug is benzgalantamine (Zunveyl) which targets AD symptoms directly and provides significant benefits in thinking (cognitive) and global function (see Alpha Cognition, a Canadian company). 

Heart Failure will come into focus as the annual Heart Failure Society of America (HFSA) meeting takes place this year in Atlanta September 27-30. We have an interview with a great Nurse Practitioner (Amy Brownell) talking about heart function versus failure—take a look at the trailer at: Interview with Amy Brownell 

One aspect of heart function that will come to light is a phase three study (the one that gives results that are submitted to the FDA) from a strong newer company called BridgeBio Pharma. The ATTRibute-CM is a Trial of a drug called Acoramadis in Patients with Transthyretin Amyloid Cardiomyopathy (ATTR-CM). A post hoc analysis will be presented by Dr. Dan Judge from MUSC who is the co-chair of the ATTRIbute-CM steering committee. The important info will be presented at 4:36 PM on September 28th. I’ll post on www.EssentialGuideToPrescriptionDrugs.com as usual and hope to bring a film crew to AHA Scientific Sessions in Chicago in November and get Dr. Dan for an interview for EGMN ! 

Because we are covering 2 months with one Newsletter, let’s look further into Autumn and October Health Recognition Days. Breast cancer has had a severe impact on my family. Many of you know that my wife got that diagnosis March 2022 and I rescinded my leadership position quest at HUMC in New Jersey to take care of her. We have a video Facing Cancer and 9 key pillars we used to cope. You can find it at: EGPD - Facing Cancer I hope it helps you rise up and get the best care possible! 

Remarkable progress is being made using some kinds of immunotherapy in cancer (oncology). I was shocked to learn that an experimental medicine called dostarlimab gave 100 % remission to a small group of patients with rectal cancer studied at Memorial Sloan Kettering Cancer Center. Great hope and as usual, more to come. 

One additional cancer where there is news of great progress is in liver cancer. The most common kind is called hepatocellular carcinoma (HCC). You can learn more about this kind of cancer at the Mayo Clinic by clicking the link: Mayo Clinic- liver cancer. The news; however is not about the cancer itself, but about a small Israeli company called Can-Fite (pronounced can fight), that most of us have NOT heard about. Namodenoson (a drug that works on the A3 adenosine receptor) is currently in phase 3 study (the one that leads to data for FDA submission) of this drug in advanced liver cancer and one patient in particular stands out.  Several years ago, this patient had advanced liver cancer and had a COMPLETE response to treatment! I did a video in Feb 2023. You can watch here. The remarkable thing is—the patient is STILL cancer free. Yes, cancer free. I’ll keep you updated at www.EssentialGuideToPrscriptio... as more information becomes available. Hope springs eternal and I think we have news and more importantly new data in oncology that warrant hope, hope hope! 

October is also National Depression Screening day (October 6th or 10th), but you can visit mhanational.org to find out more and get on a path to a brighter tomorrow. There are many many medicines to help ease depression and when combined with talk therapy, the results of those combinations can make a significant change. Depression is painful, but you simply do not have to live with it. Check out the trailer of one of our videos on depression and dextromethorphan (yes, the medi cine in some cough syrup) coupled with bupropion (brand Auvelity) at:

Newsletters I read and subscribe to 

Innovation. Where is it, how is it generated? Is there an organized, structured approach? I’ve met someone who is asking the questions, seeding the Centers of Excellence and has even woven science into her newsletter. Her name is Kasia Hein-Peters, MD and I think she is someone with a lot to say! 

Subscribe to her Monthly newsletter, Academy for SciencePreneures where she helps you “Discover How Life Science Entrepeneurs Innovate, Scale Up and Create the Future: Kasia Hein-Peters

Please let me know what you think and I will forward constructive feedback to her or, you can certainly tell her yourself. 

Head to our EssentialGuideToPrescriptionDrugs.com web site or take a look on my YouTube channel for our viewers video guide VVG- for updates on breaking conference coverage news, the new EGMN from the office or additional articles and an email list or two—you might even get a free video if you join one of our lists (only an email or at most 2 a month with updates you might like). 

Late Breakers, Upcoming Conferences and excellence 

What’s next? I always wonder with hope about tomorrow and what it will bring. 

Future therapeutics and important AI alignment happened for a newer San Francisco based company called Bridge Bio Pharma August 27th. The Company focuses on genetic diseases and they decided to collaborate with Rohan Khera, MD, MS at the Yale School of Medicine. The laboratory is called the CarDS Lab. The problem, ATTR-CM is underdiagnosed. What will happen is the start of a study called the TRACE-AI Network Study. This will be a novel approach that undertakes large-scale federated screening for ATTR-CM across multiple sites to try to get a handle on exactly how severe the underdiagnosis is. More to follow as usual and I will keep you updated on www.EssentialGuideToPrescriptionDrugs.com. IF Dr. Khera attends the AHA Scientific Sessions in Chicago in November, I’m hoping to be able to interview him for The Essential Guide to Medical News right at the conference!

You might have gleaned from this that I WILL be in Chicago for the American Heart Association Scientific Sessions-AHA Nov 15-18th. Safe travels to all of my colleagues who will be there. I expect there will be some super heart function news, practice changing research and much to talk about.

Resistant bacteria and difficult to treat infections are often in the news. It’s been more than 20 years since a new antibiotic has been available to treat urinary tract infections. Sulopenam (brand pending) has been involved in a study called REASSURE (Renewed ASsesment of Sulopenam in uti caused by Resistant Enterobacterales. The Antimicrobial Drugs Advisory Committee met September 9 and recommended approval of this important new medicine. Will the drug gain FDA approval? I do not know. While the FDA usually follows the advice of their expert committees, they do not have to. The date to watch here is October 25th. This is the PDUFA action date when the FDA must make a decision. If successful, sulopenam will be the FIRST Oral Pill form penam approved in the US. Exciting and this offers a host of IV to PO or Hospital to home shifts that might make patient lives easier, even if they have complicated Urinary Tract Infections (UTIs). 

Time inexorably moves on, please build a healthier future for yourself and your family. Take even better care of yourselves…have hope! 

Real world, real medicines and health recognition days. I’m Dr. Jim Rybacki for EGMVM, Your Essential Guide to Medical and Video News. 

Please remember that this Newsletter represents news and information and is NOT medical advice or a recommendation on any medicine or treatment. No claim is made that all possible actions or effects of any medicine are included in this newsletter. Although diligent care has been taken to help ensure that the information in this edition is accurate, the continued accuracy and currentness are ever subject to change. Copyright The Medicine Information Institute September 2024

Volume 1, Number 3 July-August 2024

By Dr. James Rybacki

Thinking back to July 4^th. Freedom and this great country of ours. You and your family may not have thought about this, but you have the freedom to choose better health. My family growing up wasn’t so smart about this and didn’t have the evidence-based medicines that we have now. In this bold new Fuster Future of Cardiometabolic health, I think you’ll find that new medicines (like inclisiran) may be recommended sooner for patients at risk of heart and blood vessel problems.

You deserve to know more about the ASCO meeting from June because some of the news was UNPRECEDENTED in tough cancers! The longest Progression FREE Survival in lung cancer was reported!

Stunningly good, off the charts and groundbreaking are phrases that you rarely hear relative to Progression Free Survival (PFS) in cancer of the lung. This non-small cell lung cancer study called the CROWN study gave patients 60 percent PFS !!!

In July where possible, we should turn our thoughts to three important Health recognitions.

Healthy Vision Month, UV safety month and International Self-care day. Let’s take a closer look because the science, understanding and treatments are getting better. Take a breath and dive in.

July is Healthy Vision Month. Can we do better? Of course we can. Have you had your yearly vision test (more often may be needed if you are living with diabetes or a chronic eye problem?

There’s an org for this, like other health recognition months:

Healthy Vision Month 2024: Reframe Your Future

UV safety month

I tend to think of the sun as activating Vitamin D and as a good thing. My understanding changed recently. I had something appear, then gradually grow where my side burns are. Seemed inconsequential. It wasn’t. The scientific name almost sounds silly. What on earth is a squamous cell? This is actually a common kind of cancer and thank God, it tends to grow slowly. This kind of skin cancer comes from excessive exposure to UV light from sun or even from tanning beds or both. IF you or a family member or friend have this kind of growing problem. SEE a Dermatologist right away. You can find out more about this kind of skin cancer at: AAD - It’s UV Awareness Month

International Self Care day is July 22^nd. Did you take care of yourself today? You can read more at: International Self-Care Day

I think we all can do better at this. Self-care means a regular effort where communities, families and you and me maintain health, avoid disease and actively protect ourselves and loved ones from illness.

Key July Conference News you can use

We need to continue to talk about the American Society of Clinical Oncology (ASCO) meeting

Important news will be coming out of this conference and it may impact the way that your doctors work within their groups

Doctors working in large groups will congregate in TN in the Summer Large Group Council Executive Summit

This is an invitation only event at the Hutton Hotel in Nashville, but I expect that important news will be coming out of this conference and it may impact the way that your doctors work within their groups. More to follow as usual!

Newsletters I read and subscribe to

We just achieved our 1,000^th subscriber to The Essential Guide to Medical and Video News (EGMVN)!

Important news will be coming out of this conference and it may impact the way that your doctors work within their groups

Innovation. Where is it, how is it generated? Is there an organized, structured approach? I’ve met someone who is asking the questions, seeding the Centers of Excellence and has even woven science into her newsletter. Her name is Kasia Hein-Peters, MD and I think she is someone with a lot to say!

Subscribe to her Monthly newsletter, Academy for SciencePreneures where she helps you “Discover How Life Science Entrepreneurs Innovate, Scale Up and Create the Future:

Linkedin - Academy for SciencePreneurs.

Please let me know what you think and I will forward constructive feedback to her.

As always, you can head to our growing and usual EssentialGuideToPrescriptionDrugs.com web site or take a look on my YouTube channel for our viewers video guide for updates on breaking conference coverage news or additional articles and an email list or two—you might even get a free video if you join one of our lists (only an email or at most 2 a month with updates you might like).

New Videos for you and maybe your friends:

Can you prevent accidental poisonings in your home? Do you know the number for the Poison Control Center?

We pulled together a lot of valuable information for you. It’s surprising how many drugs actually look like candy. Kids simply don’t know the difference. We’ve made this video our 99 cent special for July because it’s that important! Click below to watch the trailer or rent the full video

Preventing Accidental Poisoning in Your Home

Are you on a cholesterol journey like me? Have you wondered about those numbers and how to get them lower? It’s about risk of heart attack, stroke and even peripheral artery disease (PAD) and you can take control of it. We’ve gotten a lot of questions so we did a video on this. It’s a .99 cent special for July and you can watch a trailer!

My Cholesterol Journey and Maybe Yours

Concerned about your heart? I was very lucky to have a film crew at The American College of Cardiology this year (ACC24) and we got some great colleagues to come on camera with me. I decided to bundle more than an hour of videos for June and give you a special rental price! We even included a behind the scenes at ACC24 so you know what it is like to be at a major heart conference!

Heart (Cardiology) Conference Bundle

If you decide to visit our videos or our site, please let us know if you would like to see additional programs. There is a Contact us form on EssentialGuideToPrescriptionDrugs.com and we love to hear constructive input! Thanks again to everyone who has already reached out.

A Scientist and innovator you should know:

There are moments in time when paths inexplicably cross. I happened to go to a blended cardiovascular and nutrition conference. He was in the middle of a large booth in the exhibit hall. It was Dr. Nathan Bryan, signing autographs for his book, Functional Nitric Oxide Nutrition, Dietary Strategies to Prevent and Treat Chronic Disease. Nathan turned out to be just one of those brilliant people you want to know more about. I was lucky to interview him in one of our Essential Guide to Medical News, Meet the Scientist segments several months after the conference where I first met him.

Meet the Scientist: Dr. Nathan S. Bryan

Meet the Scientist: Dr. Nathan S. Bryan

The link above will take you to our Videos on demand section where you can watch the Dr. Nathan trailer, read the description, see more Videos about Dr. Bryan and even rent or buy the video itself!

Until then:

Time inexorably moves on, but true breakthrough treatments are on the way! Take every opportunity to build a healthier future for yourself and your family and control the risk factors that you can as often as you can. Please take even better care of yourselves…

Please remember that this Newsletter represents news and information and is NOT medical advice or a recommendation on any medicine or treatment. No claim is made that all possible actions or effects of any medicine are included in this newsletter. Although diligent care has been taken to help ensure that the information in this edition is accurate, the continued accuracy and currentness are ever subject to change. Copyright The Medicine Information Institute July 2024