Our Picks

Dr. Friedman prescribes various thyroid hormone preparations to his patients with hypothyroidism. This includes natural desiccated thyroid (NDT) of which two preparations are WP Thyroid and Nature-Throid, both made by RLC Labs. On August 25, 2020, RLC Labs announced a voluntary, consumer-level recall of all lots of Nature-Throid and WP Thyroid tablets because some lots contain less than the required 90% of the active ingredient as determined by the FDA. The RLC spokesperson said to Dr. Friedman that one lot of WP Thyroid and 5 lots of Nature-Throid contained between 87% and 90% of the labeled amount of levothyroxine (T4) or liothyronine (T3). The recall did not disclose which of the lots were affected and all lots are recalled, not just the affected lots. According to the recall, if a patient receives a sub-potent tablet, hypothyroid symptoms may not be controlled. To date, there have been no reports of adverse events related to this recall. Patients who have had an adverse event should contact RLC Labs.

RLC Labs advised that patients should talk to their healthcare professional before they stop taking their Nature-Throid and WP Thyroid medicine. Consumers with questions about the recall can email RLC at recall@rlclabs.com or RLC Customer Service  (877) 797-7997. Patients may return unexpired Nature-Throid and WP Thyroid tablets to their pharmacy who are legally required to refund the cost of the tablets. Currently no lots of Nature-Throid and WP Thyroid tablets are commercially available, so a replacement with the same product is not an option. It is unknown how long it will be before Nature-Throid and WP Thyroid become commercially available.

Dr. Friedman has several comments about this recall. This is the second recall of desiccated thyroid as some lots of NP thyroid were recalled in May 2020. Dr. Friedman sees this as unfortunate, but still believes desiccated thyroid is a good option for patients with hypothyroidism...

Thanks for being a member of Rare Patient Voice, LLC. We have an opportunity for you to take part in a Cushing Syndrome interview (NEON_4470) for Patients. Our project number for this study is NEON_4470.

Project Details:

Telephone interview


Interview is 60-minutes long


One Hundred Dollar Reward


Looking for Patients diagnosed with Endogenous Cushing Syndrome 


Things to Note:

Patient study only, Caregivers please pass the link along


Unique links, please do not pass along for 2nd use


Want to share this opportunity? Let us know and we can provide a new link


Please use a laptop/computer ONLY. No smartphones or tablets - Preliminary questions are Mobile Friendly!


Save this email to reference if you have any questions about the study!


If you have any problems, email michael.taylor@rarepatientvoice.com and reference the project number.  If you hit reply, you will get an auto do-not-reply email.


If you are interested in this study, please click the link below to answer a few questions to see if you qualify.

Study Link: Link

OR if the Study Hyperlink is not clickable above, please copy/paste this URL below.
https://panel.rarepatientvoice.com/newdesign/site/rarepatientvoice/surveystart.php?surveyID=9mth6d868qpc&panelMemberID=trfnbc7mvduh1gseff1h&invite=email


Thanks as always for your participation! Please be aware that by entering this information you are not guaranteed that you will be selected to participate. As always, we do not share any of your contact information without your permission.

Not Interested in this study? (Click link below so we do not send you any reminders for this study)

Study Reminder Opt Out Link: Link

We truly appreciate the time you set aside to interact with our company and don’t take it for granted. Receive a $5 gift card for referring others who may want to participate in this or future studies. Invite them to join Rare Patient Voice: https://www.rarepatientvoice.com/sign-up. They, too, receive a gift card.

Osilodrostat treatment was found to be associated with a rapid and sustained reduction in mean concentration of urinary free cortisol (UFC) and improved clinical symptoms in patients with Cushing’s disease, according to the results of a prospective, multicenter, open-label, phase 3 study published in the Lancet Diabetes Endocrinology.

Osilodrostat is an oral inhibitor of 11-β hydroxylase cytochrome P450. Adults aged 18 to 75 years of age with diagnosed persistent or recurrent Cushing’s disease were recruited between 2014 and 2017 at 66 hospitals in 19 countries. Cushing’s disease was defined by a mean UFC concentration over a 24-hour period >1.5 times greater than the upper limit of normal (ULN) and morning plasma adrenocorticotropic hormone level above normal limits.

Participants (n=137) received 30 mg osilodrostat twice daily, dose which was adjusted every 2 weeks until week 12 on the basis of mean 24-hour UFC concentration. The determined maintenance dose was continued until week 24. At week 26, participants who had achieved 24-hour UFC concentration ≤ ULN and did not need titration after week 12 were randomly assigned in an equal ratio to maintain osilodrostat treatment or were switched to a placebo for 8 weeks. This 8-week period of the study was double-blinded. During weeks 35 to 48, all patients were returned to osilodrostat treatment.

In this cohort, mean age was 40.0 years (range, 19.0-70.0 years), 77% of participants were women, the average time since diagnosis was 47.2 months (interquartile range [IQR], 19.0-88.3), 88% had previous pituitary surgery, 16% had pituitary radiation therapy, and 74% had medicinal therapy. At baseline, the mean 24-hour UFC concentration was 1006±1590 nmol/24 h.

...

...
Starting sometime around 2017, my “normal” levels of fatigue and concentration/memory issues started becoming increasingly worse. Around the time that these symptoms started becoming more noticeable, I was over committing myself in all aspects of my life and my job was very stressful (although in hindsight, I may have just not been able to do as much as I was used to doing). After several months of trying to convince myself that my symptoms were stress related, I finally went to my PCP to get blood work done since I have an extensive family history of thyroid disorders. My thyroid results were fine, but I was diagnosed with hypertension, vitamin D deficiency, and obesity. I kept going back to my doctor to try to figure out what was causing these symptoms. Long story short, I eventually got so frustrated with being told it was my fault and there wasn’t an underlying medical cause that I gave up trying for several years.

Fast forward to the end of last year, my symptoms got to be so bad that I could no longer function in my day-to-day life. In addition to the increasingly debilitating fatigue and brain fog, I started having irregular periods even though my menstrual cycle has always been EXTREMELY regular. So in January, I started the process again to figure out what was happening. After several months and numerous appointments with my PCP and endocrinologist, I had no more answers than I did before and was getting increasingly depressed and frustrated with my situation. I recently went to a different endocrinologist, who ordered a late night (midnight) saliva cortisol test. I dropped it off at the lab on Monday and am anxiously waiting for the results...

Hypercortisolism Quickly Reversed With Oral Tx

Oral osilodrostat (Isturisa) normalized cortisol levels in Cushing's disease patients who were ineligible for or not cured with pituitary surgery, according to the phase III LINC 3 trial.

After 24 weeks of open-label treatment with twice-daily osilodrostat, 53% of patients (72 of 137; 95% CI 43.9-61.1) were able to maintain a complete response -- marked by mean 24-hour urinary free cortisol concentration of the upper limit of normal or below -- without any uptitration in dosage after the initial 12-week buildup phase, reported Rosario Pivonello, MD, of the Università Federico II di Napoli in Italy, and colleagues.

Dr. Theodore Friedman (The Wiz) will host a webinar on Growth Hormone Deficiency, PCOS or Cushing’s: How do You Tell Them Apart?

Dr. Friedman will discuss topics including:

Signs and Symptoms of Cushing’s Syndrome


Testing for Cushing’s


Signs and Symptoms of Growth Hormone Deficiency


Testing for Growth Hormone Deficiency


Signs and Symptoms of PCOS


Testing for PCOS


How do you tell them apart?


Sunday • August 2 • 6 PM PDT
Click here on start your meeting or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=m4eda0c468071bd2daf33e6189aca3489
OR
Join by phone: (855) 797-9485
<br clear="ALL">
      Meeting Number (Access Code): 133 727 0164 Your phone/computer will be muted on entry.
Slides will be available on the day of the talk here
There will be plenty of time for questions using the chat button. Meeting Password: pcos
For more information, email us at mail@goodhormonehealth.com

This event has been postponed to Dec. 5, 2020

You are Cordially Invited!

The PNA is pleased to announce our participation in this event!

Saturday, December 5, 2020
8:30am – 4:30pm
Zuckerman Research Center
417 E. 68th St. New York, NY
Memorial Sloan Kettering Cancer Center

Target Audience

This course is intended for endocrinologists, neurosurgeons, otolaryngologists, radiation oncologists, neurologists, ophthalmologists, neuro-oncologists, family medicine and internal medicine physicians, physicians in training and other allied health professionals who treat and manage patients with pituitary diseases. We also invite patients with pituitary disease and their caregivers to attend this educational activity and participate in our interactive afternoon breakout sessions. 

Overall this course aims to improve patient care and outcomes through evidence-based discussion of clinical practice guidelines and emerging therapies. Our goal is to assess and update current practices to promote earlier diagnosis and treatment of pituitary diseases. The multidisciplinary nature of the course will allow for the dissemination of knowledge across the variety of practitioners caring for pituitary patients, and for the patients themselves.

Pituitary patients will be able to review treatment options, learn about ongoing clinical trials, and discuss their comprehensive care with providers and other patients. The educational objective of this patient session is to provide a forum for pituitary patients to discuss treatment options and new therapies with providers and other patients.

Patients with pituitary disease and their caregivers are invited to attend this educational activity FREE of charge. If you are a patient or caregiver interested in attending, please email cme@mskcc.org to register (registration is required in order to attend).

Medical Professionals who wish to attend must register online: 
mskcc.org/PituitaryCourse

View Course Flyer

Abstract

Despite various approaches to immunoassay and chromatography for monitoring cortisol concentrations, conventional methods require bulky external equipment, which limits their use as mobile health care systems. Here, we describe a human pilot trial of a soft, smart contact lens for real-time detection of the cortisol concentration in tears using a smartphone. A cortisol sensor formed using a graphene field-effect transistor can measure cortisol concentration with a detection limit of 10 pg/ml, which is low enough to detect the cortisol concentration in human tears. In addition, this soft contact lens only requires the integration of this cortisol sensor with transparent antennas and wireless communication circuits to make a smartphone the only device needed to operate the lens remotely without obstructing the wearer’s view. Furthermore, in vivo tests using live rabbits and the human pilot experiment confirmed the good biocompatibility and reliability of this lens as a noninvasive, mobile health care solution...

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the viral strain that has caused the coronavirus disease 2019 (COVID-19) pandemic, has presented healthcare systems around the world with an unprecedented challenge. In locations with significant rates of viral transmission, social distancing measures and enforced ‘lockdowns’ are the new ‘norm’ as governments try to prevent healthcare services from being overwhelmed. However, with these measures have come important challenges for the delivery of existing services for other diseases and conditions. The clinical care of patients with pituitary disorders typically involves a multidisciplinary team, working in concert to deliver timely, often complex, disease investigation and management, including pituitary surgery. COVID-19 has brought about major disruption to such services, limiting access to care and opportunities for testing (both laboratory and radiological), and dramatically reducing the ability to safely undertake transsphenoidal surgery. In the absence of clinical trials to guide management of patients with pituitary disease during the COVID-19 pandemic, herein the Professional Education...

I think we always knew Cushing's and pregnancy were related...

Abstract

Cushing’s syndrome (CS) during pregnancy is very rare with a few cases reported in the literature.

Of great interest, some cases of CS during pregnancy spontaneously resolve after delivery. Most studies suggest that aberrant luteinizing hormone (LH)/human chorionic gonadotropin (hCG) receptor (LHCGR) seems to play a critical role in the pathogenesis of CS during pregnancy.

However, not all women during pregnancy are observed cortisol hypersecretion. Moreover, some cases of adrenal tumors or macronodular hyperplasia with LHCGR expressed, have no response to hCG or LH. Therefore, alternative pathogenic mechanisms are indicated. It has been recently reported that estrogen binding to estrogen receptor α (ERα) could enhance the adrenocortical adenocarcinoma (ACC) cell proliferation.

Herein, we hypothesize that ERα is probably involved in CS development during pregnancy.

Better understanding of the possible mechanism of ERα on cortisol production and adrenocortical tumorigenesis will contribute to the diagnosis and treatment of CS during pregnancy.

Read the entire article here: https://www.sciencedirect.com/science/article/pii/S0306987720303893?via%3Dihub

Presented by

Georgios A. Zenonos, MD

Assistant Professor of Neurological Surgery
Associate Director, Center for Skull Base Surgery
University of Pittsburgh Medical Center

200 Lothrop Street, Pittsburgh PA, 15217
Presbyterian Hospital, Suite B400

No Registration is Required.  It will be webcast by Microsoft Teams.

Click here to attend.

 




Date: Friday, July 17, 2020

Time: 10:00 AM Pacific Daylight Time, 1:00 PM Eastern Daylight Time

What should you do if an Addison crisis threatens? How do you prepare an emergency injection and how do you administer it?

If you have a gastro-intestinal infection, accompanied by diarrhoea and vomiting, there is a big risk of an Addison crisis. Always discuss with your specialist what you have done and what else needs to be done. Explain to your family, colleagues and friends what illness you have, and what they should do if necessary.

Show them the animated clip.

 

 

Can someone please offer help, ive been suffering for a year and just got blood results today with a high cortisol reading. My doctor said that my contraceptive pill could have caused this, however, I am not on the regular pill but on the POP progesteron only pill.

Is anyone aware of if this raises cortisol levels the same way the regular combined pill does?

Any help would be so very much appreciated!

 

Please respond here, on the message boards, or in the original post.

 

Thanks!

Mr. Goacher's Son returns after 13 years to tell more of this story. Family's Despair over Rare Disease
Exclusive By Benjamin Parkes
THE family of a Chippenham man who died of a rare hormonal disorder have told of the despair his illness caused before it was diagnosed.
 
An inquest held in Flax Bourton on Tuesday ruled that John Goacher, 51, of Stonelea Close, died of natural causes on May 18 last year, after having surgery at Frenchay Hospital in Bristol.
 
The operation was intended to ease the symptoms of Cushing's Disease, which included obesity, a rounded face, increased fat around the neck and thinning arms and legs.

Dexamethasone, a cheap and widely used steroid, has become the first drug shown to be able to save lives among Covid-19 patients in what scientists hailed as a “major breakthrough”.

Results of trials announced on Tuesday showed dexamethasone, which is used to reduce inflammation in other diseases, reduced death rates by around a third among the most severely ill Covid-19 patients admitted to hospital.

 




The results suggest the drug should immediately become standard care in patients with severe cases of the pandemic disease, said the researchers who led the trials.

“This is a result that shows that if patients who have Covid-19 and are on ventilators or are on oxygen are given dexamethasone, it will save lives, and it will do so at a remarkably low cost,” said Martin Landray, an Oxford University professor co-leading the trial, known as the RECOVERY trial.

“It’s going to be very hard for any drug really to replace this, given that for less than 50 pounds ($63.26), you can treat eight patients and save a life,” he told reporters in an online briefing.

His co-lead investigator, Peter Horby, said dexamethasone was “the only drug that’s so far shown to reduce mortality - and it reduces it significantly.”

“It is a major breakthrough,” he said. “Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

 



There are currently no approved treatments or vaccines for Covid-19, the disease caused by the new coronavirus which has killed more than 431,000 globally.

Saving ‘countless lives’

The RECOVERY trial compared outcomes of around 2,100 patients who were randomly assigned to get the steroid, with those of around 4,300 patients who did not get it.

The results suggest that one death would be prevented by treatment with dexamethasone among every eight ventilated Covid-19 patients, Landray said, and one death would be prevented among every 25 Covid-19 patients that received the drug and are on oxygen.

Presented by Georgios A. Zenonos, MD

Assistant Professor of Neurological Surgery
Associate Director, Center for Skull Base Surgery
University of Pittsburgh Medical Center

200 Lothrop Street, Pittsburgh PA, 15217
Presbyterian Hospital, Suite B400
 Register Now! 

 




After registering you will receive a confirmation email containing information about joining the Webinar. 

Date: Wednesday July 1, 2020

Time: 3:00 PM Pacific Daylight Time, 6:00 PM Eastern Daylight Time

https://doi.org/10.1016/S2213-8587(20)30215-1

Over the past few months, COVID-19, the pandemic disease caused by severe acute respiratory syndrome coronavirus 2, has been associated with a high rate of infection and lethality, especially in patients with comorbidities such as obesity, hypertension, diabetes, and immunodeficiency syndromes.

These cardiometabolic and immune impairments are common comorbidities of Cushing's syndrome, a condition characterised by excessive exposure to endogenous glucocorticoids. In patients with Cushing's syndrome, the increased cardiovascular risk factors, amplified by the increased thromboembolic risk, and the increased susceptibility to severe infections, are the two leading causes of death.

.....


In conclusion, COVID-19 might have specific clinical presentation, clinical course, and clinical complications in patients who also have Cushing's syndrome during the active hypercortisolaemic phase, and therefore careful monitoring and specific consideration should be given to this special, susceptible population. Moreover, the use of medical therapy as a bridge treatment while waiting for the pandemic to abate should be considered.

Cushing's disease (CD) presents a marked female preponderance, but whether this skewed gender distribution has any relevance to the presentation and outcome of CD is not known.

The aim of the present study was the comparison of clinical features, biochemical indices of hypercortisolism, and surgical outcome among male and female patients with CD. The study population comprised 280 patients with CD (233 females, 47 males) collected by the Italian multicentre study.

Epidemiological data, frequency of clinical signs and symptoms, urinary free cortisol (UFC), plasma ACTH and cortisol levels, responses to dynamic testing, and surgical outcome were compared in female and male patients.

...

No difference in ACTH and cortisol responses to CRH, gradient at inferior petrosal sinus sampling, and cortisol inhibition after low-dose dexamethasone was recorded between sexes. In contrast, the sensitivity of the high-dose dexamethasone test was significantly lower in male than in female patients.

Of particular interest, symptoms indicative of hypercatabolic state were more frequent in male patients; indeed, males presented a higher prevalence of osteoporosis, muscle wasting, striae, and nephrolitiasis. Conversely, no symptom was more frequent in female patients with CD.

Patients with myopathy, hypokalemia, and purple striae presented significantly higher UFC levels, compared with patients without these symptoms. Lastly, in male patients, pituitary imaging was more frequently negative and immediate and late surgical outcome less favorable.

In conclusion, CD appeared at a younger age and with a more severe clinical presentation in males, compared with females, together with more pronounced elevation of cortisol and ACTH levels...

Braun LT, Fazel J, Zopp S



Journal of Bone and Mineral Research


|



May 22, 2020








 







This study was attempted to assess bone mineral density and fracture rates in 89 patients with confirmed Cushing's syndrome at the time of diagnosis and 2 years after successful tumor resection. Researchers ascertained five bone turnover markers at the time of diagnosis, 1 and 2 years postoperatively. Via chemiluminescent immunoassays, they assessed bone turnover markers osteocalcin, intact procollagen‐IN‐propeptide, alkaline bone phosphatase, CrossLaps, and TrAcP 5b in plasma or serum. For comparison, they studied 71 gender‐, age‐, and BMI‐matched patients in whom Cushing's syndrome had been excluded. The outcomes of this research exhibit that the phase immediately after surgical remission from endogenous CS is defined by a high rate of bone turnover resulting in a striking net increase in bone mineral density in the majority of patients.

Read the full article on Journal of Bone and Mineral Research.

Dr. Friedman will discuss topics including:

Who should get an adrenalectomy?


How do you optimally replace adrenal hormones?


What laboratory tests are needed to monitor replacement?


When and how do you stress dose?


What about subcut cortisol versus cortisol pumps?


Patient Melissa will lead a Q and A


Sunday • May 17 • 6 PM PST
Click here on start your meeting or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=mb896b9ec88bc4e1163cf4194c55b248f
 
OR
Join by phone: (855) 797-9485
 
 
<br clear="ALL">
      Meeting Number (Access Code): 802 841 537 Your phone/computer will be muted on entry. 
Slides will be available on the day of the talk here
There will be plenty of time for questions using the chat button. Meeting Password: addison

Hello Mary & dear Cushies!!

I’ve just discovered this article two months ago and I was very pleased to speak directly to Dr. Gerardo Burton.

He and his team developed a drug (21OH-6OP) which is a SPECIFIC antagonist for cortisol receptors, unlikely mifepristone which inhibits cortisol AND progesterone with so many undesired adverse effects.

Unfortunately the pharmaceutical company didn’t choose this drug to start the clinical trials and so it is resting in Dr. Burton’s lab.... since 2007.

The great humanity in Dr. Burton drop tears into my eyes when he told me that he would like that his whole work could help at least somebody to improve their quality of life. 

As a Cushing’s disease survivor ten years ago ... and now with a relapse of Cushing’s syndrome I keep wondering how is it possible that Dr. Burton’s work remains unknown,  wasted, buried and in oblivion.

For any of us either with Cushing’s Disease or Syndrome this drug is like the light at the end of the tunnel... I wish I could explain all this as clearly as I intended... and the reason why I post this topic is because I promised Dr. Burton I would try to help him to make his work known specially for all of us... and if somebody can help with a FDA contact and make this story known to them... that would be of so much help!!!

Thank to all of you for reading this, my best wishes for all... stay safe this pandemic

Regards from Querétaro, México

 Mayela 

https://www.intramed.net/contenidover.asp?contenidoid=48298 

Hi wondered if anyone could help me out - been suffering with these symptoms lately and wondered if cortisol could be the issue 

 

- Thinning legs 

- Fat building in the trunk (abdomen and chest)

- Seemingly more fat under my chin 

- Excessive fatigue even after a nights sleep 

- Weak muscles - mainly back /arms and shoulders 

- muscle wasting 

- Feeling very low and anxious 

 

Thanks in advance , 

Abstract

Background

Endoscopic transsphenoidal surgery (ETS) for the resection of pituitary adenoma has become more common throughout the past decade. Although most patients have a short postoperative hospitalization, others require a more prolonged stay. We aimed to identify predictors for prolonged hospitalization in the setting of ETS for pituitary adenomas.

Methods

A retrospective chart review as performed on 658 patients undergoing ETS for pituitary adenoma at a single tertiary care academic center from 2005 to 2019. Length of stay (LoS) was defined as date of surgery to date of discharge. Patients with LoS in the top 10th percentile (prolonged LoS [PLS] >4 days, N = 72) were compared with the remainder (standard LoS [SLS], N = 586).

Results

The average age was 54 years and 52.5% were male. The mean LoS was 2.1 days vs 7.5 days (SLS vs PLS). On univariate analysis, atrial fibrillation (p = 0.002), hypertension (p = 0.033), partial tumor resection (p < 0.001), apoplexy (p = 0.020), intraoperative cerebrospinal fluid (ioCSF) leak (p = 0.001), nasoseptal flap (p = 0.049), postoperative diabetes insipidus (DI) (p = 0.010), and readmission within 30 days (p = 0.025) were significantly associated with PLS. Preoperative continuous positive airway pressure (CPAP) (odds ratio, 15.144; 95% confidence interval, 2.596‐88.346; p = 0.003) and presence of an ioCSF leak (OR, 10.362; 95% CI, 2.143‐50.104; p = 0.004) remained significant on multivariable analysis.

Conclusion

For patients undergoing ETS for pituitary adenomas, an ioCSF leak or preoperative use of CPAP predicted PLS. Additional common reasons for PLS included postoperative CSF leak (10 of 72), management of DI or hypopituitarism (15 of 72), or reoperation due to surgical or medical complications (14 of 72).

 

Presented by


Jamie J. Van Gompel, M.D., B.S., Professor in Neurosurgery and Otolaryngology specializing in endoscopic/open skull base focusing on Pituitary tumors as well as Epilepsy at the Mayo Clinic in Rochester, Minnesota, USA

and
Garret W. Choby, M.D., a fellowship-trained rhinologist and endoscopic skull base surgeon practicing at the Mayo Clinic.

Objectives:




-          Understand the additional considerations that are key to performing endonasal surgery during the COVID pandemic
-          Identify the practice changes that are allowing pituitary surgery to proceed safely
-          Characterize the nasal cavity and nasopharynx as a reservoir for the coronavirus
-          Identify the risk of undergoing pituitary surgery during the Covid -19 pandemic




Register Now! 



 




After registering you will receive a confirmation email containing information about joining the Webinar. 

Date: Monday, May 11, 2020

Time: 4:00 PM Pacific Daylight Time  - 5:15 PM Pacific Daylight Time

Presented by

Nelson M. Oyesiku, MD, PhD, FACS
Professor of Neurosurgery and Medicine
Vice-Chairman, Neurosurgery Residency Program Director
Emory University School of Medicine

Register Now!

After registering you will receive a confirmation email containing information about joining the Webinar.

 

Date: Sunday, May 10, 2020

Time: 11:00 AM Pacific Daylight Time to 12:15 PM Pacific Daylight Time/ 2:00 PM - 3:15 PM Eastern Daylight Time