Podcasts about Acute

Acute medical management of valvulopathy.  Part II talks about the pathophysiology and management of stenotic valves: AS and MS.  Check out Rapid Sequence, ICUedu's new education project at rapidsequence.org   Great Core Ultrasound post on POCUS assessment of valvulopathy: https://coreultrasound.com/valves-2/  Additional content and educational resources at ICUedu.org

In today's healthcare environment, America's hospitals are experiencing increases in payer denials as a result of incorrect application of drug HCPCS units and a drug HCPCS modifier (JW/JZ).These denials have increased costs for providers, because the existing staff is either being redirected to spend more time on the issue or additional staff are being hired to resolve the drug charge denials. Healthcare industry professionals need an easy-to-use and cost-effective resource to submit their claims correctly the first time.During the next live edition of Talk Ten Tuesdays, senior healthcare consultant Tiffani Bouchard will review the current environment in which coders work while explaining how new technology tools and solutions have the potential Drew Updike to expedite the drug lookup process.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

Send us a textToday Vanessa & Heather discuss supporting acute illnesses with Homeopathy! Treating acutes with homeopathy instead of allopathic medicine is one of the best things you can do for your health or your family's health!Instead of suppressing your immune system, you teach your immune system to strengthen and self-heal. This way your body does the heavy lifting. Then you're less susceptible to that same pathology.Homeopathy is an amazing choice as the medicine for you and your family, because:1. Homeopathy has the ability to heal both acute & chronic diseases from a root-cause place. The correct indicated remedy will heal the reason you're susceptible to the disease.2. Homeopathy is safe & effective medicine without harmful side effects that has long lasting results.3. Homeopathy has the ability to heal genetic predisposition to diseases, which means it can turn genes that are expressed due to a trigger (jobs, antibiotics, birth control pills, steroids, over the counters, suppressed anger, grief, circadian mismatch, trauma & more ) back into the off position so those genes are no longer expressing.4. Homeopathy is a very affordable medicine. Remedies are quite inexpensive! This makes this care accessible to many people.5. Homeopathy reduces the need for suppressive therapies that have harmful side effects. When you use homeopathy, you won't need to turn to allopathic medicine. Homeopathy strengthens your health while conventional therapies can really suppress your immune system.6. Homeopathy strengthens the immune system by stimulating your body to self heal. With homeopathy your body does the heavy lifting. Homeopathy brings quantum coherence to the body at a cellular level by improving the spin rate of electrons.If you're ready to start learning how to use homeopathy check out these resources below! Book in  a session with Vanessa here https://brightlightwellnesscoach.com/servicesHomeopathy Courseshttps://brightlightwellnesscoach.com/homeopathy-coursesFree Homeopathy At Home Guide http://gem.godaddy.com/signups/425d2c01be2848b79193824b3e00c71f/jSupport the showFind Heather:https://www.instagram.com/heathercrimson/https://www.enlightenedmood.comDiscount codes:https://www.vivarays.com ➡️ Code: enlightenedmood.com for 10% offhttps://midwestredlighttherapy.com ➡️ Code: enlightenedmood for 10% offhttps://emr-tek.com ➡️ Code: enlightenedmood for 20% offFind Vanessa:https://instagram.com/bright_light_wellness/vanessabaldwin/https://www.instagram.com/healingfamilieswithhomeopathy/Website: https://brightlightwellnesscoach.com/Discount codes:https://midwestredlighttherapy.com/ ➡️ Code: Brightlightwellnesshttps://vivarays.com/ ➡️ Code: BrightlightwellnessFree Product Guide http://gem.godaddy.com/signups/3cdbe47a101a4d2d9b991e9b5c9a981e/join Free Homeopathy Guide ...

In this episode of the Braun Performance & Rehab Podcast, Dan is joined by Mitch Toda to discuss his principles and frameworks for acute injury management in athletes, including soft tissue injuries vs joint injuries.In this episode, we're joined by Mitch Toda, a seasoned sports medicine clinician and performance specialist with over 15 years of experience in elite soccer settings, including Major League Soccer, NCAA, and now the National Women's Soccer League. Mitch currently serves as the Head Athletic Trainer for the North Carolina Courage, where he leads the club's health and performance initiatives. He's known for his player-first approach, interdisciplinary leadership, and commitment to developing holistic strategies that support athlete well-being and performance at the highest level. Mitch is also one of the co-hosts of the PSATS Podcast, where he helps spotlight insights from professionals across the world of soccer sports medicine.LinkedIn: https://www.linkedin.com/in/michita-toda?utm_source=share&utm_campaign=share_via&utm_content=profile&utm_medium=android_appPodcast: https://open.spotify.com/show/1NKowmamllSGDGRtWxKdi3?si=OxjwWOzAQN2QpC_rrXSlxQFor more on Mitch, be sure to follow @mitchtodaatc*SEASON 6 of the Braun Performance & Rehab Podcast is brought to you by Isophit. For more on Isophit, please check out isophit.com and @isophit -BE SURE to use coupon code BraunPR25% to save 25% on your Isophit order!**Season 6 of the Braun Performance & Rehab Podcast is also brought to you by Oro Muscles. For more on Oro, please check out www.oromuscles.com***Season 6 of the Braun Performance & Rehab Podcast is also brought to you by Firefly Recovery, the official recovery provider for Braun Performance & Rehab. For more on Firefly, please check out https://www.recoveryfirefly.com/ or email jake@recoveryfirefly.comEpisode Affiliates:MoboBoard: BRAWNBODY10 saves 10% at checkout!AliRx: DBraunRx = 20% off at checkout! https://alirx.health/MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription!CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off!Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKeMake sure you SHARE this episode with a friend who could benefit from the information we shared!Check out everything Dan is up to by clicking here: https://linktr.ee/braun_prLiked this episode? Leave a 5-star review on your favorite podcast platform

When should you consider surgical management of chronic pelvic pain conditions? In this episode of the BackTable OBGYN podcast, Dr. Mark Dassel, a MIGS surgeon at Intermountain Health in Salt Lake City, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss medical and surgical management strategies for chronic pelvic pain, particularly endometriosis. --- SYNPOSIS Dr. Dassel emphasizes the importance of stopping the hormonal triggers associated with pain and explores various medical treatments, including hormonal therapies and the role of contraceptives. He also highlights his approach to surgical interventions such as endometriosis excision, endometrioma removal, and hysterectomy, and the importance of holistic treatment plans involving pelvic floor physical therapy and central pain modulators. The episode also covers the complexities of diagnosing and treating pelvic pain, the role of early intervention, and the value of multidisciplinary care. --- TIMESTAMPS 00:00 - Introduction 07:55 - Differentiating Causes of Chronic Pelvic Pain 10:13 - Multidisciplinary Care and Costs 14:26 - Acute vs Chronic Pain 17:00 - Centralized Pain 18:46 - When to Offer Surgery 23:42 - Fertility and Endometriosis 33:25 - Hormonal Suppression Post-Surgery 37:24 - Pelvic Floor Botox and Physical Therapy 44:42 - Hysterectomy for Pelvic Pain 51:53 - Nerve Ablation and Pain Management 57:10 - Final Thoughts

Effective communication is a critical skill in navigating clinical and non-clinical interactions to avoid disaster striking a facility's bottom line.In fact, poor communication directly impacts the bottom line. Today, amid a cacophony of competing and complex issues spanning generations and a range of viewpoints, there is an overarching need to foster collaboration.During the next live edition of Talk Ten Tuesday, Lorie Mills, director of health services for Primeau Consulting Group, will report on the importance of identifying both effective and ineffective communication practices, and their impact on organizational success.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• Point of View: Dr. James S. Kennedy, founder of CDI MD, will serve as the guest cohost, and will report on a topic that has caught his attention.

In today's VETgirl online veterinary continuing education podcast, we interview Dr. Khris Keller on his experience with diagnosis and treating acute onset pancreatitis. Often thought of as an around the holidays disease, it can be challenging to diagnose acute onset pancreatitis, as clinical signs can overlap with other diseases. The most common clinical signs include vomiting, diarrhea, abdominal pain, or that 'Ain't doing right' (ADR). Tune in to fine-tune diagnosing, supportive care, and treatment options for this disease!Sponsored By: Ceva Animal Health

Listen in as America’s most attractive audio engineer and her host talk craven politics, Machiavelli, infectious disease, trade wars, tariff’s, free trade , liberation day, and gullible evangelicals! Can someone please call the American Medical Association and let them know … Continue reading →

Most AI safety conversations centre on alignment: ensuring AI systems share our values and goals. But despite progress, we're unlikely to know we've solved the problem before the arrival of human-level and superhuman systems in as little as three years.So some are developing a backup plan to safely deploy models we fear are actively scheming to harm us — so-called “AI control.” While this may sound mad, given the reluctance of AI companies to delay deploying anything they train, not developing such techniques is probably even crazier.Today's guest — Buck Shlegeris, CEO of Redwood Research — has spent the last few years developing control mechanisms, and for human-level systems they're more plausible than you might think. He argues that given companies' unwillingness to incur large costs for security, accepting the possibility of misalignment and designing robust safeguards might be one of our best remaining options.Links to learn more, highlights, video, and full transcript.As Buck puts it: "Five years ago I thought of misalignment risk from AIs as a really hard problem that you'd need some really galaxy-brained fundamental insights to resolve. Whereas now, to me the situation feels a lot more like we just really know a list of 40 things where, if you did them — none of which seem that hard — you'd probably be able to not have very much of your problem."Of course, even if Buck is right, we still need to do those 40 things — which he points out we're not on track for. And AI control agendas have their limitations: they aren't likely to work once AI systems are much more capable than humans, since greatly superhuman AIs can probably work around whatever limitations we impose.Still, AI control agendas seem to be gaining traction within AI safety. Buck and host Rob Wiblin discuss all of the above, plus:Why he's more worried about AI hacking its own data centre than escapingWhat to do about “chronic harm,” where AI systems subtly underperform or sabotage important work like alignment researchWhy he might want to use a model he thought could be conspiring against himWhy he would feel safer if he caught an AI attempting to escapeWhy many control techniques would be relatively inexpensiveHow to use an untrusted model to monitor another untrusted modelWhat the minimum viable intervention in a “lazy” AI company might look likeHow even small teams of safety-focused staff within AI labs could matterThe moral considerations around controlling potentially conscious AI systems, and whether it's justifiedChapters:Cold open |00:00:00|  Who's Buck Shlegeris? |00:01:27|  What's AI control? |00:01:51|  Why is AI control hot now? |00:05:39|  Detecting human vs AI spies |00:10:32|  Acute vs chronic AI betrayal |00:15:21|  How to catch AIs trying to escape |00:17:48|  The cheapest AI control techniques |00:32:48|  Can we get untrusted models to do trusted work? |00:38:58|  If we catch a model escaping... will we do anything? |00:50:15|  Getting AI models to think they've already escaped |00:52:51|  Will they be able to tell it's a setup? |00:58:11|  Will AI companies do any of this stuff? |01:00:11|  Can we just give AIs fewer permissions? |01:06:14|  Can we stop human spies the same way? |01:09:58|  The pitch to AI companies to do this |01:15:04|  Will AIs get superhuman so fast that this is all useless? |01:17:18|  Risks from AI deliberately doing a bad job |01:18:37|  Is alignment still useful? |01:24:49|  Current alignment methods don't detect scheming |01:29:12|  How to tell if AI control will work |01:31:40|  How can listeners contribute? |01:35:53|  Is 'controlling' AIs kind of a dick move? |01:37:13|  Could 10 safety-focused people in an AGI company do anything useful? |01:42:27|  Benefits of working outside frontier AI companies |01:47:48|  Why Redwood Research does what it does |01:51:34|  What other safety-related research looks best to Buck? |01:58:56|  If an AI escapes, is it likely to be able to beat humanity from there? |01:59:48|  Will misaligned models have to go rogue ASAP, before they're ready? |02:07:04|  Is research on human scheming relevant to AI? |02:08:03|This episode was originally recorded on February 21, 2025.Video: Simon Monsour and Luke MonsourAudio engineering: Ben Cordell, Milo McGuire, and Dominic ArmstrongTranscriptions and web: Katy Moore

Overwhelm is a word that has come up a lot this week, for myself and clients, so I thought it would be the perfect topic for this week's solo episode! It got me thinking about the difference between overwhelm and full on burn out/breakdown and if there is a way to prevent both. My take is that overwhelm is inevitable and burn-out/breakdowns can be prevented. I talk about the latter in this episode yet mostly I focus on navigating overwhelm; preventative measures and tips to maneuver through it. On this solo episode I explain that when I say overwhelm I'm referring to the state where you can feel the cortisol (stress hormone) running through your body and find yourself having trouble remaining calm, civil, and not snapping or straight up yelling at others. It's a natural response to being pushed to your limit and having too much stress yet it's still important to understand and know how to work through. I give examples of my past week that led me into overwhelm and a client's account of managing 2 sick children under 2 and rightfully facing overwhelm as well. Earth Power Oracle, https://blueangelonline.com/shop/card-decks/oracle-cards/earth-power-oracle/* Women Waken Wednesdays will be held weekly on Wednesdays at 6pm PST starting in February! This is a virtual Women's group I'm holding for my beautiful listeners. I would love for you to join! Please contact me (IG or Email) for Zoom info!Donations To Women Waken To Support The Show Are Greatly Appreciated

Episode Summary: In this episode of Your Hope-Filled Perspective, I’m joined by my friend, Pastor Jessica Van Roekel, as we talk about something so many of us are facing today—the growing challenges of stress and a work-life balance that feels anything but balanced. Together, we share from our personal stories, our professional backgrounds, and, most importantly, from a place of faith. We offer practical strategies to help you reclaim peace, set healthy boundaries, and redefine what true success looks like. My hope is that through our honest conversation, you’ll be reminded that grace and flexibility are available, and that lasting peace is found when we anchor our lives in faith. Quotables from the episode: Stress is something we all face to a greater or lesser extent. We live in a culture that promotes “If it’s going to be, it’s up to me” but if we aren’t careful to attend to appropriate stress management, prolonged stress can have a detrimental impact on our physical, emotional, mental well-being. If we go too long, for too strong, ultimately our bodies will demand we stop. So how do we work toward better work-life balance? Stress comes from a variety of places, but if we don’t learn to manage stress, it will manage us. We as women struggle with the work/life balance in a unique way because culture tells us success is gained or lost in the workplace, yet we are often the primary caregivers for our family (including everything from laundry to holiday costume sewing to permission slip signing to kissing boo-boos). In 1970, about 43 percent of women ages 16 and older were in the labor force. By 2000, 61 percent of adult women were in the labor force and that has continued through today. Arguably, today women have more on their plates than a generation ago, with less down time to rest and restore. Stress is a physiological and psychological response that occurs when we perceive a threat or challenge that EXCEEDS OUR COPING RESOURCES. This perception triggers the body's CENTRAL STRESS MGMT SYSTEM, particularly the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (increased Heart Rate, Blood is directed to our muscles, increased alertness so you can face danger or run away) leading to the release of stress hormones like cortisol and adrenaline. Once stress passes, the HPA axis should return to normal but often doesn’t because we live life in a heightened state of stress. Our brain doesn’t know the difference between good stress and bad stress. While this natural stress response is useful for short-term danger, chronic stress keeps these hormones elevated for extended periods, which can harm both mental and physical health. Perfect balance is a myth; instead, balance is fluid and flexible. Sometimes career demands take precedence, while other times, family needs do. Extending grace to yourself and adjusting priorities based on seasons of life can prevent both guilt and burnout. The myth of “multi-tasking”—it’s physiologically impossible for your brain to multitask. Physically, chronic stress can cause headaches, muscle tension, fatigue, and a weakened immune system. It also raises the risk of heart disease, high blood pressure, digestive issues, and sleep disturbances, impacting overall physical wellness. Stress has significant effects on brain function and structure. ACUTE stress can sharpen focus and improve short-term performance by enhancing activity in brain regions like the amygdala and prefrontal cortex. However, chronic stress can have adverse effects and lead to structural changes in the brain, such as a reduction in the size of the hippocampus (affecting memory) and prefrontal cortex (affecting decision-making and executive function), while potentially increasing the size and activity of the amygdala (heightening emotional responses). Chronic stress often leads to constant worry, difficulty concentrating, and memory issues. The brain, under prolonged stress, struggles to function optimally, making it harder to focus and think clearly. Emotionally, prolonged stress can lead to feelings of irritability, anxiety, and even hopelessness and despair. It can cause mood swings and may contribute to depression, as persistent stress wears down emotional resilience. Constant connectivity has been shown to increase stress, as people may feel pressured by comparisons, notifications, and the need to stay updated. Increased academic and career pressures, societal instability, and economic uncertainty can all contribute to heightened stress. Having too much on our plate in one arena of our life leading to insufficient time and energy to devote to other areas of our life can spur stress. Consider adopting both a weekly and daily planning ritual across both your work and personal life whereby you establish the top 10 priorities for the week, then the top 3 priorities for each day, while circling the non-negotiable tasks. This narrows our focus and reduces the overwhelm of a long to-do list. When we consider that stress arises when situations exceed our coping resources and anxiety results from a fear of losing control, if we lower our expectations of others it leads to decreased stress & anxiety when things don’t measure up. Also, we often expect more from ourselves than do others. If you were to list everything you expect of yourself in a day or week, would you reasonably expect the same from others? Set Boundaries: we teach people how to treat us, and part of that is by setting and respecting boundaries. This includes learning to say “no” or “not now” gracefully and asking for help without guilt. Furthermore, appropriate boundary setting includes prioritizing non-negotiable family time, reserving specific hours for work, and protecting time for self-care. Consider Self-Care as Non-Negotiable: Redefine self-care as essential for your mental and physical health, including basics like adequate nutrition, exercise, scheduled rest breaks throughout the day, and consistent sleep-hygiene. Self-care also includes self-compassion especially on challenging days. There are no perfect days, but how we talk to ourselves on both good and challenging days matters! Pay attention to your thoughts and assess if you would talk to a friend the way you talk to yourself? Adopt a growth mindset: understanding that true success includes inner peace and joy, not just career milestones. Redefine “Success” in the Context of Balance: Never has anyone said at the end of their life that they wish they’d worked more. Consider envisioning a successful life that includes time for loved ones, mental wellness, and personal fulfillment. Return to Faith as Your Foundation: Surrender control to God and stay anchored in faith. Scripture References: Ecclesiastes 3 Matthew 11:28-30 “Come to Me, all who are weary and heavy-laden, and I will give you rest. “Take My yoke upon you and learn from Me, for I am gentle and humble in heart, and you will find rest for your souls. For My yoke is easy and My burden is light.” Isaiah 30:15 “This is what the Sovereign LORD, the Holy One of Israel, says: “Only in returning to me and resting in me will you be saved. In quietness and confidence is your strength. But you would have none of it.” Psalm 23 Recommended Resources: Reframing Rejection: How Looking Through a Different Lens Changes Everything By Jessica Van Roekel Sacred Scars: Resting in God’s Promise That Your Past Is Not Wasted by Dr. Michelle Bengtson The Hem of His Garment: Reaching Out To God When Pain Overwhelms by Dr. Michelle Bengtson, winner AWSA 2024 Golden Scroll Christian Living Book of the Year and the 2024 Christian Literary Awards Reader’s Choice Award in the Christian Living and Non-Fiction categories YouVersion 5-Day Devotional Reaching Out To God When Pain Overwhelms Today is Going to be a Good Day: 90 Promises from God to Start Your Day Off Right by Dr. Michelle Bengtson, AWSA Member of the Year, winner of the AWSA 2023 Inspirational Gift Book of the Year Award, the 2024 Christian Literary Awards Reader’s Choice Award in the Devotional category, the 2023 Christian Literary Awards Reader’s Choice Award in four categories, and the Christian Literary Awards Henri Award for Devotionals YouVersion Devotional, Today is Going to be a Good Day version 1 YouVersion Devotional, Today is Going to be a Good Day version 2 Revive & Thrive Women’s Online Conference Revive & Thrive Summit 2 Trusting God through Cancer Summit 1 Trusting God through Cancer Summit 2 Breaking Anxiety’s Grip: How to Reclaim the Peace God Promises by Dr. Michelle Bengtson, winner of the AWSA 2020 Best Christian Living Book First Place, the first place winner for the Best Christian Living Book, the 2020 Carolina Christian Writer’s Conference Contest winner for nonfiction, and winner of the 2021 Christian Literary Award’s Reader’s Choice Award in all four categories for which it was nominated (Non-Fiction Victorious Living, Christian Living Day By Day, Inspirational Breaking Free and Testimonial Justified by Grace categories.) YouVersion Bible Reading Plan for Breaking Anxiety’s Grip Breaking Anxiety’s Grip Free Study Guide Free PDF Resource: How to Fight Fearful/Anxious Thoughts and Win Hope Prevails: Insights from a Doctor’s Personal Journey Through Depression by Dr. Michelle Bengtson, winner of the Christian Literary Award Henri and Reader’s Choice Award Hope Prevails Bible Study by Dr. Michelle Bengtson, winner of the Christian Literary Award Reader’s Choice Award Free Webinar: Help for When You’re Feeling Blue Social Media Links for Host and Guest: Connect with Jessica Van Roekel: Website / Instagram / Facebook For more hope, stay connected with Dr. Bengtson at: Order Book Sacred Scars / Order Book The Hem of His Garment / Order Book Today is Going to be a Good Day / Order Book Breaking Anxiety’s Grip / Order Book Hope Prevails / Website / Blog / Facebook / Twitter (@DrMBengtson) / LinkedIn / Instagram / Pinterest / YouTube / Podcast on Apple Co-Host: Jessica Van Roekel is a worship leader, speaker, and writer who believes that through Jesus, personal histories don’t need to define the present or determine the future. She inspires, encourages, and equips others to look at life through the lenses of hope, trust, and God’s transforming grace. Jessica lives in rural Iowa surrounded by wide open spaces which remind her of God’s expansive love. She loves fun earrings, good coffee, and connecting with others. Hosted By: Dr. Michelle Bengtson Audio Technical Support: Bryce Bengtson Discover more Christian podcasts at lifeaudio.com and inquire about advertising opportunities at lifeaudio.com/contact-us.

World Health Day, which will be officially observed on Monday, April 7, will mark what organizers claim will be a year-long celebration. Here at ICD10monitor and Talk Ten Tuesdays, we will celebrate a bit early, during the next edition of the Talk Ten Tuesdays live Internet broadcast.Headlining the broadcast will be Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association.This year's World Health Day theme focuses on efforts to end preventable maternal and newborn deaths, and “to prioritize women's longer-term health and well-being.”The World Health Organization (WHO) cites published estimates that nearly 300,000 women lose their lives due to pregnancy or childbirth annually. The WHO also states that more than 2 million babies die during their first month of life, and that 2 million more are stillborn.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

Inflammation is at the root of most of our common chronic diseases. In this episode, I'll explain what inflammation is, and we'll review the differences between acute and chronic inflammation.We'll also talk about the main contributors to chronic inflammation. In part two, we'll review what you can do with nutrition and lifestyle to reduce chronic inflammation and the risk of getting diagnosed with a chronic disease.Go check out my website for tons of free resources on how to transition towards a healthier diet and lifestyle.You can download my free plant-based recipes eBook and a ton of other free resources by visiting the Digital Downloads tab of my website at https://www.plantbaseddrjules.com/shopDon't forget to check out my blog at https://www.plantbaseddrjules.com/blog You can also watch my educational videos on YouTube at https://www.youtube.com/channel/UCMpkQRXb7G-StAotV0dmahQCheck out my upcoming live events and free eCourse, where you'll learn more about how to create delicious plant-based recipes: https://www.plantbaseddrjules.com/Go follow me on social media by visiting my Facebook page and Instagram accountshttps://www.facebook.com/plantbaseddrjuleshttps://www.instagram.com/plantbased_dr_jules/Last but not least, the best way to show your support and to help me spread my message is to subscribe to my podcast and to leave a 5 star review on Apple and Spotify!Thanks so much!Peace, love, plants!Dr. Jules

Lower back pain is something most of us have experienced at some point. Whether it's from sitting too long, lifting something heavy, or just the wear and tear of daily life, it's a common issue. But with so many treatments available, which ones actually work? A team of researchers set out to answer this question in a massive study published in BMJ Evidence-Based Medicine. Gathering data from hundreds of previous studies, the researchers analysed 301 randomized controlled trials, covering 56 different treatments for low back pain. These treatments ranged from exercise and spinal manipulations to medications like NSAIDs (non-steroidal anti-inflammatory drugs) and antidepressants. To make the study even more precise, they divided the results into two categories: Acute low back pain (pain lasting less than 12 weeks). Chronic low back pain (pain lasting 12 weeks or more). Then, they compared each treatment to a placebo to see if it actually provided pain relief. The good news is that some non-surgical treatments do work, though not as dramatically as you might hope. For acute low back pain, NSAIDs (like ibuprofen) were the only treatment found to be effective, with a small but measurable pain reduction. For chronic low back pain, five treatments stood out: Exercise: Physical movement tailored to strengthen the back and improve flexibility. Spinal manipulative therapy: Techniques often used by chiropractors to adjust the spine. Taping: Using supportive tape to stabilize muscles and joints. Antidepressants: Certain medications that seem to reduce pain perception. TRPV1 agonists: A class of treatments that target pain receptors. Each of these treatments provided modest pain relief, meaning they worked better than a placebo, but not by much. What Doesn't Work? Some common treatments, surprisingly, did not provide significant pain relief. For acute low back pain, these treatments were found not to be effective: Exercise (which works better for chronic pain but not short-term pain). Glucocorticoid injections (steroid shots that are sometimes used for inflammation). Paracetamol (acetaminophen) (commonly recommended but found to be ineffective in this study). For chronic low back pain, these treatments failed to provide significant benefits: Antibiotics (sometimes prescribed for infections that might cause pain, but no clear benefit). Anaesthetics (numbing agents that didn't prove effective for long-term relief). Many treatments had inconclusive results, meaning there wasn't enough strong evidence to say whether they truly help. These included: Acupuncture Massage Heat therapy Laser therapy Electromagnetic therapy This doesn't necessarily mean they don't work, just that more high-quality research is needed. So, if you have low back pain and are looking for non-surgical options, the research suggests: If your pain is short-term, NSAIDs may help. If your pain is chronic, consider exercise, spinal manipulative therapy, taping, antidepressants, or TRPV1 agonists. Some treatments commonly recommended (like paracetamol and steroids) might not be as effective as previously thought. Many alternative treatments show promise but need better studies to confirm their benefits. See omnystudio.com/listener for privacy information.

On this "Outside Hospitalist" segment, Dr. Gabi Hester speaks with guest Dr. Courtney Herring, Pediatric Hospitalist, about evidence-based care of acute respiratory illnesses and nuances to consider in differently resourced settings.

What's stress got to do with your health? Only everything! But, is all stress bad? How about acute vs chronic stress? Is there a difference? Why can two people experience the same external stressor, but one develops high blood pressure while the other seems to handle it without missing a beat?  We're delving into stress, our body's response to stress, and outcomes from the stress-filled world we current exist in.

Sitzen ist das neue Rauchen. Und überhaupt: Wer rastet, der rostet. Allerdings: In Deutschland haben wir ein Problem mit Übergewicht, mit Herz-Kreislauf-Erkrankungen - unter anderem weil wir uns zu wenig bewegen. Die Weltgesundheitsorganisation empfiehlt Erwachsenen pro Woche mindestens 150 bis 300 Minuten moderate Ausdauerbelastung oder mindestens 75 bis 150 Minuten intensive körperliche Belastung - und mindestens an zwei Tagen pro Woche kräftigende Übungen. Aber wieso ist Sport überhaupt gesund? Was passiert in unserem Körper, wenn wir uns bewegen? Wieviel Sport müssen wir machen, um bestimmten Krankheiten vorzubeugen? Zusammen mit Synapsen-Host Lucie Kluth spricht Wissenschaftsjournalistin Sarah Emminghaus über sogenannte Weekend-Worriors, über die Frage, wie Sport bei Angsterkrankungen helfen kann und warum es hilfreich sein kann, in Sportkleidung ins Bett zu gehen. HINTERGRUNDINFORMATIONEN 1. Studie über die Entdeckung des Myokins IL-6: Pedersen BK, Steensberg A, Fischer C, Keller C, Keller P, Plomgaard P, et al. Searching for the exercise factor: is IL-6 a candidate? J Muscle Res Cell Motil. 2003;24(2-3):113-9. doi:10.1023/a:1026070911202. 2. Studie über das Exerkin BDNF bei Panikpatienten: Ströhle A, Stoy M, Graetz B, Scheel M, Wittmann A, Gallinat J, et al. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology. 2010 Apr;35(3):364-8. 3. Studie über das Ausbleiben der Menstruation bei Sportlerinnen: Gimunová M, Paulínyová A, Bernaciková M, Paludo AC. The prevalence of menstrual cycle disorders in female athletes from different sports disciplines: a rapid review. Int J Environ Res Public Health. 2022 Oct 31;19(21):14243. 4. Studie darüber, dass Spaß am Sport eine Rolle für Motivation spielen dürfte: Rhodes RE, Kates A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med. 2015 Oct;49(5):715-31. 5. Studie über das Hormon ANP und seine Rolle bei Angst: ​​Ströhle A, Feller C, Strasburger CJ, Heinz A, Dimeo F. Anxiety modulation by the heart? Aerobic exercise and atrial natriuretic peptide. Psychoneuroendocrinology. 2006 Oct;31(9):1127-30. 6. Studie über den Zusammenhang zwischen Bewegung und Krebs: Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176(6):816-25. doi:10.1001/jamainternmed.2016.1548. 7. Studie über den Zusammenhang zwischen Bewegung und psychischen Krankheiten: Singh B, Olds T, Curtis R, et al. Effectiveness of physical activity interventions for improving depression, anxiety, and distress: an overview of systematic reviews. Br J Sports Med. 2023;57:1203-9.

Sitzen ist das neue Rauchen. Und überhaupt: Wer rastet, der rostet. Allerdings: In Deutschland haben wir ein Problem mit Übergewicht, mit Herz-Kreislauf-Erkrankungen - unter anderem weil wir uns zu wenig bewegen. Die Weltgesundheitsorganisation empfiehlt Erwachsenen pro Woche mindestens 150 bis 300 Minuten moderate Ausdauerbelastung oder mindestens 75 bis 150 Minuten intensive körperliche Belastung - und mindestens an zwei Tagen pro Woche kräftigende Übungen. Aber wieso ist Sport überhaupt gesund? Was passiert in unserem Körper, wenn wir uns bewegen? Wieviel Sport müssen wir machen, um bestimmten Krankheiten vorzubeugen? Zusammen mit Synapsen-Host Lucie Kluth spricht Wissenschaftsjournalistin Sarah Emminghaus über sogenannte Weekend-Worriors, über die Frage, wie Sport bei Angsterkrankungen helfen kann und warum es hilfreich sein kann, in Sportkleidung ins Bett zu gehen. HINTERGRUNDINFORMATIONEN 1. Studie über die Entdeckung des Myokins IL-6: Pedersen BK, Steensberg A, Fischer C, Keller C, Keller P, Plomgaard P, et al. Searching for the exercise factor: is IL-6 a candidate? J Muscle Res Cell Motil. 2003;24(2-3):113-9. doi:10.1023/a:1026070911202. 2. Studie über das Exerkin BDNF bei Panikpatienten: Ströhle A, Stoy M, Graetz B, Scheel M, Wittmann A, Gallinat J, et al. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology. 2010 Apr;35(3):364-8. 3. Studie über das Ausbleiben der Menstruation bei Sportlerinnen: Gimunová M, Paulínyová A, Bernaciková M, Paludo AC. The prevalence of menstrual cycle disorders in female athletes from different sports disciplines: a rapid review. Int J Environ Res Public Health. 2022 Oct 31;19(21):14243. 4. Studie darüber, dass Spaß am Sport eine Rolle für Motivation spielen dürfte: Rhodes RE, Kates A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med. 2015 Oct;49(5):715-31. 5. Studie über das Hormon ANP und seine Rolle bei Angst: ​​Ströhle A, Feller C, Strasburger CJ, Heinz A, Dimeo F. Anxiety modulation by the heart? Aerobic exercise and atrial natriuretic peptide. Psychoneuroendocrinology. 2006 Oct;31(9):1127-30. 6. Studie über den Zusammenhang zwischen Bewegung und Krebs: Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176(6):816-25. doi:10.1001/jamainternmed.2016.1548. 7. Studie über den Zusammenhang zwischen Bewegung und psychischen Krankheiten: Singh B, Olds T, Curtis R, et al. Effectiveness of physical activity interventions for improving depression, anxiety, and distress: an overview of systematic reviews. Br J Sports Med. 2023;57:1203-9.

In part 2 of our series on gout, Dr. Michael Pillinger is back to talk about treatment strategies in the acute setting, as well as how to approach urate-lowering therapies in the outpatient setting. He and Dr. Gutowski discuss the impact of lifestyle changes on gout control, and review the elements that may trigger a gout attack.

Thank you for tuning in for another episode of Life's Best Medicine. P.D. Mangan is is a 68-year-old scientist with expertise in microbiology, biochemistry, and pharmacology. Passionate about the impact of diet and exercise on anti-aging and longevity, he champions metabolic health, the value of real foods, and the importance of resistance training. In this episode, Dr. Brian and P.D. talk about… (00:00) Intro (05:13) Chronic fatigue, sleep, and how to crush fatigue for good (16:11) Exercise, fatigue, and health (21:28) How to work work effectively and efficiently (26:58) Acute versus chronic stress (29:38) Carb loading (33:45) Why running too much can be unhealthy for your heart (36:58) How P.D. Mangan would start with a coaching client who has been relatively sedentary for a long time (42:57) Strength training, losing body fat, and insulin resistance (47:51) Strength training, being sedentary, and acute pain (51:09) Some observations that have surprised P.D. over the course of his coaching career (53:40) Alcohol, exercise, and carbs (58:14) Advice and inspiration for getting started with your health journey (01:06:21) Outro and plugs For more information, please see the links below. Thank you for listening!   Links:   Resources Mentioned in this Episode: Mark Sisson on the Life's Best Medicine Podcast: https://lifesbestmedicine.com/podcast/episode-236-mark-sisson/   P.D. Mangan: Instagram: https://www.instagram.com/pdmangan/ X: https://x.com/Mangan150 Website: https://pdmangan.com Crush Chronic Fatigue (new book!) https://www.amazon.com/Smash-Chronic-Fatigue-Concise-Science-Based-ebook   Dr. Brian Lenzkes:  Arizona Metabolic Health: https://arizonametabolichealth.com/ Low Carb MD Podcast: https://www.lowcarbmd.com/   HLTH Code: HLTH Code Promo Code: METHEALTH • • HLTH Code Website: https://gethlth.com

This week on the show, I'm sharing insights into managing acute integration – the crucial window after a plant medicine journey where wisdom is most alive and ready to be embodied. Here's what you'll learn:Bridging the afterglow — how to honor the off ramp and stay in your bubbleEarthy first steps: Hydration, nutrition, and physical grounding practicesJournaling — the importance of capturing raw insights and downloads before they fadeNature as an integration ally: Earthing, tree meditation, and decoding symbolic messages.Making space to feel: Inviting the water of your heart to guide youWhen to seek support—saying yes to asking for helpAnchoring your spiritual fire — putting yourself first so you can BE the medicineWORK WITH SINCLAIRNEST Group Integration Membership - https://sinclairfleetwood.com/nest1:1 Private Coaching - https://sinclairfleetwood.com/psychedlic-integrationSubscribe to The Visionary Within weekly newsletter - https://mystical-heart-collective.kit.com/5623fed941FREE Ultimate Guide to Healing with Psychedelics: https://mystical-heart-collective.kit.com/ultimate-guideRetreats: https://sinclairfleetwood.com/events

BUFFALO, NY - March 31, 2025 – A new #research paper was #published in Oncotarget, Volume 16, on March 21, 2025, titled “FGR Src family kinase causes signaling and phenotypic shift mimicking retinoic acid-induced differentiation of leukemic cells." A research team led by first author Noor Kazim and corresponding author Andrew Yen from Cornell University discovered that the FGR protein—traditionally considered a cancer-promoting molecule—can instead trigger leukemia cells to mature. This effect mirrors the response usually induced by retinoic acid (RA); a compound derived from vitamin A that is widely used in cancer therapy. Their finding presents a potential new path for therapies targeting acute myeloid leukemia (AML) and related cancers. Acute myeloid leukemia is often treated using RA-based therapies that force immature white blood cells to mature, slowing their rapid growth. Retinoic acid works through complex signaling and gene regulation involving a group of proteins that orchestrate this transformation. In this study, the team used HL-60 cells, a model for human leukemia, and engineered them to express FGR. Surprisingly, the presence of FGR alone was enough to make these cells mature in a way almost identical to what happens with RA treatment. They began producing well-known markers of maturation such as CD38 and CD11b, generated reactive oxygen species (ROS), and expressed the inhibitor of the cell cycle, p27, all signs that the cells had shifted from a cancer-like, fast-dividing state to a more specialized, mature form. Further analysis revealed that FGR activated a group of proteins known as the "signalsome," which helps trigger the changes needed for cells to differentiate. This same group is typically activated by RA. “Notably, FGR induces the expression of genes targeted by RAR/RXR, such as cd38 and blr1, even without RA." To test its potential use in treatment-resistant leukemias, the researchers introduced FGR into RA-resistant HL-60 cells. In these, FGR did not cause the same maturation process, which suggests that there are other problems with cell signaling that stop both the RA and FGR pathways. This result highlights the complexity of resistance mechanisms and the need for additional research. These findings challenge the traditional view of FGR as strictly a cancer-driving protein. Instead, in this specific context, it appears to initiate anti-cancer behavior. That a single protein can reproduce the effects of a complex therapeutic compound like RA is both surprising and promising. If future research confirms this study's results in more advanced models, FGR could become a new tool for developing therapies for AML and potentially other blood cancers. DOI - https://doi.org/10.18632/oncotarget.28705 Correspondence to - Andrew Yen - ay13@cornell.edu Video short - https://www.youtube.com/watch?v=v2fjeFFoUPQ Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Social Determinants of Health and 30-Day Readmission After Acute Myocardial Infarction in the REGARDS Study

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Changes in Liver Function Tests, Congestion, and Prognosis After Acute Heart Failure: The STRONG-HF Trial

National Doctors' Day is Sunday, March 30. Even though the national one-day observance is only a few days away, the ICD10monitor producers of Talk Ten Tuesdays want to ensure that everyone is aware of the significant contributions made daily by America's doctors. Hence, our recognition of the occasion will continue during the next live edition of the popular weekly Internet broadcast.As part of the celebration, physician and attorney Dr. John K. Hall has been invited to be the special guest on Talk Ten Tuesdays. Dr. Hall, a popular panelist on Monitor Mondays, has distinguished himself as an astute reporter of healthcare news: he introduced the audience to the concept of Chevron Deference at the time when little information was available on an unprecedented development.Dr. Hall will report on two virus outbreaks in particular that have captured the attention of Americans.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

Text us, We would love to her from YOU!The Universe is speaking… are you listening? Too often, we brush off divine nudges, gut feelings, and unexplainable “coincidences” as random events. But what if those moments were actually powerful messages guiding you toward your highest path? In this mind-expanding episode, Dr. Sandra Marie sits down with Karoleen Fober, an intuition mastery coach, divine energy reader, and author of Opening to Divine Intervention. Karoleen has experienced over 450 divine interventions (yes, you read that right!), and she's here to show you how to trust your intuition, recognize divine guidance, and step into an effortless state of flow. Here's what you'll learn:✅ How to recognize the signs & synchronicities guiding you daily✅ The biggest mistakes people make when ignoring divine energy (and how to fix it!)✅ The ACUTE method to unlock and strengthen your intuition ✅ Why your energy frequency determines what you attract (and how to shift it!)✅ The key to breaking free from fear and resistance ✅ How to activate divine flow and start receiving clear, undeniable guidance!RESOURCES & LINKSGrab Karoleen's book Opening to Divine Intervention on AmazonTake Karoleen's FREE Intuition Assessment

Time is money. And nowhere is that adage more relevant than in today's American hospitals.For example, consider the patient who is medically ready for discharge, but still waiting for a skilled nursing facility (SNF) bed to open up. Or the case in which a patient might medically require a cardiac catheterization before being safely cleared to discharge to home, but there's a delay until the procedure can be performed on Monday.So, when is it okay to delay?Answering that question as well as reporting on the nuances of such delays will be Juliet Ugarte Hopkins, MD, the special guest during the next edition of the long-running and popular Talk Ten Tuesdays broadcast produced by ICD10monitor.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

In this brief report from the BMC2 registry published in JACC and presented at ACC.25, Eric Cantey, MD, FACC, and Celina Yong discuss the study findings. In light of the DanGer Shock Trial, there is a need to define the current practice patterns in the care of AMI-CS. There is overall low annual case volumes of AMI-CS with significant heterogeneity in the intraprocedural utilization of MCS and RHC.

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal. References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309

Overwhelmed by nutrition advice?You're not alone.From sketchy influencer “secrets” to Big Food's algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.Because good nutrition shouldn't be this complicated.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

In this episode of PICU DOC on Call, Dr. Rahul Damania and Dr. Pradip Kamat chat about a challenging case involving a 15-year-old girl dealing with acute myocarditis and worsening respiratory failure. They explore the intricate dance between the heart and lungs, especially how positive pressure ventilation can affect heart function. They cover important topics like cardiac output, preload, and afterload, and discuss the delicate balance needed to manage myocarditis effectively. The episode offers practical tips for optimizing care for critically ill children, underscoring the importance of personalized treatment plans and teamwork in pediatric critical care. Tune in!Show Highlights:Clinical case of a 15-year-old girl with acute myocarditis and respiratory failureImportance of understanding cardiopulmonary interactions in pediatric critical careEffects of positive pressure ventilation on cardiac functionKey concepts of cardiac output, preload, and afterload in the context of myocarditisChallenges of managing hemodynamic instability in critically ill pediatric patientsDifferences between spontaneous breathing and positive pressure ventilationStrategies for optimizing preload and fluid management in myocarditis patientsTailoring ventilatory support and transitioning to invasive mechanical ventilationMonitoring for arrhythmias and managing myocardial function with inotropic supportImportance of frequent assessments and collaboration with cardiac ICU teams for patient careManagement StrategiesOptimizing Preload:Volume depletion is common in patients with hypotension and tachycardia. A careful fluid challenge is important to restore circulatory volume, but fluid overload should be avoided, especially with impaired left ventricular function.Tailoring Ventilatory Support:Adjust BiPAP settings to improve oxygenation without overloading the heart with excessive positive pressures.Use the optimal level of PEEP to recruit alveoli while maintaining adequate venous return to the heart.Supporting Myocardial Function:Inotropic support (e.g., milrinone) may be necessary to improve myocardial contractility. Milrinone also provides vasodilation, which can reduce afterload but must be used cautiously due to its potential to lower blood pressure.Frequent Reassessments:Bedside echocardiography and regular monitoring of biomarkers (lactate, BNP) and clinical status are essential for ongoing evaluation.In severe cases, advanced therapies like ECMO may be required if the patient's hemodynamic status continues to deteriorate.

FH is a 66-year-old woman who comes in for an urgent visit because she has been feeling woozy for two days. She is very anxious, almost distraught, because she thinks these symptoms are the same as the ones that her sister had before she died of a hemorrhagic stroke.Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.A few years ago, a team building exercise was proposed at a meeting I was attending. To say I hate team building exercises is a gross understatement. I usually run for the door when these are suggested. On this day, I was too slow. For the exercise, I sat back-to-back with a partner who looked at a picture projected onto a screen. I could not see the picture. He described the image, and I had to draw what he described. After 5 minutes, I shared my drawing, and we discussed what worked and what didn't.Recently, I was at the Art Institute of Chicago, one of my favorite places on Earth, preparing to help lead a group of medical students around the museum. Our guide described a similar exercise while looking at a painting of a woman in mourning. Because my mind was on medicine, it struck me how similar this exercise is to what I do in clinic.All diagnostic inquiries start with a patient experiencing a symptom. The symptom is a kind of platonic truth. What can make the search for an accurate diagnosis difficult is that a doctor seldom really has access to this truth. The doctor does not see or feel the symptom. Instead, the patient is asked to translate a sensation into language. Sometimes, the patient's linguistic abilities are inadequate for describing the symptoms. Sometimes, our language itself is not up to the task.Often there are issues working against the patient accurately describing his or her symptoms. The patient is anxious, in pain, exaggerating or minimizing symptoms, being rushed, or distracted.No one can say if a patient is poorly describing his or her symptoms; that would be like telling someone that their description of red is incorrect.FH describes her symptoms as wooziness. The doctor seeing her, Dr. S, not having a differential diagnosis for wooziness, asks her, “What do you mean woozy. FH says, “I feel floaty, foggy, out of it, off kilter.” FH is already getting a little exasperated. She is worried she might be having a fatal stroke.To make a diagnosis, a doctor must characterize the concern, translating the patient's words into a symptom with an established differential diagnosis and an associated diagnostic approach. This is where many diagnostic errors occur. This might happen if the doctor is not listening. But it also might happen if the doctor mischaracterizes what the patient is feeling because of how the patient reports the symptom. When that happens, the doctor begins evaluating a symptom that is not actually present.The approach to the dizzy patient should begin with the doctor asking, “What do you mean dizzy?” and then just sitting quietly while the patient describes the dizziness. This question is supposed to force the patient to characterize the dizziness as vertigo, orthostasis, disequilibrium, or non-specific dizziness. When Dr. S asked, “What do you mean by woozy?” she had decided that woozy meant dizzy and proceeded as if FH had complained of dizziness.The clinical interchange has just started and already the patient has translated her symptom into language and Dr. S has translated that into a medically useful symptom.After hearing wooziness described as “floaty, foggy, out of it, off kilter,” Dr. S. had had it with open ended questions. “When you feel woozy, does it feel like the room is spinning? Or does it feel like you are going to faint, you know like when your vision grays out? Or do you feel off balance, kind of drunk.”FH answered, “Yes.”At this point, we have a patient who is terribly worried about her condition and a doctor who is likely reconsidering her decision to come to work today.In my experience, this juncture is not uncommon. A patient is having symptoms that need to be addressed. The way these symptoms are being presented linguistically is not leading the doctor to a familiar, workable symptom. Dr. S has tried to shoehorn woozy into the diagnostic rubric for dizzy and, not surprisingly, has gotten nowhere.OK, tell me exactly what you were doing when you first got woozy?” asks Dr. S.“I had just woken up. I rolled from my left side to my right to grab my phone to check the time and then I just about lost it. I mean really lost it. I was woozy AND nauseated.”Dr. S. got really lucky. Although her interpretation of woozy as dizzy failed in her first two questions, she stuck with it with one more question. She hit on a suggestive answer, something that sounds like benign, paroxysmal, positional vertigo, BPPV. She performs the Dix Hallpike Maneuver and FH screams out. She has the most striking rotatory nystagmus Dr. S has ever seen.“Are you feeling the wooziness?”“Yes, this is exactly the sensation.”At this point, the symptom has become a visible, objective sign.What to take from all this? We always need to remember that reported symptoms are translations, one step removed from what is bringing a patient in. Unless you are lucky enough to be a dermatologist, when you can actually look at the problem, seeds for medical errors are sown as soon as a patient describes, translates, his or her symptom. The less specific the symptom, the more likely it is that the doctor will proceed down the wrong path. Acute onset pain at the base of the great toe might be reported as aching, burning, or searing, but you're likely to end up thinking about gout.Fatigue, on the other hand, might be describing tired, or weak, or sleepy, or short of breath. The differential diagnoses for those four translations probably includes every known diagnosis. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

On this "Outside Hospitalist" segment, Dr. Gabi Hester speaks with guest Dr. Courtney Herring, Pediatric Hospitalist, about evidence-based care of acute respiratory illnesses and nuances to consider in differently resourced settings. 

Emergency treatment may be necessary after a person's first seizure or at the onset of abnormal acute repetitive (cluster) seizures; it is required for status epilepticus. Treatment for these emergencies is dictated by myriad clinical factors and informed by published guidance as well as emerging research.   In this episode, Lyell K. Jones, MD, FAAN, speaks with David G. Vossler, MD, FAAN, FACNS, FAES, author of the article “First Seizures, Acute Repetitive Seizures, and Status Epilepticus,” in the Continuum® February 2025 Epilepsy issue. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Vossler a clinical professor of neurology at the University of Washington School of Medicine in Seattle, Washington. Additional Resources Read the article: First Seizures, Acute Repetitive Seizures, and Status Epilepticus Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ  Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Dave Vossler, who has recently authored an article on emergent seizure management, taking care of patients with the first seizure, acute repetitive seizures, and status epilepticus, which is an article in our latest issue of Continuum covering all topics related to epilepsy. Dr Vossler is a neurologist at the University of Washington, where he's a clinical professor of neurology and has an active clinical and research practice in epileptology. Dr Vossler, welcome. Thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Vossler: Thank you very much for the introduction, Lyell. It's a pleasure to speak with you on this podcast, and I hope to go over a lot of important new information in the management of seizure emergencies. As you said, I'm a clinical professor in neurology at University of Washington, been in medicine for many decades now and have published and done research in this area. So, I'm anxious to give you not only my academic experience, but also talk about my own management of patients with status epilepticus over the last four decades. Dr Jones: Yeah, that's fantastic. And I always appreciate hearing from experienced clinicians, and I think our readers and our listeners do appreciate that voice of clinical expertise. And I'll tell you this is a topic, you know, as a neurologist who doesn't see many patients with acute seizure emergencies in my own practice, I think this is a topic that gives many clinicians, including neurologists, some anxiety. Your article, Dr Vossler, is really chock-full of helpful and clinically relevant considerations in the acute management of seizures. So, you now have the full attention of a huge audience of mostly neurologists. What's the one most important practice change that you would like to see in the care of patients with either first or acute prolonged seizures? Dr Vossler: Without a doubt, the most important clinical takeaway with regard to the status epilepticus---and for status epilepticus, many, many clinical trials, research trials have been done over the last couple decades and they all consistently show the same thing, that by and large most patients who have status epilepticus are underdosed and undertreated and treated too slowly in the initial stages of the status epilepticus. And it's important to use full bolus dosages of benzodiazepines to prevent mortality, morbidity, and later disability of these patients. To prevent the respiratory depression, many physicians are afraid to use higher doses of benzodiazepines, even guideline-recommended doses of benzodiazepines for fear of respiratory depression. But it's actually counterintuitive. It turns out that most cases of respiratory depression are due to inadequate doses and due to the status epilepticus itself. We know there's greater mortality, we know there's greater morbidity and we know that there's greater need for higher dose, subsequent, anti-seizure medications, prolonged status, if we don't use the proper doses. So, we'll kind of go over that a little bit, but that is the one clinical takeaway that I really would like our listeners to have. Dr Jones: Let's follow that thread a little bit. Dave, I know obviously we will speak in hypotheticals here. We're not going to talk about actual patients, but I think we've all been in the clinical situation where you have a patient who comes into the emergency room usually who's actively seizing, unknown history, don't know much about the patient, don't know much about the circumstances of the onset of the seizure. But we now have a patient with prolonged convulsive seizures. How do we walk through that? What are the first steps in the management of that patient? Dr Vossler: Yeah, well, I'll try to be brief for the purposes of the podcast. We do, of course, go through all of that in detail in the Continuum article, which hopefully everybody will look at very carefully. Really in the first table, the very first table of the article, I go through the recommended guideline for the American Epilepsy Society on the management of what we call established status epilepticus. The scenario you're talking about is just exactly that: established status epilepticus. It's not sort of evolving or developing status. We're okay they're having a few seizures and we're kind of getting there. No, this patient is now having evidence of convulsive seizure activity and it's continuing or it's repeated seizures without recovery. And so, the first phase is definitely a benzodiazepine and then the second phase is then a longer-acting bolus of a drug like phosphenotoine, valproic acid or levetiracetam. I could get into the details about dosing of the benzodiazepines, but maybe I'll let you guide me on whether we wanted to get into that kind of detail right at the outset. It's going to be a little bit different. For children, its weight-based dosing, but for adults, whether you use lorazepam or you use diazepam or you use midazolam, the doses are a little bit different. But they are standardized, and gets back to this point that I made earlier, we're acting too slow. We're not getting these patients quick enough, for various reasons, and the doses that are most commonly used are below what the guidelines call for. Dr Jones: That's great to know, and I think it's fine for the details to refer our listeners to the article because there are great details in there about a step-by-step approach to the established status epilepticus. The nomenclature and the definitions have evolved, haven't they, Dr Vossler, over time? Refractory status epilepticus, new-onset refractory status epilepticus, super refractory status epilepticus. Tell us about those entities, how they're distinguished and how you approach those. Dr Vossler: That's an important thing to kind of go over. They- in 2015, the International League Against Epilepsy, ILAE, which is, again, our international organization that guides our understanding of all kinds of things epileptic in nature around the world. In 2015 they put out a definition of status epilepticus, but it used to be that patients had thirty minutes of continuous seizure activity or repetitive obvious motor seizures with impairment of awareness and they don't recover impairment between these seizures. And that goes on for thirty minutes. That was the old definition of status epilepticus. Now, the operational definition is five minutes. And I think that's key to understand that, after five minutes of this kind of overt seizure activity, you need to intervene. And that's what's called T1 in the 2015 guideline, the international guideline. There are a bunch of different axes in the classification of status that talk about semiology, etiology, EEG patterns, and what age group you're talking about. We won't really get into those in the Continuum article because that's really more detailed than a clinician really should be. Needing to think about the stages, what we call the stages of status epilepticus that you mentioned and I alluded to earlier are important. And that is sort of new nomenclature, and I think probably general neurologists and most emergency room physicians aren't familiar with those. So, it just briefly goes through those. Developing status epilepticus is where you're starting- the patient's starting to have more frequent seizures, and it's heading essentially in the wrong direction, if you will. Established status epilepticus, as I mentioned, is, you know, this seizure act, convulsive or major, major outward overt seizure activity lasting five minutes or more, at which time therapy needs to begin. Again, getting back to my point, what doesn't happen often enough is we're not- we're intervening too late. Third is refractory status epilepticus, which refers to status epilepticus which continues despite adequate doses of an initial benzodiazepine given parenterally followed by a full loading dose of a single non-sedating anti-seizure medicine, which today includes phosphenotoine IV valproic acid or IV levetiracetam. In the United States, and increasingly around the world, people really are using levetiracetam. First, it has some advantages. There's now proof from a class one NIH-funded trial. We know that these three drugs are equivalent at the full doses that I go over in the article. You have your kind of dealer's choice on those. Phenobarbital, which we used to use and I used as a resident as long as forty years ago, is really a second choice drug because of its sedating and other side effects. But around the world in resource-poor countries phenobarbital can be used and, in a pinch, certainly is an appropriate drug. And then finally, you mentioned super refractory status epilepticus and that's status that's persisting for more than twenty four hours. Now, despite initial benzo and non-sedating anti-seizure medicine, but also lasting more than twenty four hours while receiving an intravenous infusional sedating, anesthetizing anti-seizure medicine like ketamine, propofol, pentobarbital or midazolam drips. Dr Jones: So, it sounds like the definitions have evolved in a way that improves the outcomes, right? To do earlier identification of status epilepticus and more aggressive management, I think that's a great takeaway. If we move all the way to the other end of the spectrum, let's move to the ambulatory setting and we have a patient who comes in and they've had one seizure, they're an adult; one seizure, the first seizure. The key question is, how do we anticipate the risk of future seizures? But walk us through how you talk to that patient, how you evaluate that patient to decide if and when to start anti-seizure medicines. Dr Vossler: Well, it depends a little bit if it's an adult or a child, but the decision making process and the data behind it is pretty robust now. And the decision making process is pretty similar for adults and children, with some differences which I can talk about. First of all, first seizures. I think it's really important to stress that there's been so much research in this area. I'd like to get a cross point that they're not as innocuous as I think many general neurologists might suspect. We know that there is a two- to threefold increased risk of death in children and adults following a first seizure. Moreover, the risk of a second seizure, both in kids and adults, is about 36% two years after that first seizure. It's about 46% five years after that first seizure. It's really pretty substantial. The risk of a second seizure is increased twofold. It doubled in the presence of any kind of a history of prior brain insults that could result in seizures. Could be infections, it could be a prior stroke, it could be prior significant brain trauma. It's also doubled in the presence of an EEG, which shows epileptiform discharges like spikes and sharp waves---and not just a sort of borderline things like sharply contoured rhythmic Theta activity. That's really not what we're talking about. We're talking about overt epileptiform discharges. It's doubled in the presence of lesion that can be seen on imaging studies, and it's doubled in the presence of seizures if that first seizure occurs during sleep. So, we have a number of things that double the risks, above the risk of a second seizure, above that 36% at two years and 46% at five years that I spoke about. And so those things need to be considered when you're counseling a patient about that. Should you be on an anti-seizure medicine after that first seizure? Specifically, to the point of anti-seizure medications, the guideline that was done, the 2015 guideline that was done by the American Academy of Neurology for adults, and the 2003 guideline was actually a practice parameter that was done by the Academy and the American Epilepsy Society for children, are really kind of out of date. They talk about the adverse effects of anti-seizure medications, but when you look back at the studies that were included in developing that practice parameter for kids and guidelines for adults, they are the old drugs: carbamazepine, phenytoin, phenobarbital and valproate. Well, I don't think I need to tell this audience, this well-educated audience, that we don't use those drugs anymore. We are using more modern anti-seizure medicines that have been developed since 1995; things like lamotrigine, levetiracetam, and lecosamide. Those three in particular have very low adverse events. So, the guideline that the Academy, American Academy Neurology and American Epilepsy Society put together for kids and for adults talks about this high adverse event profile. And so, you need to take a look at the risks that I talked about of a seizure recurrence and balance that against adverse effects. But I'm here to tell you that the newer anti-seizure medicines---and by newer I'm talking in the last thirty years since lamotrigine was approved in 1995---these drugs have much better side effect profiles. And I think all epileptologists would agree with that. They're not necessarily more effective, but they are better tolerated. That makes the discussion of the risk of a second seizure, the risk of mortality versus side effects of drugs, it really pushes the risk category higher on the first side and not on the side of drugs. We know that if you take an anti-seizure medicine, you reduce your risk of a second seizure by half. Now, that's not sustained over five years, but over the first two years, you've reduced it by half. In a person who's driving, needs to get to work, has to take the kids to school, whatever, most of my patients are like, yeah, okay, sign me up. These drugs are really pretty well tolerated. There's a substantial risk of a second seizure. So, I'll do that. In a kid,  a child that's, you know, not driving yet, that might be a different discussion. And the parents might say, well, I'd rather not have my son exposed, my daughter exposed to this. They're trying to go to school. They're trying to learn. We don't want to hinder that. We'll wait for a second seizure and then if they have a second seizure, which by the way is, you know, one of the definitions of epilepsy, well then they have epilepsy, then they probably will need to go on the seizure medication. Dr Jones: Great summary, Dr Vossler, and it is worth our audience being aware that the evidence has evolved alongside the improvement in the adverse effect profile. And sounds like your threshold is a little lower to treat then maybe it would have been some time ago, right? Dr Vossler: I would say that's exactly correct in my opinion. Particularly for adults, absolutely. Dr Jones: That's fantastic, Dr Vossler. I imagine there are a lot of aspects of caring for these patients that are challenging, and I imagine many scenarios are actually pretty rewarding. What do you find the most rewarding aspect of caring for patients with acute seizure management? Dr Vossler: Yes, I mean, that is really true. I would say that the most challenging things are treating refractory status epilepticus, but worse yet, new onset refractory status epilepticus and the super refractory status epilepticus, which I talk extensively about or write extensively about in the article and provide a lot of guidance on. Really, those conditions are so challenging because they can go on for such a long time. Patients are hospitalized for a long time. A lot of really good clinical guidance doesn't exist yet. There is a tremendous amount of research in that area which I find exciting, and really there's an amazing amount of international research on that, I think most of our audience probably is unaware of. And certainly, with those conditions, there is a high risk of later disability and mortality. We go through all of that in the article. The rewards really come from helping these people. When someone was super refractory status and it were non- sorry, new onset refractory status epilepticus, has been in the hospital for thirty days, it gets really hard for everybody; the family, the patient. And for us, it wears on us. Yet when they walk out the door, and I've had these people come back to the epilepsy clinic and see me later. We're managing their anti-seizure medications. They've survived. The NORSE patients often have substantial disability. They have cognitive and memory and even some psychiatric disability. But yet we can help them. It's not just management in the hospital, but it's getting to know these people, and I take them from the hospital and see them in my clinic and manage them long-term. I get a lot of great satisfaction out of that. We're hoping to do even better, stop patients' status early and get them to recover with no sequelae. Dr Jones: What a great visual, seeing those patients who have a devastating problem and they come back to clinic and you get the full circle. And what a great place to end. Dr Vossler, thank you so much for joining us, and thank you for such a thorough and fascinating discussion on the importance of understanding and managing patients with the first seizure, acute repetitive seizures, and status epilepticus. Dr Vossler: Thank you very much, Lyell. Dr Jones: Again, we've been speaking with Dr Dave Vossler, author of an article on emergent seizure management, first seizures, acute repetitive seizures and status epilepticus in Continuum's most recent issue on epilepsy. Please check it out, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Terry takes some inspiration from Stephanie Allard's February 27th for this edition of the CodeCast podcast. Terry discusses the differences and subjective issues between Acute Uncomplicated Illness (or Injury) versus Acute Complicated Illness in the E/M elements of coding and auditing. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 […] The post Acute Uncomplicated vs. Acute Complicated E/M Auditing appeared first on Terry Fletcher Consulting, Inc..

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A 70 year old man with a history of BPH, HTN and dyslipidemia presents with a 3-day history of perineal pain, intermittent fever, dysuria, and difficulty initiating urine stream. He denies GI upset and is taking fluids without difficulty. He denies sexual activity with others for the past three years. He is alert, oriented and appears slightly uncomfortable while seated. Abdominal and scrotal exam are WNL, there is no penile discharge and digital rectal exam reveals a tender, enlarged prostate. UA reveals positive leukocyte esterase and > 10 WBCs per HPF. With a working diagnosis of acute bacterial prostatitis, which of the following is the most appropriate antimicrobial option in this clinical scenario?  A. Ciprofloxacin PO x 10 days B. IM Ceftriaxone as a one-time dose with doxycycline PO BID X 10 days C. IV piperacillin with tazobactam for 5 days D. Nitrofurantoin PO BID x 5 days.  Visit fhea.com to learn more!

Rare Disease Day takes place on the last day of February every year. More than 30 million people in the United States are affected by over 7,000 rare diseases. Acute hepatic porphyria (AHP) is one of these rare diseases and carries with it a substantial disease burden. Delayed diagnosis, misdiagnosis and missed diagnosis frequently occur in the journey of the person living with AHP, with the average time from symptom onset to diagnosis being 15 years. On today's episode, nurse practitioners (NPs) Drs. Laurie Connors and Paula Tucker discuss the clinical presentation and symptoms that are associated with AHP as well as management, attack prevention and treatment strategies. NPs are important members of the collaborative care team for people living with this condition and their families. A participation code will be provided at the end of the podcast — make sure to write this code down. One you have listened to the podcast and have the participation code, return to this activity in the CE Center. Click on the "Next Steps" button of the activity and Enter the participation code that was provided. Complete the post-test . Complete the activity evaluation. This will award your CE credit and certificate of completion. 0.75 CE, 0.25 RX, will be available through Feb. 28 , 2026.   This activity is supported by an independent educational grant from Alnylam.

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Acute Tubular Necrosis⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Renal section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

Which of the following clinical scenarios is most consistent with an older adult presenting with acute bacterial prostatitis?  A. A 65  year old male who presents with a 6 month history of urinary frequency, occasional difficulty initiating urine stream, without dysuria or fever. GU exam within normal limits with the exception of prostate enlargement.  B. A 50-year-old male with a 4 day history of increased urinary frequency, end-void dysuria, and intermittent fever. GU exam reveals suprapubic tenderness,  without  prostatic enlargement or scrotal abnormalities.  C. A 70 year old man with a 3-day history of perineal pain, intermittent fever, dysuria, and difficulty initiating urine stream. Scrotal exam WNL and digital rectal exam reveals a tender, enlarged prostate.  D. A 78 year old man with a 3 month history of intermittent gross hematuria and urinary frequency without dysuria. GU exam is WNL with the exam of a nontender enlarged prostate with multiple nodular lesions.  Visit fhea.com to learn more!

Veterinary surgeon Debbie Tacium, 55, wanted to flip the script of my menopause. After suffering pain, loss of coordination, weakness, and changes in body composition during perimenopause, she went back to the sport she loved most in life–gymnastics. She wanted to use it to bring herself back to herself and remember what it was like to be a child who could fly. This week she shares her journey, what it's brought her, and what we can all learn from challenging our beliefs about what's possible during this season of life.Debbie (Debra) Tacium, DMV, works as a veterinary surgeon and is an adult gymnast, former competitive child and pre-teen gymnast, and all around self described “gymnastics nerd.” She came up through the sport in a time when you were schooled to push through pain and do what it took to be as small and light as possible. Acute and chronic injuries took her out of the sport until perimenopause when she returned to the sport determined to reclaim her body and open her mind to what was possible in your 50s. Now, she's experiencing joy instead of heartbreak and excited about where she can go next.Join the Feisty Girona Gravel Camp: https://www.thomsonbiketours.com/trips/feisty-girona-gravel-camp/ Subscribe to the Feisty 40+ newsletter: https://feistymedia.ac-page.com/feisty-40-sign-up-page Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Paradis Sport: Use code: FEISTY20 for 20% off any single item at https://paradissport.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/ Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get $125 off Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ This podcast uses the following third-party services for analysis: Spotify Ad Analytics - https://www.spotify.com/us/legal/ad-analytics-privacy-policy/Podcorn - https://podcorn.com/privacyPodscribe - https://podscribe.com/privacy

Master number 11 is a powerful frequency and vibration, representing heightened intuition, inspiration, and a call to action. Understanding its base frequency of 2 is crucial for accessing its transformative power. The energy of 2 focuses on polarity, relationships (self and other), balance, and harmony. It embodies the ebb and flow, the give and take, the yin and yang of existence. The master number 11 transcends the duality of 2, operating on a paradoxical plane where surrender leads to victory and giving away results in receiving. It's an alchemical process, a fine-tuned yet infinite knowing. 11 represents those "aha" moments, the eureka experiences that signify expanded consciousness. Working with the energy of 11 involves recognizing its frequency and utilizing it to heighten your intuition. Inspiration is a key component, fostering awareness, enthusiasm, and highly original thought. The call to action inherent in 11 is grounded through the practical application of 2. Honesty, both with oneself and as an objective observer, is essential. 11 calls you into awareness of your own cognizance and consciousness. Recognizing lower vibrational states, such as judgment, ego, and linear thinking, allows you to identify the polarity and stop the mental chatter. Understanding the interplay between 3D, 4D, and 5D energies is vital. While the 5th dimension embodies oneness, love, and abundance, the 3D world often pulls us through the 4th dimension, the realm of mind and emotions, creating polarity and triggering fight-or-flight responses. Strengthening your energetic boundaries is paramount. This can be achieved by pulling your aura closer, focusing on your breath, and grounding yourself in the present moment. The energy of 11 requires precision and fine-tuning. Being grounded and present allows connection to higher states of energy. 11 fuses duality and polarity together, raising the frequency of cells and DNA, leading to alchemy, magic, and synchronicity. Acute awareness may not always be blissful; it can sometimes highlight lower frequencies. Quickly recognizing and shifting out of judgment is essential. Observing yourself honestly allows you to see what the universe is reflecting back to you for integration. What are people mirroring? How does it make you feel? What is it bringing up? What comes easily? Now is the time to ground, settle in, be open and willing, and evaluate yourself with a willingness to change. 11 is fluid: embrace change easily and naturally. Finding the middle way, the rhythm and balance, is a practice. Recognize your gifts and be curious about growth. What are you becoming in the months ahead? What is the universe bringing for you to integrate? Additional Resources: BLOG: Master Number 11: A Gateway to Higher Dimensions and the Path of Divine Duality GUIDEBOOK: 2025 Astrology-Numerology Guidebook BLOG: 11: The Master Manifester in Numerology BLOG: 5D Consciousness: What It Is & How to Tap into this Higher Frequency PODCAST: Unlocking 5D Consciousness: Your Guide to Higher Awareness Send Amanda a DM: @SoulPathology or Email: Podcast@SoulSessions.meFollow Amanda on Instagram: https://www.instagram.com/soulpathology/See omnystudio.com/listener for privacy information.

Chronic stress is the #1 driver of chronic disease and accelerated aging—so how do we fight back?

We're launching a series called "All the Lonely People," diving deep into how loneliness shows up in our lives and how our culture shapes it. This week, why are moms so acutely lonely? Brittany hears from her listeners, and from the experts: Jessica Grose, New York Times opinion writer and author of the book Screaming on the Inside: the Unsustainability of American Motherhood, and parental burnout researcher at the Ohio State University, Kate Gawlik. They discuss what mom loneliness has to do with airplanes, lobotomies, and Tik Tok - and what we can do to help alleviate mom loneliness.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy