Podcasts about Acute

Dr. Tommy Wood, BM, BCh, PhD, is a professor of neuroscience at the University of Washington and an expert on brain health, neuroplasticity, and cognitive performance. Dr. Wood explains how to use specific forms of exercise, dietary strategies, and compounds to enhance the rate and stability of mental and/or physical skill development. We also discuss science-based tools to preserve cognitive function, reduce dementia risk, and offset loss of memory after a concussion or other brain injury. This episode provides practical, science-based tools for learning new information and skills and for improving your overall ability to learn. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman David: https://davidprotein.com/huberman Function: https://functionhealth.com/huberman Rorra: https://rorra.com/huberman Timestamps (00:00:00) Tommy Wood (00:04:05) Neuroplasticity; Neurogenesis; Synaptic Pruning (00:11:11) Aging & Neuroplasticity; Familiar vs Novel Tasks (00:14:33) Protocols Book; Sponsor: David (00:16:49) Aging, Training & Processing Speed (00:21:56) Enhancing Neuroplasticity with Age, Tool: Motor & Cognitive Challenge (00:26:56) Learning New Skills, Dance, Sports, Arts; Psychological Benefits of Challenge (00:36:50) Flow, Clutch States; Virtuosity (00:46:59) Power of Practice (00:50:55) Sponsor: AG1 (00:52:14) Tools for Focused Work & Learning; Distractions (01:00:17) Nutrition for Brain Health, Dementia; Critical Nutrients (01:06:56) Nutrient Timing, Supplementation; Omega-3s, Tool: Blood Tests (01:16:41) Sponsor: Function (01:18:19) Enhancing Brain Health, Nutrition & Supplements (01:23:10) GLP-1s, Peptides, Supplements & Evaluating Efficacy (01:32:56) Stimulants: Feeling vs Performance (01:37:18) Exercise & Enhancing Cognitive Function, Tool: Optimize Exercise Volume (01:43:18) Long-Term Cognitive Health & Exercise, HIIT (01:47:17) Sponsor: Rorra (01:48:31) Cortisol Benefits, Acute vs Chronic Stress (01:54:24) Resistance & Aerobic Exercise, Brain Gray & White Matter, Cognitive Health (02:03:37) Cognitive Decline, Dementia, Alzheimer's Disease, Modifiable Risk Factors (02:09:47) Shingles Vaccine & Dementia Risk; Tool: Avoid Illness for Cognitive Health (02:18:28) Concussion, Traumatic Brain Injury (TBI), Creatine (02:24:04) Treating TBI, Supplements, Physical Therapy (02:32:16) Strongman Competition (02:38:51) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

What actually helps when you're in the middle of acute grief and every day feels impossible? In this episode, I continue my two-part series on acute grief by sharing 10 practical strategies that supported me and the thousands of widows I've coached. My goal isn't to help you avoid grief, but to make the early days feel a little less overwhelming and a little more manageable. Get full show notes, transcript, and more information here: https://www.coachingwithkrista.com/373 Follow me on Instagram: https://www.instagram.com/lifecoachkrista/Mentioned in this episode:You're Invited to Grief Essentials LIVEJoin us for 8 weeks of expert guidance, practical tools and a community of widows who understand. Next live group begins August 4 – September 22, Tuesdays from 12:30-1:30pm Central Click here to learn more and sign up: https://the-widowed-mom-podcast.captivate.fm/grief-essentials-live Join us for Grief Essentials Live here Check Out Widow We Do Now? Wherever You Get Your Podcasts!

Send us a text if you want to be on the Podcast & explain why!A sudden shoulder pop during a heavy lift can mess with your head fast. We sit down with Dr. Coleman to map out what a smart, trainer-friendly response actually looks like when you or your client has acute shoulder pain and still wants to train safely.We talk about where a coach's scope begins and ends, why “never train anyone with pain” is unrealistic in the real world, and how to separate DOMS from true tissue irritation. Dr. Coleman shares a simple decision-making framework built around time and trend lines: how symptoms should change from day 0 to day 7, what it means when progress stalls at 10 to 14 days, and why a three-week plateau is often your referral point. We also dig into practical red flags, and why the shoulder can feel more ambiguous than a clearly swollen ankle or Achilles.On the training side, we get specific about movement selection. You'll hear how to use “target tissue” to decide whether an exercise is helping or just poking the bruise, when isometrics can be a better move than more reps, and which pressing positions tend to flare anterior shoulder or biceps tendon irritation. We also tackle the stretching debate, breaking down mobilize versus stabilize so you can make better calls instead of following trends.If you coach strength training, CrossFit, or general fitness, this is a clear, usable playbook. Subscribe, share this with a trainer friend, and leave a review with the shoulder issue you want us to cover next.Want to become a SUCCESSFUL personal trainer? SUF-CPT is the FASTEST growing personal training certification in the world!Want to ask us a question?  Email info@showupfitness.com with the subject line PODCAST QUESTION to get your question answered live on the show!Website: https://www.showupfitness.com/Become a Successful Personal Trainer Book Vol. 2 (Amazon): https://a.co/d/1aoRnqANASM / ACE / ISSA study guide: https://www.showupfitness.com

In this week's episode, Blood editor Dr. James Griffin interviews Drs. Haris Sohail and Lucas Kühne on their latest articles published in volume 147 issue 21 of Blood. In this CME article titled, "Retrospective, Real-World Study of IV Iron Use to Treat Iron deficiency Anemia During Acute Infection",  Sohail et al show that IV iron given during acute infection with iron deficiency anemia is associated with improved 14-day and 90-day survival as well as hemoglobin recovery. Although this report has the limitations of a retrospective study, these findings challenge current practice and support randomized trials that include patients with infection. In "Revisiting Clinical Response and Refractoriness in Immune Thrombotic Thrombocytopenic Purpura", Kühne et al show in a multicenter registry study of 204 patients that refractoriness during caplacizumab treatment in immune TTP is uncommon and, when observed, is typically associated with confounding clinical factors. These findings underscore the importance of careful clinical reassessment and evaluation for alternative etiologies in patients with delayed platelet recovery, rather than attributing such cases to true treatment resistance.

In this episode the guys break down five weird and common things people do that cause or worsen chronic pain — poor sleep, inflammatory diet, macro and micro deficiencies, dehydration, and shallow breathing. They cover the difference between acute pain and chronic pain, how movement pattern issues are almost always the root cause, and why the experience of pain can be just as real as the physiological signal. They also get into Arthur Saxon pressing 370 pounds overhead with one arm in 1905, eating 24 eggs and 10 pounds of meat a day, the genetics study showing hyper responders gain three times as much muscle as average responders, Sal going back to jiu jitsu and the whole family trying the Organifi parasite cleanse, Manukora honey on mat burns, and how poor sleep is the number one injury predictor — worse than skipping a warmup. Then they coach live callers submitted through mplivecaller.com. MAPS Upper Lower:⁠ https://mapsupperlower.com⁠Code: LAUNCH for 40% off. Includes male and female programs, workout videos, exercise demos, coaching videos and live coaching with Cole. Mind Pump Fitness Coaching:⁠ https://mindpumpfitnesscoaching.com⁠1.9 NASM CEUs SPONSORS Organifi (natural parasite cleanse):⁠ https://organifi.com/mindpump⁠Code: MINDPUMP for 20% off. Run two cycles 15 days apart. Discussed on air — Sal's whole family has started doing it. Manukora Manuka Honey:⁠ https://manukora.com/MINDPUMP⁠Code: MINDPUMP for up to 31% off plus $25 in free gifts with the Starter Kit. Discussed on air for wound healing and anti-inflammatory properties. Eight Sleep (Pod 5 Ultra) : ⁠https://eightsleep.com/mindpump⁠Code: MINDPUMP for up to $350 off. HSA/FSA may qualify — qualified customers save about 30% on average through Truemed. Truemed is for qualified customers. HSA/FSA tax savings vary. LINKS Submit a live caller question:⁠ https://mplivecaller.com⁠ Mind Pump Store:⁠ https://mindpumpstore.com⁠ Maps Fitness Products:⁠ https://mapsfitnessproducts.com⁠ Instagram: @mindpumpmedia 0:00 - Intro 2:20 - 5 weird things you do that make chronic pain worse 5:45 - Acute pain vs. chronic pain and why movement pattern issues are almost always the root cause 12:32 - Weird cause #1: Poor sleep — why it's worse for injury risk than skipping your warmup 16:00 - Weird cause #2: Diet and inflammation — Sal's gluten reaction and how to test for food intolerances 19:31 - Weird cause #3: Macro and micro deficiencies — protein, fat, magnesium and vitamin D 22:53 - Weird cause #4: Water intake — why hydration directly changes pain perception 26:52 - Weird cause #5: Shallow breathing — how breathing patterns keep muscles chronically tight 34:12 - Arthur Saxon — 370lb one-arm press in 1905, 24 eggs for breakfast and 10 pounds of meat at dinner 43:01 - Genetics study: hyper responders gain three times more muscle than average in six months 47:17 - Sal back at jiu jitsu, Manukora honey on mat burns and the whole family on parasite cleanses 1:00:32 - Caller: Candy (California) — went from 34 to 28% body fat eating more, freaked out and cut calories, gets a coach 1:16:26 - Caller: Jessica (Massachusetts) — 9 months postpartum, eating disorder history, 1742 calories, redlining 1:32:36 - Caller: Ruth (New Jersey) — 55 years old, chronic dieting history, gut issues derailing reverse diet 1:45:14 - Caller: Angela (Washington) — trainer and business owner, 20% body fat, chasing goals and needs a new direction  

What if some of the most frightening parts of acute grief are actually completely normal? In this episode, I begin a two-part series on acute grief by sharing ten things I wish someone had told me after my husband died. My goal isn't to make acute grief hurt less, but to help you stop wondering if you're grieving "wrong" when your mind and body respond in ways you never expected. Get full show notes, transcript, and more information here: https://www.coachingwithkrista.com/372 Follow me on Instagram: https://www.instagram.com/lifecoachkrista/Mentioned in this episode: Check Out Widow We Do Now? Wherever You Get Your Podcasts!You're Invited to Grief Essentials LIVEJoin us for 8 weeks of expert guidance, practical tools and a community of widows who understand. Next live group begins August 4 – September 22, Tuesdays from 12:30-1:30pm Central Click here to learn more and sign up: https://the-widowed-mom-podcast.captivate.fm/grief-essentials-live Join us for Grief Essentials Live here

Guest: Professor Brendan Kelly

THE HOMEOPATHY HEALTH SHOW The Art of Acute Prescribing & Sensory Case-Taking – A Conversation with Marcus Christo Episode Summary In this engaging and inspiring episode, we welcome Marcus Christo, one of the UK's most respected homeopaths, educators, and acute prescribing specialists. Drawing on more than three decades of clinical practice, teaching, and public service, Marcus shares the principles that have shaped his unique approach to homeopathy—from the bustling clinics of the Glastonbury Festival to educating the next generation of practitioners. This conversation explores the power of sensory perception, the importance of efficient case-taking, and how mastering acute prescribing can transform both practitioner confidence and patient outcomes. In This Episode We Explore A Journey into Homeopathy • Marcus's unexpected path into homeopathy through Great Ormond Street Homeopathic Hospital • The influence of Charles Elliott, Physician to the Queen • Early inspirations from local homeopaths and herbalists • Building a lifelong career dedicated to teaching and practice The Travelling Homeopaths Collective • The origins of the Glastonbury Festival homeopathic clinic • Treating hundreds of patients in busy festival environments • Working alongside St John Ambulance and other healthcare services • Bringing homeopathy to the public through outreach and education The Art of Sensory Case-Taking • Applying Aphorism 84 through the use of all the senses • Observing hearing, smell, taste, appearance, and behaviour during consultation • Asking open questions and allowing the patient's story to unfold naturally • Recognising key symptoms without unnecessary complexity Mastering Acute Prescribing • Why acute prescribing builds practitioner confidence • Understanding the complete disease journey • The importance of etiology and current modalities • Clinical examples demonstrating the effectiveness of acute remedies Teaching, Training & Professional Development • Educating homeopaths through practical, experience-based learning • Encouraging confidence in fast-paced prescribing situations • Supporting practitioners to simplify complex cases • Inspiring the next generation of homeopaths The Future of Homeopathy • The need to attract younger practitioners into the profession • Adapting homeopathy to modern regulations and public expectations • Raising awareness through festivals, education, and community outreach • Preserving the essence of classical homeopathy for future generations About Our Guest Marcus Christo FSHom is an internationally respected homeopath, educator, and Fellow of the Society of Homeopaths, recognised for his outstanding contribution to the profession. He is the founder of the Travelling Homeopaths Collective and has spent more than three decades teaching acute prescribing, sensory case-taking, and practical homeopathy to practitioners around the world. Known for his work at Glastonbury Festival and his dynamic teaching style, Marcus continues to inspire homeopaths through education, clinical excellence, and his commitment to making homeopathy accessible to the wider public. About the Homeopathy Health Show The Homeopathy Health Show - co-hosted and produced by Atiq Ahmad Bhatti and Naila Cheema - is the world's #1 homeopathy talk show, reaching a global audience through the UK Health Radio Network and all major podcast platforms. Atiq Ahmad Bhatti, a 4th Generation Homeopath, Teacher, Educator, and Global Ambassador for Homeopathy, is joined by Naila Cheema, an experienced Homeopath and Nutritionist. Together, they bring thoughtful conversations, expert insights, and a shared passion for holistic healing to every episode. Connect with the Hosts Atiq Ahmad Bhatti - Homeopath, Educator, Broadcaster Online: www.liketreatslike.co.uk Instagram: @like_treatslike Facebook: @liketreatslike YouTube: like_treatslike Naila Cheema - Homeopath, Nutritionist, Educator Online: https://homeopathynaila.com Instagram: @homeopathnaila Facebook: @Neeli.KC Stream Now Across All Platforms UK Health Radio: https://ukhealthradio.com/program/homeopathy-health/ Podbean: https://homeopathyhealth.podbean.com/ Apple Podcasts: https://podcasts.apple.com/us/podcast/homeopathy-health-with-atiq-naila/id1715524908 YouTube: https://www.youtube.com/@like_treatslike/featured Spotify: https://open.spotify.com/show/17rSCmlPGDkiSCyHePLPFx?si=51c640498df84727 Join Our Global Community of Listeners Hosted by: Atiq & Naila Top 5% Podcast Worldwide (ListenNotes Global Ranking) #1 Global Talk Show on Homeopathy Audience in 60+ Countries Real conversations. Real stories. Real homeopathy. Unlock the power of natural remedies to restore balance and vitality. Inspiring guests, expert insights, and global voices shaping the future of holistic medicine. Tune in, stay inspired, and explore the world of homeopathy with us. Homeopathy in Practice Explore webinars, masterclasses, education, and practitioner resources at: https://homeopathyinpractice.co.uk Join our global Facebook community @homeopathyinpractice    

In this episode of the SRP Podcast, hosts Denise Straiges and Alastair Gray dive deep into one of homeopathy's most misunderstood concepts: what does real healing actually look like—and what should clients truly expect when working with a homeopath?From Hahnemann's original writings to modern practice debates, they unpack the difference between gradual health restoration and quick-fix protocols that can overwhelm the vital force. Whether you're a practicing homeopath, a student, or someone considering working with a homeopath, this conversation will reshape how you think about outcomes in homeopathy.Episode Highlights✔️ What Does "Cure" Really Mean?Exploring Hahnemann's definition from the footnote to Aphorism 1 and why the word carries more complexity than popular marketing suggests.✔️ Acute vs. Chronic: Different ExpectationsWhy healing trajectories differ dramatically between short-term conditions and long-standing chronic disease patterns.✔️ The Vital Force Does the WorkUnderstanding how remedies function as keys rather than force—and why gentle intervention beats bombardment every time.✔️ Case Study: An Eight-Year Healing JourneyA detailed look at one young man's path from multiple diagnoses (EOC, Crohn's, PANDAS) to improved health—complete with acute flares that signaled progress, not regression.✔️ "Fake Homeopathy" vs. Hahnemannian PracticeHow to identify simplified protocol homeopathy practices vs. rigorous, principle-based treatment—including warnings about excessive nosode protocols and "detox" regimens.✔️ Miasmatic Disease in ContextWhy Hahnemann's thinking evolved from syphilis observations to the broader concept of chronic miasms—and what that means for modern practitioners.✔️ Mansplain CornerLight-hearted but pointed discussion about online discourse, unsolicited expertise, and the responsibility that comes with public homeopathic education.Mentioned in this Episode:

Acute confusion is often one of the first signs something is wrong. The sooner you identify the cause, the sooner your patient can get the treatment they need. Hit play to review 3 common causes to keep an eye out for. ___________________ ⁠Nursing School Survival Blueprint⁠ - Feeling overwhelmed or unsure how to approach nursing school? Download this free Blueprint to understand exactly what's working against you — and what to do instead. Straight A Nursing Study Resources⁠⁠ - ⁠Check out everything Straight A Nursing has to offer, including free resources and online courses to help you succeed!

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastSPONSOROriginal Sprout. Original Sprout carries safe and effective styling, body and hair care products that are safe for babies and great for adults. Use code BADASS26 at www.originalsprout.com for 25% off of your purchase.Do you have stress in your life?  Who doesn't, right? But the big question is…will stress impact your milk supply?  Is it the number 1 killer of milk supply?  Tune in today as Dianne and Abby talk about different types of stress and what stress really does to milk supply.  If you are feeling stress around anything, you don't want to miss this episode.If you are a new listener, we would love to hear from you.  Please consider leaving us a review on iTunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com.  You can also add your email to our list and have episodes sent right to your inbox!Things we talked about:Question about cavities [4:36]The BIG giveaway [13:50]#6 and #7 on the Top 10 list [14:36]Talking about stress [16:06]What really happens with stress [21:30]Ways to help with the stress [23:48]Acute stress vs chronic stress [30:35]The big takeaway [32:04]Things we talked about or Episodes we think you should check out!https://badassbreastfeedingpodcast.com/episode/getting-a-good-latch-2/https://badassbreastfeedingpodcast.com/episode/normal-sleep-behavior-with-rebecca-michi/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/  Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc,  http://www.diannecassidyconsulting.comMusic we use:Music: Levels of Greatness from We Used to Paint Stars in the Sky (2012) courtesy of Scott Holmes at freemusicarchive.org/music/ScottHolmes

Are your blood markers telling you and your doctor the whole story? Chronic inflammation is the silent driver behind nearly every major disease, and the good news is that your lifestyle choices decide the outcome. Don't wait for a life altering diagnosis to take action.In this episode of Salad With a Side of Fries, host Jenn Trepeck breaks down how blood markers move, how preventable diseases develop, and why epigenetics means your genes are not your fate. If you have ever felt like your health was out of your hands, this episode will change the way you think about your daily choices.What You Will Learn in This Episode:✅ Why chronic inflammation is considered the root cause of virtually every major illness and how oxidative stress accelerates disease progression in the body.✅ How epigenetics reveals that your lifestyle choices, not just your genetics, impact disease-related genes.✅ What specific blood markers to track for heart disease, type 2 diabetes, liver disease, and kidney disease, and realistic timelines for improving them.✅ How to advocate for yourself in a medical system still rooted in a prescription-first approach, and how to ask your doctor for the time and space to make disease prevention changes first.The Salad With a Side of Fries podcast, hosted by Jenn Trepeck, explores real-life wellness and weight-loss topics, debunking myths, misinformation, and flawed science surrounding nutrition and the food industry. Let's dive into real-life wellness and weight loss, including drinking, eating out, and skipping the grocery store.TIMESTAMPS:00:00 Preventable diseases don't have to be your story and what blood markers can and cannot tell you05:55 The most common diseases: heart disease, type 2 diabetes, and cancer and how they are linked to lifestyle choices06:46 Epigenetics explained: how your daily habits turn disease risk genes up or down17:21 Lifestyle choices, from gut health to the brain to the endocrine system, impact every organ system20:10 Oxidative stress and free radicals explained: the science behind chronic disease25:01 Lifestyle choices that support overall health rather than disease and healthcare 3.0, being your own advocate32:12 Discussion of food with no labels; vegetables, fruit and lean meat36:19 Movement as disease prevention: why sitting all day quietly drives chronic illness more than we realize41:06 Longevity, community, connection, sleep, and stress management as overlooked pillars of health42:05 Blood marker timelines: how fast insulin, A1C, cholesterol, and blood pressure respond to lifestyle changesKEY TAKEAWAYS:

In this first deep dive, Christopher Cogle explores the evolving landscape of acute myeloid leukaemia (AML). He discusses the challenge of translating research into real-world outcomes, emerging immunotherapies, precision diagnostics, and how innovations such as the Acute Leukemia Methylome Atlas may reshape AML management in the future.  Timestamps:  00:55 – Research Gaps  03:50 – Biologics  05:46 – AML Atlas  09:15 – Immunotherapy 

Shakings Coming (1) (audio) David Eells – 6-24-26 IT WILL SHAKE THE WORLD! Lynne Johnson 5-27-26 IAM, King Yeshuya wants you, My people to know that all will erupt soon in Iran. President Trump is playing a waiting game with the radicalized left in the IRGC for there are many factions vying for control. Trump is ensuring that when the United States military strikes Iran, the United States will have very few casualties. Trump doesn't want American casualties, therefore the United States is intending to use all intelligence being fathered to ensure few American casualties. When the U.S. Military strikes, there will be no doubt that the IRGC, in its radical form, is no longer in existence. Once assured of the success of this campaign, Trump will have the military pull back to the general areas away from Iran. Very shortly after the United States military pulls back from Iran, then Israel will strike. First, Damascus, Syria (a weapon depot) destroying it. Next, Israel will move against Iran's nuclear facilities along with their weapon depots. These strikes will effectively end Iran's nuclear program. Once this is concluded, then very shortly look for the First Event of MY Judgments (again these events of Mine, King Yeshuya, are not those of Tribulation, which are far worse, for a much longer time frame), the California earthquake which will shake the world as this earthquake is massive in size and in effect. I AM, King Yeshuya tells you this again so that you MY children, MY Believers are warned to plan, to prepare for what is soon to occur. IAM always warns ahead through MY prophets and messengers. Listen to My Words, heed My Warnings for they are to help protect you and your families. Continue MY children to come to ME in prayer, stay in MY Word, stay focused, stay calm. Come directly to ME, King Yeshuya with your queries. I AM will gladly answer you. IAM loves you MY children. Your King Yeshuya, the King of Kings and Lord of Lords, the Alpha and Omega, the Beginning and the End, the Most High, Commander of heaven's hosts and armies, the Lion of Judah, the Prince of Peace. Scriptures: Psalm 20:7 NKJV “Some trust in chariots and some in horses, but we will remember and trust in the name of the Lord our God.” Isaiah 43:2 NKJV “When you pass through the waters, I will be with you; and through the rivers, they will not overwhelm you. When you walk through fire, you will not be scorched, nor will the flame burn you.” Ezekiel 7:7 NKJV “Doom has come to you, you who dwell in the land; the time has come, a day of trouble is near, and not of rejoicing in the mountains.” Isaiah 17:1 NIV “A prophecy against Damascus: “See, Damascus will no longer be a city but will become a heap of ruins.” Isaiah 13:9 NKJV “Behold, the day of the Lord comes, cruel with both wrath and fierce anger, to lay the land desolate; and He will destroy its sinners from it.” Isaiah 13:6 NKJV “Wait, for the day of the Lord is at hand! It will come as destruction from the Almighty.” John 14:29 NKJV “And now I told you before it comes, that when it does come to pass, you may believe.” Lamentations 3:25 NKJV “The Lord is good to those who wait for Him, to the soul who seeks Him.”   FAMINE WILL EXTEND WORLDWIDE Lynne Johnson – 5-9-26 I AM, King Yeshuya, would like MY people to know that it is soon for the “Iranian Conflict” to conclude. It will end as IAM has stated; the United States will deploy missiles, which will effectively end the IRGC Regime's control over Iran. Then the United States will pull back their military, leaving destroyers, aircraft carriers, and such in the area. Shortly after the United States military is pulled back, Israel will strike Damascus, the other weapon depots in Syria, then strike Iran's nuclear facilities and weapon depots. Israel will present the truth with proof that Iran fully intended to finish the building of nuclear bombs to destroy Israel. There will be the usual outcry, but no one will “lift a hand” against Israel, for all of the surrounding Arab nations know the truth. They also know that they were not safe from Iran's nuclear attacks. Again MY children, this is your marker to know that you only have a short time to finish getting your food, to prepare for what is coming, MY First Event – Judgment upon California. Do not put off procuring your food, your other necessities. Use cash as much as possible and by going to different stores. Do not discuss storing food with ANY OTHERS as IAM has clearly stated unless you have spoken directly with ME, King Yeshuya, the King of Kings and Lord of Lords to find out who you are able to trust. Ensure that you get your answer from ME, BEFORE you talk with others. If you choose not to listen to ME here, you and your family will suffer harm. People will become desperate quickly for food – any food that they are able to find. They do not wish to share, and they will harm others to get food. Those who have not done so recently or at all, are to read Jeremiah – ALL OF IT! You will see what hunger does to people. There will be few people who you will be able to trust now, so be discreet and come to ME, King Yeshuya to find out who you can SAFELY SHARE YOUR FOOD WITH. You must also accept MY answer as final. IAM alone sees the hearts, minds, thoughts and intentions of ALL people! You do not. You must also understand that the famine will extend worldwide. It will not be located only in specific cities, areas, or countries. With the famine, there will be deaths and then pestilences due to these deaths. IAM will give you more specific detail on this soon. FOR NOW YOUR JOB IS TO PREPARE. COME DIRECTLY TO ME WITH YOUR QUESTIONS AS I AM WILL GLADLY ANSWER YOU. MY BELOVED CHILDREN, STAY IN PRAYER TO ME, STAY IN MY WORD, STAY FOCUSED, STAY CALM. Your King Yeshuya, the King of Kings and Lord of Lords, the Most High, the Alpha and Omega, the Beginning and the End, the Lion of Judah, the Prince of Peace Scriptures: Isaiah 17:1 NKJV “The burden against Damascus. “Behold, Damascus will cease from being a city, and it will be a ruinous heap.” Luke 21:11 NKJV “And there will be great earthquakes in various places, and famines and pestilences; and there will be fearful sights and great signs from heaven.” Psalm 9:8 NKJV “He shall judge the world in righteousness, and He shall administer judgment for the people in uprightness.” Ecclesiastes 8:6 NKJV “Because for every matter there is a time and judgment, though the misery of man increases greatly.” Psalm 76:8 NKJV “You caused judgment to be heard from heaven; the earth feared and was still.” Deuteronomy 8:6 NKJV “Observe the commands of the LORD your God, walking in obedience to Him and revering Him.” Proverbs 15:11 NKJV “Hell and Destruction are before the Lord; so how much more the hearts of the sons of men.” Psalm 112:5 NKJV “A good man deals graciously and lends; he will guide his affairs with discretion.” Deuteronomy 32:24 NKJV “They shall be wasted with hunger, devoured by pestilence and bitter destruction; I will also send against them the teeth of beasts, with the poison of serpents of the dust.” Romans 12:12 NKJV “Rejoicing in hope, patient in tribulation, continuing steadfastly in prayer,”   GOLDEN DOME MR POOL X - *GOLDEN DOME went fully operational on June 14, 2026.** Not announced. Not disclosed. ACTIVATED. Posted By: Lymerick 6-23-26 www.rumormill.news/269653   Mr. Pool @MrPool_QQ

The term ‘polycrisis' denotes a scenario where multiple crises occur at the same time. A new book titled ‘India Out of Work: Rethinking India's Growth Story', written by two economists, Santosh Mehrotra and Jajati Parida, argues that India is facing a polycrisis -- a structural economic crisis, an employment crisis, and the education system crisis, and looming overall of all of these, a potential demographic crisis. How did India land up in a polycrisis and what is the way out? Guest: Santosh Mehrotra, a professor of economics who has worked with the Planning Commission and the United Nations Host: G Sampath, Social Affairs Editor, The Hindu Producer and editor: Jude Weston Learn more about your ad choices. Visit megaphone.fm/adchoices

Low back pain is everywhere—but the best care is often beautifully simple.

You're not depressed. You're not in crisis. You're functioning, showing up, holding it all together. But something is still off, and you can't quite name it.This episode is for that person.Brandi and Dr. Desiree Caruso, ND sit down to break down the real biology behind low-grade mood dysregulation — the kind that doesn't show up in standard bloodwork but is absolutely happening in your body. We're talking about two specific functional mushrooms, lion's mane and reishi, and going straight into the mechanisms: the actual compounds, the actual pathways, and the actual research that explains why these mushrooms have a genuine relationship with how you feel.This is not a vibe episode. This is the science.We've been asked over and over again whether functional mushrooms can do something for mood, and if so, how. Today we answer that question properly. If you've ever walked out of a doctor's appointment feeling dismissed — told everything looks normal, maybe it's stress, maybe it's your age — this episode is what comes next.What you'll learn:Why mood is a physiological state, not just a feeling, and what that means for how you address itThe specific terpenoid compounds in lion's mane (hericenones) that can cross the blood-brain barrier and what they do once they get thereWhy BDNF is the mechanism most antidepressants are thought to work through, and how lion's mane stimulates it directlyHow 90% of your serotonin is produced in your gut, and exactly how lion's mane supports that pathwayThe three-directional approach lion's mane takes: blood-brain barrier, neuroinflammation, and gut-brain axis simultaneouslyWhat the HPA axis is, why chronic stress dysregulates it, and how reishi's ganoderic acids help restore the natural cortisol rhythmReishi's relationship with GABA, the brain's calming neurotransmitter, and why that explains the felt sense of settling downThe 2026 randomized controlled trial showing measurable reductions in anxiety, cortisol, and inflammation at 12 weeksHow disrupted sleep literally changes how your brain processes emotional information, and the two specific mechanisms reishi addresses to help with thatHow to self-diagnose which mushroom fits your experience right now, and what to track over four weeks to know whether it's workingResources Mentioned:Dr. Andrew Huberman episode on adenosine and coffee: https://www.hubermanlab.com/episode/using-caffeine-to-optimize-mental-and-physical-performanceVigna, L. et al. (2019). "Hericium erinaceus Improves Mood and Sleep Disorders in the Elderly." Journal of Medicinal Food, 22(5).Contato, A.G. & Conte-Junior, C.A. (2025). "Lion's Mane Mushroom (Hericium erinaceus): A Neuroprotective Fungus with Antioxidant, Anti-Inflammatory, and Antimicrobial Potential — A Narrative Review." Nutrients, 17(8), 1307.Frontiers in Nutrition (2025). "Benefits, side effects, and uses of Hericium erinaceus as a supplement: a systematic review." Frontiers in Nutrition, 12, 1641246.Ratto, D. et al. (2023). "Hericium erinaceus: Acute and Chronic Effects on Cognitive Function, Stress, and Mood in Young Adults." Nutrients, 15(22), 4842.Cui, X.Y. et al. (2012). "Extract of Ganoderma lucidum prolongs sleep time in rats." Journal of Ethnopharmacology / Pharmacology Biochemistry and Behavior. PMID: 22297086.Yong, V.K.J. et al. (2026). "A blend of medicinal mushrooms including Reishi reduces anxiety, cortisol and CRP in a 12-week randomized controlled trial." Brain and Behavior.Your Next Steps:Follow us on Instagram: https://www.instagram.com/eversiowellness/Shop Eversio Wellness and save 15% with code PODCAST15: https://www.eversiowellness.com/discount/PODCAST15?redirect=%2Fcollections%2Fall-productsTake our wellness quiz to find the right mushroom for you: https://www.eversiowellness.com/pages/take-our-quiz

In this episode of ASTCT Talks, host Dr. Corey Cutler, MD, from Dana-Farber Cancer Institute, is joined by Dr. Pooja Khandelwal, MD (Cincinnati Children's Hospital), Dr. Ben Watkins, MD (Tulane University), and Dr. Kenneth Cooke, MD (Johns Hopkins University) for an in-depth discussion on evolving strategies to prevent graft-versus-host disease (GVHD) in pediatric transplant.The conversation explores how leading centers are approaching GVHD prophylaxis across a range of clinical scenarios, with a focus on improving both acute and chronic GVHD outcomes. Experts compare platform-based approaches — including post-transplant cyclophosphamide, calcineurin inhibitor–based regimens, abatacept, and graft manipulation — and discuss how these strategies influence long-term transplant success.Key topics include:Current approaches to reducing acute and chronic GVHD in pediatric patients.Tradeoffs between prevention platforms, including immune reconstitution and infection risk.Emerging data on novel strategies, such as vitamin A and extended co-stimulation blockade.The role of GVHD-free survival as a key endpoint in transplant outcomes.Ongoing challenges and unmet needs in preventing chronic GVHD.While advances in prophylaxis are helping to reduce GVHD incidence, chronic GVHD remains a significant clinical challenge, underscoring the importance of continued innovation across the prevention-treatment continuum.This episode was supported by an educational grant fromIncyte.

AP correspondent Ed Donahue more people are facing hunger threats.

I'm joined by Bal Matharu to talk about how breathing links the nervous system, stress biology, and Long Covid symptoms, and why recovery often begins with creating a genuine felt sense of safety. We share practical ways to assess and change breathing patterns, plus the role of co-regulation, boundaries, and carefully held breathwork support. • Bal's path from advanced respiratory physiotherapy and ICU work to lifestyle medicine and PhD breathwork research • The six pillars of lifestyle medicine and why stress management often underpins the rest • Acute stress versus chronic stress and how the body shifts blood flow, hormones, and immune function • Cell danger theory, mitochondria, ATP, and why fatigue can be a protection signal • Safety as a felt sense through neuroception rather than a purely cognitive idea • Breath assessment basics, posture, high chest breathing, diaphragm use, and longer exhales • Overstimulation, silence avoidance, and letting emotions move through the body in short windows • Co-regulation, practitioner capacity, and building safe spaces for nervous system work • Boundaries, people pleasing patterns, and choosing relationships that support regulation • Selecting credible breathwork practitioners and avoiding unsafe cathartic methods Links:Bal's Website: https://www.bodymind-iq.com Embody Ecosystem: https://go.bodymind-iq.com/embody-ecosystemMessage me! (I can't reply to these messages) For more information about Long Covid Breathing courses & workshops, please check out LongCovidBreathing.com (music credit - Brock Hewitt, Rule of Life) Support the show~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~The Long Covid Podcast is self-produced & self funded. If you enjoy what you hear and are able to, please Buy me a coffee or purchase a mug to help cover costsTranscripts available on individual episodes herewww.LongCovidPodcast.comFacebook Instagram  Twitter Facebook Creativity GroupSubscribe to mailing listI love to hear from you, via socials or LongCovidPodcast@gmail.com**Disclaimer - you should not rely on any medical information contained in this Podcast and related materials in making medical, health-related or other decisions. Please consult a doctor or other health professional**

Episode Summary:In this engaging and informative episode of the Pain Matters Podcast, hosts Sudheer Potru, DO, FASA, FASAM, and Co-Host Zafeer Baber, MD, sit down with renowned chronic pain advocate, Tom Norris. With a four-decade-long journey through the challenges of chronic pain, Tom shares his invaluable insights regarding the newly drafted Acute Low Back Pain Guideline** (drafted by the Pacific Northwest Evidence-based Practice Center at Oregon Health & Science University (OHSU EPC) and the American Academy of Pain Medicine), recently submitted to Pain Medicine Journal and currently under review. His unique perspective underscores the critical need for clear communication and collaboration between clinicians and patients, especially in the context of guideline development and healthcare delivery. Throughout the discussion, the trio delves into practical strategies for managing acute and chronic pain, emphasizing the importance of patient-centered communication, the role of alternative therapies, and the power of support groups. Tom candidly discusses his military background and how it has shaped his ability to advocate effectively for himself and others within the medical community. The episode also explores the significance of understanding non-pharmacologic pain management techniques, such as virtual reality, acupuncture, and Tai Chi, and the need for greater awareness and education on these options. Anchored by Tom's wealth of experience and wisdom, this episode serves as a robust resource for both healthcare providers and patients seeking to enhance their pain management approaches.  Key Takeaways:Patient-Centered Communication: Building trust and understanding between clinicians and patients is crucial in effectively managing pain and implementing guidelines.  Integrative and Alternative Therapies: Non-drug approaches like acupuncture, virtual reality, and Tai Chi can be beneficial in managing pain, but public awareness about these methods is limited.  Support Groups' Role: Connecting with others facing similar pain challenges can provide essential support and insights, offering solace and practical advice.  Empowering Patients: Patients should proactively educate themselves, prepare questions for their providers, and seek various treatment avenues to optimize their care.  Guideline Development Insight: Having patients involved in the creation of medical guidelines ensures that the recommendations are practical and resonate with those they are designed to help. *Views expressed by our guests are their own and do not necessarily reflect those of the hosts, their institutions, or the American Academy of Pain Medicine. **The Pacific Northwest Evidence-based Practice Center (PNW-EPC) at Oregon Health & Science University (OHSU) is partnered with AAPM for the development of an evidence-based clinical practice guideline on the assessment and management of acute low back pain (ALBP). This project was financially supported by the Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award [FAIN] totaling $1,999,980.00, with 100 percent funded by FDA/HHS. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, FDA, HHS, or the U.S. Government. The funders had no decision-making role in designing and conducting systematic review, data collection, analysis, and interpretation of the data or approval privilege on the recommendation and good practice statements. As requested, the FDA provided nonbinding feedback and technical support to the guideline panel and methodological team. A methodologically rigorous systematic review  on assessment and management of ALBP was conducted by the PNW-EPC to provide evidence for guideline development. An independent, multidisciplinary guideline development used evidence from the systematic review to formulation evidence-based clinical recommendations to the guide assessment and management of ALBP.  

Brain Endurance Training and mental fatigue may be the missing link limiting your physical performance, and this episode reveals how your brain, not your body, could be the true bottleneck. In this high-impact conversation, Dr. Greg Jones sits down with Dr. Christopher Ring, Professor of Psychology at the University of Birmingham, to explore how cognitive load, stress, and perception of effort directly influence endurance, recovery, and overall performance.In this episode, you'll learn how mental fatigue can reduce physical output, why your brain acts as a “governor” on performance, and how Brain Endurance Training (BET) can help increase resilience, delay fatigue, and improve both cognitive and physical capacity. Dr. Ring explains the science behind perceived exertion (RPE), how stress impacts the nervous system, and why traditional training has overlooked one of the most critical components of performance.We also explore how modern lifestyles—especially screen time and cognitive overload—may be silently reducing exercise capacity, and how targeted brain training protocols can reverse these effects. Whether you're an elite athlete, a high-performing professional, or someone looking to improve focus and endurance, this episode provides a science-backed framework for building a more resilient brain and body.If you're looking to break through plateaus in performance, reduce fatigue, and train smarter, this episode offers a powerful and practical blueprint grounded in cutting-edge research.

Prehospital blood is one of the hottest debates in trauma resuscitation — and the evidence just got a lot more interesting. In this episode, Drs. Patrick Georgoff and Ayman Ali sit down with Dr. Ed Barnard, UK defense professor of emergency medicine and author of the landmark SWIFT trial, and Dr. Juan De Chesney, trauma surgeon and pioneer in prehospital blood programs, to break down what we actually know about getting blood to patients before they hit the doors. The SWIFT trial — the largest prehospital whole blood RCT to date — found no superiority of whole blood over component therapy, but the story is far more nuanced than a negative headline suggests. From the logistics of carrying blood on a helicopter to the stark reality that only 1.8% of US ground EMS carries any blood products at all, this conversation exposes both the progress and the enormous gaps that remain. Hosts: Ayman Ali, MD: Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital.  Patrick Georgoff, MD @georgoff: Patrick Georgoff is faculty in the Department of Surgery at the Duke University School of Medicine where he serves as an Associate Professor of Trauma, Acute, and Critical Care Surgery and Trauma Medical Director. He is a leading educator and creator for Behind the Knife, a premier digital education platform and podcast advancing surgical training through innovative, high-yield multimedia content. Juan Duchesne, MD: Juan Duchesne is a trauma surgeon and Professor of Surgery serving as the Trauma Medical Director and Division Chief at the University of Mississippi Medical Center. His pioneering contributions to the field—particularly in whole blood and balanced resuscitation practices—have been honored with numerous accolades.  Ed Barnard, PhD FRCEM FIMC RCSEd, @edbarn @DefProfEM: Ed Barnard is an emergency physician and UK Defence Professor of Emergency Medicine, RCEM/NIHR Associate Professor, and Affiliated Assistant Professor at the University of Cambridge. He has sub-specialty training in pre-hospital and academic emergency medicine and possesses extensive experience in trauma, anaesthesia, and critical care across both civilian and military settings. His contributions to the field have been honored with five national research awards and a PhD - undertaken with the US Army in San Antonio, TX. This episode was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Date: June 12, 2026 Guest Skeptic: Mr. Ross Fisher. Ross is a paediatric surgeon, presentation guru (P-Cubed), and long-time friend of the SGEM.  Reference: Talan et al. Nonoperative Treatment of Appendicitis and Implications for Emergency Department Management: A Narrative Review. Ann Emerg Med. June 2026 Case: A 29-year-old healthy man presents to the emergency department […] The post SGEM#512: When you go your way, and I Go Mine – Surgery or Antibiotics for Acute Appendicitis. first appeared on The Skeptics Guide to Emergency Medicine.

Frustrated with attempts to manage rehab patients with soft tissue injuries? Overwhelmed at the amount of evidence regarding modalities for these injuries? Imagine being able to spend one hour and gain an understanding of the current evidence for treatment of sprains/strains and soft tissue injuries. This podcast is a concise look at the evidence for management of soft tissue injuries and includes a deep dive into modalities which are used to help the rehab process.   To view accreditation information and access completion requirements to receive a certificate for completing this course, please click here.   The content of this Summit podcast is provided only for educational and training purposes for licensed physical therapists and occupational therapists. This content should not be used as medical advice to treat any medical condition in either yourself or others.

A guide to diagnosing, imaging, and managing acute renal colic and nephrolithiasis in the ED. Hosts: Brian Gilberti, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Nephrolithiasis.mp3 Download Leave a Comment Tags: Kidney Stones, Urology Show Notes 1. CLINICAL CORE & PHYSIOLOGIC FRAMEWORK Epidemiologic Risk Profiles Lifetime incidence parameters hover around 1 in 11, presenting with a prominent male sex skew. Peak demographic manifestation concentrated within the 30–60 age band. High-yield temporal parameter: 50% recurrence vector within a 5-year post-initial-insult window. Mineralogical Composition Vectors Calcium oxalate crystals represent the predominant structural matrix. Struvite configurations (magnesium ammonium phosphate matrix) account for 1–2% of cohorts. Struvite stones function explicitly as infection-driven configurations secondary to upper tract proliferation; higher distribution index noted in female cohorts. Etiological & Modifiable Relational Dynamics Profound systemic dehydration or low baseline fluid throughput states. High-sodium diet structures and heavy animal-protein consumption loads. Positive genetic/familial history variables. Relative risk modulation: Each variable independently operates to expand baseline risk by a factor of 2x to 3x. Pathophysiologic Symptom Complexes Acute, sudden-onset, maximum-intensity (10/10) unilateral flank pain. Classic structural radiation vector tracking downward toward the ipsilateral groin/genitourinary dermatomes. Distinctive behavioral marker: Renal colic pacing/writhing behavior with zero antalgic position availability. Concomitant autonomic triggers: Nausea and emesis manifest in 50% of acute presentations. Physical Exam Discordance Metrics Severe subjective distress contrasted with a characteristically soft, completely non-tender abdominal palpation exam. CVA tenderness is completely variable and lacks reliable negative predictive value. Atypical Presentation Classifications Vague, poorly localized abdominal pain presentations occurring in up to 20% of active cases. Isolated lower urinary tract irritative signs including acute frequency or severe urgency. Incidental & Asymptomatic Dynamics Silent intrarenal or ureteral stones found incidentally. Longitudinal tracking demonstrates up to 33.3% of initially asymptomatic cohorts convert to fully symptomatic renal colic within a multi-year tracking window. 2. EXCLUSION DIAGNOSES & CRITICAL PATHWAY RED FLAGS Vascular Mimics: AAA rupture/expansion. This is a mandatory exclusion pathway in elderly cohorts presenting with acute flank or back pain. Physical tracking requires active exploration for an expansile, pulsatile abdominal mass. Gynecologic Emergencies: Ruptured ectopic pregnancy. Demands universal screening protocols via rapid beta-hCG testing in all female patients of childbearing potential presenting with lower abdominal/pelvic localization. Infectious Upper Tract Decompensation: Acute uncomplicated pyelonephritis. Differentiated via persistent high spikes, high fevers, systemic shaking chills, and profound pyuria. Genitourinary Structural Crises: Acute testicular torsion. Mandates a thorough, explicit scrotal/testicular structural exam if the flank pain radiates into the scrotum. Gastrointestinal and Adnexal Torsional Confounds: Acute appendicitis variants, acute mesenteric/bowel ischemia, and ovarian torsion syndromes. 3. LABORATORY TESTING & PHYSIOLOGIC EVALUATION Urinalysis Interpretation Nuances Microscopic or gross hematuria presents in approximately 66% to 90% of acute cases. Critical Pathological Caveat: Complete absence of hematuria documented in 20% to 33.3% of confirmed, acute obstructing ureteral stones. Diagnostic rule: A pristine urinalysis with zero red blood cells is entirely insufficient to exclude acute ureterolithiasis. Urinary pH as a Composition Clue Consistently low urinary pH parameters (pH < 5.5) point strongly toward a uric acid crystalline composition. Elevated urinary pH parameters (pH > 7.5) indicate the presence of urease-producing microbial pathogens, pointing toward a struvite infection stone. Infectious Screening Metrics Active tracking for marked pyuria, positive leukocyte esterase, and bacterial nitrites to rule out an obstructed, infected upper urinary tract system. BMP Immediate quantification of baseline serum creatinine to establish accurate eGFR values. Targeting detection of post-renal AKI from bilateral obstruction, unilateral obstruction in a single functioning kidney, or severe volume depletion. CBC Evaluation for marked leukocytosis. Physiologic Nuance: Mild-to-moderate white blood cell count elevations frequently represent non-specific stress demargination driven by severe pain and repetitive vomiting. High-grade white blood cell shifts demand immediate exclusion of systemic bacteremia or an infected, obstructed urinary system. Adjunctive Lab Pathways Rapid qualitative urine hCG testing. Reflex urine culture execution whenever urinalysis metrics display significant inflammatory profiles or clinical suspicion of UTI is high. 4. IMAGING MODALITIES & ALGORITHMIC CLINICAL SELECTION Non-Contrast CT Diagnostics Gold standard; diagnostic sensitivity and specificity parameters exceed 95% for stones >2 mm. Provides precise quantification of stone diameter (mm), exact localization (proximal, mid, or distal ureter), and degree of secondary hydronephrosis. Excellent structural visualization for detecting or ruling out alternate retroperitoneal, vascular, or intra-abdominal pathologies. Contrast-Enhanced CT Protocols Indicated when alternative intra-abdominal surgical pathology is highly suspected over isolated renal colic. Retains diagnostic capability to identify urinary tract stones >3 mm even within contrast-enhanced phases. NCCT Structural Architecture Limitations Standard stone protocol CT scans are executed in a prone position without IV contrast enhancement. It does not opacify the ureteral lumen. Presents a cumulative radiation exposure penalty when utilized serially across recurrent ED presentations. POCUS / Radiology Ultrasound Direct stone visualization capabilities are modest, operating at approximately 50% to 60% sensitivity, and is highly dependent on anatomical positioning at the extreme proximal ureter or the UVJ. Secondary obstruction tracking: Demonstration of hydronephrosis operates at a high sensitivity of approximately 80%. POCUS Clinical Utility Metrics Eliminates ionizing radiation exposure and allows immediate, rapid real-time execution directly at the patient’s bedside. Confirmation of significant hydronephrosis within a classic clinical presentation yields high post-test probability for stone presence while lowering suspicion for vascular catastrophes like a AAA. KUB Radiography Extremely poor overall diagnostic sensitivity, hovering around 57%. Fails to image radiolucent configurations (pure uric acid matrices) or small stones measuring

Welcome to the Daily Disciple Podcast. As daily disciples, we seek to adore and follow Jesus, our teacher, into the abundant life that he offers. Because we find Jesus irresistible, fascinating, and incredibly practical, we want to be students of his scripture. Today's episode is found in Luke 17 "Acute Observations."

Dr. Drew Carey interviews Dr. Avner Hostovsky on his study evaluating the diagnostic yield of a structured systemic workup in patients presenting with acute visual symptoms who were diagnosed with isolated paracentral acute middle maculopathy (PAMM). From his Ophthalmology article, "High Yield of Systemic Workup in Patients with Acute Isolated Paracentral Acute Middle Maculopathy." Hostovsky A, Peled I, Katz G, et al. High Yield of Systemic Workup in Patients with Acute Isolated Paracentral Acute Middle Maculopathy. Ophthalmology, 2025; 133, 499-505.

CardioNerds (Dr. Billy-Joe Mullinax, Dr. Dinu Balanescu, and Dr. Jane Ehret) discuss risk stratification in acute pulmonary embolism with Dr. Stavros Konstantinides, Chair of the 2019 ESC Pulmonary Embolism Guidelines. Using a real-world case, this episode explores how modern PE care has moved beyond “massive” and “submassive” labels toward a dynamic, physiology-based approach. The discussion highlights the limitations of static risk scores, the importance of right ventricular dysfunction and biomarkers, and why normotension does not imply stability. Special emphasis is placed on intermediate-high risk PE, early identification of impending hemodynamic collapse, and the role of lactate, serial reassessment, and PERT teams in guiding escalation of care. Audio editing by CardioNerds intern, Joshua Khorsandi.The 2026 American multi-society PE guidelines were published after this episode was recorded. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Stable blood pressure does not mean low risk in PEHypotension is a late finding. Patients may have severe RV failure, hypoxia, and tissue hypoperfusion while remaining normotensive — a key concept behind “normotensive shock.” Risk stratification in PE must be dynamic, not staticLegacy scores like PESI and Bova provide a snapshot and predict 30-day mortality, but they do not capture short-term trajectory or impending hemodynamic collapse. Intermediate-high risk PE is a dangerous and heterogeneous groupPatients with RV dysfunction, positive biomarkers, tachycardia, hypoxemia, and elevated lactate may have in-hospital mortality approaching 15%, rivaling STEMI. Lactate is a critical but underutilized marker in PEElevated lactate reflects tissue hypoxia and early circulatory failure and may identify patients at risk for collapse before blood pressure declines. PERT enables physiology-driven, patient-centered PE carePERT teams operationalize continuous reassessment, integrate imaging, labs, and clinical trajectory, and allow timely escalation — shifting PE management from rigid categories to real-time decision-making. Notes Drafted by Dr. Jane Ehret. 1. What is the contemporary framework for risk stratification in acute pulmonary embolism? Modern PE risk stratification prioritizes hemodynamics and right ventricular (RV) function rather than clot burden. The 2019 ESC Guidelines classify PE into high risk, intermediate risk (low vs high), and low risk, based on: Hemodynamic status, RV dysfunction on imaging, and Cardiac biomarkers. This framework emphasizes early mortality risk but requires clinical context to guide escalation decisions. 2. Why is normotension insufficient to define “stability” in PE? Blood pressure is a late marker of circulatory failure in PE. Patients can maintain normal BP through Tachycardia, Increased sympathetic tone, and RV compensation. Many patients with preserved BP may already have shock physiology, including hypoxemia, elevated lactate, and RV failure — sometimes referred to as “normotensive shock.” 3. How should intermediate-risk PE be conceptualized clinically? Intermediate-risk PE is heterogeneous, ranging from patients who do well on anticoagulation to those who deteriorate rapidly. Intermediate-high risk PE is defined by RV dysfunction on imaging and positive cardiac biomarkers. Clinical features such as tachycardia, increasing oxygen requirement, and elevated lactate identify patients at highest risk within this group. 4. What are the strengths and limitations of commonly used PE risk scores? Legacy scores are useful for initial risk categorization but are static and limited in predicting short-term deterioration. Most scores were developed to predict mortality or complications at fixed time points rather than dynamic clinical trajectory. 5. What are the commonly used risk scores and clinical tools in PE, and what is each designed to predict? ESC Risk Stratification Algorithm: Identifies high-risk PE by hemodynamics. Uses PESI or sPESI in normotensive patients to distinguish low-risk from non–low-risk PE. Uses RV dysfunction and biomarkers to differentiate intermediate-low from intermediate-high risk. Forms the basis of many institutional PE pathways. PESI and sPESI: Validated to predict 30-day mortality. Widely used to identify low-risk patients appropriate for outpatient management. Heavily influenced by age and comorbidities. Bova Score: Predicts 30-day PE-related complications in normotensive patients. Composite PE Shock Score (CPES): Predicts normotensive shock in hemodynamically stable PE patients. Pulmonary Embolism Progression (PEP) Score: Predicts progression from intermediate-risk to high-risk PE within 72 hours of diagnosis. PE Short-term Clinical Outcomes Risk Estimation (PE-SCORE): Predicts clinical deterioration or death within 5 days of PE diagnosis. Hestia Criteria: Identifies low-risk PE patients safe for outpatient treatment. Wells' Criteria and Revised Geneva Score: Determine pretest probability for diagnostic triage. PERC Score: Rules out PE in very low-risk patients. 6. What is the role of biomarkers in PE risk stratification? Troponin and natriuretic peptides reflect RV myocardial injury and strain. Current guidelines treat biomarkers as binary (positive vs negative), despite risk being continuous. Biomarkers are most helpful for: Initial risk classification. They are less useful for: Short-interval monitoring and Detecting rapid clinical deterioration. 7. Why is lactate an important physiologic marker in PE? Lactate reflects global tissue hypoxia and impaired perfusion. Elevated lactate may identify patients with: Early circulatory failure and Increased risk of imminent hemodynamic collapse. Lactate is not currently included in ESC risk algorithms but may add important prognostic information in intermediate-risk patients. 8. How does trajectory influence decision-making in PE management? Risk stratification should be viewed as a dynamic process, not a one-time label. Worsening clinical trajectory may include: Rising heart rate, Increasing oxygen needs, Rising lactate, and Progressive RV dysfunction. Serial reassessment is essential for timely escalation of care. 9. What role do Pulmonary Embolism Response Teams (PERT) play in risk stratification? PERT facilitates: Multidisciplinary decision-making and Integration of imaging, biomarkers, and clinical physiology. PERT is most valuable for: Intermediate-risk and high-risk PE and Patients with complex comorbidities or uncertain trajectory. PERT enables a shift from category-based to physiology-driven PE care. References 1. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Respir J. 2019;54(3):1901647. Published 2019 Oct 9. doi:10.1183/13993003.01647-2019 2. Leidi A, Bex S, Righini M, Berner A, Grosgurin O, Marti C. Risk Stratification in Patients with Acute Pulmonary Embolism: Current Evidence and Perspectives. J Clin Med. 2022;11(9):2533. Published 2022 Apr 30. doi:10.3390/jcm11092533 3. Choi WH, Kwon SU, Jwa YJ, et al. The pulmonary embolism severity index in predicting the prognosis of patients with pulmonary embolism. Korean J Intern Med. 2009;24(2):123-127. doi:10.3904/kjim.2009.24.2.123 4. Jiménez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383-1389. doi:10.1001/archinternmed.2010.199 5. Chen X, Shao X, Zhang Y, et al. Assessment of the Bova score for risk stratification of acute normotensive pulmonary embolism: A systematic review and meta-analysis. Thromb Res. 2020;193:99-106. doi:10.1016/j.thromres.2020.05.047 6. Zhang RS, Yuriditsky E, Zhang P, et al. Composite Pulmonary Embolism Shock Score and Risk of Adverse Outcomes in Patients With Pulmonary Embolism. Circ Cardiovasc Interv. 2024;17(8):e014088. doi:10.1161/CIRCINTERVENTIONS.124.014088 7. Zhang RS, Alam U, Sharp ASP, et al. Validating the Composite Pulmonary Embolism Shock Score for Predicting Normotensive Shock in Intermediate-Risk Pulmonary Embolism. Circ Cardiovasc Interv. 2024;17(2):e013399. doi:10.1161/CIRCINTERVENTIONS.123.013399 8. Ehret J, Wakefield D, Badlam J, Antkowiak M, Erdreich B. Development of the Pulmonary Embolism Progression (PEP) score for predicting short-term clinical deterioration in intermediate-risk pulmonary embolism: a single-center retrospective study. J Thromb Thrombolysis. 2025;58(2):243-253. doi:10.1007/s11239-024-03051-5 9. Weekes AJ, Raper JD, Lupez K, et al. Development and validation of a prognostic tool: Pulmonary embolism short-term clinical outcomes risk estimation (PE-SCORE). PLoS One. 2021;16(11):e0260036. Published 2021 Nov 18. doi:10.1371/journal.pone.0260036 10. Zondag W, Hiddinga BI, Crobach MJ, et al. Hestia criteria can discriminate high- from low-risk patients with pulmonary embolism. Eur Respir J. 2013;41(3):588-592. doi:10.1183/09031936.00030412 11. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med. 2001;135(2):98-107. doi:10.7326/0003-4819-135-2-200107170-00010 12. Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM. Prospective validation of Wells Criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med. 2004;44(5):503-510. doi:10.1016/j.annemergmed.2004.04.002 13. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 2006;144(3):165-171. doi:10.7326/0003-4819-144-3-200602070-00004 14. Kline JA, Mitchell AM, Kabrhel C, Richman PB, Courtney DM. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2(8):1247-1255. doi:10.1111/j.1538-7836.2004.00790.x 15. Kline JA, Courtney DM, Kabrhel C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6(5):772-780. doi:10.1111/j.1538-7836.2008.02944.x

In this episode, Tracey Davidoff, MD, Joe Toscano, MD, and Evan Nelson, MD, discuss the May 2026 Evidence-Based Urgent Care article, Urgent Care Evaluation and Management of Acute Bronchitis.0:08 Introduction1:08 Topic & guest introduction2:14 Differential diagnosis4:03 Respiratory virus testing6:42 Positive viral diagnosis & antibiotic prescribing8:00 Duration of cough & post-infectious cough9:41 Antibiotic stewardship12:07 Cough & cold medicines14:44 Narcotics & corticosteroids16:05 Steroid stewardship17:24 Radiologic stewardship & chest X-rays20:46 Sputum color21:53 Albuterol24:21 Special populations25:37 Take-home points & patient education27:08 Wrap-up and outroSubscribes, take the CME test here!Not a subscriber? Join here!

Hosts: Ed Jones (Owner of Nutrition World) & Clint Powell A variety of topics all related to living a healthy life Presented by: Nutrition World www.nutritionw.com Broadcasting from the Nooga Dentistry Studio www.noogadentistry.com Production of: Whitfield Media Group www.vitalhealthradio.com Title: Impact of Tennessee Hemp Bill, Discussion of Polypharmacy & Deprescribing  with Dr. Curt Dearing [0:00:00] Ed's Media & Product Updates Preview of main topics: Upcoming Tennessee hemp bill and its negative impact on people using hemp for anxiety, pain, and insomnia. Dr. Curt Deering will discuss polypharmacy and deprescribing. Ed's recent appearances on multiple TV outlets (Fox Phoenix & LA, Be Well NY, CBS Detroit). Discussion of testing the AquaTru water filtration system at home as a potential recommendation (microplastics, partial fluoride removal). Mention that peptides are a growing topic; reference to Noel Lawson as go‑to for prescribed peptides [0:10:42]  Tennessee Hemp Bill & Hemp Industry Impact Introduces guest: Dwayne Madden, owner of Hemp House, as a respected local expert. As of July 1 in Tennessee: All Delta‑8 products will no longer be available for in‑state sale. Many THCA products and all vape products will be gone from shops. CBD and Delta‑9 edibles will have caps: Max 15 mg per serving. Max 300 mg per package. Dwayne notes: Heavy users (e.g., serious pain/conditions) will need to consume many servings to reach effective doses. Law doesn't limit how many packages a person can buy, so total milligrams aren't truly stopped—just made inconvenient. Dwayne explains regulatory control moved: From Tennessee Department of Agriculture (2017–2023) To the ABC (Alcoholic Beverage Commission) Board. Key impacts: All products must now go through distributors, similar to alcohol. Distributors collect taxes and sit between producers and retailers. Small operators like Dwayne cannot qualify for distributor licenses , so he must pay a distributor to move product from his own lab to his own stores. Ed frames this as “follow the money trail” and a way to crush competition. In Tennessee after July 1: No in‑state online hemp sales. Banned products (Delta‑8, etc.) not criminalized for possession or use, only for sale. Potential Workaround: Consumers can order from out‑of‑state websites (e.g., North Carolina), receive products in Tennessee Money leaves the local economy, hurting Tennessee businesses. Ed and Dwayne suggest alcohol industry is likely threatened because many people are reducing alcohol use by using hemp products instead  Dwayne notes: Alcohol sales have declined while hemp sales rose. Regulators appear to be protecting alcohol interests via hemp restrictions. [0:17:41] Federal Regulations & State Opt‑Outs Upcoming federal regulations in November: Expected to be similarly “ugly and nasty” for hemp nationwide. States will have an option to opt out of these federal hemp rules. Tennessee's stance: Governor has stated Tennessee will NOT opt out, so federal restrictions will apply here. Other states (e.g., North Carolina) might opt out, keeping their markets more open. Industry response: Advocacy groups Tennessee Growers Coalition and Hemp Law Group monitor legislation and organize pushback. Some supportive legislators exist, but political drive to reverse current law is limited. Dwayne and Ed distinguish: Reasonable regulation (ID checks, lab tests, dosage clarity, education) vs. A “wipeout/control/takeover” by shifting to ABC and forcing distributor reliance. Dwayne: Says credible local shops (Hemp House, Chattanooga peers like BeeGrity, Snapdragon, etc.) already follow high standards. States this law is not about safety but about control and revenue capture, and will hurt small farmers and businesses. [0:25:55] What Consumers Should Do Before Deadline Practical advice: Stock up now on products that will disappear: Delta‑8 gummies (popular for sleep, anxiety, pain). Other higher‑milligram THC/CBD edibles. Flower and vapes. Hemp House is running clearance sales to move remaining inventory. Dosing notes: Many people do well with ½ Delta‑8 gummy for sleep/anxiety/pain. Some need more or less; staff helps tailor doses for goals. Hemp House will close its North Shore/Tremont Street flagship store by July 1 due to expected sales hit. Remaining Hemp House locations: Ringgold Road (East Ridge) near Spring Creek. Ooltewah by Food City on Lee Highway. Hixson Pike near Workout Anytime and Publix. Broader impact: Other Chattanooga hemp businesses have large staffs (some near 100 employees) and will be heavily affected. The industry is described as grassroots, farmer‑driven, and passionately quality‑focused. [0:33:20] Polypharmacy & Deprescribing with Dr. Curt Dearing Ed introduces Dr. Curt Dearing, clinical pharmacist at Nutrition World (30+ years experience). Curt's background: Formerly fully conventional pharmacist; later “veil lifted” as he discovered green pharmacy (nutritional & botanical alternatives). Current mission: Community outreach to medical schools and residency programs Teach about nutritional and natural alternatives not covered in standard curriculums. Traditional training provides almost zero meaningful nutrition or green pharmacy education. Polypharmacy: use of 5 or more prescription medications. Curt notes: Majority of Americans 65+ meet this definition. Average American receives ~17 prescriptions per year (not all concurrent). Consequences: Increased ER visits due to drug side effects. Estimated ~250,000 deaths/year from drug‑induced causes. Curt's role: Specializes in deprescribing: safely reducing or eliminating unnecessary pharmaceuticals and replacing them with effective natural options when possible.  How Curt Works with Patients & Their Doctors Curt provides coaching, not independent prescribing. Creates detailed packets (10–18+ pages) explaining: Why certain drugs may no longer be needed. Evidence for natural alternatives (e.g., supplements, lifestyle changes). Encourages clients to take the packet to their doctor and have an informed discussion. Patients often fear how their doctors will react to attempts to deprescribe. Green Pharmacy Approach (as described by Dr. Curt Dearing) Using nutritional, botanical, and lifestyle-based therapies either instead of or alongside pharmaceuticals. Focusing on root causes and supporting the body's own healing mechanisms, not just pushing lab numbers in a certain direction. Why polypharmacy is a problem: Increases side effects, drug–drug interactions, and emergency room visits. Contributes to cognitive decline, gut problems, and overall worse health. Often leads to the “prescribing cascade”: Drug A causes side effects → a new drug is added for those side effects → more side effects → more drugs, and so on. How Dr. Curt Dearing uses green pharmacy to reduce polypharmacy: Curt creates a comprehensive list of all medications and supplements. Asks: “Why was this started?” and “Is it still needed?” Looks for: Drugs with no clear current indication. Drugs where a natural option can give similar or better benefit with fewer risks. Drugs that can be safely tapered or sometimes stopped outright (always in coordination with the prescriber). Identifies which meds are likely causing the most harm or least benefit. Some drugs require slow, structured tapering (e.g., sleep meds, acid blockers). Others may be candidates for direct discontinuation after medical agreement. Replacing or supporting with natural alternatives ( please note this is not medical advice, this is a discussion of personal examples in collaboration with medical oversight) Cholesterol: Instead of (or in place of some) statin use, Curt uses berberine and bergamot (Berbercol). In Ed's brother's case, his cholesterol numbers improved on green-pharmacy options, matching or exceeding statin outcomes without the same side‑effect burden. Pain & inflammation: Uses curcumin (for most people), and Boswellia when curcumin isn't enough. Gut/acid issues: Long-term proton pump inhibitor (PPI) use (e.g., omeprazole, lansoprazole) is flagged as harmful to gut microbiome and nutrient absorption. Curt builds step-down plans (tapering PPIs) while supporting the gut with natural measures instead of leaving people on a PPI for 30 years. Focus on side benefits, not side effects. Green pharmacy interventions are chosen because they: Address root causes (e.g., metabolic health, inflammation, gut integrity). Often have multiple positive effects (e.g., berberine helping blood sugar and lipids; curcumin helping joints and systemic inflammation). The aim is fewer total drugs, fewer side effects, better overall function. Clients are encouraged to work with their doctor, so deprescribing is: Planned, Monitored, and Integrated with their existing care. Curt and Ed both acknowledge there are situations where “rescue medicine” is necessary: Severe pain where an opioid is appropriate. Acute crises where drugs are needed as a bandage. The green pharmacy view: Use those drugs as short‑term tools, Then remove or reduce them once the immediate crisis passes, While implementing natural strategies to decrease the need for long‑term prescriptions. [0:56:26] Final Segment  At‑home HPV testing for cervical cancer Ed explains HPV is a major driver of cervical cancer Historically, women had to schedule an in‑office visit for cervical screening, which creates barriers (cost, fear, time, discomfort, lack of insurance). He notes there is now an option for at‑home HPV testing for cervical screening. Intended to increase access for women who aren't getting regular screening. Ed strongly approves of this as a valuable preventive tool and encourages women who haven't been tested to consider it. Ed cites new data showing: Microplastics are found in 100% of human stool samples tested in one study. Higher levels of microplastics are now being linked to gallstones. Broader concerns: Everyday plastic exposure (especially with food and drink) means these particles can: Interact with cells, Drive inflammation, Contribute to premature cellular aging and reduced energy. Practical countermeasures he recommends: Avoid heating food in plastic or placing hot food into plastic containers/wrap (e.g., Saran wrap, plastic take‑out containers). Filter drinking water to remove microplastics (he's trialing the AquaTru system at home, which he says removes 100% of microplastics and much of the fluoride). Improve indoor air quality to reduce airborne microplastic exposure. Ed highlights a serious, long‑term job opening at Nutrition World: Not a summer or short‑term job. Best for someone philosophically aligned with healthy eating and the “green pharmacy” approach. Interested candidates should: Go into the store and speak with Scott, Elisha, or Matt and complete an application.  The post Radio Show / Podcast – May 31, 2026 first appeared on Vital Health Radio.

Send us Fan MailIn this episode, we discuss how to identify and manage the acute complications of sickle cell disease. Written by Dr. Yi Hui Luo (Internal Medicine Resident). Reviewed by Dr. Véronique Naessens (Hematologist) and Dr. Sanabelle Zaabat (General Internist). Support the show

T-cell-engaging bispecific antibodies represent a major therapeutic and scientific advancement in the treatment of several types of cancer. However, they carry a risk of some unique acute toxicities, such as cytokine release syndrome and neurologic toxicity. This podcast reviews this emerging drug class and strategies for recognition and management of their unique adverse events. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long (@long_brit), we cover how to evaluate and manage acute limb ischemia. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play Send us Fan Mail

In this episode, we review the high-yield topic of ⁠ Acute Abdomen from the Gastrointestinal section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

In this episode, Andrew breaks down the concept of the Acute:Chronic Workload Ratio (ACWR) in a practical and easy-to-understand way for athletes, coaches, parents, and practitioners. Rather than getting lost in complicated formulas or sports science jargon, this discussion focuses on the bigger coaching and performance lesson behind ACWR — why sudden spikes in workload can become problematic when athletes are not properly prepared for the demands being placed on their bodies.Andrew explains how workload management is not about avoiding hard training, but instead about progressively building an athlete's capacity to tolerate sprinting, jumping, conditioning, lifting, and sport-specific demands over time. He also discusses why undertraining and underexposure can sometimes be just as risky as overtraining, especially when competition intensity suddenly exceeds what an athlete has been consistently prepared for.Throughout the episode, Andrew shares practical examples and coaching insights to help listeners better understand how intelligent progression, preparation, and monitoring can improve resilience, reduce breakdown, and optimize long-term athletic performance. Whether you are an athlete, coach, clinician, or parent, this episode provides valuable perspective on balancing performance development with athlete preparedness. Enjoy the episode!

Divorce can feel like it happens in an instant: an argument, a cold sentence, papers on the counter, and your world flips upside down. We slow that moment down and look at the data that challenges the “knee-jerk decision” story, including research suggesting many people who file have been contemplating divorce for a year or more, often much longer. That timeline matters because it creates a brutal asymmetry: one spouse finishes grieving and planning while the other starts at ground zero.We also dig into what tends to happen during that hidden runway. Think financial intelligence gathering, attorney consults, custody calendar strategy, and even filing timing around school schedules and holidays. Then we connect it to what happens inside your body when you get blindsided. Acute stress is not just a feeling; it changes cognition. If your working memory and executive function drop under pressure, the worst time to negotiate is the exact time the system pushes you toward temporary orders, quick compromises, and “just keep the peace” decisions that can define the next 10 to 20 years.From there, we shift into a practical survival playbook for dads: a 24-hour buffer rule before you agree to anything, bridging the lawyer gap by taking command of day-to-day boundaries, moving communication into a documented parenting app, building dense objective records, and mastering calm emotional regulation in high-conflict environments where bias and subjectivity can shape outcomes. If you want a clearer starting line and a smarter next step, subscribe, share this with a dad who needs it, and leave a review telling us what hit home most. Being unprepared is how great fathers become weekend visitors. Most ground is lost quietly through "drift" and decisions made under pressure. Stop the drift today at TheDivorcedDadvocate.com.Access your tactical tools:Risk Assessment: Identify your "quiet loss" exposure in 10 minutes.Protection Session: Book a private triage to ensure mistakes don't become permanent.Your kids are counting on you. Support the show

In this episode, Yoga Medicine founder Tiffany Cruikshank and Katja Bartsch take a deep dive into the latest stretching research and what it means for yoga teachers, athletes, and movement professionals. Together, they unpack the latest recommendations around stretching for flexibility, stiffness, strength, hypertrophy, vascular health, recovery, and injury prevention while exploring the limitations of stretching as a standalone tool. Tiffany and Katja discuss why prolonged static stretching before explosive activity may impair athletic performance, how longer-held yin-style stretches may influence tissue stiffness, and why emerging vascular research around stretching is generating so much interest. They also explore why yoga recovery likely involves far more than just stretching mechanics, including nervous system regulation, breathwork, and relaxation. "We do not overestimate or underestimate what stretching can do." — Katja Bartsch. — What You'll Learn: What the new 2025 stretching consensus paper reveals about flexibility research [02:57] • Definitions of static, dynamic, and PNF stretching in both research and yoga practice [06:00] • Acute vs. chronic stretching effects on range of motion and mobility [13:54] • Recommendations for improving long-term flexibility and maintaining mobility with age [20:09] • The "Goldilocks" principle of tissue stiffness and athletic performance [27:24] • Why longer yin-style holds may influence connective tissue adaptation [32:12] • How stretching impacts strength, explosive performance, and warm-ups [34:32] • Research on stretching for strength gains and muscle hypertrophy [37:36] • Emerging evidence around stretching and vascular health [42:01] • Breathwork, nervous system regulation, and yoga's broader therapeutic effects [51:24] • Why stretching alone may not improve recovery or prevent soreness [54:07] • The limitations of flexibility-only approaches for injury prevention [1:00:13] • Why individualized mobility, stability, and strength work matter in yoga practice [1:01:40] • Final takeaways on stretching frequency, recovery, and long-term mobility [1:04:32] — Links Mentioned: Watch this episode on YouTube Warneke K, Thomas E, Blazevich AJ, Afonso J, Behm DG, Marchetti PH, Trajano GS, Nakamura M, Ayala F, Longo S, Babault N, Freitas SR, Costa PB, Konrad A, Nordez A, Nelson A, Zech A, Kay AD, Donti O, Wilke J. Practical recommendations on stretching exercise: A Delphi consensus statement of international research experts. J Sport Health Sci. 2025 Dec;14:101067. doi: 10.1016/j.jshs.2025.101067. Epub 2025 Jun 11. PMID: 40513717; PMCID: PMC12305623. — Learn More: Find the full show notes at YogaMedicine.com/podcast-167. Learn more about insider tips, online classes or information on our teacher trainings at YogaMedicine.com. To support our work, please leave us a 5 star review with your feedback on iTunes/Apple Podcasts or wherever you listen to podcasts. 

Retreat from New Orleans! Professor Torbjörn Törnqvist from University of Tulane finds its inevitable and start now. Carbon dioxide is cooling the Stratosphere. Lamont-Dorherty scientist Sean Cohen explains. Much of America in frightening drought, going into hot El Nino year. And new science  …

Krissy Dilger of SRNA moderated an open Q&A on acute disseminated encephalomyelitis (ADEM) with pediatric neurologist Dr. Linda Nguyen of the University of Texas Southwestern Medical Center. Dr. Nguyen discussed how widespread MOG antibody testing has shifted many cases previously labeled ADEM to MOG antibody-associated disease, recommended MOG testing at onset, and reviewed relapse risk, mimics, and follow-up imaging [00:05:07]. Questions from the community covered acute treatments, recovery, guidance on pseudo-relapse, rehabilitation, and transition from pediatric to adult care [00:14:41].Dr. Linda Nguyen completed her MD, PhD training at West Virginia University in 2017, and then pediatric neurology residency at the University of California, San Diego in 2022. She then completed a combined pediatric and adult neuroimmunology fellowship at the University of Texas Southwestern in 2024, where she now serves as an Assistant Professor in the Department of Pediatrics. Dr. Nguyen currently sees patients in the Demyelinating Disease Clinic at Children's Medical Center Dallas.00:00 Welcome and Guest Intro01:08 What Is ADEM01:51 Causes and Who Receives This Diagnosis02:55 Early Signs and Onset04:20 Diagnosis and MRI Criteria05:07 MOG Antibodies and ADEM07:21 Testing and Relapse Risk09:06 Recurrent ADEM and Labels12:34 Mimics and Differential Diagnosis14:41 Acute Treatment Options15:38 Recovery Timeline and Rehab17:47 Long Term Effects and Seizures21:23 Family Support and Accommodations24:47 Follow Up Imaging and Relapse Signs27:25 Managing Fatigue and Headaches29:31 Supplements, Vaccines, and Genetics33:40 Pseudo Relapse and Exercise Balance37:41 Research and Predicting Outcomes43:14 Transition to Adult Care45:36 Weakness Sleep Issues and Final Thoughts

Send us Fan MailOn this week's episode , we visit an unusual situation, but yet one most of have had if you've been practicing for more than a just a few years.  The topic of this episode is the New patient that reaches out to you and your office, needs to be seen “ asap” and is in horrible pain. On previous episodes we've discussed the regular and routine new patient procedure, and the subsequent home instruction and leading into the great report of findings. While all of that is incredibly important, and is by far the most common way a new patients enter our offices, on occasion we get the new patient calling or even “walking in” that is in 10/10 on the pain scale. In a cased like that, what you do , and don't do can mean the difference between relief for the patient and a great reputation being built for you OR little to no relief for them with them telling everyone forever how you failed them and so they got relief someplace else.  I hope you enjoy this discussion of care for the super acute new patient. 

UnBecoming Part 3 - The Hallway. (May 14, 2026)You look over at the light streaming in through your bedroom window. It's not the soft light of the moon; it's artificial light. Street lights. You're not home, you're back home. In the same twin bed you slept in during high school, watching the same trees dance in the wind, the same shadows play on the same hardwood floors you played on, talked on the phone in circles on, those floors have witnessed you.And now you kneel on them. You pray on them, whispering down toward them, you walk in tight circles on them, not on a call, but as a form of meditation, feeling God's Love in every step. Calling His Name with every step. Asking to be shown, to be provided the next step- whether to divorce or not. Whether to move or not? To the beach, perhaps.You're conflicted. But the floor is not. The room is not. It's bare. It's clean. It's small, but tidy. You can hear yourself think here, even as you are trying to get out to that place beyond thoughts, where the real answers come from. The Peace you feel as you listen past your thoughts and look over their shoulders, brings about sleep.Just as you drift, you are startled awake. Was that a crash? Did something fall? Did someone fall? You listen… for the children. For your parents. Acute. Aware. It was nothing. You soften back into the mattress, resting on your back, not yet asleep again,CRASH.Definitely something that time. Definitely someone. Your heart rate rises faster than you can. You jump up, grabbing your phone with shaky hands, instinctively yelling, 'DAD!' the one you worry about the most. The one you've called on the most. The one who understands. Before you can even enter the hall, you see his feet sticking out of his door. God. >>>> UNBECOMING.https://www.curlynikki.com/unbecoming.html

Can an algorithm actually give you your life back? A recent Stanford paper revealed that using large language models at home yields massive efficiency gains—up to 176%. For busy surgeons drowning in clinical duties and administrative bloat, every reclaimed second is priceless.In this episode of Behind the Knife, Ayman and Patrick sit down with Christian Péan—an orthopedic trauma surgeon, Duke's Executive Director of AI and IT Innovation, and the Founder/CEO of RevelAi Health. He's also a Core faculty member at the Duke-Margolis Institute for Health Policy. Dr. Péan breaks down how naturally skeptical surgeons can adopt AI to save time, shares his granular daily workflow, and discusses his mission to cure physician burnout through tech. Whether you are a tech enthusiast or a total skeptic, this episode gives you the practical playbook for integrating AI into your surgical career today.Hosts:- Ayman Ali, MDAyman Ali is a PGY-4 at Duke Hospital and current Behind the Knife fellow.- Patrick Georgoff, MD @georgoffPatrick Georgoff is faculty in the Department of Surgery at the Duke University School of Medicine where he serves as an Associate Professor of Trauma, Acute, and Critical Care Surgery and Trauma Medical Director. He is a leading educator and creator for Behind the Knife, a premier digital education platform and podcast advancing surgical training through innovative, high-yield multimedia content.- Christian Péan, MD @DrChristianPeanChristian Péan is faculty in the Department of Orthopaedic Surgery at the Duke University School of Medicine where he serves as Executive Director of AI and IT Innovation. He is the Founder and CEO of RevelAi Health, a health technology company advancing the transition to value-based care in musculoskeletal health with conversational AI. He is also author of the popular substack Techy Surgeon.  https://www.revelaihealth.com/https://techysurgeon.substack.com/Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this video, Dr. Ruscio discusses 8 benefits of taking butyrate, a fat molecule with gut and systemic healing properties. Butyrate is produced by gut bacteria, but it is often low in different chronic health conditions. Supplementation has been shown to improve a variety of gut conditions, including IBS, IBD, and SIBO, as well as chronic inflammation and brain health. Doctor Ruscio also discusses some simple dietary strategies to increase butyrate production naturally.    ✅ Start healing with us! Learn more about our virtual clinic:  https://drruscio.com/virtual-clinic/  

Dr. John Lewis joins the show today to discuss how to create a healthier brain and body at any age. He is the Founder and President of Dr. Lewis Nutrition and has spent years “educating others about the importance of nutrition, dietary supplementation and exercise for health”.Listeners will discover the importance of polysaccharides for brain health and immune function; how to use key dietary supplements to improve your immune system function and understanding how poor nutrition is linked to chronic diseases.Dr. John Lewis can be reached for consultation via the following links:DrLewisNutrition.com DailyBrainCare.com

Progressive Overload for Runners Over 40Build strength, mileage, and speed—without breaking downProgressive overload isn't about doing more—it's about doing just enough to create adaptation.In this episode, we break down how to train smarter as a runner over 40 by working with your body (not against it). We cover the stress → recovery → adaptation cycle and why recovery becomes even more important with age, hormones, and life stress.You'll learn how to use the 3 key training dials:VolumeIntensityFrequency…and why adjusting one at a time is the key to staying consistent and injury-free.We also dive into:5 ways to progress your strength training (without just adding weight)How to build mileage safely (without overloading your long run)Smarter speed progression, starting with stridesWhy your nervous system plays a bigger role than you thinkPlus: Join our FREE live masterclass on May 12

On this episode we were joined by special guest sports dietician Brett Singer from Memorial Hermann! Acute effects of nutritional and physical recovery strategies on exercise performance, muscle damage, and fatigue in elite basketball players: a pilot randomized crossover trial Marín-Galindo A, Perez-Bey A, Escudier-Vázquez JM, et al. Life. 2026;16(2):275. doi:10.3390/life16020275 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest VALD MoveHealth - https://movehealth.me/ Learn more about/purchase our courses: The Science PT | Dungeons & Dynamometers Support us on the Patreons! Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux  

Want to check out my online academy? Click the link belowhttps://www.skool.com/stokke-doubles-academy/aboutWant to attend a future doubles camp?https://stokketenniscoaching.comClick here for 10% off your next ADV baghttps://www.advtennis.pro/JONATHAN70538We talk:1:21 Acute vs. chronic injuries4:15 Being consistent with your routines7:12 Lower cross syndrome11:40 Structural problems vs. functional problems13:23 Improving how you sit15:05 Hydration19:27 Best food during a match22:05 3 action steps you can take

T.J. has acute laryngitis so we are keeping things short and sweet this week so he can rest his voice. If you want more of the podcast, we have extra episodes for members every week and when you become a member you get access to all of them, ad free! Join here - walkinlove.supercast.com Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode includes two full, sample vascular scenarios pulled directly from our Vascular Surgery Oral Board Review Course. Listen in and test your clinical pathways in real-time as we walk through the perfect answers and provide high-yield commentary to help you pass the "hot seat."Sample Scenarios Included in This Episode: Case 22: Aortoenteric Fistula (AEF). A 78-year-old woman presents to the ER with a massive upper GI bleed and a history of an open AAA repair 10 years ago. We walk you through the immediate stabilization, CTA evaluation, and the definitive operative management—including axillobifemoral bypass, aortic stump closure, and duodenal repair. Case 27: Acute Mesenteric Ischemia. A 79-year-old woman with a history of atrial fibrillation presents with abdominal pain out of proportion to her physical exam. Test your decision-making on systemic heparinization, SMA embolectomy versus stenting (ROMS), and how to appropriately evaluate bowel viability with a second-look laparotomy. About our Vascular Surgery Oral Board Review Course: 72 High-Yield Scenarios: Covering everything from carotid stump syndrome to a AAA with a horseshoe kidney. Dual-Format Learning: Each case includes "Part A" (a straight run-through of the perfect exam response) and "Part B" (the same scenario packed with expert tips, tricks, and commentary). Free Simulator Access: Every purchase of the course includes access to our new AI-powered Oral Board Simulator, allowing you to practice your verbal responses under pressure. Resources: Vascular Surgery Oral Board Review Course: https://app.behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Oral Board Simulator: https://app.behindtheknife.org/oral-board-simulator Download the BTK App on iOS and Android for on-the-go studying. DOMINATE THE DAY!