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Antonio Casado, Carmen Morodo, Antonio Caño, Marta García Aller y Rubén Amón comentan la actualidad política.

Antonio Casado, Carmen Morodo, Antonio Caño, Marta García Aller y Rubén Amón comentan la actualidad política.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Viele Industrieunternehmen lassen täglich bares Geld in der Neukundenakquise liegen – und das völlig unbemerkt. In dieser Podcast-Folge spricht Anes Cavka über die häufigsten Vertriebsfehler, die wir in der Zusammenarbeit mit hunderten Industrieunternehmen identifiziert haben.Egal ob mangelnde Zielgruppensegmentierung, eine zu produktzentrierte Kommunikation oder fehlendes Follow-up: Diese Stolperfallen kosten nicht nur Leads, sondern auch echte Aufträge.Außerdem zeigt Anes, wie klassische Vertriebswege durch digitale Maßnahmen gezielt ergänzt werden können – für messbar mehr Anfragen und weniger Streuverluste.

José Manuel Zapata y Pepa, hacen un emotivo homenaje a la música inspirada en Granada y al vínculo entre la ciudad y el compositor Isaac Albéniz. A través de cortes musicales y comentarios, exploran obras como "Granada", "Adiós", destacando su conexión con la cultura andaluzaEscuchar audio

Podcast Show Notes: Peripheral Vascular Disease in PainManagement Episode Highlights: - Host: Dr. David Rosenblum - Podcast: Pain Exam Podcast - Focus: Peripheral Arterial Disease (PAD) in Pain Management Download the App Key Topics Covered: 1. Peripheral Arterial Disease (PAD) Overview - Definition: Arterial sclerosis condition developing over long term - WHO Definition: Exercise-related pain or ankle-brachial index (ABI) < 0.9 - Prevalence:   * 3-4% in 60-65 year olds   * Increases to 15-20% in 85-90 year olds   * Up to 50% of patients may progress to symptomatic stages 2. Diagnostic Considerations Diagnostic Tests: - Ankle Brachial Index (ABI) - Ultrasound - CT Angiography - Physical examination - Pulse volume recordings - Transcutaneous oximetry ABI Interpretation: - 1.0-1.4: Normal - 0.9-1.0: Acceptable - 0.8-0.9: Some arterial disease - 0.5-0.8: Moderate arterial disease - < 0.5: Severe arterial disease 3. Pain Characteristics Types of Pain: - Intermittent claudication - Chronic limb ischemia - Nociceptive pain - Neuropathic pain - Mixed pain syndrome 4. Pain Management Strategies Pharmacological Approaches: - Mild Pain: Paracetamol, NSAIDs - Neuropathic Pain: Lidocaine patches, gabapentin, duloxetine - Severe Pain: Morphine, fentanyl, ketamine Non-Pharmacological Interventions: - Music therapy - Aromatherapy - Psychotherapy - Massage - Acupuncture - TENS - Intermittent pneumatic compression Upcoming Conferences Mentioned: - ASPN - ASIPP - Pain Week - Latin American Pain Society Additional Resources: - Pain Exam newsletter: painexam.com - Virtual pain fellowship at nrappain.org Disclaimer: Always consult with a healthcare professional for personalized medical advice. Reference Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi, Peripheral Artery Disease: A Comprehensive Updated Review, Current Problems in Cardiology, Volume 47, Issue 11, 2022,101082, Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512  

Zapata nos habla de un festival de música en Illescas, StarLittleFest, música para los más pequeños y para toda la familia. Escuchar audio

Zapata le hace un homenaje al Papa Francisco, hablando de la sección musical favorita del Santo Padre, desde Bob Dylan hasta Bach.Escuchar audio

Fins el 7 de juny hi ha temps per inscriure's en el Concurs d'ornamentació floral de balcons i façanes de Corpus, el requisit és només un, que les flors i plantes siguin vegetals i el balcó, façana o finestra doni al carrer. El dissabte 28 de juny, el jurat passejarà per veure les opcions que s'hagin presentat i triar els guanyadors en cada una de les tres categories. Aquest any des de la comissió de Corpus se li vol donar un impuls al concurs i augmentar-ne el nombre d'inscripcions per tal d'aconseguir uns carrers encara més florits. N'hem parlat amb Laura Gómez, membre de la comissió i amb dos concursants, Mia Muntané, que també va formar part del jurat en edicions passades i amb Víctor Peña, guanyador del primer premi en categoria de balcons l'any passat. L'entrada És oberta la inscripció per al Concurs de balcons i façanes de Corpus i en donem alguns detalls ha aparegut primer a Radio Maricel.

Laura Anes é oficial de gestão de programas no secretariado do comité intergovernamental de negociação do Programa das Nações Unidas para o Meio Ambiente, no Quénia.

Programa 5x129, amb Mama Dousha. Ja sabeu que les biografies d'"El b

El Teatro de la Zarzuela presenta una vibrante nueva producción de El bateo y La revoltosa, dos clásicos del género que regresan con renovada energía bajo la dirección musical de Lara Diloy y la interpretación del barítono Gerardo Bullón.Escuchar audio

Zapata presenta la segunda parte del "Repertorio de Vituperios Musicales" de Nicolas Slonimsky, donde se recopilan algunas de las críticas más duras y sarcásticas a grandes compositores y sus obras. Se mencionan casos como la "Novena Sinfonía" de Beethoven, que fue recibida con incomprensión en su estreno, y las críticas al "La consagración de la primavera" de Stravinsky, entre otras.Escuchar audio

Asociația Moașelor din România (AMsR) și Agenția Națională pentru Egalitate de Șanse între Femei și Bărbați (ANES) au semnat recent un protocol de colaborare privind respectarea drepturilor femeilor și accesul real la servicii de sănătate și de protecție împotriva abuzurilor. Ce reprezintă această colaborare, cum și cînd se vor traduce în realitate obiectivele propuse? Am întrebat-o pe Irina Mateescu, președinta Asociației Moașelor din România.Ce prevede legislația din România cu privire la violența de gen și violența domestică - forme complexe care includ mai multe tipuri de violență, nu doar pe cele mai vizibile, cum e violența fizică?Irina Mateescu: „Avem incluse mai multe tipuri de violență în legislația din România, care s-a tot îmbunătățit în ultima perioadă - și ne bucurăm să avem acest parteneriat cu ANES, le mulțumim pentru toată munca imensă depusă pe îmbunătățirea legislației și a implementării ei. Avem, într-adevăr, violență fizică, violență economică, violență religioasă - cînd îți impui partea de credințe, valori și asupra celuilalt sau nu-l lași pe celălalt să-și exprime liber religia - avem violență emoțională și noi am pus pe masa deciziilor privind îmbunătățirea acestei legislații și violența obstetrică și sperăm să fie adoptată, am făcut toate demersurile pentru a fi inclusă și această formă de violență în definiția violenței de gen din România. (...) Rolul sistemului de sănătate este unul major în prevenirea prin educație, identificarea și gestionarea tuturor formelor de violență de gen, inclusiv traficul de persoane, agresiunile sexuale sau violența partenerului intim. Toate astea ajung uneori la medicul de familie, la specialist, la o cameră de gardă, într-un ambulatoriu sau într-o clinică privată. Am avut noi, ca moașe, multe cazuri care ne-au ajuns la cursuri, le-am identificat la o consiliere de după naștere. Identificăm niște riscuri, pentru că de multe ori nu putem vorbi separat cu femeia. Dar trebuie să fim noi în alertă constantă, să observăm riscurile care ne arată controlul din partea partenerului, care ne pot semnala un abuz și o nevoie a acelei persoane de a i se întinde o mînă, de-a o ajuta să iasă din abuz. Sistemul de sănătate e o poartă de intrare pentru aceste persoane.”  Apasă PLAY pentru a asculta interviul integral! O emisiune de Adela Greceanu și Matei Martin Un produs Radio România Cultural 

Zapata habla sobre Antonio Vivaldi, conocido como el "Cura Rojo" debido a su cabello pelirrojo y su rol como sacerdote. Comienzan explorando su infancia y formación musical bajo la tutela de su padre, su carrera como maestro en el Ospedale della Pietà en Venecia, y su producción musical, especialmente sus conciertos y óperasEscuchar audio

Los Premios Goya 2025 llegan a Granada, y Zapata nos acompaña en un recorrido por las músicas nominadas. Desde compositores consagrados hasta nuevos talentos, la gala promete ser una fiesta para los sentidos. A lo largo de la noche, Zapata nos presentará las canciones y bandas sonoras que han marcado las películas más destacadas del cine español, con propuestas que van desde el cine de animación hasta el drama más profundoEscuchar audio

Zapata reflexiona sobre su amor por la poesía y la frustración de no poder musicarla él mismo, pero señala cómo grandes compositores como Serrat y Turina lo hicieron magistralmente. A lo largo de la sección, comparte interpretaciones de compositores clásicos que transformaron los poemas de Campoamor, Bécquer, Lorca, Alberti y otros en obras musicales, destacando la fusión entre la música popular, el flamenco y la música culta. Escuchar audio

Zapata nos transporta a Sicilia, donde rememora su experiencia en la isla y presenta a Mario del Monaco, uno de los tenores más emblemáticos de la historia de la ópera. A través de su música, nos muestra la impresionante carrera de este tenor florentino, conocido por su voz poderosa y su generosidad vocal. Se destacan sus interpretaciones en obras como Otello, Aida y Il Trovatore, y se revela su relación con la famosa soprano Maria Callas, con quien compartió tanto colaboraciones artísticas como tensiones personales.Escuchar audio

Send us a textIn this inaugural episode of the Spain Series, Sara and Rabbi Yisroel Bernath reflect on their fascinating journey to Celler de Capçanes, a historic winery nestled in the heart of the Montsant region of Spain. The episode begins with an exploration of the region's breathtaking landscape and the history of the Capçanes winery, which dates back over 500 years. The focus shifts to their kosher wines, crafted with meticulous care despite being a tiny fraction of the winery's overall production. Rabbi Bernath and Sara reflect on their tour with Jürgen Wagner, the winery's visionary winemaker, who shared insights into the vineyards, the terroir, and the labor of love behind their kosher wine journey.Listeners are taken to the vineyards, where Jürgen discusses how the unique Montsant landscape influences the character of the wines. The episode also touches on the impact of the phylloxera plague that shaped the region's winemaking history, as Jürgen provides a vivid narrative during a drive through the area.The episode concludes with a sit-down tasting session with Jürgen Wagner at the winery, where the Bernaths sample Capçanes' newest kosher offerings—the Peraj Petita White and Peraj Petita Rosé. This engaging conversation delves into Jürgen's personal connection to the winery, his passion for kosher winemaking, and the artistry that brings these exceptional wines to life.Through captivating storytelling and a behind-the-scenes look at Capçanes, this episode celebrates the intersection of wine, history, and Jewish tradition, offering a rich and flavorful start to the Spain Series.Support the showEmail your questions and comments to kosherwinepodcast@gmail.com

José Manuel Zapata nos habla de ¿Por qué Beethoven? de Norman Lebrecht, donde se relatan diversos datos de Beethoven, como icono de la música clásica. Escuchar audio

José Manuel Zapata nos muestra canciones navideñas y villancicos, de nuestro país o de otros, cantadas por líricos.Escuchar audio

José Manuel Zapata, nos ofrece una fascinante mirada a la figura de Ludwig van Beethoven, uno de los pilares de la música clásica. ¿Qué tiene que decir Zapata sobre la vida y obra de este genio? ¿Cómo nos invita a redescubrir a Beethoven, su legado y su impacto? Escuchar audio

José Manuel Zapata nos trae un homenaje a las grandes voces que, aunque no operísticas, han marcado la historia de la música con su talento y fuerza interpretativa. Desde el legendario Nino Bravo hasta la inconfundible Mina, pasando por la diva del tango Susana Rinaldi y la flamante Mariza.Escuchar audio

José Manuel Zapata entrevista a Isamay Benavente, quien asumió la dirección del Teatro de la Zarzuela en noviembre de 2023. Conversan sobre los retos y oportunidades que enfrenta la zarzuela en la actualidad. Benavente, primera mujer en ocupar este cargo desde la fundación de la institución en 1856.Escuchar audio

Dice nuestro tenor favorito que hasta para los muertos se ha hecho buena música. Hoy recorremos con José Manuel Zapata algunos réquiems de grandes compositores como Mozart, Bach, Brahms, Verdi e incluso el aparentemente desconocido Ligeti. ¡Música, maestro!Escuchar audio

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Sylvain Beltran Lamy était au téléphone des Grosses Têtes ce 23 octobre. Il incarne une célèbre personnalité au théâtre des Deux Anes, en la personne de Winston Churchill. Retrouvez tous les jours le meilleur des Grosses Têtes en podcast sur RTL.fr et l'application RTL.

En el Día Mundial del Cáncer de Mama, Zapata nos invita a recordar a tres mujeres valientes que rompieron moldes en la historia de la música: Hildegarda de Bingen, Clara Schumann y Nadia Boulanger. A través de sus historias, descubrimos cómo desafiaron las barreras de su tiempo y dejaron un legado que sigue inspirando generaciones.Escuchar audio

Como ya es norma, José Manuel Zapata se viste de traje para brindarnos una nueva tanda, la tercera, del compositor italiano Giacomo Puccini y ahondar aún más en su obra. En este tercer capítulo, nuestro experto analizará otras 6 obras del compositor de Lucca, de las que destacan: "Edgar", "Rondine" o "Perduta". Escuchar audio

durée : 00:04:14 - Chroniques littorales - par : Jose Manuel Lamarque - Pour leur seconde édition, ces rencontres vont se dérouler au Pouliguen, à La Baule, à Nantes et à Saint-Nazaire les 23, 24 et 25 septembre prochains. Des rencontres franco-québécoises pour la prise en compte des initiatives locales.

Al igual que Madama Butterfly de Puccini cierra el lunes esta temporada del Teatro Real, Joan Matabosch es el responsable de despedir "Buena música para gañanes y gañanas" en nuestro cierre de temporada. En esta ocasión, nos presenta un adelanto de la programación 2024/2025 del Teatro Real que se centrará sobre todo en el s. XVIII. Estos son algunos de los títulos que podremos disfrutar: 1) Adriana Lecouvreur de Francesco Cilea (del 23 de septiembre al 11 de octubre, en la semana de la ópera). 2) Maria Stuarda de Gaetano Donizetti (del 14 al 30 diciembre, siendo el estreno de esta producción)3) Eugene Oneguin de Chaikovski (del 22 enero al 18 febrero, en honor a Aleksandr Pushkin)4) Mitridate, re di Ponto de Mozart (del 23 de marzo al 9 de abril, compuesta cuando tenía 14 años) 5) Les Indias Galantes de Jean-Phillipe Rameau (del 28 mayo al 1 de junio, un híbrido entre la ópera y la danza)6) I Lombardi Alla Prima Crociata de Verdi (del 6 y el 9 de julio, se presentarán otros dos títulos suyos)Escuchar audio

El encanto de Franz Liszt, el romanticismo del primer acto de La Traviata, el violín de Izaak Perlman, el talento de Jacqueline du Pré, la detención de Nicola Ugo Stame…¿Que tienen todos en común? Que sus historias y su música han sonado en la sección de nuestro querido Jose Manuel Zapata. En su última aparición de esta temporada en "No es un día cualquiera", el popular tenor da el do de pecho con un resumen musical del curso 2023/2024.Escuchar audio

Aprovechando el paso de la comedia lírica Doña Francisquita por el madrileño Teatro de la Zarzuela, donde se representará hasta el próximo 30 de junio, -y que cuenta en la dirección musical con Guillermo García y en la escénica con Lluís Pasqual- nos sumergimos en su historia de la mano de la selección musical que nos ha preparado el tenor José Manuel Zapata. Un destilado melódico con algunos de los mejores momentos de esta obra redonda, emocionante, muy difícil de cantar para los solistas y con algunos momentos que ya son historia de la música universal. ¡Música, maestro!Escuchar audio

Aparte de “disfrutones”, en esta sección somos “justicieros”. Quien más, quien menos, reconoce a Luciano Pavarotti, Maria Callas, Montserrat Caballé o Josep Carreras. Pero a cuántos de los que estáis al otro lado os suenan los nombres de Pedro Lavirgen, Katia Ricciarelli o Marcello Giordani… ¿Nadie? ¿Alguien al fondo levanta la mano? En sus minutos musicales de hoy, el tenor José Manuel Zapata nos acerca una selección de cantantes del siglo XX desconocidos para el gran público pero con un talento igual e incluso superior al de algunas de las mayores estrellas del género. Escuchar audio

Hace unas semanas una de las grandes voces del panorama lírico mundial, Josep Carreras, era distinguido con el Premio Talía de Honor 2024 que otorga la Academia de las Artes Escénicas de España. Para celebrar toda una vida llena de talento y éxitos, José Manuel Zapata nos propone hacer un viaje musical en el que descubrir a ese niño barcelonés que se enamoró de la ópera viendo la película El gran Caruso que protagonizaba, el también tenor, Mario Lanza.Un niño que con siete años comenzó a estudiar solfeo, piano y canto, y que ya en esa época entonaba todo lo que escuchaba. Desde fragmentos de zarzuela y ópera hasta canciones de moda.Escuchar audio

Estamos acostumbrados a amanecer con algunas de las mejores voces de la ópera. Sin embargo, en esta ocasión José Manuel Zapata convierte en protagonista a un instrumento que no supera (o no debería) los 280 gramos y en cuya construcción se emplean madera de arce, de pino y de palisandro. ¡En efecto!, se trata del violín. Y nuestro colaborador hoy nos habla de los mejores, los Stradivarius, y de la historia de su creador: Antonio Stradivari. Escuchar audio

En vísperas de celebrar nuestro “2.000+1”, el tenor José Manuel Zapata se escapó a disfrutar unos días de París. En la ciudad de la luz ha vivido momentos profesionales y personales muy importantes. Y en este viaje exprés ha tenido tiempo de repasar y recordar melodías y artistas que son un auténtico placer para los oídos y que quiere compartir con nosotros. Desde grandes maestros como Gioachino Rossini o Charles Ambroise Thomas hasta voces intimistas del jazz como la de Melody Gardot de la que escuchamos una joya como “La chanson des vieux amants”. ¡Prepárate para una selección musical que te hará flotar!Escuchar audio

Elijah Bryant and Sarah Anes comes to the show to talk about making millions flipping lands APPLY TO BE ON THE PODCAST: https://forms.gle/D2cLkWfJx46pDK1MA BUSINESS INQUIRIES/SPONSORS: Jenna@DigitalSocialHour.com SPONSORS: Deposyt Payment Processing: https://www.deposyt.com/seankelly LISTEN ON: Apple Podcasts: https://podcasts.apple.com/us/podcast/digital-social-hour/id1676846015 Spotify: https://open.spotify.com/show/5Jn7LXarRlI8Hc0GtTn759 Sean Kelly Instagram: https://www.instagram.com/seanmikekelly/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Elijah Bryant and Sarah Anes comes to the show to talk about making millions flipping lands APPLY TO BE ON THE PODCAST: https://forms.gle/D2cLkWfJx46pDK1MA BUSINESS INQUIRIES/SPONSORS: Jenna@DigitalSocialHour.com SPONSORS: Deposyt Payment Processing: https://www.deposyt.com/seankelly LISTEN ON: Apple Podcasts: https://podcasts.apple.com/us/podcast/digital-social-hour/id1676846015 Spotify: https://open.spotify.com/show/5Jn7LXarRlI8Hc0GtTn759 Sean Kelly Instagram: https://www.instagram.com/seanmikekelly/ Learn more about your ad choices. Visit megaphone.fm/adchoices

El divertimento musical semanal de José Manuel Zapata hoy se multiplica por tres. El tenor granadino comparte estudio con el actor Paco Mir y con el guitarrista Juan Francisco Padilla. Dos talentos con los que suma fuerzas en un espectáculo con el que están girando estos días, La loca y breve historia de la música. Y precisamente lo que vamos a hacer hoy es historia. Bueno, quizá historia concentrada. O… puede que con el poco tiempo que tenemos para un asunto de esta magnitud la cosa se quede en una story de Instagram. En cualquier caso, comenzamos por la madre de todas las preguntas: ¿cómo nace la música? Escuchar audio

La inspiración aguarda al tenor José Manuel Zapata a la vuelta de casi cada esquina. Después de ver la película La mujer de Tchaikovsky (2022) de Kirill Serebrennikov, nuestro colaborador no ha podido evitar recorrer el tortuoso camino de la vida del genio musical ruso. Un talento precoz que a los 5 años ya superaba a su profesora en lectura y comprensión musical. Un prodigio para el que su familia tenía unos planes completamente alejados de la música y que pasaban por convertirlo en un funcionario. Arropados por las melodías de Tchaikovsky y guiados por la sabiduría y sensibilidad de Zapata, recorremos el camino vital nada sencillo del maestro ruso. ¡Oídos bien atentos, escuchantes!Escuchar audio

José Manuel Zapata no abandona la música sacra porque hoy viene a hablarnos de una apasionante obra maestra: el Réquiem de Wolfgang Amadeus Mozart. Esta obra que analizaremos con nuestro tenor favorito ofrece a la historia de la música uno de sus más enrevesados misterios, que hasta hoy siguen creando fascinación a musicólogos e investigadores. Escuchar audio

Wisconsin Badgers football 2025 verbal commit Brenden Anes joins the show! Wisconsin Badgers football 2025 verbal commit Brenden Anes joins the show!We talk about the Badgers football program and how Anes fits into the defense going forward. We talk about his game and his journey so far as a player and why he's such a valuable defensive player. We talk about his athletic ability and why he's the perfect fit the way Wisconsin wants to play defense under Luke Fickell. We also talk about his recruiting journey, the ups and downs and why ultimately Wisconsin won out for him. Support Us By Supporting Our Sponsors! eBay Motors With all the parts you need at the prices you want, it's easy to turn your car into the MVP and bring home that win. Keep your ride-or-die alive at EbayMotors.com. Eligible items only. Exclusions apply. eBay Guaranteed Fit only available to US customers. Athletic Brewing Go to AthleticBrewing.com and enter code LOCKEDON to get 15% off your first online order or find a store near you! Athletic Brewing. Milford, CT and San Diego, CA. Near Beer. PrizePicks Go to PrizePicks.com/lockedoncollege and use code lockedoncollege for a first deposit match up to $100! Daily Fantasy Sports Made Easy! Gametime Download the Gametime app, create an account, and use code LOCKEDONCOLLEGE for $20 off your first purchase. Jase Medical Save more than $360 by getting these lifesaving antibiotics with Jase Medical plus an additional $20 off by using code LOCKEDON at checkout on jasemedical.com. LinkedIn LinkedIn Jobs helps you find the qualified candidates you want to talk to, faster. Post your job for free at LinkedIn.com/LOCKEDONCOLLEGE. Terms and conditions apply. FanDuel Make Every Moment More. Right now, NEW customers can bet FIVE DOLLARS and get TWO HUNDRED in BONUS BETS – GUARANTEED. Visit FanDuel.com/LOCKEDON to get started. FANDUEL DISCLAIMER: 21+ in select states. First online real money wager only. Bonus issued as nonwithdrawable free bets that expires in 14 days. Restrictions apply. See terms at sportsbook.fanduel.com. Gambling Problem? Call 1-800-GAMBLER or visit FanDuel.com/RG (CO, IA, MD, MI, NJ, PA, IL, VA, WV), 1-800-NEXT-STEP or text NEXTSTEP to 53342 (AZ), 1-888-789-7777 or visit ccpg.org/chat (CT), 1-800-9-WITH-IT (IN), 1-800-522-4700 (WY, KS) or visit ksgamblinghelp.com (KS), 1-877-770-STOP (LA), 1-877-8-HOPENY or text HOPENY (467369) (NY), TN REDLINE 1-800-889-9789 (TN) Follow & Subscribe on all Podcast platforms…

Anuman ang sini-celebrate mo this February 14, mapa-Valentine's Day o Singles Awareness Day, bagay sa iyo ang episode na ito. Kasama natin ang award-winning at bestselling author ng librong "How to Grieve" na si Jade Mark Capiñanes! BOOM! Sa episode na ito, bukod sa napag-usapan natin ang kuwento kung bakit at paano nagsusulat si Jade, madaraanan din natin ang iba't ibang experiences when it comes to love and grief, not just for one person… but for a whole country. Wiw.  Ready ka na ba sa #feels na hatid ng episode na ito? Listen up, yo!

Anuman ang sini-celebrate mo this February 14, mapa-Valentine's Day o Singles Awareness Day, bagay sa iyo ang episode na ito. Kasama natin ang award-winning at bestselling author ng librong "How to Grieve" na si Jade Mark Capiñanes! BOOM! Sa episode na ito, bukod sa napag-usapan natin ang kuwento kung bakit at paano nagsusulat si Jade, madaraanan din natin ang iba't ibang experiences when it comes to love and grief, not just for one person… but for a whole country. Wiw. Ready ka na ba sa #feels na hatid ng episode na ito? Listen up, yo!

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Brenden Anes commits to the Wisconsin Badgers football team ! Big time athletic linebacker! Support Us By Supporting Our Sponsors! eBay Motors With all the parts you need at the prices you want, it's easy to turn your car into the MVP and bring home that win. Keep your ride-or-die alive at EbayMotors.com. Eligible items only. Exclusions apply. eBay Guaranteed Fit only available to US customers. Athletic Brewing Go to AthleticBrewing.com and enter code LOCKEDON to get 15% off your first online order or find a store near you! Athletic Brewing. Milford, CT and San Diego, CA. Near Beer. PrizePicks Go to PrizePicks.com/lockedoncollege and use code lockedoncollege for a first deposit match up to $100! Daily Fantasy Sports Made Easy! Gametime Download the Gametime app, create an account, and use code LOCKEDONCOLLEGE for $20 off your first purchase. Jase Medical Save more than $360 by getting these lifesaving antibiotics with Jase Medical plus an additional $20 off by using code LOCKEDON at checkout on jasemedical.com. LinkedIn LinkedIn Jobs helps you find the qualified candidates you want to talk to, faster. Post your job for free at LinkedIn.com/LOCKEDONCOLLEGE. Terms and conditions apply. FanDuel Make Every Moment More. Right now, NEW customers can bet FIVE DOLLARS and get TWO HUNDRED in BONUS BETS – GUARANTEED. Visit FanDuel.com/LOCKEDON to get started. FANDUEL DISCLAIMER: 21+ in select states. First online real money wager only. Bonus issued as nonwithdrawable free bets that expires in 14 days. Restrictions apply. See terms at sportsbook.fanduel.com. Gambling Problem? Call 1-800-GAMBLER or visit FanDuel.com/RG (CO, IA, MD, MI, NJ, PA, IL, VA, WV), 1-800-NEXT-STEP or text NEXTSTEP to 53342 (AZ), 1-888-789-7777 or visit ccpg.org/chat (CT), 1-800-9-WITH-IT (IN), 1-800-522-4700 (WY, KS) or visit ksgamblinghelp.com (KS), 1-877-770-STOP (LA), 1-877-8-HOPENY or text HOPENY (467369) (NY), TN REDLINE 1-800-889-9789 (TN) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Anes Balic is the Director Of Sales & Business Development at Balic Transport Inc. BTI is an asset based transportation company. Based in Denver,CO specializing in truck load and less the truck load freight. Other services we provide is dedicated and local freight movement along with LTL movements. Reach out to us today for any questions on how we can move your freight. Make sure to connect with Anes & follow BTI!  To learn more about becoming a Freight Agent: https://spi3pl.com/ To learn more about Denim: https://www.denim.com/ To learn more about Tai Software: https://tai-software.com/request-demo/ Ditch your carrier packet, Drive more carrier sales and get better load coverage with seamless digital onboarding, TMS integration, and smart load coverage, visit: https://brokercarrier.com/

Check out this week's episode with Sarah Anes from REI Kash where she shares hacks for creating success habbits for her kids. She has created processes and routines to set her kids up for positive mental health. You won't want to miss how she redirects her kids behaviors to make her household flow much more smoothly.

Check out this week's episdoe with Sarah Anes. Tune into hear Sarah's story of how she went from nurse to real estate investor to software devolper all while being a mom and going through a divorce. She shares how to flip land and provides amazing resources to help stream line the process so you can do it too. You won't want to miss it.