Podcasts about apr jun

Team, we are back with another installment of the Epic Table podcast! We are joined by award winning neurologists, Drs. Ayesha and Dean Sherzai aka Team Sherzai. Team Sherzai is responsible for one of the largest clinical studies on Alzheimers at Loma Linda University Medical center. The Duo, who are happily married, are co author of the book The Alzheimer's Solution, a book dedicated to sharing their hands on research and is equipped with a extensive step by step guide to preventing Alzheimer's disease and information on improving cognitive brain function. Specifically we discuss... What is Alzheimers? What is the main cause of Alzheimer's? How to prevent Alzheimer's disease, How lifestyle plays a huge role in Alzheimer's The difference between Alzheimer's and Dementia When does Alzheimer's disease starts? What are the beginning stages? How Inflammation, Lipid dysregulation, oxidation, glucose/energy dysregulation damage the brain. How to sharpen brain cognition Good stress vs Bad Stress, how they influence brain function Resources... Preventing Alzheimer's Our Most Urgent Health Care Priority: Sherzai AZ, Parasram M, Haider JM, Sherzai D. Alzheimer Disease and Cancer: A National Inpatient Sample Analysis. Alzheimer Dis Assoc Disord. 2020 Apr-Jun;34(2):122-127. doi: 10.1097/WAD.0000000000000369. PMID: 31990712. Alzheimer Disease and Cancer: A National Inpatient Sample Analysis, https://journals.lww.com/alzheimerjournal/Abstract/2020/04000/Alzheimer_Disease_and_Cancer__A_National_Inpatient.4.aspx learn more about Team Sherzai - https://teamsherzai.com (Website), https://www.facebook.com/SherzaiMD/ (Facebook), @SherzaiMD https://www.instagram.com/sherzaimd/ (Instagram).

In this episode, I discuss the positive effects of sunlight that many do not mention. This episode is sponsored by WYSK Spark Radio, https://live365.com/station/Spark-Radio-a82219. To keep this podcast going please feel free to donate at paypal.me/yopistudio If you would like to read more on this topic or any other previous topics, you can do so by checking out our blog at https://yopistudio.blogspot.com/ Feel free to see what we are up to by following us at:  https://twitter.com/Dauricee https://www.facebook.com/yopistudio/ https://www.facebook.com/LouisianaEntertainmentAssociation/ To listen to the podcast, watch creative videos and skits go to https://www.youtube.com/channel/UCvn6tns6wKUwz9xZw11_vAQ/videos Interested in projects Daurice has worked on in the movie industry you can check it out at www.IMDb.com under Daurice Cummings. For comments or questions, you can reach us at yopi@post.com To read more about today’s topic check out the references below. Reference Zeckhauser, R. J., & Slusky, D. (2018). Sunlight and Protection Against Influenza. The National Bureau of Economic Research. Retrieved from https://www.nber.org/papers/w24340 Phan, T., Jaruga, B., Pingle, S. et al. Intrinsic Photosensitivity Enhances Motility of T Lymphocytes. Sci Rep 6, 39479 (2016). https://doi.org/10.1038/srep39479  Pathology 2012, Volume 44, Supplement 1, Page S40 https://www.sciencedirect.com/science/article/abs/pii/S0031302516326927  Radiat Res (2017) 187 (4): 493-501. https://meridian.allenpress.com/radiation-research/article-abstract/187/4/493/192663/Germicidal-Efficacy-and-Mammalian-Skin-Safety-of?redirectedFrom=fulltext Dermatoendocrinol. 2013 Jan 1; 5(1): 51-108.  J Pharmacol Pharmacother. 2012 Apr-Jun; 3(2): 118-126.  Environ Health Perspect. 2008 Apr; 116(4): A160-A167.  J Pharmacol Pharmacother. 2012 Apr-Jun; 3(2): 118-126.  Phan, T., Jaruga, B., Pingle, S. et al. Intrinsic Photosensitivity Enhances Motility of T Lymphocytes. Sci Rep 6, 39479 (2016). https://doi.org/10.1038/srep39479  https://www.mdpi.com/2076-3417/10/7/2597/htm  Phan, T., Jaruga, B., Pingle, S. et al. Intrinsic Photosensitivity Enhances Motility of T Lymphocytes. Sci Rep 6, 39479 (2016). https://doi.org/10.1038/srep39479  J Hosp Infect. 2013 Aug; 84(4): 271-282.  J Hosp Infect. 2013 Aug; 84(4): 271-282.  J Hosp Infect. 2013 Aug; 84(4): 271-282.  Jia J, Hu J, Huo X, Miao R, Zhang Y, Ma F. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer's disease: a randomised, double-blind, placebo-controlled trial. J Neurol Neurosurg Psychiatry. 2019;90(12):1347‐1352. doi:10.1136/jnnp-2018-320199  Int J Mol Sci. 2018 Sep; 19(9): 2736.  Issues Ment Health Nurs. Author manuscript; available in PMC 2011 Jun 1. Can Fam Physician. 2006 Apr 10; 52(4): 422-423.  Horio T. Skin disorders that improve by exposure to sunlight. Clin Dermatol. 1998;16(1):59‐65. doi:10.1016/s0738-081x(97)00170-3  Berg M. Epidemiological studies of the influence of sunlight on the skin. Photodermatol. 1989;6(2):80‐84. Environ Health Perspect. 2008 Apr; 116(4): A160-A167.  Environ Health Perspect. 2008 Apr; 116(4): A160-A167.Fleury N, Geldenhuys S, Gorman S. Sun Exposure and Its Effects on Human Health: Mechanisms through Which Sun Exposure Could Reduce the Risk of Developing Obesity and Cardiometabolic Dysfunction. Int J Environ Res Public Health. 2016;13(10):999. Published 2016 Oct 11. doi:10.3390/ijerph13100999  Environ Health. 2009; 8: 34.  Issues Ment Health Nurs. Author manuscript; available in PMC 2011 Jun 1. Int J Biometeorol. Author manuscript; available in PMC 2015 Apr 1.  Clin Interv Aging. 2018; 13: 2075-2082. Environ Health. 2009; 8: 34.  Int J Biometeorol. Author manuscript; available in PMC 2015 Apr 1.    

Are you freaking out about the coronavirus? Looking for more food-as-medicine solutions to support your family’s health during this time? Need a little reassurance to reduce the anxiety this pandemic is causing? Tune in to hear Ali and Becki discuss emerging information about the coronavirus, new statistics on infection rates and what this means for you and your family. Learn about the connection of ACE 2 receptors, symptoms of coronavirus vs. cold and flu, and how you can best support your system during this time.   With evolution of the coronavirus pandemic over the past week, we are interrupting our regularly scheduled content to bring you up-to-date information about the mechanism of the virus, how it spreads and factors that put individuals at higher risk. The added stress and anxiety that self-quarantine, 24/7 news coverage and business and school closures is definitely NOT supportive of immune health, in fact stress can actually shut down the immune system! Learn how stress wreaks havoc on your body’s ability to fight, from reduced white blood cell activity to suppressed autophagy to depletion of micronutrients like Vitamin C and what you can do keep your immune system robust to the impact of stress!    Also in This Episode: Episode 179: Coronavirus and Immune Support Symptoms of COVID-19 How COVID-19 Gets Into the Body The ACE-2 Connection and How Herbal Compounds Can Support SkullcapBerberine Boost Sleep Support  HesperidinBio-C Plus Vitamin D and Virus SupportVitamin D Balanced Blend Risk Factors for Coronavirus Vulnerability  Cytokine Storm Why to Skip Elderberry During This Time! Updated Coronavirus Kit SupplementsRebuild Spectrum Probiotic Targeted Strength Probiotic Vitamin D Balanced Blend Multidefense Bio-C Plus Adaptogen Boost Cellular Antiox Naturally Nourished Grassfed Whey Herbal Immune Berberine Boost Additional ProductsColloidal Silver Herbal Throat Spray XClear Nasal Spray Doterra OnGuard Essential Oil Products The Stress-Immune Connection How Stress Impacts the BodyEpisode 56: Rebounding Your Body from Trauma Episode 77: The Stress Connection to Autoimmune Disease The Stress GI ConnectionGI Lining Support Stress Reduction TechniquesWhy You Need SleepSleep Support Relax and Regulate How to Approach Exercise Under Stress Mantra, Meditation and 4-7-8 Breath Stress Supporting Supplements GabaCalm Calm and Clear Adaptogen Boost Research Mentioned in This Episode: Wang, L., Ma, Q., 2018. Clinical benefits and pharmacology of scutellarin: A comprehensive review. Pharmacol Ther 190, 105-127. Wang, W., Ma, X., Han, J., Zhou, M., Ren, H., Pan, Q., Zheng, C., Zheng, Q., 2016. Neuroprotective Effect of Scutellarin on Ischemic Cerebral Injury by Down-Regulating the Expression of Angiotensin-Converting Enzyme and AT1 Receptor. PLoS One 11(1), e0146197. Kuhn, J.H., Radoshitzky, S.R., Li, W., Wong, S.K., Choe, H., Farzan, M., 2006. The SARS Coronavirus receptor ACE 2 A potential target for antiviral therapy, New Concepts of Antiviral Therapy. Springer, pp. 397-418. Ding, L., Li, J., 2019. Baicalin ameliorates oxidative stress and apoptosis by restoring mitochondrial dynamics in the spleen of chickens via the opposite modulation of NF-kappaB and Nrf2/HO-1 signaling pathway during Mycoplasma gallisepticum infection. Poult Sci 98(12), 6296-6310. Cinatl, J., Jr., 2005. Antiviral activity of glycyrrhizic acid derivatives against SARS-coronavirus. J Med Chem 48(4), 1256-1259. Lingchong Wang† ORCID logoab, Dapeng Zhang† bc, Ning Wangb, Sha Lib, Hor-Yue Tanb and Yibin Feng *b. Polyphenols of Chinese skullcap roots: from chemical profiles to anticancer effects. DOI: 10.1039/C9RA03229K (Review Article) RSC Adv., 2019, 9, 25518-25532 Barak V1, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. 2001 Apr-Jun;12(2):290-6. Sponsors For This Episode:   This episode is sponsored by Wild Foods, a company that puts quality, sustainability, and health first in all of their products. They have everything from coffee to turmeric to medicinal mushrooms, and every single product is painstakingly sourced from small farms around the globe. They take their mission seriously to fix the broken food system, and believe real food is medicine. They’ve partnered with us to give you guys an exclusive discount, so use the code ALIMILLERRD for 12% off your order at WildFoods.co!   

References:Adriana Sarah Nica, Adela Caramoci, Mirela Vasilescu, Anca Mirela Ionescu, Denis Paduraru, Virgil Mazilu.  Magnesium supplementation in top athletes - effects and recommendations. Medicina Sportiva (2015), vol. XI, no 1, 2482-2494 Journal of the Romanian Sports Medicine SocietyAikawa JW. Magnesium: its biological significance. Boca Raton, FL: CRC Press, 1981:21–38.Abbasi B, Kimiagar M, Sadeghnijat K, Shirazi MM, Hedayati M, Rashidkhani B. “The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial.”  J Res Med Sci. 2012 Dec 17 (12): 1161-9.PubMed PMID: 23853635. Arnaud MJ: Update on the assessment of magnesium status. Br J Nutr 2008;99(suppl 3):S24–S36 Brilla LR, Haley TF. Effect of magnesium supplementation on strength training in humans. J Am Coll Nutr 1992;11:326​​​​​​​Chandrasekaran NC, Weir C, Alfraji S, Grice J, Roberts MS, Barnard RT. Effects of magnesium deficiency--more than skin deep. Exp Biol Med (Maywood). 2014 Oct;239(10):1280-91. doi: 10.1177/1535370214537745. Epub 2014 Jun 13.Ebel H, Gunther T. Magnesium metabolism: a review. J Clin Chem Biochem 1980;18:257–70.Emelyanov A, Fedoseev G, Barnes PJ: Re- duced intracellular magnesium concentra- tions in asthmatic patients. Eur Respir J 1999;13:38–40.Fawcett WJ, Haxby EJ, Male DA: Magnesium: physiology and pharmacology. Br J Anaesth 1999;83:302–320.Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press, 1997.Guerrero-Romero F, Rodríguez-Morán M. Relationship between serum magnesium levels and C-reactive protein concentration, in non-diabetic, non-hypertensive obese subjects. Int J Obes Relat Metab Disord. 2002;26:469–74.Hosty´nek JJ, Hinz RS, Lorence CR, Price M, Guy RH. Metals and the skin. Crit Rev Toxicol 1993;23:171–235Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J 2012;5:i3–i14Kupetsky-Rincon EA1, Uitto J. Magnesium: novel applications in cardiovascular disease--a review of the literature. Ann Nutr Metb. 2012;61(2):102-10.Lansdown AB. Physiological and toxicological changes in the skin resulting from the action and interaction of metal ions. Crit Rev Toxicol1995;25:397–462.Mochizuki M, Akagi K, Inoue K, Shimamura K.[A single dose toxicity study of magnesium sulfate in rats and dogs]. J Toxicol Sci. 1998 May;23 Suppl 1:31-5Navarrete-Cortes A, Ble-Castillo JL, Guerrero-Romero F, Cordova-Uscanga R, Juárez-Rojop IE, Aguilar-Mariscal H, Tovilla-Zarate CA, Lopez-Guevara Mdel R. No effect of magnesium supplementation on metabolic control and insulin sensitivity in type 2 diabetic patients with normomagnesemia. Magnes Res. 2014 Apr-Jun;27(2):48-56. doi: 10.1684/mrh.2014.0361.Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Peney PD. “Insufficient sleep undermines dietary efforts to reduce adiposity.”  ANN Intern Med. 2010 Oct 5:153(7):435-41. PubMed PMID: 20921542.Nowacki W, Daveau M, Malpuech-Bruge C. Inflammatory responsefollowing acute magnesium deficiency in the rat. Biochim Biophys Acta 2000;1501:91–8Nielsen FH, Johnson LK, Zeng H.  Magnesium supplementation improves indicators of low magnesium status and inflammatory stress in adults older than 51 years with poor quality sleep.  Magnes Res. 2010 Dec;23(4):158-68. doi: 10.1684/mrh.2010.0220. Epub 2011 Jan 4.Malon A, Brockmann C, Fijalkowska- Morawska J, Rob P, Maj-Zurawska M: Ionized magnesium in erythrocytes – the best magnesium parameter to observe hypo- or hypermagnesemia. Clin Chim Acta 2004; 349:67–73.Martin K, Jackson CF, Levy RG, Cooper PN. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Syst Rev. 2016 Feb 9;2:CD001903. doi: 10.1002/14651858.CD001903.pub3.Meolie AL, Rosen C, Kristo D, Kohrman M, Gooneratne N, Aguillard RN, Fayle R, Troell R, Townsend D, Claman D, Hoban T, Mahowald M. Oral nonprescription treatment for insomnia: an evaluation of products with limited evidence; Clinical Practice Review Committee; American Academy of Sleep Medicine.J Clin Sleep Med. 2005 Apr 15;1(2):173-87.Rodríguez-Morán M, Guerrero-Romero F. Serum magnesium and C-reactive protein levels. Arch Dis Child. 2008;93:676–80University of Maryland Medical Center “Magnesium” access May 8. 2016 http://umm.edu/ health/medical/altmed/supplement/magnesiumShils ME. Magnesium. In: Shils ME, Olson JA, Shike M, eds. Modern nutrition in health and disease. 8th ed. Philadelphia: Lea & Febiger, 1993:164–84.Simsek E, Karabay M, Kocabay K: Assess- ment of magnesium status in newly diag- nosed diabetic children: measurement of erythrocyte magnesium level and magne- sium tolerance testing. Turk J Pediatr 2005; 47:132–137.Waring, RH  Report on Absorption of magnesium sulfate (Epsom salts) across the skin.  School of Biosciences, University of Birmingham. B15 2TT, U.K. r.h.waring@bham.ac.uk   URL http://www.epsomsaltcouncil.org/wpcontent/uploads/2015/10/report_on_absorption_of_magnesium_sulfate.pdfWinkelmann RK. The relationship of the structure of the epidermis to percutaneous absorption. Br J Dermatol 1969;81:11–22Witkowski M, Hubert J, Mazur A. Methods of assessment of magnesium status in humans: a systematic review. Magnes Res. 2011 Dec;24(4):163-80. doi: 10.1684/mrh.2011.0292.

A Surprising Cure for Fear of the Unknown|Why Are We Turned On By Terror? https://fifty20com.com/ https://www.intrinsicmotivation.life/ Whether it's a horror movie or a haunted house, there are a lot of people who love being scared out of their wits. What's up with that? Is it normal? And what about kids? How much is too much for a child? Myke Merrill, D.Min., author of “Why Do People Act that Way? (And What Can I Do About It?),” will explain why we get a thrill from being spooked, whether it's emotionally healthy or not, and what parents should consider before taking their kids to a scary movie or haunted attraction. The author of 22 books and training manuals, Dr. Myke was a panelist on the national television show Ask the Pastor for 18 years. He has traveled worldwide for training and educational development in over 20 countries, and speaks or reads eight languages. A journey into the Five Basic Emotional Systems: This book is about the human experience. It focuses on one key aspect of how human beings experience life: emotions. It presents a sequence by which people develop their experience of life: 1. The Complex of Perceptions 2. The Complex of Emotional Systems 3. The Complex of Motivations 4. The Complex of Behaviors While these four complexes initially engage in this sequence, they become interactive, each complex affecting all the other complexes in dynamic ways. dealing with fear, what is fear, the root of fear, protection from fear, overcoming fear,refuge from fear, love overcomes fear, fear of death, fear and attachment, ... These can also be divided into fear of the inevitable and fear of the evitable. The key to dealing with fear is to check which type of fear we have, and to transform ... Practical and spiritual solutions for dealing with fear. J Christ Nurs. 2012 Apr-Jun;29(2):77. Offering whole person care: dealing with fear. Diggins K. PMID: 22480077; [Indexed for MEDLINE]. MeSH terms. Sep 28, 2017 - Dealing with the fear of parkinson's can be difficult since progression is uncertain. However, there are ways to harness that energy to wase your ... Getting an ovarian cancer diagnosis can be really overwhelming - but your medical team can help with feelings of fear and anxiety, either be prescribing ... Individual fear. Fear is very personal. Different people are afraid of different things, and for different reasons. Here are some ways of dealing with fears:. Aug 18, 2017 - A leading North American sports psychologist recently called to tell me something he thought I would enjoy. He said in studying the importance ... Last week I wrote about how to find the positive when you're not feeling well, something I've been struggling a lot with recently. After having had two minor ... Apr 30, 2015 - Soooo I didn't write to you last week. I had been in Virginia with my family and my grandmother (who is slowly getting better) for over two weeks, ... Oct 14, 2018 - Dealing with Fear. Training through the field of fears. The Field of Fears is a short one to two days training program that is designed to assist ... Jun 24, 2019 - The Work is one of my favorite ways of dealing with fears, anxieties, and worries. There are many methods available, so pick the one that you ... Fear of the unknown meaning that people sometimes tend to avoid those who are ill for fear of “upsetting them” or “making them worse” #fearoftheunknown #intrinsicmotivationfromahomiesperspective Subscribe To Our YT channel: https://www.youtube.com/channel/UCxCy8t2zrzeXly9vC527QhQ Facebook Page: https://www.facebook.com/Intrinsic-Motivation-A-Homies-Perspective-1840324906181321/ Google Plus: https://aboutme.google.com/b/104269580399573766056 SoundCloud: https://soundcloud.com/intrinsic-motivation-from-a-homies-perspective Stitcher: https://www.stitcher.com/s?fid=158463&refid=stpr iTunes: https://itunes.apple.com/us/podcast/intrinsic-motivation-from-a-homies-perspective/ Media Inquiries: howintrinsic AT intrinsicmotivation DOT life Playe --- Support this podcast: https://anchor.fm/intrinsic-motivation/support

Justin Rash, PharmD, Co-Host of SenioRx Radio interviews Frank Grosso, CEO of the ASCP about the "State of Senior Care Pharmacy". The importance of senior care | Long-term care pharmacy is more important than ever before. The “baby boomer” population began in 1946, which means the “tip of the spear” just began turning 70 years old in 2016. As these baby boomers age, they will develop more comorbidities and health issues, and their impact on the system and their consumption of medications and health care services will skyrocket, so, this is probably just the tip of the iceberg. Consider this: Today there are over 46.2 million adults aged 65 and older in the United States; by 2060, that number is expected to double to 98 million. Starting in 2011 and continuing until 2030, approximately 10,000 baby boomers will celebrate their 65th birthday each day. Seniors represent 14.5% of the United States population, about 1 in 7 Americans. Nearly 92% of older adults have at least one chronic condition, and 77% have at least two. Some type of disability (e.g. difficulty in hearing, vision, cognition, ambulation, self-care, or independent living) was reported by 36% of adults aged 65 and over in 2012. The Centers for Disease Control and Prevention website has a useful tool - The Healthy Aging Data Portal - in which users can enter search categories and regions of interest in the US and Territories to find current healthy aging data for that area. "Medications are probably the single most important health care technology in preventing illness, disability, and death in the geriatric population." Brahma, Wahlang, Marak, Sangama. "Adverse Drug Reactions in the Elderly”: Journal of Pharmacology & Pharmacotherapeutics, Apr-Jun 2013.Senior Care Facts: http://www.ascp.com/page/seniorcarefacts See omnystudio.com/listener for privacy information.

Most newborns will have some jaundice.  Most jaundice is benign. So, how can we sort through the various presentations and keep our newborns safe? Pathologic Jaundice When a baby is born with jaundice, it’s always bad.  This is pathologic jaundice, and it’s almost always caught before the baby goes home.  Think about ABO-incompatbility, G6PD deficiency, Crigler-Najjar, metabolic disturbances, and infections to name a few.  Newborns are typically screened and managed. Physiologic Jaundice Physiologic jaundice, on the other hand, is usually fine, until it’s not. All babies have some inclination to develop jaundice.  Their livers are immature.  They may get a little dehydrated, especially if mother’s milk is late to come in.  In today’s practice, we are challenged to catch those at risk for developing complications from rising bilirubin levels. Hyperbilirubinemia is the result of at least one of three processes: you make too much, you don’t process it enough, or you don’t get rid of it fast enough. Increased production Bilirubin mostly comes from the recycling of red blood cells. Heme is broken down in in the liver and spleen to biliverdin then bilirubin. Normal, full term babies without jaundice run a little high -- bilirubin production is two to three times higher than in adults, because they are born with a higher hematocrit.  Also, fetal hemoglobin is great at holding on to oxygen, but has a shorter life span, and high turn-over rate, producing more bilirubin. Impaired conjugation Think of bilirubin as your email.  Unconjugated bilirubin is your unread email.  To process it or get rid of it – you have to open it.  Of course, the more unread messages that accumulate, the more unwell you feel. Conjugated bilirubin is your opened and processed email.  So much easier to sort out, deal with, and get rid of. Decreased excretion Both unread email and unconjugated bilirubin continue to float around in your inbox.  Unconjugated bilirubin keeps getting reabsorbed in the intestinal mucosa through enterohepatic circulation. Processed email and conjugated bilirubin are easier to sort out.  Conjugated bilirubin is water soluble, so it goes right into the read folder in your gallbladder, and is excreted off your inbox.  Later on down the line in the intestine, conjugated bilirubin can’t be reabsorbed through the intestinal mucosa.  Like when you open an email and forget about it – it passes on through, out of your system. Newborns are terrible at answering emails.  There is a lot of unread unconjugated bilirubin is floating around.  The liver and spleen are just not able to keep up. Also, newborns have a double-whammy administrative load.  Normally, bacteria in the gut can further break down conjugated bilirubin to urobilin and get excreted in the urine.  The infant’s gut is relatively sterile, so no admin assistance there.  Just to add to the workload a poor little newborn has to do – he is being sabotaged by extra beta-glucuronidase which will take his hard-earned conjugated bilirubin and unconjugate it again, then recycle it, just like email you “mark as unread”. How Does this All Go Down? The recommended followup is 48 hours after discharge from the nursery for a routine bilirubin check, often in clinic, and often via the transcutaneous route. More Specifically: Infant Discharged Should Be Seen by Age Before age 24 h 72 h Between 24 and 48 h 96 h Between 48 and 72 h 120 h The neonate will end up in your ED off hours, if there is concern, if his status deteriorates, or simply by chance.  We need to know how to manage this presentation, because time is of the essence to avoid complications if hyperbilirubinemia is present. Critical Action #1: Assess risk for developing severe hyperbilirubinemia. This will tell you: check now in ED or defer to clinic (default is to check). Risk Factors for Developing Hyperbilirubinemia Total serum bilirubin/Transcutaneous bilirubin in high-risk zone Jaundice in first 24 hours ABO incompatibility with positive direct Coombs, known hemolytic disease, or elevated ETCO Gestational age 35-36 weeks Prior sibling had phototherapy Cephalohematoma or bruising Exclusive breastfeeding, especially with poor feeding or weight loss East Asian Race Critical Action #2 Check bilirubin and match this with how old the child is -- in hours of life -- at the time of bilirubin measurement. This will tell you: home or admission. Use the Bilitool or Bhutani Nomogram (below).   Can I go Home Now? Risk Stratification for Developing Severe Hyperbilirubinemia. Bhutani et al. Pediatrics. 1999. In general, babies at low-risk and low-intermediate risk can go home (see below).  Babies at high-intermediate or high risk are admitted (see below). Critical Action #3: Assess risk for developing subsequent neurotoxicity. This will tell you: a) phototherapy or b) exchange transfusion     Phototherapy Now?     Exchange Transfusion Now? Threshold for Initiating Exchange Transfusion by Risk Stratum. Bhutani et al. Pediatrics. 1999. Home care The neonate who is safe to go home is well appearing, and not dehydrated.  His total bilirubin is in the low to low-intermediate risk for developing severe hyperbilirubinemia, and he is not at high risk for neurotoxicity based on risk factors. Babies need to stay hydrated.  Breast feeding mothers need encouragement and need to offer feeds 8-12 times/day – an exhausting regimen.  The main message is: stick with it.  Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can.  Supplementing with formula or expressed breast milk is not routinely needed.  Be explicit that the neonate should not receive water or sugar water – it can cause dangerous hyponatremia.  A moment of solid precautionary advice could avert a disaster in the making. The child’s pediatrician will help more with this, and you can remind nursing mothers of the excellent La Leche League – an international group for breastfeeding support.  They have local groups everywhere, including a hotline to call. Nursery Care If the baby is at high intermediate or high risk for hyperbilirubinemia, then he should be admitted for hydration, often IV.  Most babies with hyperbilirubinemia are dehydrated, which just exacerbates the problem. Bililights or biliblankets, provide the baby with the right blue spectrum of light to isomerize bilirubin to the more soluble form.  Traditionally, we have thought them to be more effective or safer than filtered sunlight.  A recent randomized control trial by Slusher et al. in the New England Journal of Medicine compared filtered sunlight versus conventional phototherapy for safety and efficacy in a resource-poor environment.  These were all term babies with clinically significant jaundice in Nigeria.  To standardize the intervention, they used commercial phototherapy canopies that remove most UV rays. None of them became dehydrated or became sunburned.  The filtered sunlight resulted in a 93% successful treatment versus 90% for conventional phototherapy.  My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home. Critical Care Although rare, the critically ill neonate with hyperbilirubinemia requires immediate intervention. He will be dehydrated – possibly in shock.  He will be irritable. Or, he may just have a dangerously high bilirubin level – at any minute he could develop bilirubin induced neurologic dysfunction, or BIND, especially when bilirubin concentrations reach or surpass 25 mg/dL (428 micromol/L).  The bilirubin is so concentrated that it leeches past the blood brain barrier and causes neuronal apoptosis.  BIND is a spectrum from acute bilirubin encephalopathy to kernicterus, all involving some disorder in vision, hearing, and later gait, speech, and cognition. Acute bilirubin encephalopathy starts subtly.  The neonate may be sleepy but hypotonic or have a high-pitched cry; he maybe irritable or inconsolable, jittery or lethergic. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever.  Check the bilirubin in any neonate you are working up for sepsis. Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. Kernicterus is the final, permanent result of bilirubin encephalpathy.  The child may have choreoathetoid cerebral palsy with chorea, tremor, ballismus, and dystonia.  He may have sensorineural hearting loss, or cognitive dysfunction. It is for this reason that any child sick enough to be admitted should be considered for exchange transfusion.  Most babies need just a little gentle rehydration and bililights, but to be sure, the admitting team will look at a separate nomogram to gage the child’s risk and decide whether to pull the trigger on exchange transfusion.  For our purposes, a ballpark estimate is that if the total serum bilirubin is 5 mg/dL above the phototherapy threshold, or if they have any red flag signs or symptoms, then exchange transfusion should be started. Exchange transfusion involves taking small aliquots of blood from the baby and replacing them with donor blood.  It’s often a manual procedure, done with careful monitoring.  It can be done with any combination of umbilical arteries or veins with peripheral arteries or veins.  In general, arteries are the output, veins are for transfusion. The baby may need a double-volume exchange, which ends up replacing about 85% of circulating blood, a single-voume exchange, replacing about 60% of blood, or any fraction of that with apartial volume exchange.  It is a very delicate procedure that requires multiple hours and often multiple staff. For our pruposes, just be aware that the jaundiced baby in front of you may need escalation of his care. Summary Find out the hour of life of the baby at the time of bilirubin measurement.  Identify risk factors for developing severe hyperbilirubinemia and/or neurotoxicity The child with low to low-intermediate risk may be a good outpatient candidate provided he is well, not dehydrated, and follow-up is assured. The child with high-intermediate to high-risk for developing severe hyperbilirubinemia should be admitted for hydration, bililights, and/or assessment for exchange transfusion. The unwell child with or without current neurologic findings should have immediate exchange transfusion. References Benitz WE. Hospital Stay for Healthy Term Newborn Infants. Pediatrics. 2015; 135(5):948-53. Bhutani V et al. Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2004; 114(1). Bhutani VK, Wong RJ. Bilirubin Neurotoxicity in Preterm Infants: Risk and Prevention. J Clin Neonatol. 2013 Apr-Jun; 2(2): 61–69. Bosschaart N et al. Limitations and Opportunities of Transcutaneous Bilirubin Measurements. Pediatrics. 2012; 129(4). Colletti JE, Kothari S, Jackson DM, Kilgore KP, Barringer K. An emergency medicine approach to neonatal hyperbilirubinemia. Emerg Med Clin North Am. 2007 Nov;25(4):1117-35, vii. Gamaleldin R et al. Risk Factors for Neurotoxicity in Newborns With Severe Neonatal Hyperbilirubinemia. Pediatrics. 2011; 128(4):825-31. Lauer BJ, Spector ND. Hyperbilirubinemia in the Newborn. Pediatrics in Review. 2011; 32(8):341-9. Maisels J et al. Hyperbilirubinemia in the Newborn Infant ≥35 Weeks’ Gestation: An Update With Clarifications. Pediatrics. 2009; 124(4):1193-6. Smitherman H, Stark AR, Bhutani VK. Early recognition of neonatal hyperbilirubinemia and its emergent management.  Semin Fetal Neonatal Med. 2006 Jun;11(3):214-24. Vandborg PK, Hansen BM, Greisen G, Ebbesen F. Dose-response relationship of phototherapy for hyperbilirubinemia. Pediatrics. 2012 Aug;130(2):e352-7. This post and podcast are dedicated to Gita Pensa, MD, for her commitment to #FOAMed and passion for asynchronous learning and education innovation.

Episode 38   Introductions Karla - K-Rae on Ravelry and Karlacrafts on Instagram, Twitter and Pinterest Emily -  EmGemKnits - Instagram, and Ravelry . EmKnits on Twitter and EmGem on Pinterest   Shout outs Introduce yourself in the Ravelry group or leave us a review on itunes or google music   Circusbear! Rosberrycrafts! Stashandknit! bonjimac! HereIKnit!   KAL!   #stashtogiftknit2017 The KAL will begin January 1st 2017 and run until December 31st 2017. We will have quarterly entry threads in the ravelry group for your FOs and prizes to give away (more on those in a bit)! There is also a year long thread to keep track of all your gifts knits and there will be prizes for most gifts knit in 2017! Thank you to the following prize sponsors! Denise of Sock Ruler Brenda of Two Sticks and Ewe Sara of Riv Creative Sally of Yarn Friendly Joanne who is @porthardy1 on instagram Caitlyn Ffrench Okanagan Knit Co Chantal of Mudpunch Jess of Haven Fiber Arts Jocelyn who is @jocelyn_shuman Sylvia of Softsweater Knits It’s not too late if you would like to sponsor a prize! Just drop as a line and we’d be happy to have you on board. All sponsors will be mentioned in each episode of 2017! Ok! Here are THE RULES! Any and all gift knits will be accepted, there’s no minimum yardage, if it’s a gift it counts. Gifts knit from yarn acquired in 2016 or before get two entries, so post those FOs twice for more chances to win. (Please be honest, there’s no way for me to actually track this so I’m holding out on good knitting karma that there will be no cheating). If you knit a gift from yarn from 2017, you get one entry. Entries are quarterly, Jan - Mar, Apr - Jun, Jul - Sept, Oct - Dec. You cannot enter something finished in March in the July quarter etc. Year long FO thread is where you will open one post and keep a running tally of ALL the gifts knit in the year. Go back and edit this post as many times as you need to include all gifts. This really should be rule #1 but HAVE FUN! Post pictures of what you’re knitting on instagram with the hashtag #stashtogiftknit2017 so we can see all your projects! All prizes will be drawn with random number generator except the full year thread winner will be the one with the most gifts knit.   Art of Yarn Art of Yarns Knit-a-long to start the year off! We are teaming up with BC locals Shannon Cook and Jane Richmond to explore the Knits from their latest book Within Knits and the the amazing Westcoast Cardigan (stand alone pattern). To coincide with the KAL, we will have the complete trunk show for the book and Cardigan at the shop. If you are in the area please stop by and check it out. Prizes will be randomly awarded at the end of the KAL to participants. There are a few ways to join sand enter in the fun…. Posting your photos on instagram and tagging us in the photo @artofyarn Joining our ravelry group Art of Yarn Kal 2017 and sharing your project with us Tagging us on Facebook @artofyarn with your project For our locals too we will be hosting a small knit social to show off your FO’s Check us out on our website artofyarn.com if you would like to order the book and feel free to contact us if you need help in choosing a Yarn that is right for your project. Happy knitting and looking forward to seeing everyone’s progress! Melissa What's knitting now Emily - Socks for Bug in river city yarns - Hat trick calgary flames Genevieves tube socks - knitmoregirls Vanilla is the new black - CatGreen OMG you guys Hibernation Bridie for Bug in Sweet Fiber Canadian. Hand spun Love and Light by softsweater Bradway by Very Shannon in Brooklyn Tweed Shelter in Plume, Stormcloud and Yellow Advent calendar stockings (I finished one) Master Knitter Program in Cascade 220   Karla- Two custom socks for Grandma, Baby Boy Watson & Relativity   FO’s - Emily Karla - Brioso by Heather Zoppetti in 100% merino I dyed a dusty pink colour - stalled a little bit, on to second repeat   Design features Emily-  Not enough knitting to make mistakes Karla - reading charts on Relativity...   Spinning Emily -. none Karla - none but I want to so bad! Best laid plans Emily - Get out of the no knitting Rut. Karla -  Knit as much as I can!   Stash Enhancement Emily- 12days of knitmas - Vogue Knitting Holiday Karla - GC for Christmas! 12 days of knitmas! Talky Talk (Chatter?) Emily - The Big Move Karla - Michelle’s help with stash sorting   Crafternoon/Sew-what Emily - nope Karla - nope, but found CaliFayeCollection Adventures in Mommyhood Emily- Christmas holidays - single momming Karla- Renan is smiling and giggling and getting more use to being in his bed! Locke’s language skills are incredible and he’s all about the toys!   Inquiring minds Tell us about you! Join us on Ravelry or our Facebook page

In this episode of MyPal I discuss the potential uses of virtual reality (VR) in healthcare and what this may mean for palliative care. Beyond gaming: virtual reality in healthcare. Claire Bower. BMJ Blogs 2014. http://blogs.bmj.com/bmj-journals-development-blog/2014/03/27/beyond-gaming-virtual-reality-in-healthcare/ What can Oculus Rift do for healthcare?Mike Miliard. HealthcareIT news 2014. http://www.healthcareitnews.com/news/what-can-oculus-rift-do-healthcare The future of pain relief? Dutch burns unit trialling new virtual reality computer system that distracts patients from the agony of their wounds. Paul Donnelly, Daily Mail 9th Aug 2014. http://www.dailymail.co.uk/sciencetech/article-2720712/The-future-pain-relief-Dutch-burns-unit-trialling-new-virtual-reality-computer-distracts-patients-agony-wounds.html IS VR CHANGING HEALTHCARE? http://weareformation.com/is-vr-changing-healthcare/ A Survey of Health-Related Activities on Second Life. Leslie Beard et al. J Med Internet Res. 2009 Apr-Jun; 11(2): e17. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762804/ Virtual reality for the palliative care of cancer. Oyama 1997 http://www.ncbi.nlm.nih.gov/pubmed/10175345 Copyright Dr Amara Nwosu, AmiPal Media 2016. www.amaranwosu.com Music by Purple Planet http://www.purple-planet.com Photo by Jordi Boixareu https://www.flickr.com/photos/jobopa/16696929145/in/photolist-rrs8jH-rrs8mM-3MDfx-qKnTu4-rGanMp-b9mcPi-rpHzg8-rpB6SJ-kSPP9-bi5sXZ-rGatMF-rpHwT2-u74s5N-rGarCk-oAL3wY-6bRG9s-uoDHj8-saUyek-r7ATWe-Q2c6b-n7C2b-6bMx48-72SPhm-oWS4dH-tpyDhR-qrZC-wFc2p5-pcoahT-qrZy-trCizL-oMvrvF-bi5s4a-4XAPsx-rpacFf-riz3TM-pendcM-yNhwvM-iqg34e-w1W2Zr-cLEPq7-a1YL7s-qUsiSS-5V44RG-qUE9Bx-ryZR18-ryTgFf-ryTfNJ-4TkycL-49wC8u-4HYWqe

LightHouse News – Spring 2012 – Apr-Jun 2012 The post LightHouse News – Spring 2012 – Apr-Jun 2012 appeared first on LightHouse for the Blind and Visually Impaired.