Podcasts about Brachial

Episode 193: Gestational Diabetes IntroJesica Mendoza (OMSIII) describes the pathophysiology of gestational diabetes and the right timing and method of screening for it. Dr. Arreaza adds insight into the need for culturally-appropriate foods, such as vegetables in Mexican cuisine.    Written by Jesica Mendoza, OMSIII, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.DefinitionGestational diabetes mellitus (GDM) is a condition that occurs to previously non-diabetic pregnant women, caused by glucose intolerance at around the 24th week of gestation. PathophysiologyGDM arises due to an underlying pancreatic beta cell dysfunction in the mother which leads to a decrease in the amount of insulin produced and thus leads to higher blood sugar levels during pregnancy. The placenta of the fetus will produce hPL (human placental lactogen) to ensure a steady supply of sugars to the fetus, creating an anti-insulin effect. However, hPL readily crosses the placental barrier causing the mothers insulin requirement to increase, when the mother's pancreas cannot increase production of insulin to that level needed to counter the effect of hPL they become diabetic, and this leads to gestational diabetes. So, basically the placenta is asking for more glucose for the baby and the mother's pancreas struggles to keep the glucose level within normal limits in the body of the mother. If left untreated, high levels of glucose in the mother can cause glucotoxicity in the mother.“Glucotoxicity” refers to the toxic effect of glucose. Glucose is the main fuel for cell functions, but when it is high in the bloodstream, it causes toxicity to organs. Prevalence of GDM.The CDC reports mean prevenance of GDM is 6.9%. In U.S. mothers the prevenance increased from 6.0% in 2016 to 8.3% in 2021. Many different factors have played a role in increasing gestational diabetes in American mothers, some of those being the ongoing obesity epidemic with excess body weight being a known risk factor for insulin resistance. Another being advanced maternal age (AMA) as more American women have children later in life their body becomes less sensitive to insulin and requires a higher insulin output on top of the insulin that is required for the fetus. The “American diet” is also something that has a big effect in diabetes development. With the increase of high-carb foods that are readily available, the diet of Americans has declined and is affecting the metabolic health of mothers as they carry and deliver their children. Despite ongoing awareness of GDM, 6% to 9% of pregnant women in the United States are diagnosed with gestational diabetes, and the prevalence continues to increase worldwide. It is estimated that in 2017 18.4 million pregnancies were affected by GDM in the world, which then continued to increase to 1 in 6 births to women with GDM in 2019. It was also found that women living in low-income communities were disproportionately affected due to limited healthcare access. Additionally, women with GDM had a 1.4-fold increase in likelihood of undergoing a c-section, with 15% increase in risk of requiring blood transfusion. Screening for GDMGestational diabetes is screened between the 24th to 28th week of gestation in all women without known pregestational diabetes. In women who have high-risk for GDM the screening occurs during the first trimester, these women usually have at least one of the following: BMI > 30, prior history of GDM, known impaired glucose metabolism, and/or a strong family history of diabetes. The screening during the first trimester is to detect “pregestational diabetes” because we have to keep a good glycemic control to improve outcomes of pregnancy. So, if it's positive, you start treatment immediately. If these women are found to have a normal glucose, they repeat the testing again as done normally, at 24-28 weeks of gestation. How do we screen?The screening itself consists of two types of approaches. The two-step approach includes a 50-gram oral glucose tolerance test (OGTT), where blood glucose is measured in an hour and if it is below 140 they are considered to not have GDM, however if the reading is greater than 140 they must then do a 3-hour, 100g oral glucose tolerance test. The 3-hour OGTT includes measuring the blood sugars at Fasting which should be less than 95, at 1 hour at less than 180, at 2 hours at less than 155, and at 3 hours at less than 140. If 2 or more of these values exceed the threshold the patient is diagnosed with gestational diabetes mellitus. The one-step approach includes 75g after an overnight fast. Blood glucose is measured while fasting which should be less than 92, at 1 hour less than 180 and at 2 hours less than 153. If any one of these values is exceeded, the patient is diagnosed with GDM.If the mother is found to be GDM positive during pregnancy she will also need continued screening post-partum to monitor for any development of overt diabetes. The testing is usually 75g 2-hour OGTT at 6-12 weeks postpartum. If this testing is normal, then they are tested using HbA1c every 3 years. If the post-partum testing shows pre-diabetes, annual testing is recommended using HbA1c measurements. Maternal complications Women with GDM are at an increased risk for future cardiovascular disease, T2DM, and chronic kidney disease. GDM is also associated with increased likelihood of developing pre-eclampsia following delivery. Pre-eclampsia is a complication seen in pregnancy characterized by high blood pressure, proteinuria, vision changes, and liver involvement (high LFTs). Pre-eclampsia can then progress to eclampsia or HELLP syndrome, both of which can include end organ damage. Additionally, she can develop polyhydramnios which leads to overstretching of the uterus and can induce pre-term labor, placental abruption, and or uterine atony, all of which additionally put the mother at increased risk for c-section. All of these maternal complications that stem from GDM lead to complications and extended hospitalization. Child's complications Although there is an increased set of risks for the mother, the neonate can also develop a variety of risks due to the increased glucose while in utero. While the fetus is growing, the placenta is the source of nutrition for the fetus. As the levels of glucose in the mother increase so does the amount of glucose filtered through the placenta and into the fetal circulation. Over time the glucose leads to oxidative stress and inflammation with activation of TGF-b which leads to fibroblast activation and fibrosis of the placenta. This fibrosis decreases the nutrient and oxygen exchange for the fetus. As the fetus attempts to grow in this restrictive environment its development is affected. The fetus can develop IUGR (intrauterine growth restriction) leading to a small for gestation age newborn which can then lead to another set of complications. The low oxygen environment can lead to increased EPO production and polycythemia at birth which can then lead to increased clotting that can travel to the newborn brain. Newborns can also be born with fetal acidosis due to the anerobic metabolism and lactic acid buildup in fetal tissues which can cause fetal encephalopathy leading to cerebral palsy and developmental delay. And the most severe of newborn complications to gestational diabetes can lead to fetal demise. Furthermore, the increase of glucose can also lead to macrosomia in the infant which can often lead to a traumatic delivery and delivery complications such as shoulder dystocia and brachial plexus injury. Brachial plexus injury sometimes resolves without sequela, but other times can lead to permanent weakness or paralysis of the affected arm. The baby can be born too small or too big.Additionally, once the fetus is born the cutting of the umbilical cord leads to a rapid deceleration in blood glucose in the fetal circulation and hypoglycemic episodes can occur, that often lead to NICU admission. The insulin that is created by the fetus in utero to accommodate the large quantities of glucose is known to affect lung maturation as well. The insulin produced inhibits surfactant production in the fetus. Upon birth some of the newborns also have to be placed on PEEP for ventilation and some children require treatment with surfactant to prevent alveolar collapse and/or progression to NRDS created by the low surfactant levels. Additionally, neonates who are macrosomic, which is usually seen in GDM mothers, are larger and stronger and when put on PEEP to help increase ventilation the newborn's stronger respiratory effort can lead to higher pulmonary pressures and barotrauma such as neonatal pneumothorax.Long term complications to the child of a mother with GDM also occur. As the child grows, they are also at an increased risk for developing early onset obesity because of the increased adipose storage triggered by the increase in insulin in response to the high glucose in utero. This then can lead to a higher chance of developing type 2 diabetes mellitus in the child. With diabetes, also comes an increase in cardiovascular risk as the child ages and becomes an adult. The effects of GDM go beyond the fetal life but continue through adulthood.What can be done?Gestational Diabetes Mellitus has many severe and lifelong consequences for both the mother and the child and prevention of GDM would help enhance the quality of life of both. Many of the ways to prevent GDM complications include patient education and dietary modifications with a diet rich in whole grains, fruits, vegetables and lean proteins. Benefits of some vegetables in the Mexican cuisine that may be beneficial: Nopales, Chayote, and Jicama. Those are good alternatives for highly processed carbs.Mothers are usually offered nutritional counseling to help them develop a tailored eating plan. This and 30 minutes of moderate exercise daily is recommended to increase insulin sensitivity and lower the post-prandial glucose levels. If within 2 weeks of implementing lifestyle changes alone the glucose measurements remain high, then medications like insulin can be put onboard to manage the GDM. If they require insulin, I think it is time to refer to a higher level of care, if available, high risk OB clinic.Conclusion: Now we conclude episode number ###, “[TITLE].” [summary here]. _____________________References:Eades CE, Burrows KA, Andreeva R, Stansfield DR, Evans JM. Prevalence of gestational diabetes in the United States and Canada: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024 Mar 15;24(1):204. doi: 10.1186/s12884-024-06378-2. PMID: 38491497; PMCID: PMC10941381. https://pubmed.ncbi.nlm.nih.gov/38491497/QuickStats: Percentage of Mothers with Gestational Diabetes,* by Maternal Age — National Vital Statistics System, United States, 2016 and 2021. Weekly / January 6, 2023 / 72(1);16. https://www.cdc.gov/mmwr/volumes/72/wr/mm7201a4.htm?utmAkinyemi OA, Weldeslase TA, Odusanya E, Akueme NT, Omokhodion OV, Fasokun ME, Makanjuola D, Fakorede M, Ogundipe T. Profiles and Outcomes of Women with Gestational Diabetes Mellitus in the United States. Cureus. 2023 Jul 4;15(7):e41360. doi: 10.7759/cureus.41360. PMID: 37546039; PMCID: PMC10399637. https://pmc.ncbi.nlm.nih.gov/articles/PMC10399637/?utmPerlman, J. M. (2006). Summary proceedings from the neurology group on hypoxic-ischemic encephalopathy. Pediatrics, 117(3), S28–S33.DOI: 10.1542/peds.2005-0620C.Low, J. A. (1997). Intrapartum fetal asphyxia: definition, diagnosis, and classification. American Journal of Obstetrics and Gynecology, 176(5), 957–959.DOI: 10.1016/S0002-9378(97)70609-0.Hallman, M., Gluck, L., & Liggins, G. (1985). Role of insulin in delaying surfactant production in the fetal lung. Journal of Pediatrics, 106(5), 786–790.DOI: 10.1016/S0022-3476(85)80227-0.Sweet, D. G., Carnielli, V., Greisen, G., et al. (2019). European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update. Neonatology, 115(4), 432–450.DOI: 10.1159/000499361.Raju, T. N. K., et al. (1999). Respiratory distress in term infants: when to suspect surfactant deficiency. Pediatrics, 103(5), 903–909.DOI: 10.1542/peds.103.5.903.Burns, C. M., Rutherford, M. A., Boardman, J. P., & Cowan, F. M. (2008). Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics, 122(1), 65–74.DOI: 10.1542/peds.2007-2822.Dabelea, D., et al. (2000). Long-term impact of maternal diabetes on obesity in childhood. Diabetes Care, 23(10), 1534–1540.DOI: 10.2337/diacare.23.10.1534.Dashe, J. S., et al. (2002). "Hydramnios: Etiology and outcome." Obstetrics & Gynecology, 100(5 Pt 1), 957–962.DOI: 10.1016/S0029-7844(02)02279-6.Long-term cost-effectiveness of implementing a lifestyle intervention during pregnancy to prevent gestational diabetes mellitus: a decision-analytic modelling study. Diabetologia.American College of Obstetricians and Gynecologists. (2018). Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstetrics & Gynecology, 131(2), e49–e64. https://doi.org/10.1097/AOG.0000000000002501Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

Trant hat die Zukunft von DOOM selbst erlebt – und sie liegt in der Vergangenheit! Genau genommen in den DARK AGES. Fabian war derweil in der DDR, hat das ungewöhnliche KARMA: THE DARK WORLD gespielt. Gregor wiederum erzählt uns eine neue STORY OF SEASONS, war außerdem in der RUNE FACTORY. Zurück ins 16-Bit-Zeitalter geht es bei RENDERING RANGER: R2 [REWIND]. Die erstaunlich vielen Themen der letzten NINTENDO DIRECT wie METROID PRIME 4: BEYOND, MARVEL COSMIC INVASION und RHYTHM PARADISE GROOVE runden diesen GAME TALK ab. Viel Freude damit!

Brachial, wütend und mit einer ordentlichen Portion Größenwahn – dafür ist die Berliner Noise-Rock Band Gewalt bekannt. Ihr neuer Song „Ein Sonnensturm tobt über uns“ klingt für ihre Verhältnisse überraschend gut gelaunt. Hier entlang geht's zu den Links unserer Werbepartner. >> Artikel zum Nachlesen: https://detektor.fm/musik/popfilter-wie-gewalt-den-kitsch-fuer-sich-entdecken

Brachial, wütend und mit einer ordentlichen Portion Größenwahn – dafür ist die Berliner Noise-Rock Band Gewalt bekannt. Ihr neuer Song „Ein Sonnensturm tobt über uns“ klingt für ihre Verhältnisse überraschend gut gelaunt. Hier entlang geht's zu den Links unserer Werbepartner. >> Artikel zum Nachlesen: https://detektor.fm/musik/popfilter-wie-gewalt-den-kitsch-fuer-sich-entdecken

Brachial, wütend und mit einer ordentlichen Portion Größenwahn – dafür ist die Berliner Noise-Rock Band Gewalt bekannt. Ihr neuer Song „Ein Sonnensturm tobt über uns“ klingt für ihre Verhältnisse überraschend gut gelaunt. Hier entlang geht's zu den Links unserer Werbepartner. >> Artikel zum Nachlesen: https://detektor.fm/musik/popfilter-wie-gewalt-den-kitsch-fuer-sich-entdecken

Brachial, wütend und mit einer ordentlichen Portion Größenwahn – dafür ist die Berliner Noise-Rock Band Gewalt bekannt. Ihr neuer Song „Ein Sonnensturm tobt über uns“ klingt für ihre Verhältnisse überraschend gut gelaunt. Hier entlang geht's zu den Links unserer Werbepartner. >> Artikel zum Nachlesen: https://detektor.fm/musik/popfilter-wie-gewalt-den-kitsch-fuer-sich-entdecken

Brachial, wütend und mit einer ordentlichen Portion Größenwahn – dafür ist die Berliner Noise-Rock Band Gewalt bekannt. Ihr neuer Song „Ein Sonnensturm tobt über uns“ klingt für ihre Verhältnisse überraschend gut gelaunt. Hier entlang geht's zu den Links unserer Werbepartner. >> Artikel zum Nachlesen: https://detektor.fm/musik/popfilter-wie-gewalt-den-kitsch-fuer-sich-entdecken

Table tennis star Melissa Tapper is the first Australian athlete to represent the country at both the Paralympics and the Olympics. Melissa has a physical condition Brachial plexus palsy that came about from birth complications. As a kid growing up in country Victoria, she played multiple sports such as netball, basketball and athletics before discovering table tennis at the age of 8.    Melissa speak with En Route to Paris Host Rowie Webster about what it's like to not only represent Australia in the Olympics, but also the Paralympics and how she deals with failure. Make sure you've followed En Route to Paris in your favourite podcast app, to hear revealing conversations with stars like boxer Harry Garside, cyclist and Chef de Mission Anna Meares, runner Jye Edwards, Hockeyroos superstar Amy Lawton and more.See omnystudio.com/listener for privacy information.

Wir hoffen ihr verzeiht uns die etwas längere Pause! Dafür haben wir direkt mehrere Games mit an Bord, wie Alone in the Dark oder The Rise of the Ronin! Außerdem quatschen wir im Vorfeld ein wenig über Coolness, Peinlichkeit und wie alt wir uns wirklich fühlen! Zudem quatschen wir im [...]

Kim Gordon war 30 Jahre lang das Rückgrat der Kult-Band Sonic Youth und jetzt beschäftigt sich die 70jährige auf dem 2. Soloalbum mit Trap-Beats und der Verachtung des Genormten. Fragmentiert, brachial, grenzwertig - «The Collective» feiert ungedachte Verbindungen gleichermassen cool wie verstörend.

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Obstetric Brachial Plexopathy (Erb's, Klumpke's Palsy) ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Pediatrics section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

Posterior shoulder instability can occur after a fall onto an outstretched arm, or diving and hitting the ground with your arm (like diving to score a try in rugby), injuring the posterior labrum and/or the glenohumeral joint. Unlike anterior shoulder instability, patients with posterior shoulder instability may not have have a feeling of instability, but may just experience pain, fatigue and weakness. How can you identify posterior shoulder instability in your shoulder pain patients? What does your rehab for posterior shoulder instability need to include? Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio). The handout for this podcast consists of a transcript and articles referenced in the podcast. Free video series “Frozen shoulder assessment & treatment” with Jo Gibson Improve your frozen shoulder assessment and treatment now with Jo Gibson's free video series at clinicaledge.co/shoulder Shoulder: Steps to Success online course with Jo Gibson Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess Free trial Clinical Edge membership Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial Links associated with this episode: Get your access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: CLICK HERE to download the article associated with this podcast Brelin A, Dickens JF. Posterior shoulder instability. Sports Medicine and Arthroscopy Review. 2017 Sep 1;25(3):136-43. Gutkowska O, Martynkiewicz J, Urban M, Gosk J. Brachial plexus injury after shoulder dislocation: a literature review. Neurosurgical review. 2020 Apr;43:407-23. Longo UG, Ciuffreda M, Locher J, Casciaro C, Mannering N, Maffulli N, Denaro V. Posterior shoulder instability: a systematic review. British Medical Bulletin. 2020 Jul 9. Sadi J, Torchia E, Faber KJ, MacDermid J, Lalonde C, Watson L, Weber M, Wu N. Posterior shoulder instability classification, assessment, and management: an international Delphi study. Journal of Orthopaedic & Sports Physical Therapy. 2020 Jul;50(7):373-80.   Chapters: 03:17 - Case study 06:57 - Assessment tests 13:17 - Rehab 15:32 - Other treatment options 16:10 - Recovery 17:43 - Scapular dyskinesis 21:59 - Barriers to recovery

Dr. Amro Stino interviews Dr. Larry Robinson about the role of electrodiagnosis in nerve transfers for focal neuropathies and brachial plexopathies.

Dr. Amro Stino interviews Dr. Larry Robinson about the role of electrodiagnosis in nerve transfers for focal neuropathies and brachial plexopathies.

In this episode, we review the high-yield topic of Obstetric Brachial Plexopathy (Erb's, Klumpke's Palsy) from the Pediatrics section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

When people ask me for quick tips to improve their health numbers (e.g., weight, blood sugar, blood pressure) I usually tell them to stop sauteing in oil. It's an easy strategy to get started. However, their response is usually, "oh, but I use olive oil", thinking that because they use olive oil they are improving their health. In this episode, we dive into whether olive oil is actually helping you improve your health. Instagram: Nutrition_with_Robin Facebook: Nutrition with Robin Studies mentioned in this episode: Brachial artery ultrasound: a noninvasive tool in the assessment of triglyceride-rich lipoproteins Olive, soybean and palm oils intake have a similar acute detrimental effect over the endothelial function in healthy young subjects PREDIMED study

For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources:  ·Newsletter Sign Up·Jubilee website·PrevMed's website·PrevMed's YouTube channel·PrevMed's Facebook page·PrevMed's Instagram·PrevMed's LinkedIn·PrevMed's Twitter ·PrevMed's Pinterest

Er ist die wundersame und brodelnde Vereinigung von Widersprüchen: Konstantin Wecker. Brachial und sinnlich, sentimental und frivol - eine sensible Wuchtgestalt. Als hätte er stets von allem zu viel: zu viel Kraft, zu viel Lebensfreude. Daraus schöpft er seine Kreativität, gerät dadurch aber freilich auch immer wieder in Schwierigkeiten.

For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources:  ·Jubilee website·PrevMed's website·PrevMed's YouTube channel·PrevMed's Facebook page·PrevMed's Instagram·PrevMed's LinkedIn·PrevMed's Twitter ·PrevMed's Pinterest

Diese Woche sprechen Kathie und Alexander über die Konstellationen der Woche, nehmen Bezug auf einen spannenden astrologischen Standpunkt von Hörerin Manuela, und Kathie teilt faszinierende Neuigkeiten aus der Weltraumforschung mit uns. Merkur befindet sich im Zeichen Zwilling und bietet uns daher die ideale Gelegenheit, unsere Fähigkeiten zu trainieren und uns zu vernetzen. Heute treffen Merkur und Venus aufeinander, wodurch wir unsere Anliegen besonders gut mit rhetorischem Geschick verpacken können – eine gute Gelegenheit, um unmissverständlich direkt zu sein. Am Samstag befindet sich die Sonne in einem harmonischen Aspekt mit Mars in den Fischen. Dies kann uns Durchsetzungsfähigkeit verleihen, aber auf eine verborgene Art und Weise. Es geht nicht darum, brachial nach außen zu treten, sondern den anderen subtil mit an Bord zu bringen und gemeinsam Initiative zu ergreifen. Bei dieser Gelegenheit werfen Alexander und Kathie noch einmal einen genaueren Blick darauf, was das Zeichen Fische als Horoskop bedeutet. Einem rückläufigen Merkur begegnen wir am Dienstag im Zeichen Zwilling, was uns die Möglichkeit der größtmöglichen Flexibilität und Reflexion bietet. Der optimale Zeitpunkt, um unsere Kommunikation der letzten Wochen zu hinterfragen. Auch auf globaler Ebene könnte es hier zu Kurskorrekturen kommen. Der rückläufige Merkur ist gar nicht so schlimm wie sein Ruf, findet Alexander. Er steht eben nur nicht im Dienste eines, im Erdreich so geschätzten, linearen Fortschritts, sondern eröffnet uns neue Perspektiven. Der wichtigsten Konstellation der Woche begegnen wir am Mittwoch. Die langsam laufenden Planeten befinden sich ab diesem Tag in fünf aufeinander folgenden Zeichen – ein extrem seltenes Phänomen. Jupiter wandert vom Schoß des Neptuns herunter in den Widder: Es geht um die Sehnsucht, um eine größtmögliche Verbindung und um Offenheit. Um das Sehen von Zusammenhängen, fernab von kausalem Denken. Der Traum wird zur Tat und wir können die ersten kleinen Schritte für unsere neuen Wege unternehmen. Brachial nach vorne zu stürmen, ist allerdings noch nicht angesagt. Das könnte erst ab dem 24.5. sinnvoll sein, wenn der Mars sich auf den Weg in das Zeichen Widder begibt. Jetzt Alexanders Buch "Das astrologische Luftzeitalter" bestellen: https://bit.ly/3lymMjo. Und das Hörbuch: https://bit.ly/3ACmX1z Habt ihr Rückmeldung zum Astropod? Schreibt uns gerne an astropod@astropod-schlieffen.de, auf Instagram oder Facebook. Mehr von Kathie gibt es hier: https://linktr.ee/kathie_kleff. Jetzt für Get Happy beim Deutschen Podcast Preis stimmen: https://bit.ly/37MpSML. Viel Spaß mit dem Astropod. See acast.com/privacy for privacy and opt-out information.

In this episode, we review the high-yield topic of Obstetric Brachial Plexopathy (Erb's, Klumpke's Palsy) from the Pediatrics section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

Investigating the anti-hypertensive effects of pumpkin seed oil Marymount University and University of Guilan (Iran), September 29, 2021 In a study, researchers from Iran and the U.S. found that pumpkin seed oil can potentially treat hypertension in postmenopausal women. Their report was published in Complementary Therapies in Clinical Practice. Postmenopausal women are more likely to develop hypertension than men of the same age. In vivo studies reveal that pumpkin seed oil has anti-hypertensive activity. The team investigated the effects of pumpkin seed oil supplementation on vascular function and heart rate variability in postmenopausal women with elevated blood pressure. Participants were assigned to take either a pumpkin seed oil supplement or a placebo for the six-week study. Those in the experimental group took 3 grams of pumpkin seed oil every day. Brachial and central blood pressure, wave reflection (augmentation index, AIx), arterial stiffness (SI) and various HRV parameters were measured at baseline and at the end of the study. Those who took pumpkin seed oil had significantly lower AIx, brachial and systolic blood pressure after treatment. SI and HRV parameters remained unchanged for the treatment group and the placebo group at the end of the study. In sum, taking pumpkin seed oil may improve arterial hemodynamics in postmenopausal women.     Health benefits of evening classes revealed   Oxford University, September 20, 2021    Those with a taste for adult education classes have long known it, but now Oxford University scientists have confirmed that taking part in the weekly sessions can boost wellbeing – regardless of the subject studied.   In partnership with the Workers' Educational Association (WEA), the largest voluntary sector provider of adult education in England and Scotland, a team from Oxford's department of experimental psychology studied attendees at seven separate day-time adult education classes. Their findings are published in a series of papers.   Each class took place over seven months and included a break in the middle. Attendees completed questionnaires before and after their class three times over the seven months: at the beginning of their courses, after 3 months, and at the end of the seven months. Participants were involved in one of three activities: singing, crafts or creative writing.   Overall, attendees at all seven classes had improved mental and physical health and reported more satisfaction with their lives at the end of their courses.   Dr Eiluned Pearce led the research. She said: 'The students reported benefits including increased self-confidence, a greater feeling of control over their lives and more willingness to take on new challenges. Some said the classes made them more motivated to be more active, despite the classes not specifically involving physical activity.   'Participants also said that the classes broadened their networks of friends and gave them an increased sense of belonging. We also found that the more someone felt part of their group, the more their health and wellbeing improved.' An intriguing finding was in the singing and creative writing classes. Building on the results of an earlier paper from the same study, which found that people in singing classes felt closer to their group more quickly than those in the other classes, the team looked at how relationships formed between individuals in the classes.   Each person was asked to name those other people in the class whose name they could remember, whether or not they felt connected to each person they named, and whether they had talked to that person during class.   Dr Pearce said: 'The results showed that those in the singing and creative writing groups built up relationships with other individuals more quickly than the crafters, and singers felt more connected to the class as a whole more quickly than both the other groups. 'While this confirms our earlier finding that singing has an 'ice-breaker effect' compared to other activities, it shows that other activities may enable people to increase their social networks just as much, even if it takes them longer to feel connected to their group as a whole.'   Co-author Dr Jacques Launay adds: 'While much of our previous work has demonstrated the importance of music, it is likely that the most socially bonding activities are always those that are personally chosen and enjoyed. This research adds to growing support for the relevance of creative activities in creating happy communities and improving health and well-being, with consequent benefits for public services and society.'   Dr Pádraig Mac Carron, Dr Anna Machin and Professor Robin Dunbar were also involved in the research.   Howard Croft, WEA Regional Education Manager, said: 'The findings reiterate the feedback that we have had from our students over the years: learning is a fantastic way to boost your self-esteem and confidence. Also of note, is its therapeutic effect. For many students, creative courses are a means of finding a new outlet for expressing their feelings. This can be of immense help during times of personal difficulty or emotional upheaval, such as divorce or bereavement. Simply going to a course can offer much-needed respite.   'For others, learning can be an opportunity to reignite a former passion. This could be anything from a subject which you enjoyed at school to an area which you are interested in. Whatever your reason, there are so many benefits to be gained by signing up to a course.'       Want to live forever? Theoretically, you could, study says Swiss Federal Institute of Technology, September 29, 2021 Humans can probably live to at least 130, and possibly well beyond, though the chances of reaching such super old age remain vanishingly small, according to new research. The outer limit of the human lifespan has long been hotly debated, with recent studies making the case we could live up to 150 years, or arguing that there is no maximum theoretical age for humans. The new research, published Wednesday in the Royal Society Open Science journal, wades into the debate by analyzing new data on supercentenarians—people aged 110 or more—and semi-supercentenarians, aged 105 or more. While the risk of death generally increases throughout our lifetime, the researchers' analysis shows that risk eventually plateaus and remains constant at approximately 50-50. "Beyond age 110 one can think of living another year as being almost like flipping a fair coin," said Anthony Davison, a professor of statistics at the Swiss Federal Institute of Technology in Lausanne (EPFL), who led the research. "If it comes up heads, then you live to your next birthday, and if not, then you will die at some point within the next year," he told AFP. Based on the data available so far, it seems likely that humans can live until at least 130, but extrapolating from the findings "would imply that there is no limit to the human lifespan," the research concludes. The conclusions match similar statistical analyses done on datasets of the very elderly. "But this study strengthens those conclusions and makes them more precise because more data are now available," Davison said. The first dataset the team studied is newly released material from the International Database on Longevity, which covers more than 1,100 supercentenarians from 13 countries. The second is from Italy on every person who was at least 105 between January 2009 and December 2015. 'One in a million' The work involves extrapolating from existing data, but Davison said that was a logical approach. "Any study of extreme old age, whether statistical or biological, will involve extrapolation," he said. "We were able to show that if a limit below 130 years exists, we should have been able to detect it by now using the data now available," he added. Still, just because humans can theoretically reach 130 or beyond, doesn't mean we're likely to see it anytime soon. For a start, the analysis is based on people who have already achieved the relatively rare feat of making it to well over 100. And even at age 110, your chances of making it to 130 are "about one in a million... not impossible but very unlikely," said Davison. He thinks we could see people reaching 130 within the century, as more people make it to supercentenarian status, increasing the chances of one becoming that one in a million. "But in the absence of major medical and social advances, ages much over this are highly unlikely ever to be observed," he added. For now, the oldest person on record is Frenchwoman Jeanne Calment, who died in 1997 at the confirmed age of 122. Her true age was the subject of some controversy, with claims of a possible fraud, but in 2019 several experts said a review of the evidence confirmed her age. Other pretenders to the throne of oldest person ever have a long way to go. The oldest verified living person in the world is Japan's Kane Tanaka, a comparatively youthful 118.     Psychological treatment shown to yield strong, lasting pain relief, alter brain networks University of Colorado, September 29, 2021 Rethinking what causes pain and how great of a threat it is can provide chronic pain patients with lasting relief and alter brain networks associated with pain processing, according to new University of Colorado Boulder-led research. The study, published Sept. 29 in JAMA Psychiatry, found that two-thirds of chronic back pain patients who underwent a four-week psychological treatment called Pain Reprocessing Therapy (PRT) were pain-free or nearly pain-free post-treatment. And most maintained relief for one year. The findings provide some of the strongest evidence yet that a psychological treatmentcan provide potent and durable relief for chronic pain, which afflicts one in five Americans. "For a long time we have thought that chronic pain is due primarily to problems in the body, and most treatments to date have targeted that," said lead author Yoni Ashar, who conducted the study while earning his Ph.D. in the Department of Psychology and Neuroscience at CU Boulder. "This treatment is based on the premise that the brain can generate pain in the absence of injury or after an injury has healed, and that people can unlearn that pain. Our study shows it works." Misfiring neural pathways Approximately 85% of people with chronic back pain have what is known as "primary pain," meaning tests are unable to identify a clear bodily source, such as tissue damage. Misfiring neural pathways are at least partially to blame: Different brain regions—including those associated with reward and fear—activate more during episodes of chronic pain than acute pain, studies show. And among chronic pain patients, certain neural networks are sensitized to overreact to even mild stimuli. If pain is a warning signal that something is wrong with the body, primary chronic pain, Ashar said, is "like a false alarm stuck in the 'on' position." PRT seeks to turn off the alarm. "The idea is that by thinking about the pain as safe rather than threatening, patients can alter the brain networks reinforcing the pain, and neutralize it," said Ashar, now a postdoctoral researcher at Weill Cornell Medicine.or the randomized controlled trial, Ashar and senior author Tor Wager, now the Diana L. Taylor Distinguished Professor in Neuroscience at Dartmouth College, recruited 151 men and women who had back pain for at least six months at an intensity of at least four on a scale of zero to 10. Those in the treatment group completed an assessment followed by eight one-hour sessions of PRT, a technique developed by Los Angeles-based pain psychologist Alan Gordon. The goal: To educate the patient about the role of the brain in generating chronic pain; to help them reappraise their pain as they engage in movements they'd been afraid to do; and to help them address emotions that may exacerbate their pain.  Pain is not 'all in your head' "This isn't suggesting that your pain is not real or that it's 'all in your head'," stressed Wager, noting that changes to neural pathways in the brain can linger long after an injury is gone, reinforced by such associations. "What it means is that if the causes are in the brain, the solutions may be there, too." Before and after treatment, participants also underwent functional magnetic resonance imaging (fMRI) scans to measure how their brains reacted to a mild pain stimulus. After treatment, 66% of patients in the treatment group were pain-free or nearly pain-free compared to 20% of the placebo group and 10% of the no-treatment group. "The magnitude and durability of pain reductions we saw are very rarely observed in chronic pain treatment trials," Ashar said, noting that opioids have yielded only moderate and short-term relief in many trials. And when people in the PRT group were exposed to pain in the scanner post-treatment, brain regions associated with pain processing—including the anterior insula and anterior midcingulate —had quieted significantly. The authors stress that the treatment is not intended for "secondary pain"—that rooted in acute injury or disease. The study focused specifically on PRT for chronic back pain, so future, larger studies are needed to determine if it would yeild similar results for other types of chronic pain.  Meanwhile, other similar brain-centered techniques are already ememrging among physical therapists and other clinicians who treat pain. "This study suggests a fundamentally new way to think about both the causes of chronic back pain for many people and the tools that are available to treat that pain," said co-author Sona Dimidjian, professor of psychology and neuroscience and director of the Renee Crown Wellness Institute at CU Boulder. " It provides a potentially powerful option for people who want to live free or nearly free of pain."     Citicoline (CDP-choline) and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial  Kyowa Hakko Bio (Japan), September 2021 Supplementation of citicoline (CDP-choline), a naturally occurring mononucleotide, has shown beneficial effects on memory function and behavior in populations with a wide range of impairments. However, few studies have investigated its effect in healthy older populations. Objective The objective of this study was to investigate the effects of citicoline, on memory in healthy elderly populations with age-associated memory impairment (AAMI). Methods A total of 100 healthy men and women aged between 50 and 85 y with AAMI participated in this randomized, double-blind, placebo-controlled trial. Participants were randomized to receive placebo (n = 51) or citicoline (n = 49; 500 mg/d) for 12 wk. Memory function was assessed at baseline and end of the intervention (12 wk) using computerized tests (Cambridge Brain Sciences, Ontario, Canada). Safety measurements included adverse events query, body weight, blood pressure, and hematology and metabolic panel. Intent-to-treat analysis was conducted using ANCOVA for the primary and secondary outcome variables with Bonferroni correction for multiple comparisons. Results A total of 99 out of 100 participants completed the study in its entirety. After the 12-wk intervention, participants supplemented with citicoline showed significantly greater improvements in secondary outcomes of episodic memory (assessed by the Paired Associate test), compared with those on placebo (mean: 0.15 vs. 0.06, respectively, P = 0.0025). Composite memory (secondary outcome), calculated using the scores of 4 memory tests, also significantly improved to a greater extent following citicoline supplementation (mean: 3.78) compared with placebo (mean: 0.72, P = 0.0052). Conclusions Dietary supplementation of citicoline for 12 wk improved overall memory performance, especially episodic memory, in healthy older males and females with AAMI. The findings suggest that regular consumption of citicoline may be safe and potentially beneficial against memory loss due to aging.      Sleep may strengthen long-term memories in the immune system   University of Tuebingen (Germany) September 29, 2021   More than a century ago, scientists demonstrated that sleep supports the retention of memories of facts and events. Later studies have shown that slow-wave sleep, often referred to as deep sleep, is important for transforming fragile, recently formed memories into stable, long-term memories. Now, in an Opinion article published  in Trends in Neurosciences, part of a special issue on Neuroimmunology, researchers propose that deep sleep may also strengthen immunological memories of previously encountered pathogens.   "While it has been known for a long time that sleep supports long-term memoryformation in the psychological domain, the idea that long-term memory formation is a function of sleep effective in all organismic systems is in our view entirely new," says senior author Jan Born of the University of Tuebingen. "We consider our approach toward a unifying concept of biological long-term memory formation, in which sleep plays a critical role, a new development in sleep research and memory research."   The immune system "remembers" an encounter with a bacteria or virus by collecting fragments from the bug to create memory T cells, which last for months or years and help the body recognize a previous infection and quickly respond. These memory T cells appear to abstract "gist information" about the pathogens, as only T cells that store information about the tiniest fragments ever elicit a response. The selection of gist information allows memory T cells to detect new pathogens that are similar, but not identical, to previously encountered bacteria or viruses.   Studies in humans have shown that long-term increases in memory T cells are associated with deep slow-wave sleep on the nights after vaccination. Taken together, the findings support the view that slow-wave sleep contributes to the formation of long-term memories of abstract, generalized information, which leads to adaptive behavioral and immunological responses. The obvious implication is that sleep deprivation could put your body at risk.   "If we didn't sleep, then the immune system might focus on the wrong parts of the pathogen," Born says. "For example, many viruses can easily mutate some parts of their proteins to escape from immune responses. If too few antigen-recognizing cells [the cells that present the fragments to T cells] are available, then they might all be needed to fight off the pathogen. In addition to this, there is evidence that the hormones released during sleep benefit the crosstalk between antigen-presenting and antigen-recognizing cells, and some of these important hormones could be lacking without sleep."   Born says that future research should examine what information is selected during sleep for storage in long-term memory, and how this selection is achieved. In the end, this research could have important clinical implications.   "In order to design effective vaccines against HIV, malaria, and tuberculosis, which are based on immunological memory, the correct memory model must be available," Born says. "It is our hope that by comparing the concepts of neuronal and immunological memory, a model of immunological memory can be developed which integrates the available experimental data and serves as a helpful basis for vaccine development."         Standardized astragalus extract for attenuation of the immunosuppression induced by strenuous physical exercise: randomized controlled trial University of Physical Sciences (Poland), September 3, 2021 This paper aimed to verify how a supplementation of rower's diet with Astragalus Membranaceus Root (AMR) modulated their immune system response to maximal physical exertion. Methods The double-blind study included 18 members of the Polish Rowing Team assigned to the supplemented group (n = 10), and the placebo group (n = 8). The participants performed a 2000 m test on a rowing ergometer at the beginning and at the end of the six-week of intensive training camp during which the supplemented group received 500 mg of AMR. Blood samples were obtained prior to, 1 min after completing, and 24 h after the exertion test. The levels of interleukin 2 (IL2), interleukin 4 (IL4), interleukin 10 (IL10), interferon ɤ (IFN-ɣ), and lactic acid were determined. Subpopulations of T regulatory lymphocytes [CD4+/CD25+/CD127−] (Treg), cytotoxic lymphocytes [CD8+/TCRαβ+] (CTL), natural killer cells [CD3−/CD16+/CD56+] (NK), and TCRδγ-positive cells (Tδγ) were determined with flow cytometry. Results After the camp, the initial NK and Treg levels sustained at the baseline, while Tδγ counts increased relative to the levels in the placebo group. In the supplemented subgroup, a decrease in IL2 level in reaction to maximal exertion clearly deepened while the change in IL-2/IL-10 level induced by the recovery after this exertion clearly increased, relative to the changes in the placebo group. Conclusions AMR restored the immunological balance in strenuously trained athletes through a stabilization of NK and Treg cells with a positive trend in Tδγ towards Th1 response during restitution by cytokine IL2 modulation.

Dr. Martin answers questions sent in by our listeners. Some of today's topics include: Psoriatic arthritis Temporal arteritis Glutathione supplementation  Brachial radial bursitis Fulvic acid Varicose veins Prolia shots for osteoporosis Calcium supplements Hydrochloric acid Celiac disease Tune in to hear Dr. Martin's responses!  

The Gary Null Show Notes – 08.25.21 American Medical Association Calls for Covid-19 Vaccine Mandates China, 2049 The Leak That ‘Exposed the True Afghan War' Fauci Dismisses “Freedom” In Call For Vaccine Mandates: “The Time Has Come. Enough Is Enough.” A New Low for the FDA Eight Key Points on America's Defeat in Afghanistan 2 Things Mainstream Media Didn't Tell You About FDA's Approval of Pfizer Vaccine America in an Age of Faucism Today's Videos 1.  Dave Cullen Video on Mandating Vaccines: ” Vaccination: They're Becoming Desperate” 2. The Dunning-Kruger Effect – Cognitive Bias – Why Incompetent People Think They Are Competent 3. Dr. Malone Sounds Alarm On Liability Coverage Of Pfizer Vax Start this clip at 5.00 in when Dr. Malone begins to speak. 4. Dr. Ryan Cole #StoptheMandate (start at 1:25) Study suggests vitamin D supplementation may serve as part of strategy for autoimmune and infectious diseases associated with leaky gut MacKay Children's Hospital (Taiwan), August 15, 2021 According to news reporting from Taipei, Taiwan, research stated, “Vitamin D (VD) plays an important role not only in mineral balance and skeletal maintenance but also in immune modulation. VD status was found correlated with the pathophysiology and severity of inflammatory bowel diseases and other autoimmune disorders. Epithelial barrier function is primarily regulated by the tight-junction (TJ) proteins.” The news reporters obtained a quote from the research from MacKay Children's Hospital: “In this study, we try to establish an animal model by raising mice fed VD-deficient diet and to investigate the effects of VD-deficient diet on gut integrity and zonulin expression. Male C57BL/6 mice were administered either VD-deficient [VDD group, 25(OH)2D3 0 IU/per mouse] or VD-sufficient [VDS group, 25(OH)2D3 37.8 IU/per mouse] special diets for 7 weeks. Body weight and diet intake were recorded weekly. Serum VD levels were detected. After sacrifice, jejunum and colon specimens were collected. The villus length and crypt depth of the jejunum as well as mucosa thickness of the colon were measured. Various serum pro-inflammatory cytokines and intestinal TJ proteins were assessed. The serum level of zonulin and the mRNA expression of jejunum zonulin were also investigated. We found that mice fed a VDD diet had a lower serum level of VD after 7 weeks (p < 0.001). VDD mice gained significant less weight (p = 0.022) and took a similar amount of diet (p = 0.398) when compared to mice raised on a VDS diet. Significantly decreased colon mucosa thickness was found in VDD mice compared with the VDS group (p = 0.022). A marked increase in serum pro-inflammatory cytokine levels was demonstrated in VDD mice. All relative levels of claudin (CLD)-1 (p = 0.007), CLD-3 (p < 0.001), CLD-7 (p < 0.001), and zonulin-1 (ZO-1, p = 0.038) protein expressions were significantly decreased in the VDD group when compared to the VDS group. A significant upregulation of mRNA expression of jejunum zonulin (p = 0.043) and elevated serum zonulin (p = 0.001) were found in the VDD group.” According to the news editors, the research concluded: “We successfully demonstrated that VDD could lead to impaired barrier properties. We assume that sufficient VD could maintain intestinal epithelial integrity and prevent mucosal barrier dysfunction. VD supplementation may serve as part of a therapeutic strategy for human autoimmune and infectious diseases with intestinal barrier dysfunction (leaky gut) in the future. To our knowledge, this is the first study to demonstrate that VDD could lead to a significant upregulation in mRNA expression of the jejunum zonulin level and also a marked elevation of serum zonulin in a mouse model.” Investigating the anti-hypertensive effects of pumpkin seed oil Marymount University (US) and University of Guilan (China), August 24, 2021 In a study, researchers from Iran and the U.S. found that pumpkin seed oil can potentially treat hypertension in postmenopausal women. Their report was published in Complementary Therapies in Clinical Practice. Postmenopausal women are more likely to develop hypertension than men of the same age. In vivo studies reveal that pumpkin seed oil has anti-hypertensive activity. The team investigated the effects of pumpkin seed oil supplementation on vascular function and heart rate variability in postmenopausal women with elevated blood pressure. Participants were assigned to take either a pumpkin seed oil supplement or a placebo for the six-week study. Those in the experimental group took 3 grams of pumpkin seed oil every day. Brachial and central blood pressure, wave reflection (augmentation index, AIx), arterial stiffness (SI) and various HRV parameters were measured at baseline and at the end of the study. Those who took pumpkin seed oil had significantly lower AIx, brachial and systolic blood pressure after treatment. SI and HRV parameters remained unchanged for the treatment group and the placebo group at the end of the study. In sum, taking pumpkin seed oil may improve arterial hemodynamics in postmenopausal women.   Lack of exercise and poor nutrition could increase the risk of diseases like dementia Kings College London, August 23, 2021 New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London has found that both diet and exercise can influence the risk of cognitive decline (CD) and dementia by potentially influencing hippocampal neurogenesis (the process by which the brain produces new brain cells) long before their onset. The study, published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, suggests that altered neurogenesis in the brain could potentially represent an early biomarker for both CD and dementia. The investigation studied how the blood of participants with and without CD and dementia could influence hippocampal neurogenesis in laboratory settings and whether diet and exercise were important factors. Specifically, blood samples of 418 French adults over the age of 65 were collected 12-years prior to CD and dementia diagnosis and tested on human hippocampal stems cells. Additionally, information on each participant's sociodemographic, lifestyle, and clinical data were collected and incidence cognition status and dementia were measured every two to three years over a 12-year period. Over the course of the study, the researchers established that 12 years prior to diagnosis, both CD and Alzheimer's were associated with levels of neural stem cell death. The team also found that exercise, nutrition, vitamin D levels, carotenoid and lipid levels are all associated with the rate at which cells die off. Furthermore, physical activity and nutrition were key factors that then also determined CD status. Specifically, researchers found that reduced physical activity and increased malnutrition both increased cell death which in turn increased the risk for future CD. While previous studies have established that diet and exercise have some protective effects against CD and dementia, these roles have been poorly understood at the neurobiological level. To date, studies on animals have shown how diet and exercise can directly influence hippocampal neurogenesis, potentially explaining how exercise and diet may biologically exert their effects, but this study sheds further light on this in the context of a human model. Dr. Sandrine Thuret, the study's lead investigator said, “Our study has demonstrated not only that there are individual markers of hippocampal neurogenesis associated with CD and dementia 12 years later, but also that there is some degree of specificity with respect to diagnoses of dementia subtypes. If an individual displays an increase in their levels of cell death during differentiation (when neural stem cells are becoming neurons), we can look at this as a potential warning sign of CD. Conversely, a decrease in levels of cell death during proliferation (the process by which a single cell divides into a pair) and reduced hippocampal progenitor cell integrity could be viewed as a predictor for Alzheimer's Disease and Vascular dementia, respectively.” According to Alzheimer's Research UK, there were a total of 525,315 people living with a dementia diagnosis in the UK in 2020. Rates of cognitive decline and dementia are expected to triple in prevalence by 2040. Dr. Andrea du Preez, the study's first author from King's IoPPN said, “While more work is undoubtedly needed to fully understand how diet and exercise might modulate hippocampal neurogenesis, our findings may represent an effective early preventative strategy against CD and dementia.” Mindfulness may improve cognition in older adults University College London, August 23, 2021 Mindfulness may provide modest benefits to cognition, particularly among older adults, finds a new review of evidence led by UCL researchers. The systematic review and meta-analysis, published in Neuropsychology Review, found that, while mindfulness is typically geared towards improving mental health and well-being, it may also provide additional benefits to brain health. The study's lead author, PhD student Tim Whitfield (UCL Psychiatry) said that “the positive effects of mindfulness-based programs on mental health are already relatively well-established. Here, our findings suggest that a small benefit is also conferred to cognition, at least among older adults.” The researchers reviewed previously published studies of mindfulness, and identified 45 studies that fit their criteria, which incorporated a total of 2,238 study participants. Each study tested the effects of a mindfulness-based intervention delivered by a facilitator in a group setting, over at least four sessions, while excluding mindfulness retreats in order to have a more homogenous set of studies. The majority of studies involved a certified instructor teaching participants techniques such as sitting meditation, mindful movement and body scan, generally on a weekly basis across six to 12 weeks, while also asking participants to continue the practices in their own time. The researchers found that overall, mindfulness conferred a small but significant benefit to cognition. Subgroup analysis revealed that the effect was slightly stronger for people over 60, while there was not a significant effect for people under 60. Tim Whitfield commented that “executive function is known to decline with age among older adults; the improvement in people over 60 suggests that mindfulness may help guard against cognitive decline, by helping to maintain or restore executive function in late adulthood. It might be easier to restore cognitive functions to previous levels, rather than to improve them beyond the developmental peak.” When they investigated which aspects of cognition were affected, the researchers found that mindfulness was beneficial only to executive function, and more specifically, there was strong evidence of a small positive effect on working memory (which is one facet of executive function). The researchers also analyzed whether mindfulness outperformed other ‘active interventions' (such as brain training, relaxation, or other health or educational programs) or only when compared to people who were not offered any alternative treatment. They found that cognitive benefits of mindfulness were only significant compared with an ‘inactive' comparison, which means they cannot rule out that the benefits may have been at least partly derived from an expectation of treatment benefits, or social interactions. The researchers say that more research is needed into which characteristics of mindfulness training may be more likely to confer cognitive benefits, or whether delivering interventions over longer periods, or in intensive retreat settings, might yield greater cognitive benefits. Senior author Dr Natalie Marchant (UCL Psychiatry) said that they “know mindfulness-based programs benefit mental health, and our paper now suggests that mindfulness may also help to maintain cognitive faculties as people age. Mindfulness practices do not share much in common with cognitive test measures, so it is notable that mindfulness training's impact appears to transfer to other domains. While our review only identified a small benefit to executive function, it remains possible that some types of mindfulness training might deliver larger gains.” Major Depression Symptoms Improved with Chlorella University of Western Australia, August 23rd 2021    The symptoms of depression are often treated with drugs that can have long-term adverse side effects. A new study finds chlorella significantly reduces symptoms of major depression. Research from the University of Western Australia in Perth has found that chlorella can significantly improve symptoms of depression. The researchers tested 92 patients with major depressive disorder – a disorder that affects millions of people around the world. The researchers split the patients into two groups. They gave 42 of the patients 1,800 milligrams of Chlorella vulgaris extract per day. The other 50 patients continued their standard care. The researchers used a scale called the Hospital Anxiety and Depression Scale (HADS) to test the patients' symptoms of depression, along with the Beck Depression Inventory II (BDI-II) scale. Both of these have been used in clinical settings to establish the range of depressive symptoms and the severity of the diagnosis. After six weeks of treatment with either the standard pharmaceutical treatment or chlorella extract, the researchers found that those patients who had taken the chlorella had significantly reduced scores in both depression tests. The BDI-II scores went down by over four points and the HADS scores went down by 3.71 points. To give some reference, the HADS scale consists of 21 points, and anything over an 8 is considered symptomatic of anxiety or depression. In addition to reduced total scores, the researchers also saw significant reductions in some of the subset scores. For example, physical and cognitive symptoms were significantly improved in the chlorella group, and subscales for depression and anxiety were significantly lower among the chlorella group. The researchers concluded: “This pilot exploratory trial provides the first clinical evidence on the efficacy and safety of adjunctive therapy with CVE in improving physical and cognitive symptoms of depression as well as anxiety symptoms in patients who are receiving standard antidepressant therapy.” Chlorella is a microalga. It is a single-celled algae that is typically grown in controlled growth medium tanks. It is significantly high in protein, with over 40 percent protein, with all of the essential amino acids. It also contains proteins that stimulate growth hormone and brain neurotransmitters. Concentrated extract was used in this study due to the fact that whole chlorella can be difficult for the body to break down the cell wall. An extract provides the contents of the cell after the cell wall has been broken. Greater adherence to Mediterranean diet associated with decreased cardiometabolic risk during pregnancy University of Granada, August 20, 2021 According to news reporting out of Granada, Spain,research stated, “Studies regarding dietary patterns and cardiometabolic risk markers during pregnancy are scarce. The aim of the present study was to analyse whether different degrees of adherence to the Mediterranean diet (MD) and the MD components were associated with cardiometabolic markers and a clustered cardiometabolic risk during pregnancy.” Our news journalists obtained a quote from the research from the University of Granada, “This study comprised 119 pregnant women from the GEStation and FITness (GESTAFIT) project. Dietary habits were assessed with a food frequency questionnaire at the 16th and 34th gestational weeks (g.w.). The Mediterranean Diet Score was employed to assess MD adherence. The following cardiometabolic markers were assessed: pre-pregnancy body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C). A greater MD adherence was associated with a better cardiometabolic status in cross-sectional (16th g.w. and 34th g.w.) and prospective analyses (MD adherence at the 16th g.w. and cardiometabolic markers at the 34th g.w.; SBP, DBP and HDL-C; all, p< 0.05). Participants with the highest MD adherence (Tertile 3) had a lower clustered cardiometabolic risk than those with the lowest MD adherence (Tertile 1) at the 16th and 34th g.w. (both, p< 0.05). A higher intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts were associated with a lower cardiometabolic risk during pregnancy (all, p< 0.05).” According to the news editors, the research concluded: “A higher MD adherence, a greater intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts showed a cardioprotective effect throughout gestation.” Unhealthy diet during pregnancy could be linked to ADHD King's College London and the University of Bristol , August 20, 2021   New research led by scientists from King's College London and the University of Bristol has found that a high-fat, high-sugar diet during pregnancy may be linked to symptoms of ADHD in children who show conduct problems early in life. Published in the Journal of Child Psychology and Psychiatry, this study is the first to indicate that epigenetic changes evident at birth may explain the link between unhealthy diet, conduct problems and ADHD. Early onset conduct problems (e.g. lying, fighting) and attention-deficit/hyperactivity disorder (ADHD) are the leading causes of child mental health referral in the UK. These two disorders tend to occur in tandem (more than 40 per cent of children with a diagnosis of conduct disorder also have a diagnosis of ADHD) and can also be traced back to very similar prenatal experiences such as maternal distress or poor nutrition. In this new study of participants from the Bristol-based ‘Children of the 90s' cohort, 83 children with early-onset conduct problems were compared with 81 children who had low levels of conduct problems. The researchers assessed how the mothers' nutrition affected epigenetic changes (or DNA methylation) of IGF2, a gene involved in fetal development and the brain development of areas implicated in ADHD – the cerebellum and hippocampus. Notably, DNA methylation of IGF2 had previously been found in children of mothers who were exposed to famine in the Netherlands during World War II. The researchers from King's and Bristol found that poor prenatal nutrition, comprising high fat and sugar diets of processed food and confectionary, was associated with higher IGF2 methylation in children with early onset conduct problems and those with low conduct problems. Higher IGF2 methylation was also associated with higher ADHD symptoms between the ages of 7 and 13, but only for children who showed an early onset of conduct problems. Dr Edward Barker from King's College London said: ‘Our finding that poor prenatal nutrition was associated with higher IGF2 methylation highlights the critical importance of a healthy diet during pregnancy. These results suggest that promoting a healthy prenatal diet may ultimately lower ADHD symptoms and conduct problems in children. This is encouraging given that nutritional and epigenetic risk factors can be altered.' Dr Barker added: ‘We now need to examine more specific types of nutrition. For example, the types of fats such as omega 3 fatty acids, from fish, walnuts and chicken are extremely important for neural development. ‘We already know that nutritional supplements for children can lead to lower ADHD and conduct problems, so it will be important for future research to examine the role of epigenetic changes in this process.' Green tea may help protect against sunburn Taiyo Kagaku Co (Japan), August 24, 2021 A systematic review and meta-analysis published in a recent issue of Molecules found an association between oral intake or topical application of green tea catechins and a reduction in ultraviolet (UV) radiation-induced sunburn, which is an inflammatory reaction of the skin to UV exposure, clinically known as erythema.* Catechins are a type of flavonoid that occur in plants such as Camellia sinensis (tea). Green tea catechins include (-)-epigallocatechin-3-gallate (EGCG), well known for its anti-cancer and health-promoting effects, (-)-epicatechin, and many other similar molecules. These compounds have been recognized as having anti-inflammatory, antioxidant and photo-protective properties. “To our knowledge, this is the first meta-analysis to assess the effectiveness of green tea catechins specifically on measures of ultraviolet radiation-induced erythema and related pro-inflammatory mediators,” authors Mahendra P. Kapoor and colleagues wrote. “Regular intake of as low as 540 mg of green tea catechins per day could be beneficial for the protection against ultraviolet radiation-induced erythema, wherein green tea catechin metabolites are bioavailable at the dermis and epidermis levels of the skin, and thus increase the minimal dose of radiation (MED) required to induce erythema.” Dr Kapoor added that the study “suggests that green tea catechins can strengthen the skin's tolerance to ultraviolet radiation-induced skin damage from radiation through the prevention of the ultraviolet radiation-induced perturbation of epidermal barrier functions.” Study details: 12 weeks of green tea intake yields benefits The meta-analysis included three randomized, double-blind, placebo-controlled trials and one non-double-blind, non-placebo-controlled study that examined potential protective effects of orally administered capsules containing green tea catechins against sunburn (clinically known as erythema) induced by solar-simulated UV radiation. Two additional studies that involved a single dose of topically administered catechins were separately analyzed. Pooled analysis of data from three studies that evaluated erythema in skin exposed to UV radiation before and after 12 or more weeks of green tea catechin intake revealed a favorable effect in association with catechin intake. Both low and high doses of the green tea capsules were effective at decreasing low-dose UV radiation-induced erythema. It was also noted that a significant favorable effect was seen in the one study which assessed UV radiation-induced erythema after green tea intake for only six weeks, but as none of the other studies assessed this shorter duration of intake, further analysis was not performed. When green tea catechins' effects compared to a placebo were analyzed, pooling the data of two placebo-controlled trials confirmed their effectiveness against low-intensity UV radiation-induced erythema. Pooling data from participants in the studies involving topical green tea catechins revealed significant benefit for green tea at higher UV radiation doses.

We continue our rapid-fire question-based review of pediatric orthopedics with focusing on Brachial plexus injuries (Mainly Erb & Klumpke's palsy) with some high-yield review of over-all upper extremity innervation; We follow that with Nursemaid's elbow and Anterior shoulder dislocation; We then begin our discussion of spine disorders with cervical spine: Torticollis, Atlantoaxial instability, and Klippel-Feil syndrome; We follow the rest of spine disorders (including Kiphosis & scoliosis) as well as important Differential Diagnoses of Low-Back pain among children in the next episode.

Episode content:. 1. Rotator cuff muscles 2. Arm abduction 3. Upper extremity nerves 4. Brachial plexus lesions 5. Wrist region --- Send in a voice message: https://anchor.fm/zusmle/message

Herzlich Willkommen zur nächsten Camp Dörfl Podcast Episode. Heute hab ich mit Herrn Köllner meinen alten Auswahltrainer mit an Bord. Wege können sich ändern - neue Türen sich eröffnen. Wichtig ist immer, das man den Moment genießt und das macht Herr Köllner mit seinen Löwen im aktuellen Aufstiegskampf auf jeden Fall! Eine sehr geerdete Episode mit einem sehr sympathischen Menschen! #löwenstark Verschiedene Sportarten - verschiedene Ansätze. Wir finden zusammen die Lösung für eure Hürden. CAMP DÖRFL SOCIAL MEDIA:  Du hast Fragen oder eine Idee für einen der nächsten Gäste? Dann schreib mir doch auf Instagram: https://www.instagram.com/dominik.doerfl/?hl=de & wenn Du Hilfe in Sachen Ernährung / Training usw. brauchst, schau gerne mal auf meiner Homepage vorbei: www.dominikdoerfl.com ansonsten freue ich mich, wenn Ihr nächste Woche wieder dabei seid! :-) Bis dahin Euer Dominik ___________________________ *Werbung 10% sparen auf meine Nahrungsergänzungsmittel bei www.peak.ag mit "Dominik10". Gesund leben? Mit MyShot by Lukas Podolski seid ihr super aufgestellt und könnt auch hier mit "Dominik10" sparen. Für Gewürzfans, kann ich euch www.gewuerzverlag.de empfehlen! Ein sehr umfangreiches Sortiment für alle Geschmäcker und mit "Dominik15" spart ihr gleichzeitig noch etwas. :-) Du willst Trainer werden oder dich sportlich einfach theoretisch und praktisch weiterentwickeln? Dann schau doch mal bei Online-Trainer-Lizenz vorbei, absolviere ganz entspannt deine Trainerlizenz von Zuhause und ebne Dir damit den Start in die Fitnessbranche. Mit dem Gutscheincode "Dominik" könnt ihr auch hier einen Rabatt generieren. & Wenn Ihr Sport- oder Freizeitkleidung sucht, seid Ihr bei Brachial genau richtig! *Mit allen Bestellungen über meine Gutscheincodes unterstützt ihr dieses Format und alle weiteren Projekte, die noch kommen mögen! :-) Vielen Dank und bis zum nächsten Mal!

Let's talk about peripheral artery disease, ABI (Ankle Brachial Index), plaque, a bit about stress tests as well as the calcium score. For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources:  ·PrevMed's website·PrevMed's YouTube channel·PrevMed's Facebook page

There are many ways used to detect and measure plaque—stress tests, Agatston score through a calcium CT scan, CIMT, and angiograms. But all these tests may come at a cost, and you need to visit the clinic or laboratory to get them done. There is one DIY test which you can easily do at home—the ABI or Ankle Brachial Index. You can perform it with just your BP (blood pressure) monitoring tool. In this podcast, I'll explain what ABI is, how to do ABI test, how to calculate and interpret your ABI results, and ABI's limitations.For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources: PrevMed's blogPrevMed's websitePrevMed's YouTube channelPrevMed's Facebook page

Wir haben lange genug darauf gewartet. Die Länderspielpause ist endlich vorbei und der "normale" Wahnsinn startet wieder. Und dann auch noch mit einem Krachersamstag in der Bundesliga. Uiuiui! Denn Faktlos - der Fußballpodcast mit Seidel & Klöster hat vielen Experten eines Voraus: Wir haben die Länderspiele schon vorher ignoriert, nicht erst seitdem man damit angeben kann! Ha! Während in Deutschland gemault wird, werden in England Reformen gefordert und dann dagegen entschieden und einfach krass viel Geld für Spieler gezahlt die einfach im Verein keine Rolle mehr spielen. Bleiben wir auf der Insel: Wie steht es um Manchester United? Die Championsleague steht in den Startlöchern und für ManU wird es ein ganz harter Kampf. Können da die Neuzugänge stechen? Wie schlagen sich die Bayern gegen Madrid? Schafft Gladbach das Wunder? Macht ein Internationaler Wettbewerb während einer Pandemie überhaupt Sinn? Fragen über Fragen. Antworten können da nur eure 2 Lieblings-Alleskönner beantworten. Übrigens, Hector ist aus der Nationalmannschaft zurückgetreten. Im Ligenwahn wird der Wahnsinn quasi spürbar. Nicht nur der Krachersamstag in der Bundesliga, sondern vor allem in Italien. Was für eine Inszenierung von Juventus. Jetzt auch noch mit Folgen für Neapel. What the funk?! Damit Özil wenigstens 3x auftauchen darf (unendlich mal mehr als in irgendeinem 16er in der Premier League, lol) bekommt er einen feinen Gehaltscheck, den vielleicht Pasanen bald kommentieren darf (hoffentlich nicht im Auswärtstrikot).

Wir haben lange genug darauf gewartet. Die Länderspielpause ist endlich vorbei und der "normale" Wahnsinn startet wieder. Und dann auch noch mit einem Krachersamstag in der Bundesliga. Uiuiui! Denn Faktlos - der Fußballpodcast mit Seidel & Klöster hat vielen Experten eines Voraus: Wir haben die Länderspiele schon vorher ignoriert, nicht erst seitdem man damit angeben kann! Ha! Während in Deutschland gemault wird, werden in England Reformen gefordert und dann dagegen entschieden und einfach krass viel Geld für Spieler gezahlt die einfach im Verein keine Rolle mehr spielen. Bleiben wir auf der Insel: Wie steht es um Manchester United? Die Championsleague steht in den Startlöchern und für ManU wird es ein ganz harter Kampf. Können da die Neuzugänge stechen? Wie schlagen sich die Bayern gegen Madrid? Schafft Gladbach das Wunder? Macht ein Internationaler Wettbewerb während einer Pandemie überhaupt Sinn? Fragen über Fragen. Antworten können da nur eure 2 Lieblings-Alleskönner beantworten. Übrigens, Hector ist aus der Nationalmannschaft zurückgetreten. Im Ligenwahn wird der Wahnsinn quasi spürbar. Nicht nur der Krachersamstag in der Bundesliga, sondern vor allem in Italien. Was für eine Inszenierung von Juventus. Jetzt auch noch mit Folgen für Neapel. What the funk?! Damit Özil wenigstens 3x auftauchen darf (unendlich mal mehr als in irgendeinem 16er in der Premier League, lol) bekommt er einen feinen Gehaltscheck, den vielleicht Pasanen bald kommentieren darf (hoffentlich nicht im Auswärtstrikot). Du möchtest deinen Podcast auch kostenlos hosten und damit Geld verdienen? Dann schaue auf www.kostenlos-hosten.de und informiere dich. Dort erhältst du alle Informationen zu unseren kostenlosen Podcast-Hosting-Angeboten.

Wir haben lange genug darauf gewartet. Die Länderspielpause ist endlich vorbei und der "normale" Wahnsinn startet wieder. Und dann auch noch mit einem Krachersamstag in der Bundesliga. Uiuiui! Denn Faktlos - der Fußballpodcast mit Seidel & Klöster hat vielen Experten eines Voraus: Wir haben die Länderspiele schon vorher ignoriert, nicht erst seitdem man damit angeben kann! Ha! Während in Deutschland gemault wird, werden in England Reformen gefordert und dann dagegen entschieden und einfach krass viel Geld für Spieler gezahlt die einfach im Verein keine Rolle mehr spielen. Bleiben wir auf der Insel: Wie steht es um Manchester United? Die Championsleague steht in den Startlöchern und für ManU wird es ein ganz harter Kampf. Können da die Neuzugänge stechen? Wie schlagen sich die Bayern gegen Madrid? Schafft Gladbach das Wunder? Macht ein Internationaler Wettbewerb während einer Pandemie überhaupt Sinn? Fragen über Fragen. Antworten können da nur eure 2 Lieblings-Alleskönner beantworten. Übrigens, Hector ist aus der Nationalmannschaft zurückgetreten. Im Ligenwahn wird der Wahnsinn quasi spürbar. Nicht nur der Krachersamstag in der Bundesliga, sondern vor all...

In this episode I tell the unbelievable, yet absolutely true story of “The Ballad of Brachial Bill”!!

The purpose of this study was to conduct a review of current literature on the effectiveness of neuromuscular electrical stimulation (NMES) for restoring motion and function in neonatal brachial plexus palsy (NBPP).

David Schmidt ist ein sanfter Riese. Brachial wirkt er nur auf dem Handballfeld, er mag die leisen Töne. Allein Freundin Johanna kann ihn die Fassung verlieren lassen. Und dann schämt er sich auch schonmal. So wie anfangs für den Chihuahua, den sie mit in die Beziehung gebracht hat – ein Zwei-Kilo-Hündchen an der Leine eines 100-Kilo-Mannes führt schon mal zu Lachern auf der Straße… In der dritten Folge des Podcasts “Wirklich wichtig” spricht David mit der Journalistin Inga Olfen über bedeutende Spiele, die zentrale Rolle der Familie in seinem Leben und darüber, wie wichtig es ist, dass Sportler politisch Stellung beziehen. Shownotes (Weiterführende Links zur Episode): • https://de.wikipedia.org/wiki/David_Schmidt • https://kontenta-gmbh.de

Ofilia was recently diagnosed with Whiplash-Associated Disorder (WAD) after a severe motor vehicle accident. The patient has an inverted supinator sign, clumsiness in both hands, and difficulty performing wrist extension against resistance. Which of the following pathologies is the MOST likely present: A. Central cord syndrome B. Brachial plexus traction injury C. C6 nerve root compression D. Radial nerve lesion

In this episode, we review the high-yield topic of Brachial Neuritis (Parsonage-Turner Syndrome) from the Shoulder & Elbow section. --- Send in a voice message: https://anchor.fm/orthobullets/message

Meghann Rose has been a pediatric OT for almost 14 years. Her first 12 years were spent working at a Children's Hospital in Rochester, NY, where she helped establish a team-based approach to occupational therapy in the NICU and where she focused on infant feeding, positioning and transition to home. In 2007, Meg and neurologist Jennifer Kwon established the Brachial Plexus Outpatient Clinic and in 2011 they received a grant to develop a protocol for care of infants with brachial plexus injuries and a referral system. In 2017, Meg transitioned from the hospital setting to private practice, and she now works in an outpatient clinic as part of a feeding team and with infants with brachial plexus injuries. In addition, she works with children and families as part of the Early Intervention system. She has published an article on feeding and another on brachial plexus injuries. Meg is also a mom to three kids ages 10, 8 and 4 and participates in hobbies that include photography and volunteering with the local ambulance core. On this episode, Meg shares about her path into OT and as a specialist in BPI, and she discusses the different types of BPI and how each is addressed via the protocol. To connect with Meg, go to www.ontheair.us

Meghann Rose has been a pediatric OT for almost 14 years. Her first 12 years were spent working at a Children's Hospital in Rochester, NY, where she helped establish a team-based approach to occupational therapy in the NICU and where she focused on infant feeding, positioning and transition to home. In 2007, Meg and neurologist Jennifer Kwon established the Brachial Plexus Outpatient Clinic and in 2011 they received a grant to develop a protocol for care of infants with brachial plexus injuries and a referral system. In 2017, Meg transitioned from the hospital setting to private practice, and she now works in an outpatient clinic as part of a feeding team and with infants with brachial plexus injuries. In addition, she works with children and families as part of the Early Intervention system. She has published an article on feeding and another on brachial plexus injuries. Meg is also a mom to three kids ages 10, 8 and 4 and participates in hobbies that include photography and volunteering with the local ambulance core. On this episode, Meg shares about her path into OT and as a specialist in BPI, and she discusses the different types of BPI and how each is addressed via the protocol. To connect with Meg, go to www.ontheair.us

In this episode, I continue our why’s of anatomy series with further discussion of the brachial plexus. I strongly encourage listening to Ep 147 before this. It will make your life considerably easier. The brachial plexus is not hard, it just requires understanding. These 2 podcasts make that possible. There are no attached slides. Remember … Continue reading Divine Intervention Episode 148 – The Why’s of Anatomy For The USMLE Step 1 (Upper Limbs 2, Brachial Plexus)

In this episode, I begin a series I am describing as the why’s of anatomy. I am especially going to hone in on Step 1 relevant anatomy but from the perspective of trying to show you that anatomy actually has mechanisms as against being solely memorization. This podcast focuses on the brachial plexus. There are … Continue reading Divine Intervention Episode 147 – The Why’s of Anatomy For The USMLE Step 1 (Upper Limbs 1, Brachial Plexus)

Brachial plexus avulsion is a medical term to describe damage to the nerves that feed a dog's or cat's front legs. This type of injury is usually serious because it means significant damage has occurred to the nerves running to the front leg or legs. Physical therapy with a certified animal rehabilitator is usually the best treatment option.

In this episode, we review multiple-choice questions related to the high-yield topics of Obstetric Brachial Plexopathy & Intramedullary Osteosarcoma. --- Send in a voice message: https://anchor.fm/orthobullets/message

In this episode, we review the high-yield topic of Obstetric Brachial Plexopathy (Erb's, Klumpke's Palsy) from the Pediatrics section. --- Send in a voice message: https://anchor.fm/orthobullets/message

Andreas Ollmann ist einer der vier Gründer der Ministrygroup. Eine Agenturgruppe, die abseits von Worthülsen und Trends "waschechtes" new work lebt und sich tagtäglich - mit jeder Zelle der Unternehmung - dem stetigen Wandel stellt. Keine starren Hierarchien, keine Teppichetage mit Führungsriege, sondern ein agil-dynamisches Miteinander. Gemeinsam mit der kompletten Belegschaft investiert Andreas seine Kraft, um eine Unternehmung zu gewährleisten, die selbst lernen kann. Andreas bereitet den Boden für eigenverantwortliche Entscheidungen eines jeden, schenkt maximales Vertrauen, lebt Transparenz - genau wie die gesamte Truppe. Andreas lebt vollumfänglich seine "Meta Haltung": Demut. Sich - gerade als Geschäftsführer - immer wieder neu einzugestehen NICHT allwissend sein zu können. Mit stetiger Geduld und Gelassenheit dem permanenten "Führungskraft Reflex" zu widerstehen, um eben NICHT alles sofort und in Eigenregie zu entscheiden und Dinge laufen zulassen, Fehler zuzulassen - immer mit dem Wissen, dass Veränderungen nicht via Knopfdruck funktionieren und im Fehler der Lern- und Veränderungsmoment wartet. Genauso hat Andreas selbst erfahren, dass sein persönliches Wachstum eher im konflikthaften Miteinander, in Reibung entstand. Trotz aller Bereitschaft und Begeisterung für den permanenten Wandel wünscht er sich mehr im "hier und jetzt" zu leben. Brachial mit der Endlichkeit konfrontiert appelliert Andreas Dinge, Wünsche, Vorhaben keineswegs auf die lange "wenn-dann" Bank zu schieben, sondern einfach zu leben, zu machen und zu tun. Sein tägliches Ritual ist der schönste und beste Beweis, dass die firmenbedingte Agilität, Flexibilität und Veränderung auch in Andreas Alltag stattfindet: täglich immer "ein bisschen irgendwas zu verändern", egal ob im Haushalt mit der linken Hand zu wischen oder einen neuen Arbeitsweg zu wählen. Andreas Rat an sein jüngeres Ich gilt genauso seinen Schützlingen in der Hacker School und Berufsberatung: schau nach Dingen, Themen, die dich wirklich interessieren und fokussiere dich nicht auf einzelne Ausbildungen, sondern bereite dich aufs Leben vor und vor allem: lass alles auf Dich zukommen! Respekt für Andreas Großmut und Gelassenheit.

A deep-dive into the poem, Brachial Supernova --- Support this podcast: https://anchor.fm/detoxpodcast/support

Tut man ihnen nur genug Unrecht, nehmen "echte Männer" (sic!) das Gesetz (und die Knarre) selbst in die Hand - vor allem, wenn ihr Name mit B beginnt. Zum Release des Remakes DEATH WISH (2018) besprechen wir den Film und das "Original" EIN MANN SIEHT ROT von 1974, sowie James Wan's Neuinterpretation DEATH SENTENCE von 2007 gleich mit. Moral, Selbstjustiz, Waffenkult, Manneskraft, Polizei, Recht, Gesellschaft - die Themen die der Stoff hergibt sind umfangreich. Also ladet den Podcatcher durch und geht raus, in die dunklen Straßen, wo Gesindel sich herumtreibt und Filmfans mit Mitteilungsbedürfnis stundenlang ins Mic faseln.

Transcript for this episode is found under the pic   Ron is a co-host of PodcastDX, he was injured as a child when he was struck by an automobile.  He survived the critical injuries but a permanent deficit of his brachial plexus nerve bundle remained.  Although he does not have the use of his right arm, he continues to take on challenge after challenge.  His latest goal is to compete in the 2020 Paralympics!  We certainly support his drive to excel, and hope to see him on the podium for that event accepting his first medal! Episode 13 Brachial Plexus .mp3   Ron [00:00:19] Hello and welcome to PodcastDX the show that brings you interviews with people, just like you whose lives were forever changed by a diagnosis. This podcast is not intended to be a substitute for professional medical advice diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen and never disregard professional medical advice or delay it in seeking because it's something you have heard on this podcast.   Lita [00:00:58] I'm Lita.   Jean [00:00:59]  I'm Pokémon.   Lita [00:01:00] . Pokey man?   Ron [00:01:04] And I guess I'm Ron. I am one of the co-hosts and also today's guest.   Lita [00:01:10] Yes. Yay Ron. Collectively we are the hosts of podcast D X and Ron we will not make you ask questions as well as answer them today because that would be a whole different theme show under DSM 5.   Ron [00:01:24] I do appreciate that thank you very much.   Jean [00:01:27] The topic for today is rather complex so bear with me a moment. The actual injury we will discuss is a brachial Plexus Avulsion and a secondary topic is living a full life with any type of disability from handling bullying as a child to searching for a job as an adult. The first brachial plexus is a network of nerves that sends a signal from your spinal cord out to your shoulder arm and hand.   Lita  [00:01:54] That's correct. It's a bundle. Or like Jean said a network of nerves starting at c5 going down to T1. So it's C5 C 6, c7 c 8 and T1 there are five of them coming from the spinal cord going out through each shoulder down to the arm and the fingers they connect and they run all the way to the fingers and they separate and rejoin as they do this so they'll be like opening up closing back together. It's it's a nerve bundle. Now if. Part of the nerve bundle is stretched or compressed possibly through contact sports like wrestling or football. The individual can feel an electric shock or a burning sensation down the arm or a numbness or weakness in the arm. For minor injuries the symptoms could last well maybe a couple of seconds a couple of minutes they might linger for days but in a more severe injury called an avulsion the nerve root is actually torn from the spinal cord where it originates. This might happen in a motor vehicle accident or other trauma. And Ron was a youngster when his occurred. It affected his right arm which never recovered from what must have been a complete tear.   Ron [00:03:15] That's pretty much true. I was so young at the time. I. I didn't get any information from the doctors. I mean we've had like almost 50 years ago.   Lita [00:03:26] Yeah that's, that's probably hard to remember that.   Jean [00:03:29] Right in when you get injured as a young child it must be you've had been a very frightened time for you and for your mother as well.   Ron [00:03:37] Well to be honest for me I don't really have any recollection. I think I was maybe too young or something that maybe just blocked out of my mind. I was four…   Jean:  Sure Ron:  … when the accident happened but for my mom, I'm sure it was much more of a traumatic event. Anybody who's a parent out there when something happens to your child it's like...   Lita [00:04:07] it's your whole world.   Ron [00:04:07] yeah Because you're her child.   Ron [00:04:07] Yeah right.   Ron & Lita [00:04:08] Your whole world.   Ron [00:04:09] The responsibility and all that whether or not it's your fault or not. So yeah I'm sure it's probably much harder on the mom. But again for me as a kid I don't recollect any of it whatsoever.   Lita [00:04:25] ok, We've had many medical advances since the what, this would be like the 1960s that this has happened.   Ron [00:04:32] Somebody said you know, I'm not that old (Laughter)   Lita [00:04:33] I'm sorry about that. ( laughter )But again we're dating myself and treatment protocols are more aggressive now with the use of nerve transplants. This injury is more common than you would think during birth when the baby's shoulder has trouble passing under the mother's pubic bone. And the doctor has to do significant manipulation of the baby in order to allow the birthing process to take place. The resulting injuries called Herb's palsy depending on the severity of the injury it can also be a lifelong detriment or it could clear up on its own in time or with the new surgical procedures and techniques like nerve transplant.   Jean [00:05:13] That's right. Obstetrical brachial plexus injuries happened about four out of a thousand births. It's not it's common but it's not all that common in parents probably don't even hear about it unless it happens to their child breech deliveries force babies arms to stretch up over their head during birth and that can be one of the causes.   Ron [00:05:32] It's pretty interesting I'm sure that the new mothers out there or mothers to be are going to be thinking about this right now.   Jean [00:05:40] Yeah.   Ron [00:05:41] And of course we know that the brachial plexus injury have been very contact sports like football hockey and wrestling.   Jean [00:05:47] Or even high jumps.   Lita [00:05:49] ohhh High Jumps, . The only data I could find was dated 1990s where it was reported to be the most common injury during contact sports with two point two per hundred players incurring this injury during their time playing sports. And that's across the board. That's all sport players from youngsters up to professional athletes when the injury occurs the athlete feels a sharp burning or stinging pain hence the common names burner or Stinger radiating from the Super Clavicular area down the arm to the hand. This is accompanied by numbness or tingling of the upper extremity.   Jean [00:06:29] I think everyone's felt something comparable to this at some point in their lives if they never hit their elbow.   Lita [00:06:34] Right.   Jean [00:06:34] Sharply. And you feel that selection faint tingling painful feeling and that's the nerve being hit at that point. There are actually several forces at work when a youngster has a traumatic accident on a plus size because the nerves and muscles are still developing there's always a chance for some recovery with just given time and possibly with physical therapy. Also if the incident occurs very early on the child may learn to adapt well with this and automatically without even realizing that there is maybe a deficit or something they'll just be able to adapt and learn around it. And if it's all you've ever known well then it's your own level of normal. And Ron I think that is what you're saying. You were saying before the show that you're used to it.   Ron [00:07:21] Well yeah that's right. Because the accident it had happened so long ago and I was so young I never really learned how to do something. Another way. I grew up learning how to do things that I did with we'll be getting into that but I learned how to do them the way I learned how to do them. So that was my normal. But it's a lot different for people who are older that have to adapt. Yes I'd become their new normal. But the older you are the more you're used to doing it one way then you need to change what you're doing to a different way to adapt to you know whatever happened. A lot of times that becomes much more difficult for people because they have to relearn how to do something.   Jean [00:08:08] Right.   Lita [00:08:09] Right. So you're injury because it was so young and it resulted in atrophy of your right arm. You just adapted to life without it and because it happens so young you really didn't even realize that. It was there or wasn't there. And what you might have been missing is that right.   Ron [00:08:26] Right. I wouldn't call it adapting, because I didn't know any other way you know what I mean I guess you could say it wasn't happening but because I didn't know you just said hey this is how it works for me right.   Jean [00:08:39] Right. Well as a youngster did your friends or family members ever treat you differently. Were you ever bullied or were you just one of the guys.   Ron [00:08:48] You know looking back. Family wise not always always encouraged to do stuff. I've always played sports as a kid growing up. I would have been playing baseball softball and baseball in my mid 30s. I played a lot of different sport. I never really had that from my family at all and from kids growing up I guess if I look back it probably was some but because I was doing a lot of the same sports activities as my parents and my friends I didn't look at it that way or I wasn't getting as much as some people may get.   Jean [00:09:31] OK. And in no matter what happened you persevered and you've kept your positive attitude throughout and I'm sure your family had a lot to do with your attitude and always looking you know to succeed and that's you know obviously their support is extremely important.   Ron [00:09:49] Oh absolutely my family's been great. I never ever. Had things. Given to me differently or told I couldn't do something for fear of get hurt or told you should'nt try this. I was always encouraged or maybe not encouraged, but my mom or my family would always be behind you when I said you could do stuff. Never surprised when they tried to do something new or different. But I was encouraged to do so. Yeah. My family's been great my whole life.   Lita [00:10:22] I know that some of the sports you've participated in scuba for sure since you're a part of the Dive Heart organization and baseball golf and lately archery. Has it been any easier the last 30 years compared to the first 20 years of your injury. The Americans With Disabilities Act of 1990 that might have been having a benefit for your pursuing sports.   Ron [00:10:45] To be honest the ADA really has not been an issue for me one way or the other. Again when I started playing sports. It was 20 years you know almost 20 years before the ADA came about and I've been doing it my whole life. I like the challenge. I when I was a kid I loved playing baseball I still wish I could. But you know father time has caught up with me. But I still do other sports that may not be as physically active I like to be involved and whatever it is. I like the challenge.   Lita [00:11:28] right, Well I know that at the range we were talking yesterday and you said as an adult you still have to prove yourself when joining a new group. You said that. It sounded a lot like where I said it sounded a lot like. Being a female mechanic and you didn't understand that because you're not a female or a mechanic but talk about that a little bit now as an adult. How difficult is it for you to get into new situations. Are there people that stare. Does it make you self-aware.   Ron [00:11:57] Right. And before we go along with this I need to say thank you for stealing my line. I think that was my line yesterday. I'm not a woman or a mechanic.   Lita [00:12:04] Laughter.   Ron [00:12:06] I mean.   Lita [00:12:08] I knew I heard it somewhere.   Ron [00:12:13] The reality. Yes. You know the one thing I have noticed throughout the years is because I do things my own way to participate. I do see people that busted me or does dare I lead them and now I'm used to it. But it's probably a little more un-nerving when I was growing up. But again like I said I'm used to it now. But even since I was a kid I did always have to prove myself. But even with my peers or the kids from little league that I grew up with. After a while they knew me. But when I started playing against other people they didn't, or when I played in travel leagues. we did, you know, other people people didn't know me per se, yes. And I always had to prove myself again because they're always looking at me out there who's doing things differently than them. And a lot of times I would get the look, or the stares, or the "yeah this kid doesn't belong. This guy shouldn't be here" until I started playing.   Jean [00:13:18] Okay. Well I just learned that, when you're meeting new people or entering a new group the functional MRI of someone who is meeting new people looks the same as a functional MRI of someone who is perceives a threat. Or is in distress. So for I think for everyone it's always challenging and a little bit scary when entering a new group and it's just interesting that you know it it's it can be hard for anyone. And I know that when I was using a wheelchair I often felt that people always wanted to help me even if I didn't need help or I felt like I could do something on my own. And I oftentimes felt conflicted. You know sometimes I wanted people I needed help and other times I just wanted to be able to do things on my own and I had difficulty finding the words to actually let someone know that I'm okay I can handle something and I I'm okay and I know what I was doing. Do you ever feel uncomfortable asking for help or would rather do things on your own until you can acquire the ability or something like that.   Ron [00:14:28] That's an interesting question. I'm pretty stubborn in that sense that yeah I like to do things independently. I will ask if I can't or it just becomes too difficult. But there really isn't much at all that I can't do because again I find a way to do it.   Jean [00:14:49] mmhmm.   Ron [00:14:49] And there are people out there and with all good intention some kind of want to help or whatever. Sometimes it's difficult to not accept the help or I mean I do. I'm just so used to doing things myself.   Jean [00:15:04] Mmhmm ok,   Lita [00:15:06] Your your recent challenge is a personal one. That's archery. I know you're working hard to improving your stance and you're breathing. What is the hardest part of your current challenge.   Ron [00:15:20] Well you are an Archer from the past and you could understand the sport and every little part of your stand. Every part of your posture, every little part of your release it impacts where your arrows are lined up. So right now I think the biggest challenge I'm having is consistency with all the little minute aspects of the sport. If you're aware I'm shooting at a target it's 50 meters 55 yards from where I'm standing and the whole size is about half the size of a compact disc. So trying to hit a target that small from that distance precision and accuracy is paramount. So any little. Change in posture or release can affect the arrow where it hits the target. So it's getting that consistency with every aspect of eventually releasing the arrow.   Jean [00:16:26] OK. And I think those of us who have fired at a range with weaponry we kind of understand that where even like the slightest variation in your breath can affect where you hit on a target and if any of our listeners have any tips or tricks or suggestions we'd be happy to hear them and pass them on to Ron. And I know I won't be at the archery range anytime soon. I was almost almost never made it into this world when a stray arrow almost got me when I was still in my mom's belly. So yeah a little bit of a fear there.   Lita [00:17:01] Yeah yeah. We won't be dragging you out there. I want the parents at home to realize that. It's only a disability if you let it become one. I know it's simplistic. I don't mean to be shallow regarding anyone's feelings but I think it's okay to let your child stumble just like any other child that will, as they're growing. You don't need to be overprotective. You can let the child learn and adapt. You can give guidance and support. And be there when they need you but don't be so overprotective that they can't grow and learn for themselves what will work, what won't work, is that What you are trying to say Ron?   Ron [00:17:43] Yeah it's funny that you put it that way. I recall when I was a child. One of the parents, this was in little league, actually. Told my mom. That she was surprised that my mom was allowing me to ride a bike.   Lita [00:18:03] tskk.   Ron [00:18:03] Exactly. It's ridiculous. Now I again I'm sure she meant well but sometimes if you're overprotective you don't allow your kids to be kids you know grow and flourish.   Lita [00:18:15] Right.   Jean [00:18:17] Well we heard about a quad amputee who had a bike  modified from Ride to Recovery. And he was injured. The gentleman was injured in the military and had to have all four limbs amputated amputated and he actually he works. His part. He works there, I don't know exactly how the motion works but he's had adapt, adaptations made to the bike. And when it's first time out on the road he fell over and was,.   Lita [00:18:46]  wiped out.   Jean [00:18:48] And wiped out.  And they went to him and said "Oh you you do not want to try this." and he said "oh no let's. Let's go. Let's try it". You know you got to get out there you've got to try it and adoptions can be made for anyone.   Ron [00:18:59] Oh absolutely. I remember I could take some of my students adaptted  water skiing with a group that provides beach sports in waterskiing for people that can't walk. And one of my students who was waterskiing on the lake up in Twin Lakes Wisconsin wiped out.   Jean [00:19:18] Yeah.   Ron [00:19:18] You know everybody's freaking out. "Oh my God oh my God." And we got the girl up, and get her back on to the ski boat. She was laughing.   Lita [00:19:30] (laughter).   Ron [00:19:30] And everybody said what are you laughing for.  I'm having fun.   Jean [00:19:34] Yeah.   Ron [00:19:35] You know I think she cut herself. Who doesn't. You know you can't treat somebody you know like glass just because you're afraid something's going to happen.   Lita [00:19:45] Kids are gonna get hurt.   Ron [00:19:46] Exactly. But it's great. Nowadays a lot of organizations are out there that have opportunity if you will both for sport and for. The other other forms of leisure that weren't around many many years ago. You guys were aware of being Veterans and through the VA hospital,.   Jean [00:20:12] yeah.   Ron [00:20:12] And we have in Chicago now known as the Shirley Ryan ability clinic or ability lab.   Lita [00:20:18] Right.   Ron [00:20:19] They have so much going on out there, that borders, of the different organizations that I'm involved with, with the Dive Heart which does adapted Scuba diving, the other organization which I mentioned is the water skiing, is called dreams for kids.   Jean [00:20:36] OK,.   Ron [00:20:36] And they allow kids to be kids.   Jean [00:20:39] Right.   Ron [00:20:39] So by water skiing in the summer snow skiing in the winter. You know for kids that can't walk. There's a lot more that goes into it. But where I'm going with this is a lot more opportunity for not just kids. Kids and adults, with any type of disability to get involved in sport or any other recreational activities. So the sky can be the limit now.   Lita [00:21:03] I think we finally touched on the recreational therapy portion.   Jean [00:21:08] Oh Shocking given that we have two recreational therapists in the room. What do you get when you have two recreational therapists in the room. Yeah. A lot of talk about recreational therapy. And they will tell you that anyone can do anything.   Lita [00:21:22] Yes.   Ron [00:21:24] What's not great about that. (Laughter)  Yeah. Anything that's out there, there is always a way to modify it for somebody to participate in and that's what Lita and I went to school for and I believe we both still believe wholeheartedly in this and the way I got involved had nothing to do with my disability although having a disability it's kind of helped me to help others. But again because of the times we are in now and all the different organizations there are out there and the opportunities that exist if you are interested  whether an active sport or any other type of recreational opportunity is always going to be something there for you.   Jean [00:22:12] Well that's that's really great. I know always our world gets smaller with our ability to communicate instantly and diversity is easier to observe and hopefully more accepted our collective appreciation and acceptance of people is certainly one of human natures its greatest strengths.   Ron [00:22:32] Oh I totally agree. I think nowadays with much more emphasis on acceptance I don't think there is much of a stigma, that used to be when I was a kid. And I think that the world is more open to people with disabilities participating in sports.   Jean [00:22:55] OK, Yeah. You got to see the person.   Lita [00:22:57] Right. Well. We started out the episode discussing brachial plexus injury but also we drifted off into the difficulties children may have when there's something a little bit different than their peers. But we celebrate those differences we stand in support of anyone with a physical mental or emotional challenge and we hope our listeners will do the same and help those in their lives to also do the same.   Jean [00:23:24] When they need help or when they ask for it.   Lita [00:23:26] If they need it.   Jean [00:23:27] Yeah.   Lita [00:23:27] Be there for them all   Jean: right.   Lita:  If you have any questions or comments related to today's show please contact us at Podcast D X at yahoo dot com to our Web site Podcast DX dot com, our Facebook page, Pinterest, Instagram or Twitter and Ron. Thank you for being our guest.   Jean:  Thank you.   Ron [00:23:47] I appreciate it. I wish I had more time but I'm joking over here.   Lita [00:23:54] (laughter).   Ron [00:23:54] Thank you. And for our listeners out there if you have a moment to spare please give us a five star review where ever you get your podcast ap. Until next time.   Lita [00:24:03] We're gone.    

Eine Comedy mit einer Botschaft: Die britische Serie "Derek" will nicht nur unterhalten, sondern dem Publikum auch zeigen, wie wichtig es ist, gut zu sein. Die Comedy von und mit Ricky Gervais hat die Drehbuchautorin Annette Hess so beeindruckt, dass sie über eine deutsche Adaption nachdenkt. In "Derek" geht es um den Alltag des Altenpflegers Derek (gespielt von Ricky Gervais), der nichts weniger erreichen will, als dass es allen Menschen um ihm herum gut geht. Zu Dereks Alltag im Seniorenheim gehört auch Kev, der einen besonderen Hang zu Brachial- und Fäkalhumor hat und so die harmonische Welt, die Derek schaffen will, konterkariert. Ein Gespräch über Humor, Ricky Gervais' Beobachtungsgabe und die Schwierigkeit, eine gute Adaption zu schreiben. Weitere Informationen zur Serie, der Gesprächspartnerin und zu den anderen im Podcast empfohlenen Serien gibt es in den Shownotes beim Medienmagazin DWDL.de unter: http://www.dwdl.de/seriendialoge/58510/seriendialoge_26_derek__diese_comedy_hat_eine_message/

Do you know what the ABI is? Have you done one? Have you done is correctly and do you know what it all means? Listen this month to learn all about it...and Monique's learns the difference between some anatomy as well! Support the show (https://nursem.org/en/home/)

Thu, 7 Apr 2016 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/19331/ https://edoc.ub.uni-muenchen.de/19331/1/Guelap_Mustafa.pdf Gülap, Mustafa ddc

Commentary by Dr. Valentin Fuster

ABPI is not a credit card interest rate, but just about the most important measurement you can make in vascular surgery.Find out what it is, what it means, who not to do it on, and a video on how to perform it quickly and efficiently using our point of view technique (like you're really there!) with James Blackwell (research fellow in surgery) and Greg McMahon (consultant in Vascular Surgery, Royal Derby Hospital, UK). This comes up in OSCEs a lot and so is essential knowledge for exams, both undergraduate and postgraduate, and you never know, might actually be useful when you're treating patients! If you just want to watch how to do the ABPI and not hear the what and why, skip to 6:30 in the video

Dr. Rosenblum interviews Dr. Schwartz of AABP Pain Management Topics Discussed Combined Anethesia Pain Jobs vs. 100% Pain Jobs Private Practice vs. Academic Practice vs. Hybrid Anesthesia/Pain Jobs growing a pain practice Ethical Pain Medicine Ultrasound utility in practice growth ERAS protocol Narcotic sparing  Acute Pain Practice   For more information on Pain Management Topics and keywords Go to PainExam.com David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com 718 436 7246 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment.  You should regularly consult a physician in matters relating to yours or another's health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional.    Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.        

This week in Nugget 7, I will show to how to draw Brachial Plexus - the easy way!. Find more exciting stuff at: http://www.regionalfortrainees.com

In this podcast we talk about the anatomy of the brachial plexus. Find more exciting stuff at: http://www.regionalfortrainees.com

A birth injury is any sort of injury that a child sustains, or suffers, during the process of birth often resulting in a lawsuit. Join Ringler Radio host, Larry Cohen with co–host and Ringler Associate from the Louisville, Kentucky office Cindy L. Chanley, as they report from the 2007 AAJ Convention in Chicago. Ringler Radio welcomes expert guest, Attorney Paul Casi, partner in the firm of Hoffman & Casi PLLC located in Louisville, Kentucky, to discuss the definition of a birth injury, determining the standard of care, birth trauma, birth injury malpractice claims and the role of representing the child. Don't miss this important discussion.

Sat, 1 Jan 2000 12:00:00 +0100 https://epub.ub.uni-muenchen.de/16813/1/10_1159_000008184.pdf Brandt, T.; Brüning, R.; Hamann, Gerhard F.; Brückmann, H.; Strupp, M.