2 sexy singers are in the building for this very musical episode. @VictoriaKimani is a Kenyan singer, songwriter, actress and entertainer previously signed to Nigerian record label Chocolate City. She is breaking the Kenyan curfew to come on the podcast. Natalia Estrella aka @BlueHeartChild is a very beautiful singer from New Jersey. We have singers from all over the globe on this episode! CBF may or may not have seen a UFO.... Enjoy the show you Modasucka's! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
After all the controversy surrounding Dave Chapelle's new Netflix special, we decided to get educated. In this episode Pink Foxx brings the knowledge and informs Mike and CBF about the LGBTQIA2S+ community and honestly, we learned a lot. Keep an open mind, an open heart, and check this one out Modasucka family. Pink Foxx was introduced to the dazzling world of entertainment very early in her childhood. Born into a musical family, she was enrolled in acting, and improvisation classes by age 10. Influenced by such talents as Redd Foxx, Eddie Murphy, Richard Pryor, & Martin Lawrence, shortly after college she began developing a career in stand-up comedy. Gracing greenrooms, & sneaking into vip sections all over the country she's rubbed more elbows than Johnson & Johnson. Now relocated to Hollywood, CA, she can be spotted bringing the funny to various comedy clubs and theaters throughout California. Producer of Pink Foxx Presents, an all-women show. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
The Gouldian Finch is holding strong in the final moments of Bird of the Year; will this rainbow pom pom take the crown? Tweets have definitely been louder this week, that's for sure, after Facebook, Instagram and Whatsapp went offline for hours, leaving people to flock to Twitter. What did the outage say about our daily habits and addictions? Meanwhile an epic long read about a Bad Art Friend has the internet in a tizz, but if you're seeing it and CBF reading it don't worry, we got you. Squid Game? That's another story. Myf is reading a great piece about how and why our work defines us, and how to break that pattern of self-objectification. And a thread about a man who has become a bird husband (basically) has us howling. We really are leaning into the ornithology aye? Meanwhile Zan is watching Summer of Soul, and Myf is digging into The Truth About Anxiety. Show notes: Bird of the Year Poll final votes: https://www.theguardian.com/environment/ng-interactive/2021/sep/27/australian-bird-of-the-year-2021-vote-now-for-your-favourite Twitter tweet: https://twitter.com/Twitter/status/1445078208190291973 Who Is the Bad Art Friend: https://www.nytimes.com/2021/10/05/magazine/dorland-v-larson.html The Guardian summary of Bad Art Friend: https://www.theguardian.com/books/shortcuts/2021/oct/06/bad-art-friend-should-fiction-writers-ever-lift-stories-from-other-peoples-lives Self-Objectification: https://www.theatlantic.com/family/archive/2021/09/self-objectification-work/620246/ Summer of Soul: https://www.youtube.com/watch?v=slFiJpAxZyQ The Truth About Anxiety: https://www.sbs.com.au/ondemand/movie/the-truth-about-anxiety-with-celia-pacquola/1945155651586 Wife Guy / Bird Husband: https://twitter.com/berudenotto_/status/1444915701630705669 Email us: firstname.lastname@example.org Bang On is recorded on the lands of the Wurundjeri people of the Kulin nation. We pay our respects to elders past and present. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the land where we live, work, and learn.
@Mia_Francisss comes through and we talk what kind of men she is attracted to, 1 night stands, CBF's taxes, and more! Then, @_France__1 comes all the way from Philly to sing us a song... Enjoy Modasucka's! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
O final de semana foi repleto de jogos bastante interessantes ao redor da Europa. A Premier League, sobretudo, ofereceu uma rodada de partidas de peso e também com muita emoção.Falamos ainda do Dérbi duplo em SP, Série C, patifarias da CBF e o que mais virá pela semana em relação às competições continentais.
Em reunião bilateral, Boris Johnson elogia AstraZeneca e Bolsonaro diz que não se vacinou. E comissão reconhece assédio e aumenta punição de presidente da CBF. See omnystudio.com/listener for privacy information.
Depois de aprovação no Congresso, a Lei do Mandante recebeu sanção presidencial e falamos sobre as mudanças.Também abordamos o aumento da punição a Rogério Caboclo na CBF, agora afastado até o final do mandato.Por fim, mas não menos importante, fizemos a prévia das semifinais da Libertadores, que começam nesta terça-feira com Palmeiras x Atlético Mineiro e na quarta com Flamengo x Barcelona, de Guayaquil. APOIE: https://apoia.se/trivela
Dietary propolis supplementation reduced proinflammatory cytokines associated with air pollution exposure, without impacting on immune cell infiltration or lung function New Zealand Institute for Plant and Food Research, September 10, 2021 Air pollution is estimated to cause 7 million annual deaths globally. Our aim was to determine if dietary propolis consumption could prevent the immune and functional damage in a mouse model of acute urban dust exposure. Female C57BL/6J mice were challenged three times with intranasal urban dust over seven days which significantly increased proinflammatory cytokines and immune cells in the lung 24 h post final challenge. Dietary New Zealand propolis (2%) with gamma cyclodextrin supplementation reduced urban dust-induced lung TNFα, IL-4, and IL-6 cytokine production; but did not alter immune cell infiltration into the lung, or lung function outcomes. This suggests that daily consumption of 8% propolis with gamma cyclodextrin supplemented food was sufficient to reduce urban dust pollution-induced proinflammatory cytokine production but was not sufficient to prevent immune cell recruitment into the lung or lung function decline in a murine model of lung inflammation. In this study we found that daily consumption of a New Zealand propolis reduced proinflammatory cytokines within the lung in response to acute urban dust exposure but this inhibition was not sufficient to reduce immune cell infiltration or prevent increased airways tissue constriction. These results suggest that dietary supplementation of 8% propolis with gamma cyclodextrin (equivalent to 2% propolis resin) does not result in sufficient bioavailable concentrations of the bioactive polyphenolics to fully overcome urban dust pollution-induced acute immune cell infiltration into the lung. Other studies have shown that acute gavage consumption or intraperitoneal injection of specific propolis bioactive components can protect against a number of different immune challenges within the lung. These effects appear to be both concentration and administration route dependent, and may not be achievable using unenriched propolis as a dietary intervention. 20-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment Comprehensive Pain Management Institute (Ohio), August 6, 2021 New research published in the Journal of Evidence-Based Integrative Medicine shows that early intervention against a Wuhan coronavirus (Covid-19) infection using natural, over-the-counter remedies is a safe and effective way to avoid complications. Researchers from Ohio looked at modalities that are readily available for the Chinese Virus, including zinc, zinc ionophores, vitamins C, D3, and E, and l-lysine. These items were categorized in the study as “preventive measures” and “early-stage treatments” that can help to avoid the need for more “advanced” anti-covid measures such as pharmaceutical drugs and vaccines. Each of these tested remedies is natural, by the way, and the results of what they can do are impressive. Once again, nature wins out as our most abundant medicine cabinet, far exceeding anything cooked up in a lab. The clinical study found that this “multi-component OTC (over-the-counter) ‘core formulation' regimen” successfully protected test subjects against getting sick from the Chinese Virus, even as others got sick. “While both groups were moderate in size, the difference between them in outcomes over the 20-week study period was large and stark: Just under 4% of the compliant test group presented flu-like symptoms, but none of the test group was COVID-positive,” the paper reveals. “[W]hereas 20% of the non-compliant control group presented flu-like symptoms, three-quarters of whom (15% overall of the control group) were COVID-positive.” For 20 weeks, test subjects took these natural supplements. Adjustments were made for those with pre-existing health conditions and other health factors that may have influenced the outcome. Since all of the remedies utilized fall into the “low cost” category, anyone can access them. They are all dubbed as “anti-viral” as well, meaning they are safe and effective for use against viruses. By taking advantage of these remedies early, the paper explains, people can help to protect themselves against the types of adverse events that are causing some people to have to be hospitalized and put on a ventilator. “From early March through the end of July 2020, one of us (LM) monitored approximately 600 patients in Columbus and Cleveland, Ohio cities heavily affected by the COVID-19 pandemic, and did consultations with several colleagues (including JL) in the New York City metropolitan area, also heavily hit,” the paper explains. “Over that 5-month period, we dealt with dozens of clinical and/or test-confirmed cases of COVID-19. Much of the monitoring was performed via telemedicine; approximately 20% was performed in-office. It is from in-office monitored patients and staff that the study groups emerged.” We have been covering some of these same remedies along with others that have been scientifically shown to help protect against spike protein-induced illness. Hydroxychloroquine (HCQ), as one example, is a zinc ionophore that helps to deliver more zinc into cells for improved immune function. Epigallocatechin gallate (EGCG), a polyphenol component of green tea, is a natural zinc ionophore that improves zinc absorption. For this latest study, the research team used quina (cinchona) plant bark extract and quercetin as zinc ionophores, as these, too, help to deliver more healing nutrients like zinc to the cells. “The core supplementation formulation components have been demonstrated … to have beneficial effects both outside of and within clinical settings in the prevention of viral infections and also in the treatment of early stages of such diseases,” the study reveals. “Zinc ionophores can … be utilized to gain the anti-viral benefit of enhanced intracellular Zn+2 concentrations while limiting tolerance / side-effect / toxicity issues associated with elevated serum levels of zinc supplementation.” You can review the full paper at this link. Neuroprotective effect of L-carnitine against glyceraldehyde-induced metabolic impairment University Politecnica delle Marche (Italy), September 7, 2021 According to news reporting originating from Ancona, Italy, research stated, “Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive regression and memory loss. Dysfunctions of both glucose metabolism and mitochondrial dynamics have been recognized as the main upstream events of the degenerative processes leading to AD.” Our news editors obtained a quote from the research from the School of Medicine, “It has been recently found that correcting cell metabolism by providing alternative substrates can prevent neuronal injury by retaining mitochondrial function and reducing AD marker levels. Here, we induced an AD-like phenotype by using the glycolysis inhibitor glyceraldehyde (GA) and explored whether L-carnitine (4-N-trimethylamino-3-hydroxybutyric acid, LC) could mitigate neuronal damage, both in SH-SY5Y neuroblastoma cells and in rat primary cortical neurons. We have already reported that GA significantly modified AD marker levels; here we demonstrated that GA dramatically compromised cellular bioenergetic status, as revealed by glycolysis and oxygen consumption rate (OCR) evaluation. We found that LC ameliorated cell survival, improved OCR and ATP synthesis, prevented the loss of the mitochondrial membrane potential (Dps) and reduced the formation of reactive oxygen species (ROS). Of note, the beneficial effect of LC did not rely on the glycolytic pathway rescue. Finally, we noticed that LC significantly reduced the increase in pTau levels induced by GA. Overall, these findings suggest that the use of LC can promote cell survival in the setting of the metabolic impairments commonly observed in AD.” According to the news editors, the research concluded: “Our data suggest that LC may act by maintaining mitochondrial function and by reducing the pTau level.” Hyperbaric oxygen study shows reversal of biologic hallmarks responsible for development of Alzheimer disease Tel Aviv University & Shamir Medical Center (Israel), September 10, 2021 A new study, published today in peer-review medical journal Aging, marks the first time non-pharmaceutical clinical exploration proves efficacy in reversing the main activators of Alzheimer's disease. Using a specific protocol of hyperbaric oxygen therapy (HBOT), cerebral blood flow (CBF) improved/increased in elderly patients by 16-23%, alleviating vascular dysfunction and amyloid burden. The study, part of a comprehensive research program directed toward aging and accompanying ailments as a reversible disease, holds promise for a new strategic approach to the prevention of Alzheimer's by addressing not only the symptoms or targeting biomarkers, but rather the core pathology and biology responsible for the advancement of the disease. Vascular dysfunction is a crucial element in the development of Alzheimer's and cognitive decline: Amyloid beta deposits in the brain blood vessel walls are the most common vascular pathology in Alzheimer's. Reduced blood flow to the brain and its related decrease in oxygen supply (hypoxia) can precede the clinical onset of dementia and correlates with the degree of cognitive impairment in Alzheimer's. The comprehensive research, conducted at the Sagol School of Neuroscience at Tel Aviv University and the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center, was led by study co-authors, Professor Shai Efrati, M.D.; Professor Uri Ashery, Ph.D.; Ronit Shapira, Ph.D.; Pablo Blinder, Ph.D.; Amir Hadanny, M.D. Using combined data from an animal model of Alzheimer's, where effects were evaluated directly on brain tissue (Sagol School of Neuroscience at Tel Aviv University); humans, assessed with the use of high-resolution MRI and computerized cognitive test (Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center); correlating results displayed beneficial effects of HBOT on patients suffering from mild cognitive impairment (MCI), the stage before dementia. Each patient received 60 HBOT sessions over a 90-day period, showcasing substantial improvement in cognitive functions – with memory, attention and information processing speed exhibiting the strongest results. "After dedicating our HBOT research to exploring its impact on the areas of brain functionality and age-related cognitive decline, we have discovered for the first time HBOT induces degradation and clearance of pre-existing amyloid plaques – treatment, and the appearance of newly formed plaques- prevention," explains Professor Uri Ashery. "Elderly patients suffering from significant memory loss at baseline revealed an increase in brain blood flow and improvement in cognitive performance, demonstrating HBOT potency to reverse core elements responsible for the development of Alzheimer's disease." "By treating vascular dysfunction, we're mapping out the path toward Alzheimer's prevention. More research is underway to further demonstrate how HBOT can improve cognitive function and become an influential tool in the imperative fight against the disease," affirms Professor Efrati, research group leader and medical advisor to Aviv Scientific. Aviv has developed a unique medical treatment protocol that includes HBOT, cognitive and physical training, and nutritional coaching, to enhance brain and body performance of aging adults at Aviv Clinics, currently available in Central Florida and Dubai. HBOT is already used in patients with other pathologies and is known to be a relatively safe treatment modality, illustrating its potential to be easily implanted in clinical practice. In recent years, there is growing scientific evidence that certain protocols of HBOT can improve brain oxygen supply, induce proliferation of neuronal stem cells and induce generation of new blood vessels and neurons in the brain. Increased flatulence from eating plant-based diet found to indicate healthier gut microbiome Center for Biomedical Research Network for Liver and Digestive Diseases (Spain), September 10, 2021 A team of researchers affiliated with a host of institutions across Spain has found that the increase in flatulence experienced by people switching to a plant-based diet is an indication of a healthier gut microbiome. In their paper published in the journal Nutrients, the group describes experiments they conducted with healthy, male volunteers regarding diet, fecal sample size and flatulence. It is widely known that switching from a fat or carbohydrate-based diet to one that features more vegetables results in more flatulence—particularly if the switch is to cruciferous vegetables. But as the researchers with this new effort have noted, little research has been done to learn more about the association between diet and flatulence. To learn more about the impact of switching to a plant-based diet on digestion and the gut biome, the researchers enlisted the assistance of 18 healthy, adult male volunteers. Each was asked to eat a western-style diet and then to switch to the plant-based Mediterranean diet for two weeks. Over the study period, the volunteers were asked to count the number of times they defecated each day and to capture and weigh each stool sample. Each of the volunteers was also asked to count the number of times they passed gas. The volunteers were also asked to submit to randomized testing that involved measuring the amount of gas that was emitted during episodes of flatulence, using balloons. The researchers found that the change in diet did not change the number of times the volunteers defecated each day—but it did change the amount of material discharged. The researchers found the plant-based diet doubled the stool size on average. The researchers note this was due to a huge increase in the mass of bacterial growth and excretion. The data also showed that the number of flatulence episodes increased by seven times per day on the plant-based diet—and each discharge had approximately 50% more gas. The researchers note this was due to fermenting of plant material in the gut. The researchers suggest their experiments show that a plant-based diet promotes more healthy types of gut bacteria which leads to better overall gut health. Physical exercise can relieve tumor-associated anemia University of Basel (Switzerland), September 10, 2021 Many cancer patients suffer from anemia leaving them fatigued, weak, and an impaired ability to perform physical activity. Drugs only rarely alleviate this type of anemia. Researchers at the University of Basel have now been able to show what causes the anemia, and that physical exercise can improve this condition. The two major symptoms of cancer are loss of muscle mass and a reduced hemoglobin level, leading to weight loss, fatigue, lethargy and reduced physical performance. Moreover, both symptoms—atrophy and anemia—prompt many patients to schedule a doctor's appointment, then resulting in the diagnosis of a tumor. Why cancer causes muscle atrophy and anemia is not yet understood, and treatment is currently difficult. The fact that anemia leads to a decline of the overall state of health and can negatively affect the course of cancer therapy highlights the urgency to obtain insights into causes and potential remedies. In collaboration with the Department of Biomedicine at the University of Basel, the research group of Professor Christoph Handschin at the Biozentrum has now been able to show in a mouse model that cancer not only triggers a systemic inflammatory reaction, but also massively changes the handling of lipids and other metabolites in the body. The body's fight is unsuccessful These changes result in a tumor-related enhanced destruction of red blood cells. The study published in Science Advances shows that exercise normalizes these metabolic abnormalities and thereby reduces the anemia caused by cancer. The body tries to counteract the degradation by increasing red blood cell productionin the bone marrow and the spleen—without success. However, the increased production of blood cells is insufficient to prevent tumor-associated anemia. "We have now been able to clarify how cancer causes the degradation of red blood cells," says Christoph Handschin. "Cancer massively alters the metabolism of lipids and other compounds. This alters not only the red blood cells but also the macrophages, causing a sharp increase in red blood cells destruction by the macrophages." Macrophages are a type of white blood cells and part of the immune system. Exercise normalizes metabolism and alleviates anemia The research group attempted to normalize the metabolism by pharmacological means. However, none of the drugs could significantly improve the anemia. In contrast, however, the metabolism was regulated to such an extent by exercise that the anemia also decreased. Even the abnormal increase in red blood cell production could be reduced to a lower level. "Training was able to restore tumor-induced metabolic remodeling and inflammation sufficiently to blunt the excessive blood cell formation and destruction," explained Handschin. This study provides novel insights into the development of tumor-associated anemia. The findings suggest that exercise is a useful therapy for cancer patients, in order to counteract anemia and associated fatigue and lethargy and in turn to improve their general well-being and quality of life. This also leads to improved tolerance of radio- and chemotherapy, as has previously been established. Mango could help maintain gut bacteria at risk from high-fat diets Oklahoma State University, September 13, 2021 Mango consumption could help prevent the loss of beneficial gut bacteria caused by a high fat diet, according to research on mice. The findings, published in the Journal of Nutrition , appears to reveal for the first time the positive impact of mango on gut microbiota. In the study, 60 male mice were assigned to one of four dietary treatment groups for 12 weeks - control (with 10% of calories from fat), high fat (with 60% calories from fat), or high fat with 1% or 10% mango. All high-fat diets had similar macronutrient, calcium, phosphorus, and fiber content. “We investigated the effects of freeze-dried mango pulp combined with an high-fat diet on the cecal microbial population and its relation to body composition, lipids, glucose parameters, short-chain fatty acid (SCFA) production, and gut inflammatory markers in a mouse model of diet-induced obesity,” the study reports. The high-fat dietary treatment with 10% mango (equivalent to 1½ cups of fresh mango pieces) was found to be the most effective in preventing the loss of beneficial bacteria from a high-fat diet without decreasing body weight or fat accumulation. Specifically, mango supplementation regulated gut bacteria in favor of Bifidobacteria and Akkermansia and enhanced short-chain fatty acid (SFCA) production. SCFAs have been shown to possess a wide range of beneficial effects, such as anti-inflammatory properties. Fibre benefits In previous studies, Bifidobacteria, for example, has been found to be lower in both obese individuals and those with type-2 diabetes. Similar results have been observed withAkkermansia in animal studies. High-fat diets, meanwhile, have been linked to gut dysbiosis, or bacterial imbalances within the intestinal tract. "Fibre and other bioactive compounds in plant-based foods are suggested to prevent gut dysbiosis caused by a high-fat diet," said Edralin A. Lucas, professor of nutritional sciences at Oklahoma State University and lead researcher of the study. "Mango is a good source of fibre and has been reported in previous studies to have anti-obesogenic, hypoglycemic and immunomodulatory properties. The results of this animal study showed that adding mango to the diet may help maintain and regulate gut health and levels of beneficial bacteria levels.” India, China, Indonesia and Thailand are the top four Mango growing countries, accounting for well over half the total global production. Although more research is needed on the effects of mango on human health, this study suggests that mango consumption may be important in improving gut health particularly for those consuming a high-fat diet, the researchers concluded.
No Inteira ou Meia desta quinta-feira (9), temos atualizamos importantíssimas para o movimento #FreeBritney, que podem significar o fim do regime de tutela e a liberdade (finalmente) da cantora! Também trazemos uma análise dos resultados do lançamento de "Donda", novo álbum de Kanye West, para avaliar se todos os esforços do rapper para divulgar o álbum antes do seu lançamento trouxeram retorno. Ainda no programa de hoje, o comeback das Pussycat Dolls que mal começou e já vai acabar; a retomada dos eventos pelos Brasil e pelo mundo e os drops da semana sobre Lorde, Miley Cyrus, MET Gala e muito mais!
Michael has not looked at a beautiful woman since he got engaged, but Modasucka, Paula Contento aka Paula Happy is in the building today. She is a Columbian Baddie and she tells us how she made 15 thousand a month on Only Fans. We also discuss with her the great debate - should prostitutes be able to collect disability? We also have breaking news! The MODASUCKA podcast officially has listeners in China. That's right we are global now. Mike and CBF also discuss DNA tests and their ancestry. All that plus more on this episode, Modasucka's! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Yuri Queiroga fala sobre o dolorido empate que o Botafogo cedeu nos acréscimos ao Tombense e sobre a vergonha coletiva de Conmebol, CBF e AFA no que deveria ser um Brasil x Argentina. --- Send in a voice message: https://anchor.fm/esportes-com-yuri-queiroga/message
Mike has been in Ghana for 21 days! He returns looking like the Ghetto Evel Knievel just parachuted into the building, and gives us the update on the school he is building in Africa. Then, Mike and CBF catch up after Mike's long trip. They talk about Mike getting engaged to Rada on the Breakfast Club, what you find when you Google Chinese Best Friend's name, Afro Spirits, and more! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
First Baptist Decatur is a vibrant, progressive, welcoming and affirming community of faith located in the heart of Decatur, GA.To learn more about our community:Visit our websiteSubscribe to our email listTo help us keep resources like this available:Give a tax-deductible gift online
In today's news segment: Tyrese and his civil rights beard, Dennis Schroder and his unwise accountant, and Soulja Boy's fake jewelry. Also, Mike checks in with CBF about his lady and his baby. Then we have Tigi Tristan stop by to teach us the importance of tea that makes you shhh... and finally Markas Jon stops by and tells us about his underwear line. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
O Fleets acabou mas teve seus 15 minutos de fama ao unir o Brasil pelo poder da carentena. Também neste episódio do Lá do Bunker, comentamos novidades da série de O Senhor dos Anéis, os atletas olímpicos mostrando sua paixão por animes e jogos, a queda de assinantes da PS Plus e o patrocínio do Free Fire para as seleções brasileiras de futebol, encerrando com Jennifer Aniston e a Revolta da Vacina. CITADO NO PROGRAMA Brasileiros se despedem dos Fleets sem pudores e sem limites Série de O Senhor dos Anéis ganha data de estreia e primeira imagem One Piece, Avatar e mais: atletas olímpicos mostraram seu lado nerd durante os Jogos Número de assinantes da PS Plus caiu mais de 1 milhão nos últimos meses Free Fire fecha patrocínio com CBF e Seleção Brasileira Jennifer Aniston cortou relações com quem se recusa a tomar a vacina contra a COVID-19 APRESENTAÇÃO Pedro Duarte -- Instagram / Twitter Pri Ganiko -- Instagram / Twitter EDIÇÃO Doug Bezerra -- Instagram
Começamos pela participação da seleção brasileira feminina na Olimpíada de Tóquio 2020 (jogada em 2021). O que faltou para o Brasil ir mais longe? Também analisamos o trabalho de Pia Sundhage e ressaltamos que há questões a serem resolvidas.No mais, falamos sobre a tentativa de saída de Harry Kane do Tottenham - que faltou ao treino de hoje - a confusão da CBF, o VAR intervencionista no Brasileirão e o bom futebol do Flamengo, que pinta como candidato ao título se unindo a Palmeiras e Atlético Mineiro.
Processo do Ministério Público de 2017 anula a Assembleia Geral da CBF daquele ano e, por consequência, anula a eleição da Confederação, feita em bases que se tornaram ilegais. Calma que a gente explica tudo isso para você neste episódio! Ouça!APOIE: https://apoia.se/trivela
Who has had more STD's? Who has had the most threesomes? These answers plus more on this episode with comedian Reedo Brown (@reedobrown). Mike, Reedo and CBF also talk coming up as a comedian in this new era of social media and how to make BANK! You know what to do MODASUCKA'S! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
No podcast ‘Notícia No Seu Tempo', confira em áudio as principais notícias da edição impressa do jornal ‘O Estado de S. Paulo' desta terça-feira (20/07/21): O governo de SP anunciou que, a partir de 17 de janeiro, pretende revacinar toda a população do Estado, com prioridade para a aplicação da Butanvac, imunizante na fase 1 de testes clínicos, desenvolvido pelo Instituto Butantan. Embora essa vacina ainda tenha de comprovar segurança e eficácia nos estudos, o Butantan prevê ter em estoque 40 milhões de doses em outubro – a opção à Butanvac seria a Coronavac. O novo ciclo de imunização poderá ser feito com apenas uma dose e deve abranger toda a população adulta, independentemente da vacina originalmente administrada. E mais: Metrópole: Anvisa autoriza estudo clínico com terceira dose da AstraZeneca Política: Em Angola, Mourão intercedeu pela Universal Economia: Estados driblam nova regra sobre saneamento Internacional: Haiti tem nova troca no poder após assassinato Esportes: A vez de Pia tentar o ouro olímpico no futebol See omnystudio.com/listener for privacy information.
A CBF fez uma parceria com a empresa de blockchain Bitci Technology para o lançamento de uma criptomoeda oficial e de tokens não fungíveis (NFTs) da Seleção Brasileira. Mas a seleção brasileira não será a primeira a lançar um token de torcedor no mundo do futebol. A seleção da Espanha e da Argentina já tem o seu próprio “Fan Token”, além de times de peso como Juventus, Paris Saint-Germain, Barcelona, Milan e porque não o Corinthians. Entenda tudo sobre o mundo dos NFTs no futebol.
On Episode 6 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the July 2021 issue of Stroke: “Prevalence and Clinical Correlates of Intracranial Dolichoectasia in Individuals With Ischemic Stroke” and “Dose Escalation and Safety of Capsaicin for Cerebral Perfusion Augmentation.” She also interviews Dr. Osama Zaidat about his article “Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes.” Dr. Negar Asdaghi: 1) Is intracranial dolichoectasia the new intracranial atherosclerotic disease? 2) What is the latest on collateral flow improvement through sphenopalatine ganglion stimulation in patients with acute ischemic stroke? 3) Is endovascular therapy futile in patients presenting with a low ASPECTS score? These are the topics that we will cover in today's podcast. You're listening to the Stroke Alert Podcast. Stay with us. Dr. Negar Asdaghi: From the Editorial Board of Stroke, welcome to the Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. Dr. Negar Asdaghi: For the July 2021 issue of Stroke, we have a systematic review and meta-analysis of safety and efficacy of dual antiplatelet therapy with P2Y12 inhibitors and aspirin versus aspirin monotherapy in patients with mild ischemic stroke or high-risk transient ischemic attack, which I encourage you to review in addition to today's podcast. Dr. Negar Asdaghi: Later in the podcast, I have the pleasure of interviewing Dr. Osama "Sam" Zaidat, Professor of Neurosurgery and Neurology at Bon Secours Mercy Health Neuroscience Institute. Dr. Zaidat will speak to us about his work on endovascular therapy in patients presenting with a large ischemic core as determined by a low ASPECTS score on presentation. But first with these two articles. Dr. Negar Asdaghi: In the setting of acute ischemic stroke, intracranial large-vessel disease is often equated with processes which result in narrowing of the intracranial vessels, such as what is seen in the setting of intracranial atherosclerotic disease, or ICAD, where much research has focused on the degree of noumenal stenosis. Less is known about intracranial dolichoectasia, or IDE, which is characterized by ectasia, that is dilation, or dolichosis, which is increased length or tortuosity of the intracranial arteries. Dr. Negar Asdaghi: IDE can occur due to inflammatory, infectious, or genetic abnormalities. But much like its stenotic counterpart, or ICAD, most cases of IDE are diagnosed in the setting of uncontrolled vascular risk factors. Keeping in mind that the pathophysiology of ICAD and IDE are entirely different. Dr. Negar Asdaghi: Despite recent advances in recognition of IDE beyond an arteriopathy involving the basilar artery alone, the prevalence of IDE in patients with acute ischemic stroke is unknown, in part related to the lack of a unified diagnostic criteria for this condition. In this issue of the journal, Dr. Victor Del Brutto from the Division of Cerebrovascular Disease at the University of Miami and colleagues studied the prevalence and clinical correlates of IDE among 211 consecutive acute ischemic stroke patients admitted to a tertiary care hospital during a four-month period. IDE was defined as either ectasia or dolichosis of at least one proximal intracranial artery equal or greater than two standard deviations from the study population mean as measured by semi-automated segmentation method. Dr. Negar Asdaghi: So, what they found was that IDE was identified in 24% of stroke cases: a small percentage, which was only 5%, with only isolated ectasia; 9.5% with isolated dolichosis; and the rest with both ectasia and dolichosis. Anterior and posterior circulation were equally involved, but not surprisingly, the basilar artery was the single most common affected artery by IDE. After a complete stroke work-up, stroke was classified as cardioembolic in 25.5% of their population, large-artery atherosclerosis in 30%, small-artery occlusion in 14.5%, and undetermined in 25.5% of cases. Using cardioembolic stroke as a reference, the prevalence of IDE was significantly higher across strokes of undetermined etiology with odds ratio of 2.8. And there was a trend towards higher IDE prevalence in those whose stroke was classified as small-vessel disease. Dr. Negar Asdaghi: Furthermore, IDE was considered the most likely pathogenic mechanism in 6% of the entire cohort, which represented over 23% of strokes initially categorized as undetermined etiology and 21% of those with strokes categorized in small-vessel disease category, suggesting a likely causal correlation between parent vessel dolichoectasia and occlusion of the small vessel perforators in these patients. Dr. Negar Asdaghi: The authors concluded that IDE is an arteriopathy frequently found in patients with acute ischemic stroke and likely responsible for a sizable fraction of strokes initially categorized as undetermined etiology and those with small-vessel ischemic disease. Dr. Negar Asdaghi: The concept of freezing ischemic penumbra refers to either pharmacological or non-pharmacological interventions that aim to reduce tissue energy requirements for increased oxygen delivery and collateral perfusion to the tissue at risk for ischemia while awaiting revascularization therapies. Sphenopalatine ganglion, or SPG, electrical stimulation via an injectable implant had been previously shown to augment collateral flow and improve clinical outcomes in patients with acute ischemic stroke. Dr. Negar Asdaghi: The benefit of SPG stimulation is likely conferred not only from its potent collateral augmentation properties, but also from other mechanisms, such as blood-brain stabilization, direct neuroprotection and enhancement of neuroplasticity, though the need to implant the device diminishes its applications in the hyperacute stroke setting. Dr. Negar Asdaghi: Capsaicin, the pungent ingredient in hot chili peppers, is an SPG chemical stimulator, which affects the trigeminal vascular system, resolving in vasodilation and improved collateral flow. In the paper titled "Dose Escalation and Safety of Capsaicin for Cerebral Perfusion Augmentation: A Pilot Study," Dr. Juan Manuel Marquez-Romero from IMSS Institute in Mexico and colleagues completed a dose escalation study of capsaicin ranging from 33 to 165 micromole topically applied to the posterior surface of the subject's hemi-palate in 30 healthy volunteers. By applying capsaicin in the palate mucosa, the SPG can be stimulated directly through the greater and lesser palatine nerves while minimizing that pungent sensation. Dr. Negar Asdaghi: During the 20-minute applications, the investigators used transcranial Doppler to study various flow parameters, including the mean velocity, positivity index, and the CBF index, or cerebral blood flow index, over the middle cerebral artery. The median age of participants in the study was 21. All reported having consumed capsaicin in their diets sometimes in the past. So, what they found was, at baseline, TCD measurements and the calculations were all within normal limits. All the tested doses of capsaicin reduced augmentation of the MCA mean velocity while reducing the positivity index. The effects peaked between the five and the 10 minutes measurements and then returned to basal levels for all doses of capsaicin, except for the 66 micromole dose group, in which the effect remained stable with the same pattern. There were no side effects reported, and the investigators found no correlation between the perceived pungency and the dose of capsaicin administered. Dr. Negar Asdaghi: The authors noted that capsaicin appears to produce a hemodynamic response in the intracranial circulation, similar to the one achieved with SPG electrical stimulation. Understanding that this is data from a small pilot study, the results are hypothesis-generating at this point, and further research is required to measure the safety and efficacy of capsaicin in the elderly stroke population. Dr. Negar Asdaghi: Endovascular thrombectomy is an effective evidence-based treatment to improve outcomes in patients with acute ischemic stroke. Studies to expand the applications of this therapy to late-presenting patients, those with large ischemic cores, or distal occlusions are leading to major changes in clinical practice worldwide. Whether the ischemic core is measured by volumetric methods or by ASPECTS score, the presenting infarct core beyond which endovascular therapy is futile, or even potentially harmful, has not been established. Dr. Negar Asdaghi: So, the commonly encountered question in routine practice is whether thrombectomy should be offered to patients with presenting low ASPECTS. In other words, what are the characteristics of patients who continue to benefit from thrombectomy despite presenting with a large ischemic core? In the paper titled "Impact of Age and ASPECTS of 0 to 5 on Mechanical Thrombectomy Outcomes: Analysis From the STRATIS Registry," we learn about the outcomes of thrombectomy-treated patients stratified into low and high ASPECTS categories and the specific interaction between increasing age and low ASPECTS. Dr. Negar Asdaghi: I'm joined now by the first author of the paper, Dr. Osama "Sam" Zaidat, who's one of the principal investigators of the STRATIS Registry. Dr. Zaidat, of course, needs no introduction to our listeners. He's the past president of the Society of Vascular and Interventional Neurology. He's a leader in the field of neurointerventional therapists and currently is the neurology residency director and the endovascular fellowship director at the Bon Secours Mercy Health Neuroscience Institute. Welcome Sam. Welcome to our podcast. Thank you for joining us. Dr. Osama Zaidat: Thanks for having me. I really appreciate Dr. Negar and the Stroke journal team for featuring our research and our results and sharing it with your listeners today. Thank you for having me. Dr. Negar Asdaghi: Thank you very much. So, let's start by learning about the STRATIS Registry. Can we please hear an overview of the registry? Dr. Osama Zaidat: Yes, that's a good question because this is kind of the database where we really go and mine for questions that we still need answers for in the stroke field. For example, and specifically in the thrombectomy field, the STRATIS Registry was designed to evaluate post-marketing, real-life experience and results using Solitaire device stent retriever as the first mechanical thrombectomy choice. So, if you have enrolled a patient, that means the first attempt to take the clot out was using the Solitaire device for large vessel occlusion that presented with acute ischemic stroke. Dr. Osama Zaidat: We planned about 1,000 patients, so we needed a bigger patient population than the randomized trial. So, we have 1,000 patients treated with Solitaire device within eight hours from symptoms onset with large vessel occlusion presenting with acute ischemic stroke. To do that, we needed 55 medical centers with various clinical experience, various volume, and various operator experience because that really reflects a little bit of not a selection bias, meaning that data can be reproducible and can be validated across different spectrum of centers and neurointerventionalists and stroke neurologists for that matter. Dr. Osama Zaidat: This also, the aim of it — the spectrum — in addition to validate and reproduce randomized clinical trial data, to try to address questions that are hard to address with a clinical trial. For example, what's the outcome in nonogenarians? What's the outcome in tandem lesion? What's the outcome in different technique we use in the lab? What's the outcome of large infarct sites? Until we find the randomized trial, we can have some signals from those large registry to really inform future randomized trial. Dr. Osama Zaidat: So that's kind of the scope of the STRATIS Registry. Dr. Negar Asdaghi: Perfect. So truly a real-life, large cohort of endovascularly-treated patients, allowing us to look at the many aspects of this therapy in real life, rather than in a randomized setting. Dr. Negar Asdaghi: So, now coming to the current paper, we often think of low ASPECTS as a phenomenon of late presenters. Yet the current paper included endovascularly treated patients in a relatively early time window, within eight hours of symptom onsets. Please walk us through what percentage of your study patients actually had low ASPECTS, and what were their baseline characteristics as compared to high ASPECTS of patients? Dr. Osama Zaidat: That's an excellent question. STRATIS was basically a core lab adjudicated. So, independent, experienced core lab have read all the angiogram outcomes and have read all the CT scan, all the MRI, so he doesn't know about what's going on at 90 days functional outcome. And we wanted to restrict the analysis to the available baseline CT scan that was evaluated by the core lab, like you mentioned. So, from the 984 evaluable patients, only 763 patients, almost 75%, had the CT scan available for the core lab and the core lab blinded to the functional outcome and blinded to the angiographic outcome have read the ASPECTS. Dr. Osama Zaidat: So, this is a centrally read ASPECTS score by experienced interpreter that read them. So, 75% has available CT, or 763 patients. From those 763 patients, as a clinical practice out there, 92.5% had an ASPECTS of six to 10, consistent with the guidelines that we all treat on everyday basis. If the CT scan looks good, we treat. STRATIS is consistent with that. 92.5% had an ASPECTS of six to 10, or 706 patients. 7.5%, close to 8%, of the site had enrolled patients with low ASPECTS, or 57 patients have low ASPECTS, zero to five. So, about one out of maybe eight, less than one out of 10 patients, had low ASPECTS at the time the STRATIS was conducted between 2014 and 2016. Dr. Osama Zaidat: People were following the AHA/ASA guideline, with an ASPECTS of six to 10 the majority of the time, like in the STRATIS. It came up to 92% with ASPECTS and 8%, very low ASPECTS, for example. Dr. Osama Zaidat: So, kind of really what we like about the STRATIS, the real-life practice tried to adhere to the guideline for most of the time. However, we managed to find good sample size, 57, that people kind of did not necessarily, for one reason or another follow the guidelines. Dr. Osama Zaidat: And I feel like the first things, when you asked me the second question, the baseline characteristics, is there is a difference between the low ASPECTS group and the good ASPECTS. The first thing, really, that stand out-- the young age. So, the age was 62 years versus almost 69. So there's absolute difference of about seven years between low ASPECTS and good ASPECTS, six to 10 versus less than five. And the P value was significant. The listener can look at the paper, but it was a very statistically significant ASPECTS. Dr. Osama Zaidat: My feeling and my interpretation to this difference is that the physician felt, even with the low ASPECTS, he wanted to give the younger population a chance and take the clot out and see if they do well. So, I think they were more aggressive to take a low ASPECTS in a young patient than not necessarily offering them a mechanical thrombectomy, which probably mirrors what you do and what I would do in real life. If you have 55 years old and ASPECTS of four, you want to say, "Let me take the clot out and see how the functional status pans out." So, that's one thing. Dr. Osama Zaidat: The other difference, besides the difference in age, slightly more diabetic in the low ASPECTS, but it didn't reach statistical significance. Slightly less AFib than the ASPECTS of six to 10. What really also makes sense, besides the age, is the stroke scale, the stroke severity scale. The stroke severity scale was higher in the low ASPECTS, which makes sense. The infarct is completed, the patient had a worse stroke scale at baseline. So, their stroke scale was almost 20 versus 17, consistent with literature and the good ASPECTS. So, 17 in the good ASPECTS, the average score, and 20 in the low ASPECTS, slightly higher stroke severity scale. Dr. Osama Zaidat: What also makes sense in the low ASPECTS is you have more ICAT occlusion. When you have an ICAT occlusion, will lead to loss of collateral, will lead to more tissue, and more core infarct volume with a completed stroke. Dr. Osama Zaidat: So, I feel like also that's consistent. So, the difference between the baseline characteristic can be summarized with younger age, higher proximal occlusion, and more severe stroke than usual. And then the general anesthesia use was more often because now you have more severe stroke, now you have more core infarct volume, you are more likely to need anesthesia than not. So again, that's also consistent. Dr. Osama Zaidat: The onset to puncture time, because you may need more anesthesia, the patient was sicker to stabilize, the onset to puncture time was also more prolonged in the lower ASPECTS group versus the good ASPECTS. Dr. Osama Zaidat: So, those are the differences at baseline, Negar, as you can see. Not sure how you think about it, how you feel about them as well, but kind of the best way to explain them. But I'm curious also to hear your thought about them, if you have any comment or questions. Dr. Negar Asdaghi: Yeah, I think I want to repeat just what you said and the point you raised because it's, as you mentioned, it is not surprising to see that low ASPECTS patients are presenting with more severe strokes with higher NIH Stroke Scale, have more tandem occlusions or more proximal occlusions. They're obviously sicker patients. So, those differences were not surprising at all to a reader of your paper. What was surprising is that age gap that you mentioned within your low ASPECTS and high ASPECTS category, and that from the registry-based study is actually, exactly what you mentioned, is a signal that clinicians are more comfortable to push the guidelines boundaries in the younger population. That's something that has to be taken with a grain of salt, because we're not talking about a population-based study where we're comparing age groups between low ASPECTS and high ASPECTS. We're talking about a highly selected group of individuals who've already received endovascular therapy, and now we're comparing the age groups depending on their lower ASPECTS. So that's an important distinction that you beautifully outlined for our listeners. Dr. Negar Asdaghi: Now, coming to your primary outcomes, please tell us about the reperfusion rates in the study and comparing the low to high ASPECTS categories. Dr. Osama Zaidat: That's an excellent question, to try to see — in spite of you're taking the chances — and treating patients with low ASPECTS. How did they do functionally and angiographically? The angiographic outcome and revascularization success can be a surrogate of functional outcomes. So, let's try to review with your listeners and readers the reperfusion outcome, like you mentioned. If you look at the reperfusion outcome in the paper, and I direct the readers and the listeners to Table 2. Specifically, what stands out is the rate of complete reperfusion because that's the one with the highest difference and significance between the two groups, which is TICI 3. The frequency of obtaining TICI 3 was 83 patients out of 662 that had an angiographic outcome with a good ASPECTS was zero out of the 55 patients; none of them had a TICI 3 complete occlusion. Dr. Osama Zaidat: What's really astonishing in the result is the fact that there's a statistical difference between complete reperfusion, TICI 3, between the low ASPECTS group and cohort versus the good ASPECTS cohort of six to 10, and the theory and explanation, one of the explanations at least that may be plausible, is the fact that you probably had a good collateral in the good ASPECTS to have less core infarct, and the good collateral reduced the clot length, because the pial flow goes all the way backward into the clot in a retrograde fashion and makes it probably more likely to have a successful removal of the clot and hence achieving a TICI 3. Dr. Osama Zaidat: So, but overall, if you just lump TICI 2b or higher, the standard definition of successful reperfusion as TICI 2b or higher, there was no statistical difference between the group. It was 85.5% in the low ASPECTS and 87.6% in the good ASPECTS group. So, that was not statistically different. Dr. Osama Zaidat: When we looked at the first-pass effect, there was a trend toward more first-pass effect in the good ASPECTS group, but 61% and 57% in the low ASPECTS. That's defining first pass as TICI 2b from the first attempt, and not TICI 3, for example. Dr. Osama Zaidat: So again, you can see that your success of reperfusion probably related to the ASPECTS in an indirect way, as a surrogate of collateral. Poor collateral tissue dies quickly, low ASPECTS and higher core infarct volume, and hence low success of reperfusion, but again, the only statistical significance here is in the complete reperfusion and TICI 3. Dr. Osama Zaidat: So, if you kind of evaluate if the reperfusion outcome translated to a difference in the functional outcome, yes, indeed. In the low ASPECTS group, three out of 10 patients achieved independence at 90 days, or to be precise, 28.8% of that cohort and population had mRS of zero to two at 90 days in comparison to 59.7% in the good ASPECTS group. Dr. Osama Zaidat: So, it's almost six out of 10 patients in the good ASPECTS versus three out of 10 patients in the low ASPECTS group. Still, they achieved a good outcome because we don't have a control group, but in comparison to the good ASPECTS, it's lower outcome, as you can see on Table 2, as well. Dr. Osama Zaidat: The mortality is higher; it's almost 31% in the low ASPECTS versus 13.4% in the good ASPECTS group. The symptomatic hemorrhage rate was 7% versus almost 1% only in the good ASPECTS group. So, functional outcome across the board is lower than the good ASPECTS, but since this is not a randomized trial, we don't know if doing nothing to those low ASPECTS will necessarily yield similar results. Dr. Osama Zaidat: So, it could be better than control, but clearly it's the likelihood of the patient doing better correlates with a better ASPECTS, which we all kind of already know, but we want to try to identify the group beyond which, like you started, Dr. Negar, beyond which the mechanical thrombectomy may be futile. Dr. Negar Asdaghi: Right. So a very unfortunate vicious cycle almost, that those who needed the first-pass effect, TICI 3 perfusion the most actually ended up achieving it less than their high ASPECTS counterpart, as you mentioned. And again, it's important to understand that these observations are based on an observational large registry study. Dr. Negar Asdaghi: Now, you found an important interplay between age and low ASPECTS in the clinical outcomes from thrombectomy in your study. Can you please elaborate on those findings? Dr. Osama Zaidat: Absolutely. That's an excellent question because that's kind of the unique part of our research and our paper is we're trying to really combine the low ASPECTS with another variable that we all know as a clinician and people who treat stroke on a daily basis, that influence outcome. If you combine two poor predictors of good functional outcome. A good predictor that they could predict the outcome one way or another in either direction, good or bad outcome, you know ASPECTS was one of them, and age. So, we wanted to see if there's a threshold beyond which, if you combine the two, you can identify the patients that are almost less likely to benefit and the resources and the, if you may say, the resources and the message to the patient and their families should be with this consideration to try to provide guidance to the clinician nowadays. Dr. Osama Zaidat: So, based on the previous data, we kind of wanted to really trichotomize the age into young, less than 65, 65 to 75, and 75. Dr. Osama Zaidat: There is enough signal in the literature out there that 75 with low ASPECTS is a good cutoff to see. And indeed, we looked at that and we compared those three cohorts. We compared less than 65, 65 to 75, and more than 75 in the low ASPECTS group to see which one stands out. Now, the sample size is fairly small. So, I want to caution the reader and the listener to us today that this is a good signal, this is a good hypothesis-generating result; however, it needs to be reproduced in, again, large sample size and see if other researchers and investigators can have similar results. Dr. Osama Zaidat: What we've found in this group of more than 75 and less than 65, I feel like the equipoise should remain between 65 and 75, but less than 65 is probably beneficial more than 75. Unfortunately, we could not find a strong signal of good functional outcome in those people more than 75. Dr. Osama Zaidat: We had 12 patients; none of them achieved (mRS of) zero to two at 90 days, 0% at zero to two. And their mortality was close to 60%, and their symptomatic hemorrhage was close to 15%. So, when you treat a low ASPECTS (zero to five), and they are older than 75, the current data or the current signals suggest that the likelihood of good outcome is 0%, if you consider good outcome as (mRS) 0-2, and the likelihood of mortality close to 60%. More than half of them will die, and the likelihood of symptomatic hemorrhage is going to be higher, close to 16%. Dr. Osama Zaidat: So, that's the cohort that we have to be very cautious about. I think the younger cohort had even better outcome than the overall zero to five. If you recall, from the previous question of Dr. Negar, discussion that the overall was 28.8%. If you restrict the analysis to the young, they have probably a good plasticity, good recovery, good rehab potential. If you look at those less than 65, their mRS zero to two went up to 44.8%, which is decent, acceptable, functional outcome in those young patients, and their mortality went down from 30% or 31% to 20%, and the symptomatic hemorrhage from 7% to 6%. So, it seems that there is a good signal in those less than 65 for being aggressive and try to provide them with a therapy, less aggressive with 75, and in between, where we really have no clear answer, and their mRS score was close to 20% versus 44 and 0%. So 44%, 18%, and 0%; less than 65, 65 to 75, and older than 75. Dr. Osama Zaidat: Hopefully, this will shed the light and make the decision-making in the middle of the night probably more informed to the best of our knowledge nowadays. Dr. Negar Asdaghi: Right. And how do these rates, the symptomatic intracerebral hemorrhage rates and mortality rates, compare in the low ASPECTS group as compared to those reported from the randomized trials? Dr. Osama Zaidat: This is an excellent question because the randomized clinical trial had the advantage of having a control group, and the HERMES meta-analysis in all patient-level meta-analysis have looked at the CT ASPECTS. However, they combined it with the MRI ASPECTS, so kind of a heterogeneous population. It's not exactly the same, like the STRATIS low ASPECTS study that we're discussing today, and they have a very small sample size. What they found in that group from three to five, that 31%, so almost identical- if you think about -it to our outcome in the ASPECTS group. HERMES group didn't go to the 24 hour; they did up to six hours. Maybe the ESCAPE was 12 hours, the only one with the expanded time window, but interesting that their three to five ASPECTS had a good outcome of mRS zero to two at 31% versus 16% in the tPA group with an absolute difference about 15%. Dr. Osama Zaidat: So, again, our result is consistent with the HERMES patient-level meta-analysis. However, in the (ASPECTS) zero to two group, they found the futility in the zero to two. They found 0% (90 day mRS) in the mechanical thrombectomy. We didn't have that much of a sample size of zero to two (ASPECTS), and we didn't obtain a 0% (90 day mRS) similar to them, but we did obtain a 0% (mRS) if you are zero to five (ASPECTS) and older than 75. They have not really looked at the intersection and the interaction with the age like we looked at it, for example. So again, in their trial, the three to five (ASPECTS) is consistent with the ASPECTS with our low ASPECTS trial at 28.8% (90 day mRS) versus 31% in the HERMES meta-analysis, for example. Dr. Osama Zaidat: MR-CLEAN group, however, even they have a better outcome, zero to four (ASPECTS), than us and HERMES, at about (90 day mRS) 36.7%. Their sample size was very small, less than 30 patients in the whole cohort, almost half the size of our sample size. So MR-CLEAN showed also, so if you think about it, the registry is close to 30% (mRS of 0-2 at 90 days), the randomized trial 31% to 35%. So, we are within the confidence interval of what's the likelihood of good outcome, which is almost one-third of the patients with low ASPECTS would have a good outcome. Dr. Osama Zaidat: The good news that the standard care therapy with tPA gives you half of that outcome almost. So, there's a good signal that future randomized trial may be positive if they follow the STRATIS registry, HERMES, or MR-CLEAN data. Dr. Negar Asdaghi: So, Sam, very important information and percentages to keep in mind as we counsel patients and family members, especially those elderly patients we see with large ischemic cores and low ASPECTS in the early timeframe from stroke onset. Dr. Negar Asdaghi: I know you alluded to the future randomized trials, but I want to end with our takeaway message from your study, and how do you see these randomized trials in low ASPECTS population unfolding in the future? Dr. Osama Zaidat: I mean, this is an excellent question that has two aspects about it. One is, can we use some of this data to guide us nowadays until we have future randomized trial? And I think each patient is individual, each family's individual family. I want the listener and the readers to take their time to explain the data to the patient. They have to keep in mind that there is a small sample size and also how definitive they feel about their reads with ASPECTS score, how definitive they feel about the large core infract, and is this plus minus one, is five the cutoff, in the elderly? Is it four or zero? Dr. Osama Zaidat: So, I think if you are confident that your score may be zero to three, and the patient is more than 75, is more justifiable, kind of, at that extreme and to say this is less likely to benefit (from endovascular therapy) based on collective data. Dr. Osama Zaidat: Again, without randomized trial, it's hard to strongly send a message, don't treat them (endovascularly) and futile. But based on HERMES, based on our analysis, extreme ASPECTS in older than 75, probably you have to be cautious taking them to the (cath) lab, for example. Now that's been said, the future trial will answer that. We are running the randomized trial ourself, myself and my co-PI, Dr. Albert Yoo, are doing an international TESLA trial. We are close to 125 patients randomized from two to five ASPECTS score and up to 85 years of age. So, we have almost 60-plus randomized in each arm, and we are hoping if we continue at this rate in the next two years to complete the enrollment and have some answer. Dr. Osama Zaidat: Our sample size-it's an adaptive design trial called TESLA Trial--and our sample size is 300 patients. In Germany, there is an ongoing Tension trial. In U.S., there is another trial that mixed a CT scan with the perfusion for large core infarct called SELECT 2. That's ongoing, as well. And then a fourth trial, which is the IN EXTREMIS trial in France, that also going to answer it, and hopefully we can do a meta-analysis among those four large core infarct trials. Dr. Osama Zaidat: Some of them allowed diffusion MRI, as well as CT scan; some of them allowed perfusion. And this way, if we combine all our data together, we can have probably a more reliable and precise answer to this important clinical question that has been identified by the National Institutes of Health [inaudible 00:36:43] as priority number one for thrombectomy following what we know so far. It's ranked as the next question that needs answer. Dr. Negar Asdaghi: Dr. Sam Zaidat, congratulations on this work, and we look forward to the completion of TESLA results and the results of other randomized trials. Thank you for being with us today. Dr. Osama Zaidat: Thank you for having me, and I appreciate the listener tuning in, and I appreciate the ASA and the journal team for having me. This is on behalf of my co-authors, the sponsor of the registry. Thank you very much. Dr. Negar Asdaghi: Thank you. Now, before we end the July podcast, I want to draw your attention to a special invited report prepared by the Stroke Council Leadership on behalf of the American Heart and Stroke Associations on diagnosis and management of cerebral venous sinus thrombosis, or CVST, with vaccine-induced immune thrombotic thrombocytopenia. Dr. Negar Asdaghi: This report is to heighten clinicians' awareness regarding the six cases of CVST, with thrombocytopenia in patients who received the Johnson & Johnson vaccine in the United States. Similar thromboembolic events were reported in Europe following the administration of AstraZeneca vaccination. These are adenoviral vector–containing vaccines, which are mechanistically different from the mRNA SARS-CoV-2 vaccines produced by Pfizer and Moderna. Dr. Negar Asdaghi: The putative mechanism of vaccine-induced thrombotic thrombocytopenia is believed to be related to the leakage of DNA from the adenovirus-infected cells that subsequently binds to the platelet factor 4 and triggers the production of auto-antibodies against platelets. Dr. Negar Asdaghi: The authors emphasize that while we wait for further research on the causal nature of the relationship of vaccines to CVST with thrombocytopenia, it is important to keep in mind that the reported risk of CVST associated with COVID-19 infection itself is far greater than that associated with vaccination. Dr. Negar Asdaghi: And with that, we conclude our podcast for the July 2021 issue of Stroke. On behalf of the Editorial Board, I want to thank you all for listening and a special thanks to our healthcare providers and clinicians who continue to work on the front lines of this pandemic. We hope that you find this information useful, and until our next podcast, stay alert with Stroke Alert. This program is copyright of the American Heart Association, 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit AHAjournals.org.
Gillie Da Kid (@gillie_da_king) aka the King of Philly and Wallo (@Wallo267) come through to chop it up with Michael and CBF. Mike tells the story of the first time he went to jail, and spoiler alert, it was Buckwild's fault. Wallo calls Buck so Mike can ask him why he sold him a fake Rolex back in the day, plus Philly sports talk..... enjoy MODASUCKA'S... Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Pela primeira vez em sua história, a seleção brasileira não foi campeã de uma Copa América em sua casa. Pela primeira vez desde 1950, o Brasil perdeu uma partida no Maracanã em torneios oficiais. E essas marcas foram quebradas graças ao fim de 28 anos de fila da Argentina. Lionel Messi, finalmente, chega ao topo com a camisa de seu país. Para falar sobre essa histórica final e fazer um balanço geral da Copa América, Alexandre Lozetti recebe Bruno Cassucci, Carlos Eduardo Mansur, Martin Fernandez e Raphael Zarko. Quem ganhou moral com Tite? E quem perdeu? Qual é o saldo da competição? Possível volta de Renato Augusto ao futebol brasileiro mexe com a Seleção? E Coutinho, fez falta? Além de responder essas e tantas outras questões, essa mesa de craques ainda fala sobre o futuro, seleção olímpica e a situação da CBF.
Who TF light skin @$$ was sliding in Michael's girl DM's?! Michael, J'Vonne and CBF get into it on this weeks recap so catch up now.... you MODASUCKA'S... Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Com a seleção brasileira classificada como líder de seu grupo da Copa América, com 10 pontos em 12 disputados, 3 vitórias e 1 empate, o que Tite tira desse período de testes para o mata-mata e para a Copa do Mundo de 2022? Com muitas opções botadas à prova, principalmente no quarteto ofensivo, qual é o verdadeiro time titular do momento? Alexandre Lozetti recebe Bruno Cassucci e Carlos Eduardo Mansur para falar do saldo do momento na Seleção, analisar as notícias e informações da equipe de Tite e da CBF e bater um papo sobre as quartas-de-final da Copa América, com o Brasil encarando o Chile. Ainda deu tempo para conversar sobre o sarrafo altíssimo que é colocado para avaliar o futebol de seleções, como se fossem clubes milionários, e passar por alguns jogadores em especial, como Richarlison, Firmino e Paquetá, entre outros.
Nesta edição do "Estadão Esporte Clube", Robson Morelli e Gustavo Lopes falam sobre o documento assinado por 19 clubes da Série A do Brasileirão, e entregue à CBF, com a intenção de criar uma liga que teria, entre outras funções, a organização dos campeonatos nacionais. Ainda no programa, a rodada do Brasileirão com jogos de São Paulo, Palmeiras e Corinthians, e tudo sobre a Eurocopa. O "Estadão Esporte Clube" vai ao ar, ao vivo, de segunda a sexta-feira, às 13h, no Facebook: facebook.com/estadaoesporte. See omnystudio.com/listener for privacy information.
O Vida de Jornalista recebe os repórteres Gabriela Moreira e Martín Fernandez, do esporte da Globo, para contar os bastidores de uma das mais importantes investigações do ano: a denúncia de assédio sexual e moral que levou ao afastamento do presidente da CBF, Rogério Caboclo. ||||| Apresentação, produção, entrevista, roteiro, edição, trilha sonora e artes (para capa e redes sociais): Rodrigo Alves. ||||| Este podcast faz parte da Rádio Guarda-Chuva (@guardachuvapod) ||||| Apoie o Vida: https://www.catarse.me/vidadejornalista ou https://picpay.me/vidadejornalista PIX: email@example.com ||||| O Vida está no Twitter e no Instagram (@vida_jornalista) e no e-mail firstname.lastname@example.org ||||| Logo do podcast: Mauricio Henriques (email@example.com)
Michelle Lions is running for Congress! Michael and CBF learn all about what congress is from Michelle. The lovely AJ Faye (@AjFaye) joins the show making this the first episode with two lovely ladies who DON'T have Only Fans..... Enjoy this episode featuring two Nubian Queens.... you MODASUCKAS... pro tip: The competition for the best jollof is discussed nearly an hour into this one, don't miss it! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Na coluna Direto de Brasília desta segunda-feira, 07, Eliane Cantanhêde comenta decisão do presidente sobre Copa América. A Conmebol realizou neste sábado uma reunião que contou com a presença do presidente Jair Bolsonaro. Participaram integrantes do conselho da Confederação sul-americana, entre eles o mandatário da CBF, Rogério Caboclo. O encontro não foi considerado uma excepcionalidade, uma vez que é normal que os dirigentes se reúnam às vésperas de uma competição como a Copa América. Eliane Cantanhêde ainda trata de outros assuntos e responde a perguntas de ouvintes. Ela conversa ao vivo com Haisem Abaki e Carolina Ercolin, no Jornal Eldorado, da Rádio Eldorado (FM 107,3), de segunda a sexta, das 9h às 9h30. See omnystudio.com/listener for privacy information.
Um em cada cinco brasileiros com mais de 70 anos ainda não completou a vacinação contra a Covid-19. São idosos que tomaram a primeira dose do imunizante, mas não receberam a segunda dose. Vacina da Pfizer reduz pela metade chance de infecção pelo coronavírus 13 dias depois da primeira dose. Ministério Público vai investigar CBF e patrocinadores da Copa América por 'atos violadores' do direito à vida. See omnystudio.com/listener for privacy information.
Em meio ao caos dos bastidores, Rogério Caboclo foi afastado da presidência da CBF, provavelmente de forma definitiva. Falamos sobre as graves denúncias contra o dirigente e sobre a sucessão do poder na entidade máxima do futebol brasileiro. No mais, os jogadores parecem dispostos a participar da Copa América.
On today's episode Cara interviews Angela Miller, who is the co-owner of Consider Bardwell Farm based in West Pawlet, Vermont. The creamery has gone through a full relaunch since it's voluntary food safety recall. But restarting cheese production is nothing new to co-owner Angela Miller - city slicker turned curd nerd. We'll examine her side of the story and ask what's next for the CBF.Image courtesy of Consider Bardwell Farm.Heritage Radio Network is a listener supported nonprofit podcast network. Support Cutting the Curd by becoming a member!Cutting the Curd is Powered by Simplecast.
Nesta edição do "Estadão Esporte Clube", Robson Morelli e Gustavo Lopes falam sobre todo o caso envolvendo a CBF e seu presidente, Rogério Caboclo, que foi denunciado por assédio sexual por uma ex-secretária. Diante do escândalo, o dirigente foi afastado por 30 dias. Já os jogadores da seleção brasileira, após decisão da CBF, resolveram jogar a Copa América, mas deverão fazer um manifesto com críticas ao torneio. E ainda, a rodada do Brasileirão. O "Estadão Esporte Clube" vai ao ar, ao vivo, de segunda a sexta-feira, às 13h, no Facebook: facebook.com/estadaoesporte. See omnystudio.com/listener for privacy information.
Neste episódio, Arnaldo Ribeiro, Eduardo Tironi, Juca Kfouri e Mauro Cezar Pereira analisam a crise na CBF, com o afastamento do presidente Rogério Caboclo após denúncia de assédio moral e sexual em meio à Copa América no Brasil, seleção brasileira e Bolsonaro querendo Renato Gaúcho no lugar de Tite, o Campeonato Brasileiro com reabilitações de Corinthians e Palmeiras, o São Paulo derrotado pelo Atlético-GO, o Fortaleza líder após golear o Internacional por 5 a 1, a venda de Gerson pelo Flamengo, além das dificuldades do Cruzeiro na Série B
Caboclo fica longe do cargo por 30 dias para se defender da acusação de assédio moral e sexual feito por uma cerimonialista da CBF. Brasil teve mais de 1.300 feminicídios na pandemia, com forte alta no Norte e no Centro-Oeste. E Manaus vive madrugada de ataques depois de PM matar liderança do tráfico. See omnystudio.com/listener for privacy information.
O caos na CBF. Denúncias contra Caboclo, possível desistência da copa américa e a vitória do Brasil contra o Equador pela eliminatória foram os assuntos que abriram o nosso programa. Na sequência do programa, as prévias dos jogos no fim de semana. Uma análise dos confrontos e projeções de Bahia, Ceará, Fortaleza e Sport na […]
Tite no está pasando un buen momento, criticado por su presidente en una conversación que fue filtrada y en divorcio absoluto con los directivos de la CBF al apoyar también la voluntad de los jugadores de no disputar la Copa América y boicotearla. Un paso que no se dará públicamente hasta el próximo martes cuando termine la fecha ocho de Eliminatorias Sudamericanas. o analizamos con Daniel Chapela, Juan Fernando Mora y Nacho García, más todos los mensajes de los amigos que se conecten y quieran participar. No olvides suscribirte a nuestro canal y disfruta de nuestros contenidos! Síguenos en nuestras redes sociales
Neste episódio, Arnaldo Ribeiro, Eduardo Tironi, Juca Kfouri e Mauro Cezar Pereira analisam a situação da seleção brasileira, com os jogadores insatisfeitos com a Copa América e pressionando o presidente da CBF, Rogério Caboclo, antes do jogo com o Equador pelas Eliminatórias da Copa, no Corinthians a segunda derrota seguida para o Atlético-GO, tem ainda o São Paulo derrotado pelo 4 de Julho, Palmeiras passando apertado contra o CRB e o Fluminense atuando bem mais uma vez
We have a new MODASUCKA record! 400 Thousand a month! She turned the pandemic into a BANDEMIC and made 400k a month during Corona Lock Down! Mikayla aka @KKVSH is in the building to talk about getting shot, the length of her tongue, and what she does with vegetables on camera. Also, Michael and CBF sing for you! Don't miss it... you MODASUCKA'S! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Depois de Colômbia e Argentina terem que abrir mão por problemas com a pandemia etambém sociais, o Brasil salvou a pátria da Conmebol para realizar o torneio. CBF pediu aogoverno federal que o Brasil salvasse a Copa América e convenientemente, aceitou. Agora, oBrasil deve receber o torneio em meio a muitos casos de Covid-19, CPI e recentes protestoscontra o governo.
CBF needs to be baptized again. William paid 20 thousand to get HIS ass done. Sidney Starr has so much fun she almost twerks off the set of the podcast. Catch up you MODASUCKA'S! with highlights from the recent episode with @SidneyStarrBad and @WilliamTheBaddest. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Michael is late! CBF fills in for the news and then we have a very special guest... She made her Bad Girls Club dreams come true... She has also de-virginized thousands of men and she hit on Marcus Cromartie during the podcast. In this episode we laugh a lot, but we learn even more, as Sidney Starr (@SidneyStarrBad) joins us for Episode 13. Sidney's best-friend-and-gay-white-rapper, William The Baddest (@WilliamTheBaddest) also joins for a podcast that is very educational.... you MODASUCKA'S! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Uma crise assola a sede da CBF: o presidente Rogério Caboclo está imerso em uma crise quepode tirá-lo do poder. A crise é tamanha que trouxe à tona figuras das sombras do futebolbrasileiro: Marco Polo Del Nero e Ricardo Teixeira, ambos banidos do futebol, mas ainda compoder nos bastidores da entidade que comanda o futebol brasileiro.
Two girls one painting... Keke was going to do an Only Fans with Ray J, and Toni will paint anything ;) What could go wrong? On this episode Keke Diablo (@keke.diablo) is here to talk about needing a twerking lesson, how she got her name, and she explains how Ray J makes 30 grand a week! Toni Weathers (@ToniWeathers_) is also here and shows off her painting skills. Michael and CBF try to figure out how many kids Michael's father has, and Michael tells us why he is proud of Usher... Fake money for fake ___'s! Learn more about your ad-choices at https://www.iheartpodcastnetwork.com