Podcasts about cochrane database syst rev

Collection of databases in medicine and other healthcare specialties

  • 79PODCASTS
  • 186EPISODES
  • 36mAVG DURATION
  • 1WEEKLY EPISODE
  • May 23, 2025LATEST
cochrane database syst rev

POPULARITY

20172018201920202021202220232024


Best podcasts about cochrane database syst rev

Latest podcast episodes about cochrane database syst rev

Breakpoints
#117 – Amnio-Oh-No You Didn't: Modernizing Antimicrobial Regimens for Intraamniotic Infections

Breakpoints

Play Episode Listen Later May 23, 2025 72:27


Drs. Amy Crockett (@amyhcrockett), Ben Ereshefsky (@brainofbpharm), and Pamela Bailey (@pamipenem) join Dr. Julie Ann Justo (@julie_justo) to discuss new treatment strategies for management of intraamniotic infections, also known as chorioamnionitis. They discuss whether it is time to move away from the combination of ampicillin, gentamicin, and/or clindamycin, alternative antibiotic regimens to consider, and stewardship strategies to approach this practice change at a local level. References: Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593 Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.

Frankly Speaking About Family Medicine
Can Vaping Help with Smoking Cessation? Understanding the Risks of Dual Use - Frankly Speaking Ep 433

Frankly Speaking About Family Medicine

Play Episode Listen Later May 19, 2025 10:38


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-433 Overview: E-cigarette use has risen significantly, especially among adolescents and young adults. Many people begin vaping alongside conventional cigarettes in an effort to quit or reduce smoking. But risks are emerging, challenging the belief that vaping is safer than combustible cigarettes. Join us as we explore the latest evidence on vaping, dual use, and the associated health risks. Episode resource links: Hamoud J, Hanewinkel R, Andreas S, et al. A Systematic Review Investigating the Impact of Dual Use of E-Cigarettes and Conventional Cigarettes on Smoking Cessation. ERJ Open Res 2024; in press (https://doi.org/10.1183/23120541.00902-2024). Lindson N, Butler AR, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2024;1(1):CD010216. Published 2024 Jan 8. doi:10.1002/14651858.CD010216.pub8 Pisinger C, Rasmussen SKB. The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review. Int J Environ Res Public Health. 2022;19(20):13687. Published 2022 Oct 21. doi:10.3390/ijerph192013687 Nabbout, M. RSNA Press Release: Vaping Causes Immediate Effects on Vascular Function.  NIH-funded studies show damaging effects of vaping, smoking on blood vessels.  Kramarow, EA & Elgaddal, MS. Current Electorinc Cigarette Use Amoing Adults Aged 19 and Over: US, 2021. NCHS Data Brief, #475, Juky 2023.  CDC/NCHS Data: https://www.cdc.gov/nchs/fastats/smoking.htm Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Pri-Med Podcasts
Can Vaping Help with Smoking Cessation? Understanding the Risks of Dual Use - Frankly Speaking Ep 433

Pri-Med Podcasts

Play Episode Listen Later May 19, 2025 10:38


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-433 Overview: E-cigarette use has risen significantly, especially among adolescents and young adults. Many people begin vaping alongside conventional cigarettes in an effort to quit or reduce smoking. But risks are emerging, challenging the belief that vaping is safer than combustible cigarettes. Join us as we explore the latest evidence on vaping, dual use, and the associated health risks. Episode resource links: Hamoud J, Hanewinkel R, Andreas S, et al. A Systematic Review Investigating the Impact of Dual Use of E-Cigarettes and Conventional Cigarettes on Smoking Cessation. ERJ Open Res 2024; in press (https://doi.org/10.1183/23120541.00902-2024). Lindson N, Butler AR, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2024;1(1):CD010216. Published 2024 Jan 8. doi:10.1002/14651858.CD010216.pub8 Pisinger C, Rasmussen SKB. The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review. Int J Environ Res Public Health. 2022;19(20):13687. Published 2022 Oct 21. doi:10.3390/ijerph192013687 Nabbout, M. RSNA Press Release: Vaping Causes Immediate Effects on Vascular Function.  NIH-funded studies show damaging effects of vaping, smoking on blood vessels.  Kramarow, EA & Elgaddal, MS. Current Electorinc Cigarette Use Amoing Adults Aged 19 and Over: US, 2021. NCHS Data Brief, #475, Juky 2023.  CDC/NCHS Data: https://www.cdc.gov/nchs/fastats/smoking.htm Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Always On EM - Mayo Clinic Emergency Medicine
Chapter 43 - Code Brown: When the runs run the room! - Management of Acute Diarrheal Emergencies

Always On EM - Mayo Clinic Emergency Medicine

Play Episode Listen Later May 1, 2025 59:35


Diarrhea is one of the more common concerns in emergency medicine worldwide and in the United States, yet we often do not spend enough time understanding the breadth of causes and considerations for this syndrome. Do you know which patients benefit from Zinc? Would you like to review HUS? Can you mixup Oral Rehydration Solution if you needed to? We cover all of this and more in this “code brown” of a chapter! So come, get dirty with Alex and Venk in this truly crappy chapter of Always on EM!   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Shane AL, Mody RK, Crump JA, Tarr PI, Steiner TS, Kotloff K, Langley JM, Wanke C, Warren CA, Cheng AC, Cantey J, Pickering LK. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80. doi: 10.1093/cid/cix669. PMID: 29053792; PMCID: PMC5850553. Gore JI, Surawicz C. Severe acute diarrhea. Gastroenterol Clin North Am. 2003 Dec;32(4):1249-67. doi: 10.1016/s0889-8553(03)00100-6. PMID: 14696306; PMCID: PMC7127018. Freedman SB, van de Kar NCAJ, Tarr PI. Shiga Toxin–Producing Escherichia coli and the Hemolytic–Uremic Syndrome. The New England Journal of Medicine. 2023;389(15):1402-1414. doi:10.1056/NEJMra2108739. Logan C, Beadsworth MB, Beeching NJ. HIV and diarrhoea: what is new? Curr Opin Infect Dis. 2016 Oct;29(5):486-94. doi: 10.1097/QCO.0000000000000305. PMID: 27472290. Chassany O, Michaux A, Bergmann JF. Drug-induced diarrhoea. Drug Saf. 2000 Jan;22(1):53-72. doi: 10.2165/00002018-200022010-00005. PMID: 10647976. Schiller LR. Secretory diarrhea. Curr Gastroenterol Rep. 1999 Oct;1(5):389-97. doi: 10.1007/s11894-999-0020-8. PMID: 10980977. Gong Z, Wang Y. Immune Checkpoint Inhibitor-Mediated Diarrhea and Colitis: A Clinical Review. JCO Oncol Pract. 2020 Aug;16(8):453-461. doi: 10.1200/OP.20.00002. Epub 2020 Jun 25. PMID: 32584703. Do C, Evans GJ, DeAguero J, Escobar GP, Lin HC, Wagner B. Dysnatremia in Gastrointestinal Disorders. Front Med (Lausanne). 2022 May 13;9:892265. doi: 10.3389/fmed.2022.892265. PMID: 35646996; PMCID: PMC9136014. Expert Panel on Gastrointestinal Imaging; Chang KJ, Marin D, Kim DH, Fowler KJ, Camacho MA, Cash BD, Garcia EM, Hatten BW, Kambadakone AR, Levy AD, Liu PS, Moreno C, Peterson CM, Pietryga JA, Siegel A, Weinstein S, Carucci LR. ACR Appropriateness Criteria® Suspected Small-Bowel Obstruction. J Am Coll Radiol. 2020 May;17(5S):S305-S314. doi: 10.1016/j.jacr.2020.01.025. PMID: 32370974. Rami Reddy SR, Cappell MS. A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction. Curr Gastroenterol Rep. 2017 Jun;19(6):28. doi: 10.1007/s11894-017-0566-9. PMID: 28439845. Modahl L, Digumarthy SR, Rhea JT, Conn AK, Saini S, Lee SI. Emergency department abdominal computed tomography for nontraumatic abdominal pain: optimizing utilization. J Am Coll Radiol. 2006 Nov;3(11):860-6. doi: 10.1016/j.jacr.2006.05.011. PMID: 17412185. Scheirey CD, Fowler KJ, Therrien JA, et al. ACR Appropriateness Criteria Acute Nonlocalized Abdominal Pain. Journal of the American College of Radiology : JACR. 2018;15(11S):S217-S231. doi:10.1016/j.jacr.2018.09.010. Atia AN, Buchman AL. Oral rehydration solutions in non-cholera diarrhea: a review. Am J Gastroenterol. 2009 Oct;104(10):2596-604; quiz 2605. doi: 10.1038/ajg.2009.329. Epub 2009 Jun 23. PMID: 19550407. Musekiwa A, Volmink J. Oral rehydration salt solution for treating cholera: ≤ 270 mOsm/L solutions vs ≥ 310 mOsm/L solutions. Cochrane Database Syst Rev. 2011 Dec 7;2011(12):CD003754. doi: 10.1002/14651858.CD003754.pub3. PMID: 22161381; PMCID: PMC6532622. Centers for Disease Control and Prevention (CDC). Scombroid fish poisoning associated with tuna steaks--Louisiana and Tennessee, 2006. MMWR Morb Mortal Wkly Rep. 2007 Aug 17;56(32):817-9. PMID: 17703171. Résière D, Florentin J, Mehdaoui H, Mahi Z, Gueye P, Hommel D, Pujo J, NKontcho F, Portecop P, Nevière R, Kallel H, Mégarbane B. Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies-A Case Series. Toxins (Basel). 2022 Aug 3;14(8):535. doi: 10.3390/toxins14080535. PMID: 36006197; PMCID: PMC9415704. Centers for Disease Control and Prevention (CDC). Ciguatera fish poisoning--Texas, 1998, and South Carolina, 2004. MMWR Morb Mortal Wkly Rep. 2006 Sep 1;55(34):935-7. PMID: 16943762. Thyroid Inferno EM Blog: https://emblog.mayo.edu/2014/11/01/thyroid-inferno/  Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016 Dec 20;12(12):CD005436. doi: 10.1002/14651858.CD005436.pub5. PMID: 27996088; PMCID: PMC5450879. Dhingra U, Kisenge R, Sudfeld CR, Dhingra P, Somji S, Dutta A, Bakari M, Deb S, Devi P, Liu E, Chauhan A, Kumar J, Semwal OP, Aboud S, Bahl R, Ashorn P, Simon J, Duggan CP, Sazawal S, Manji K. Lower-Dose Zinc for Childhood Diarrhea - A Randomized, Multicenter Trial. N Engl J Med. 2020 Sep 24;383(13):1231-1241. doi: 10.1056/NEJMoa1915905. PMID: 32966722; PMCID: PMC7466932. Dalfa RA, El Aish KIA, El Raai M, El Gazaly N, Shatat A. Oral zinc supplementation for children with acute diarrhoea: a quasi-experimental study. Lancet. 2018 Feb 21;391 Suppl 2:S36. doi: 10.1016/S0140-6736(18)30402-1. Epub 2018 Feb 21. PMID: 29553435.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

Pharmascope
Épisode 155 – THC: Tour d'Horizon sur les Cannabinoïdes – Partie 2

Pharmascope

Play Episode Listen Later Apr 21, 2025 42:45


Un nouvel épisode du Pharmascope est disponible… Et on s'attaque encore aux cannabinoïdes! Dans cette deuxième partie, Nicolas, Isabelle, Olivier et un invité discutent de douleurs non-neuropathiques, d'autres indications potentielles des cannabinoïdes et de cannabinoïdes topiques.  Les objectifs pour cet épisode sont les suivants: Discuter des données d'efficacité des cannabinoïdes pour les douleurs non-neuropathiques Discuter des données d'efficacité des cannabinoïdes pour d'autres indications que le traitement de la douleur Discuter des cannabinoïdes topiques dans le traitement de la douleur Ressources pertinentes en lien avec l'épisode  Société québécoise de la douleur Häuser W, Welsch P, Radbruch L, Fisher E, Bell RF, Moore RA. Cannabis-based medicines and medical cannabis for adults with cancer pain. Cochrane Database Syst Rev. 2023 Jun 5;6(6):CD014915. Filippini G, Minozzi S, Borrelli F, Cinquini M, Dwan K. Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis. Cochrane Database Syst Rev. 2022 May 5;5(5):CD013444. Smith LA, Azariah F, Lavender VT, Stoner NS, Bettiol S. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database Syst Rev. 2015 Nov 12;2015(11):CD009464. Kafil TS, Nguyen TM, MacDonald JK, Chande N. Cannabis for the treatment of Crohn's disease. Cochrane Database Syst Rev. 2018 Nov 8;11(11):CD012853. Kafil TS, Nguyen TM, MacDonald JK, Chande N. Cannabis for the treatment of ulcerative colitis. Cochrane Database Syst Rev. 2018 Nov 8;11(11):CD012954. Black N et coll. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. Lancet Psychiatry. 2019 Dec;6(12):995-1010. Coelho CF et coll. The Impact of Cannabidiol Treatment on Anxiety Disorders: A Systematic Review of Randomized Controlled Clinical Trials. Life (Basel). 2024 Oct 25;14(11):1373. Bahji A, Meyyappan AC, Hawken ER. Efficacy and acceptability of cannabinoids for anxiety disorders in adults: A systematic review & meta-analysis. J Psychiatr Res. 2020 Oct;129:257-264. Rodas JD, George TP, Hassan AN. A Systematic Review of the Clinical Effects of Cannabis and Cannabinoids in Posttraumatic Stress Disorder Symptoms and Symptom Clusters. J Clin Psychiatry. 2024 Feb 14;85(1):23r14862 Bhagavan C et coll. Cannabinoids in the Treatment of Insomnia Disorder: A Systematic Review and Meta-Analysis. CNS Drugs. 2020 Dec;34(12):1217-1228. Wang M et coll. Effects of a cannabidiol/terpene formulation on sleep in individuals with insomnia: a double-blind, placebo-controlled, randomized, crossover study. J Clin Sleep Med. 2025 Jan 1;21(1):69-80. Joshi N, Mariam H, Kamath A. Cannabinoids for the Treatment of Glaucoma: A Review. Med Cannabis Cannabinoids. 2024 Sep 16;7(1):183-192. Boylan PM, Santibañez M, Thomas J, Weeda E, Noel ZR, Caballero J. Cannabinoids for obstructive sleep apnea: A systematic review. Pharmacotherapy. 2024 Nov;44(11):880-891. Hunter D et coll.Synthetic transdermal cannabidiol for the treatment of knee pain due to osteoarthritis. Osteoarthritis and Cartilage. 2018. 26. S26.

PICU Doc On Call
96: Management of Upper Airway Obstruction | Croup in the PICU

PICU Doc On Call

Play Episode Listen Later Apr 13, 2025 32:34


In today's episode, Dr. Rahul Damania and Dr. Pradip Kamat welcome their new co-host, Dr. Monica Gray. They'll dive into the topic of upper airway obstruction in children and explore a case involving a 12-month-old girl who presents with stridor and fever. Throughout the discussion, they delve into the underlying causes, possible diagnoses, and management strategies. Key takeaways include the significance of keeping the child calm, ensuring proper positioning, and utilizing treatments such as dexamethasone and Racemic epinephrine. They'll also touch on advanced therapies and serious infections like epiglottitis. The episode highlights the importance of recognizing stridor, knowing when to consider PICU admission, and the effectiveness of low-dose dexamethasone. Tune in to learn more!Show Highlights:Overview of upper airway obstruction in pediatric patientsCase presentation of a 12-month-old girl with stridor and feverDiscussion on the pathophysiology of stridor and its clinical significanceDifferential diagnoses for stridor, including croup, epiglottitis, and foreign body aspirationManagement strategies for upper airway obstruction, including stabilization and medicationImportance of calming the child and optimal positioning during treatmentUse of dexamethasone and racemic epinephrine in managing croupAdvanced therapies, such as Helios, for specific casesIndicators for pediatric intensive care unit (PICU) admissionKey clinical points and takeaways for healthcare professionals managing airway emergenciesReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 47 Otteson T, Richardson C, Shah J: Diseases of the upper Airway. Pages 524-535Rogers Textbook of Pediatric Intensive Care: Chapter 25; Ong May Soo Jacqueline, Tijssen J, Bruins BB and Nishisaki A: Airway management. Pages 341-365Reference: Asmundsson AS, Arms J, Kaila R, Roback MG, Theiler C, Davey CS, Louie JP. Hospital Course of Croup After Emergency Department Management. Hosp Pediatr. 2019 May;9(5):326-332. doi: 10.1542/hpeds.2018-0066. PMID: 30988017; PMCID: PMC6478427.Reference: Aregbesola A, Tam CM, Kothari A, Le ML, Ragheb M, Klassen TP. Glucocorticoids for croup in children. Cochrane Database Syst Rev. 2023 Jan 10;1(1):CD001955. doi: 10.1002/14651858.CD001955.pub5. PMID: 36626194; PMCID: PMC9831289.Previous Episode Mentioned:PICU Doc On Call Episode 80

Pharmascope
Épisode 154 – THC: Tour d'Horizon sur les Cannabinoïdes – Partie 1

Pharmascope

Play Episode Listen Later Apr 3, 2025 51:19


Un nouvel épisode du Pharmascope est disponible! Dans ce 154e épisode à saveur psychoactive, Nicolas, Isabelle et Olivier reçoivent un nouvel invité pour discuter de cannabis. Cette première partie est consacrée à discuter des composantes du cannabis, des différents cannabinoïdes pharmaceutiques et de leur efficacité en douleur neuropathique.  Les objectifs pour cet épisode sont les suivants: Discuter des composantes du cannabis et des cannabinoïdes pharmaceutiques Discuter de l'efficacité des cannabinoïdes dans le traitement de la douleur neuropathique Comparer les données d'efficacité et d'innocuité des cannabinoïdes en douleur neuropathique Ressources pertinentes en lien avec l'épisode  Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018 Mar 7;3(3):CD012182. Hansen JS et coll. Cannabis-Based Medicine for Neuropathic Pain and Spasticity-A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial. Pharmaceuticals (Basel). 2023 Jul 28;16(8):1079. Ware MA, Fitzcharles MA, Joseph L, Shir Y. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg. 2010 Feb 1;110(2):604-10. Skrabek RQ, Galimova L, Ethans K, Perry D. Nabilone for the treatment of pain in fibromyalgia. J Pain. 2008 Feb;9(2):164-73. Bell AD et coll. Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions. Cannabis Cannabinoid Res. 2024 Apr;9(2):669-687. Busse JW et coll. Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ. 2021 Sep 8;374:n2040. Wang L et coll. Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ. 2021 Sep 8;374:n1034. Allan GM et coll. Simplified guideline for prescribing medical cannabinoids in primary care. Can Fam Physician. 2018 Feb;64(2):111-120. Allan GM et coll. Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms. Can Fam Physician. 2018 Feb;64(2):e78-e94.

The Flipping 50 Show
4 Exercise Mistakes Hijacking Your Menopause Fitness (and how to fix them)

The Flipping 50 Show

Play Episode Listen Later Mar 28, 2025 30:52


You're doing it all but could there be hidden mistakes hijacking your menopause fitness. Increasing protein, lifting weights, doing high intensity… How can you be this active but not working?  Disclaimer: This could trigger you. The mistakes hijacking your menopause fitness you could be doing on purpose because you were told once this is what you SHOULD DO.  This episode is for all women, and for you. So let's unpack these mistakes hijacking your menopause fitness.  Before anything.. Measure.  If you aren't measuring your body composition - skeletal muscle mass vs. body fat—you won't truly know what's working. I'll link to the 4 Smart scales in my store. You can get a Dexa or go to a gym. #1 Not Consuming Enough Fuel Women are not the same as men on carbohydrate needs. We get little, we disrupt hormones. You are influenced by cortisol, insulin, thyroid, testosterone, growth hormone and the endocrine.   How much fuel do you need? Endocrine dysfunction - ~30-35 calories per kg of FFM in women; but around 15 calories per kg FFM in men. Fat Free Mass (FFM) - say you're 130kg and you have 25% body fat. You need 2923 kcals to keep your body functioning well.   Fueling Your Workouts: Cardio: 30g carbs and 15g protein before Strength: 15g protein before + 30-45g protein after (higher in and after menopause)    Thyroid & Carbohydrates Low carb diets (under 100g) - pivotal point for lower thyroid function.  Serotonin - produced in the gut, declines with low carb diets.  Low-carb diets - don't lead to better weight loss long-term, they cause water loss.   What Happens When You're Under-Fueled?Low Energy Availability from brain (hypothalamus) to body… Hypothalamus signals HPA axis dysfunction Adrenals releases cortisol Thyroid slows metabolism Body conserves energy and breaks down muscle instead of fat for fuel   When You Fast, try one of these: High intensity intervals  Lift heavy weights  High intensity boot camp class  Reduce carbs, maintain a keto-like diet while increasing your walks   Know the Sneaky Mistakes Hijacking Your Menopause Fitness #2 Never REALLY Recovering From Hard Intervals or Hard Workouts  Some bootcamps and spin classes are rapid, high-intensity intervals without adequate recovery. Your cortisol levels during this session accumulate.  It feels like you crushed it, but here's the truth: if you're not giving yourself real recovery, you're not hitting your peak.  When you skip the full recovery, you're not building the strength and power that protect against sarcopenia (muscle loss). Try these: Warm-up A:  Run up a steep hill for 40 seconds Mark that point on the hill Slowly go back down Fully recover, with your nasal breathing. Repeat until you don't make it to the same spot on the hill Warm-up B: Run up a steep hill for 40 seconds Mark that point on the hill Quickly make your way down Cool down within 60 seconds Immediately run up again Repeat until you don't make it to the same spot on the hill They both will feel hard, but only one gets you to your maximum capacity.  The glycolytic fibers - fast twitch that sustain power fatigue quickly. Women have fewer of them than slow twitch and lose twice as fast as slow-twitch fibers. Fast-twitch fibers need power moves — like heavy lifting or box jumps — and plenty of recovery to reload and go again.  You're fooling yourself into thinking you're getting in better shape.  So test yourself… a simple protocol you can do at home. Try a full test battery you can easily do at home - I'll provide access to it in the show notes as soon as it's ready.  Measure. Monitor your waist girth, your body fat percent and your skeletal muscle. Rate your energy, sleep, focus, digestion and elimination. Are you improving, worse or the same? When you're exercising optimally these things also improve. It's not just muscle mass and fat.    Are these Mistakes Hijacking Your Menopause Fitness?   #3 Relying on Caffeine, Bar Codes and Over Emphasis on Packaged Food By nature, your cortisol level is highest at about 8am. You've fasted overnight and if you're not eating soon after waking, especially if you're exercising as a female, your body has stressor on top of stressor: Punched your ticket in midlife (less estrogen, more cortisol) Caffeine (more cortisol)  No fuel (more cortisol)  Exercise (more cortisol)  Fuel before intense exercise.  Fuel again after, especially within the 24 hour period after resistance training or other HARD workouts the need for recovery persists, so it's not just that single meal following activity. #4 Always High and Hard You have never needed high intensity more in your life than whatever age over 40 you are now.  You also need full recovery … between intervals, strength training sets and sessions.  Here's the secret: Muscle gets stronger between sessions. The exercise is the stimulus. The recovery is where fitness happens – the release of hormones, the repair and supercompensation.  Recovery time. Get AT LEAST 48 to 72 hours between hard use of the same muscle groups. Active Recovery. The low intensity movement between your hard sessions is absolutely important in increasing circulation, blood sugar stabilization, improving sleep and mood and overall fitness levels.    Keep It Simple: Movement Time. Walking at the level below where cortisol negatively spikes so you can reduce or optimize it. Short & Intense. Spend small amounts of time in high intensity interval session - where you recover completely between sessions. All Major Muscle Groups. Spend 2-3 sessions a week hitting all major muscle groups or twice to total muscle fatigue. If you're in post menopause, the volume of sets has to be greater compared to a perimenopause woman. Recover. Give yourself at least 48 hours.. 72 is often BEST.  Resources: Flipping50 Membership Flipping50 Insiders Group   Other Podcasts You Might Like: Previous Episode - Is Red Light Therapy the Answer to Aches, Pains and More Movement? Next Episode - 3 Short Strength Training Session Strategies for Women in Menopause More Like This - 12 Strength Training Mistakes in Menopause Robbing Your Results   References: Loucks AB, Verdun M, Heath EM. Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. J Appl Physiol (1985). 1998 Jan;84(1):37-46. doi: 10.1152/jappl.1998.84.1.37. PMID: 9451615. https://doi.org/10.1152/jappl.1998.84.1.37 Naude CE, Brand A, Schoonees A, Nguyen KA, Chaplin M, Volmink J. Low-carbohydrate versus balanced-carbohydrate diets for reducing weight and cardiovascular risk. Cochrane Database Syst Rev. 2022 Jan 28;1(1):CD013334. doi: 10.1002/14651858.CD013334.pub2. PMID: 35088407; PMCID: PMC8795871. https://doi.org/10.1002/14651858.cd013334.pub2 Shulhai AM, Rotondo R, Petraroli M, Patianna V, Predieri B, Iughetti L, Esposito S, Street ME. The Role of Nutrition on Thyroid Function. Nutrients. 2024 Jul 31;16(15):2496. doi: 10.3390/nu16152496. PMID: 39125376; PMCID: PMC11314468. https://doi.org/10.3390/nu16152496 

Pharmascope
Épisode 153 – Chlamydia et gonorrhée: les invités qu'on ne veut pas laisser entrer! – Partie 2

Pharmascope

Play Episode Listen Later Mar 18, 2025 35:44


Un nouvel épisode du Pharmascope est disponible! Dans ce 153e épisode, Nicolas, Isabelle et Olivier discutent de chlamydia et de gonorrhée. Cette deuxième partie est consacrée au traitement de ces infections. Les objectifs pour cet épisode sont les suivants: Discuter de la prise en charge de la chlamydia et de la gonorrhée.  Discuter des traitements antibiotiques de la chlamydia et de la gonorrhée.  Discuter de l'utilisation de la DOXY-PEP. Ressources pertinentes en lien avec l'épisode  Agence de la santé publique du Canada. Chlamydia, gonorrhée et syphilis infectieuse au Canada : Données de surveillance de 2021. INESSS. Guide d'usage optimal : Infection confirmée à Chlamydia trachomatis ou à Neisseria gonorrhoeae. Septembre 2024. INESSS. Guide d'usage optimal : Approche syndromique. Décembre 2024. Portail VIH/sida du Québec : Notification anonyme des partenaires. MSSS. Traitement accéléré des partenaires pour les infections à Chlamydia trachomatis et à Neisseria gonorrhoeae - Aide-mémoire pour les cliniciens. Juillet 2021. MSSS. Traitement accéléré des partenaires pour les infections à Chlamydia trachomatis et à Neisseria gonorrhoeae - Aide-mémoire pour les pharmaciens. Juillet 2021. MSSS. Carte de notification chlamydia/gonorrhée. Juillet 2021. Páez-Canro C et coll. Antibiotics for treating urogenital Chlamydia trachomatis infection in men and non-pregnant women. Cochrane Database Syst Rev. 2019 Jan 25;1(1):CD010871. Lau A et coll. Azithromycin or Doxycycline for Asymptomatic Rectal Chlamydia trachomatis. N Engl J Med. 2021 Jun 24;384(25):2418-2427. Bížová B et coll. Single-dose cefixime 800 mg plus doxycycline 100 mg twice a day for 7 days compared with single-dose ceftriaxone 1 g plus single-dose azithromycin 2 g for treatment of urogenital, rectal, and pharyngeal gonorrhoea: a randomised clinical trial. Clin Microbiol Infect. 2024 Feb;30(2):211-215. Nguyen PTT et coll. Randomized controlled trial of the relative efficacy of high-dose intravenous ceftriaxone and oral cefixime combined with doxycycline for the treatment of Chlamydia trachomatis and Neisseria gonorrhoeae co-infection. BMC Infect Dis. 2022 Jul 9;22(1):607. Yang KJ et coll. Effectiveness of Cefixime for the Treatment of Neisseria gonorrhoeae Infection at 3 Anatomic Sites: A Systematic Review and Meta-Analysis. Sex Transm Dis. 2023 Mar 1;50(3):131-137. Kirkcaldy RD et coll. The efficacy and safety of gentamicin plus azithromycin and gemifloxacin plus azithromycin as treatment of uncomplicated gonorrhea. Clin Infect Dis. 2014 Oct 15;59(8):1083-91. Bachmann LH, Barbee LA, Chan P, et colll. CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024. MMWR Recomm Rep. 2024;73(2):1-8.

The Skeptics Guide to Emergency Medicine
SGEM #470: Here We Go Up Up Up or Lateral for Infant Lumbar Punctures

The Skeptics Guide to Emergency Medicine

Play Episode Listen Later Mar 8, 2025 23:00


Reference: Pessano S, et al. Positioning for lumbar puncture in newborn infants. Cochrane Database Syst Rev. December 2023 Date: February 7, 2025 Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. She is also a new podcast host for Emergency Medicine Residents' Association (EMRA) Cast Series. Case: A five-day-old […] The post SGEM #470: Here We Go Up Up Up or Lateral for Infant Lumbar Punctures first appeared on The Skeptics Guide to Emergency Medicine.

The Body of Evidence
128 – Is hyperbaric oxygen therapy a cure-all?

The Body of Evidence

Play Episode Listen Later Mar 5, 2025 45:56


While it is proven to be lifesaving in carbon monoxide poisoning, is there any evidence that hyperbaric oxygen therapy helps with cerebral palsy, autism, long covid, migraines and many other conditions? Can HBOT be both a valid medical therapy and a pseudoscience? Guest co-host Pedro Mendes joins Dr. Chris Labos to parse out fact from fiction. Bonus points if you know the one condition where hyperbaric oxygen therapy is strictly contra-indicated.   Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Email us your questions at thebodyofevidence@gmail.com.   Editor:    Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer   Obviously, Chris not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References:   Hyperbaric oxygen therapy – Health Canada https://www.canada.ca/en/health-canada/services/healthy-living/your-health/medical-information/hyperbaric-oxygen-therapy.html   Chris' article on hyperbaric oxygen therapy: https://www.montrealgazette.com/opinion/columnists/article560792.html   Recent child's death https://www.medscape.com/viewarticle/clinic-death-raises-questions-about-oxygen-therapy-2025a10003wa?ecd=wnl_tp10_daily_250216_MSCPEDIT_etid7230220&uac=207389HY&impID=7230220   Trauma Bouachour G, Cronier P, Gouello JP, Toulemonde JL, Talha A, Alquier P. Hyperbaric oxygen therapy in the management of crush injuries: a randomized double-blind placebo-controlled clinical trial. J Trauma. 1996 Aug;41(2):333-9. doi: 10.1097/00005373-199608000-00023. PMID: 8760546.   Burns Brannen AL, Still J, Haynes M, Orlet H, Rosenblum F, Law E, Thompson WO. A randomized prospective trial of hyperbaric oxygen in a referral burn center population. Am Surg. 1997 Mar;63(3):205-8. PMID: 9036884.   Radiation injury Lin ZC, Bennett MH, Hawkins GC, Azzopardi CP, Feldmeier J, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev. 2023 Aug 15;8(8):CD005005. doi: 10.1002/14651858.CD005005.pub5. PMID: 37585677; PMCID: PMC10426260.   Chronic wounds: Kranke P, Bennett MH, Martyn-St James M, Schnabel A, Debus SE, Weibel S. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev. 2015 Jun 24;2015(6):CD004123. doi: 10.1002/14651858.CD004123.pub4. PMID: 26106870; PMCID: PMC7055586.   Cerebral palsy Collet JP, Vanasse M, Marois P, Amar M, Goldberg J, Lambert J, Lassonde M, Hardy P, Fortin J, Tremblay SD, Montgomery D, Lacroix J, Robinson A, Majnemer A. Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group. Lancet. 2001 Feb 24;357(9256):582-6. doi: 10.1016/s0140-6736(00)04054-x. PMID: 11558483.  

The World’s Okayest Medic Podcast

Listener discretion is advised (language). References: Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. Bonilla Arcos D, Krishnan JA, et al. High-Dose Versus Low-Dose Systemic Steroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Systematic Review. Chronic Obstr Pulm Dis. 2016 Feb 17;3(2):580-588. Fawzy A, Wise RA. Pulse Oximetry Misclassifies Need for Long-Term Oxygen Therapy in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2023 Nov;20(11):1556-1557. Goldberg P, Reissmann H, Maltais F, Ranieri M, Gottfried SB. Efficacy of noninvasive CPAP in COPD with acute respiratory failure. Eur Respir J. 1995 Nov;8(11):1894-900. Jennifer T. Thibodeau, Mark H. Drazner. The Role of the Clinical Examination in Patients With Heart Failure,JACC: Heart Failure, Volume 6, Issue 7, 2018, Pages 543-551. Kartal M, Goksu E, Eray O, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011 Feb;18(1):9-12. Ni, H., Aye, S., Naing, C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2022 May 26; 2022(5):CD013506. Pertzov, B., Ronen, M., Rosengarten, D. et al. Use of capnography for prediction of obstruction severity in non-intubated COPD and asthma patients. Respir Res 22, 154 (2021). Pu X, Liu L, Feng B, Wang M, Dong L, Zhang Z, Fan Q, Li Y, Wang G. Efficacy and Safety of Different Doses of Systemic Corticosteroids in COPD Exacerbation. Respir Care. 2021 Feb;66(2):316-326. Tyagi D, Govindagoudar MB, et al. Correlation of PaCO2 and ETCO2 in COPD Patients with Exacerbation on Mechanical Ventilation. Indian J Crit Care Med. 2021 Mar;25(3):305-309. van Gestel AJ, Steier J. Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD). J Thorac Dis. 2010 Dec;2(4):215-22. doi: 10.3978/j.issn.2072-1439.2010.02.04.5.

Frankly Speaking About Family Medicine
Fluoride in Drinking Water: Why Is There Controversy? - Frankly Speaking Ep 419

Frankly Speaking About Family Medicine

Play Episode Listen Later Feb 10, 2025 12:20


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419 Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children's IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic. Episode resource links: Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children's IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025.  Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856.  Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Pri-Med Podcasts
Fluoride in Drinking Water: Why Is There Controversy? - Frankly Speaking Ep 419

Pri-Med Podcasts

Play Episode Listen Later Feb 10, 2025 12:20


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419 Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children's IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic. Episode resource links: Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children's IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025.  Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856.  Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Pharmascope
Épisode 151 – Les hormones au masculin: andropause – Partie 2

Pharmascope

Play Episode Listen Later Feb 8, 2025 47:53


Un nouvel épisode du Pharmascope est disponible… Et on aborde encore l'andropause et son traitement! Dans cette deuxième partie, Nicolas, Isabelle et Olivier discutent des données d'efficacité et d'innocuité de la testostérone en contexte d'andropause. Les objectifs pour cet épisode sont les suivants: Discuter de la prise en charge pharmacologique de l'andropause Discuter des données d'efficacité de la testostérone en contexte d'andropause Discuter des données d'innocuité de la testostérone en contexte d'andropause Ressources pertinentes en lien avec l'épisode  Série documentaire « L'andropause sans tabou ». Disponible sur l'EXTRA d'ICI TOU.TV TTrialsSnyder PJ, et coll.; Testosterone Trials Investigators. Effects of Testosterone Treatment in Older Men. N Engl J Med. 2016 Feb 18;374(7):611-24. Resnick SM, et coll. Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment. JAMA. 2017 Feb 21;317(7):717-727. Roy CN, et coll. Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial. JAMA Intern Med. 2017 Apr 1;177(4):480-490. TRAVERSELincoff AM, et coll; TRAVERSE Study Investigators. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023 Jul 13;389(2):107-117. Pencina KM, et coll. Effect of Testosterone Replacement Therapy on Sexual Function and Hypogonadal Symptoms in Men with Hypogonadism. J Clin Endocrinol Metab. 2024 Jan 18;109(2):569-580. Bhasin S, et coll. Depressive Syndromes in Men With Hypogonadism in the TRAVERSE Trial: Response to Testosterone-Replacement Therapy. J Clin Endocrinol Metab. 2024 Jun 17;109(7):1814-1826. Pencina KM, et coll. Efficacy of Testosterone Replacement Therapy in Correcting Anemia in Men With Hypogonadism: A Randomized Clinical Trial. JAMA Netw Open. 2023 Oct 2;6(10):e2340030. Snyder PJ, Bauer DC, Ellenberg SS, Cauley JA, Buhr KA, Bhasin S, Miller MG, Khan NS, Li X, Nissen SE. Testosterone Treatment and Fractures in Men with Hypogonadism. N Engl J Med. 2024 Jan 18;390(3):203-211. Autres référencesLee H, et coll. Testosterone replacement in men with sexual dysfunction. Cochrane Database Syst Rev. 2024 Jan 15;1(1):CD013071. Domes T, et coll. Canadian Urological Association guideline: Erectile dysfunction. Can Urol Assoc J. 2021 Oct;15(10):310-322. Buvat J, et coll. Hypogonadal men nonresponders to the PDE5 inhibitor tadalafil benefit from normalization of testosterone levels with a 1% hydroalcoholic testosterone gel in the treatment of erectile dysfunction (TADTEST study). J Sex Med. 2011 Jan;8(1):284-93. Walther A, Breidenstein J, Miller R. Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2019 Jan 1;76(1):31-40. Wittert G, et coll. Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM): a randomised, double-blind, placebo-controlled, 2-year, phase 3b trial. Lancet Diabetes Endocrinol. 2021 Jan;9(1):32-45. Bhasin S, et coll. Effect of Testosterone on Progression From Prediabetes to Diabetes in Men With Hypogonadism: A Substudy of the TRAVERSE Randomized Clinical Trial. JAMA Intern Med. 2024 Apr 1;184(4):353-362.

Frankly Speaking About Family Medicine
My Back Still Hurts! Nonpharmacologic Approaches to Chronic Back Pain - Frankly Speaking Ep 416

Frankly Speaking About Family Medicine

Play Episode Listen Later Jan 20, 2025 14:23


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-416 Overview: Listen in as we discuss chronic sacroiliac (SI) dysfunction and the role of nonpharmacological therapies, including acupuncture, in managing back pain and improving function. Hear evidence-based considerations for integrating acupuncture into your practice to offer effective, medication-free options for patients with chronic SI pain. Episode resource links: Kim G, Kim D, Moon H, et al. Acupuncture and Acupoints for Low Back Pain: Systematic Review and Meta-Analysis. Am J Chin Med. 2023;51(2):223-247. doi:10.1142/S0192415X23500131 Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. 2020;12(12):CD013814. Published 2020 Dec 11. doi:10.1002/14651858.CD013814 Tu J-F et al. Acupuncture vs sham acupuncture for chronic sciatica from herniated disk: A randomized clinical trial. JAMA Intern Med 2024 Oct 14; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5463) Wu M, Fan C, Liu H, et al. The Effectiveness of Acupuncture for Low Back Pain: An Umbrella Review and Meta-Analysis. Am J Chin Med. 2024;52(4):905-923. doi:10.1142/S0192415X2450037X https://www-dynamed-com.umassmed.idm.oclc.org/condition/sciatica Guest: Susan Feeney, DNP, FNP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Pri-Med Podcasts
My Back Still Hurts! Nonpharmacologic Approaches to Chronic Back Pain - Frankly Speaking Ep 416

Pri-Med Podcasts

Play Episode Listen Later Jan 20, 2025 14:23


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-416 Overview: Listen in as we discuss chronic sacroiliac (SI) dysfunction and the role of nonpharmacological therapies, including acupuncture, in managing back pain and improving function. Hear evidence-based considerations for integrating acupuncture into your practice to offer effective, medication-free options for patients with chronic SI pain. Episode resource links: Kim G, Kim D, Moon H, et al. Acupuncture and Acupoints for Low Back Pain: Systematic Review and Meta-Analysis. Am J Chin Med. 2023;51(2):223-247. doi:10.1142/S0192415X23500131 Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. 2020;12(12):CD013814. Published 2020 Dec 11. doi:10.1002/14651858.CD013814 Tu J-F et al. Acupuncture vs sham acupuncture for chronic sciatica from herniated disk: A randomized clinical trial. JAMA Intern Med 2024 Oct 14; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5463) Wu M, Fan C, Liu H, et al. The Effectiveness of Acupuncture for Low Back Pain: An Umbrella Review and Meta-Analysis. Am J Chin Med. 2024;52(4):905-923. doi:10.1142/S0192415X2450037X https://www-dynamed-com.umassmed.idm.oclc.org/condition/sciatica Guest: Susan Feeney, DNP, FNP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Rounding@IOWA
76: Music Therapy in End-of-Life Care

Rounding@IOWA

Play Episode Listen Later Jan 14, 2025 61:52


Join Dr. Clancy and guest Katey Kooi for a discussion of the benefits of music therapy in palliative and end-of-life care. CME Credit Available:  https://uiowa.cloud-cme.com/course/courseoverview?P=0&EID=72842  Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guest: Katey Kooi, MT-BC Music Therapist, Supportive and Palliative Care University of Iowa Health Care Financial Disclosures:  Dr. Clancy, Ms. Kooi, and the members of the Rounding@IOWA planning committee have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.0 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 1.0 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. Pharmacist UAN: JA0000310-0000-25-039-H99-P Pharmacy Tech UAN: JA0000310-0000-25-039-H99-T Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References/Resources:  Gutgsell, Kathy Jo et al. (2013) Music Therapy Reduces Pain in Palliative Care Patients: A Randomized Controlled Trial. Journal of Pain and Symptom Management, Volume 45, Issue 5, 822 – 831. Gallagher, Ragman, Rybicki. (2018) Outcomes of Music Therapy Interventions on Symptom Management in Palliative care patients. American Journal of Hospice and Palliative Medicine Vol 35(2) 250-257. Hilliard R. E. (2003). The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. Journal of music therapy, 40(2), 113–137. https://doi.org/10.1093/jmt/40.2.113 Bradt J, Dileo C, Grocke D, Magill L. (2011) Music interventions for improving psychological and physical outcomes in cancer patients.Cochrane Database Syst Rev. Aug 10;(8) Ramesh B. (2024) Role of Music Therapy in Palliative Care—Methods and Techniques. Journal of Palliative Care. https://journals.sagepub.com/doi/10.1177/08258597241235110 Whitford, Kevin J. et al.Music Therapy Intervention to Reduce Caregiver Distress at End of Life: A Feasibility Study Journal of Pain and Symptom Management, Volume 65, Issue 5, e417 - e423 https://www.jpsmjournal.com/article/S0885-3924(23)00035-0/fulltext Sarah Kordovan, Pia Preissler, Anne Kamphausen, Carsten Bokemeyer, and Karin Oechsle. (2016)Prospective Study on Music Therapy in Terminally Ill Cancer Patients during Specialized Inpatient Palliative Care Journal of Palliative Medicine  19:4, 394-399. Lopez, G., Christie, A.J., Powers-James, C. et al. (2019). The effects of inpatient music therapy on self-reported symptoms at an academic cancer center: a preliminary report. Support Care Cancer 27, 4207–4212. https://doi.org/10.1007/s00520-019-04713-4 Brungardt A, Wibben A, Tompkins AF, Shanbhag P, Coats H, LaGasse AB, Boeldt D, Youngwerth J, Kutner JS, Lum HD.(2021) Virtual Reality-Based Music Therapy in Palliative Care: A Pilot Implementation Trial. J Palliat Med. May;24(5):736-742. Ghetti, C. M., Schreck, B., & Bennett, J. (2023). Heartbeat recordings in music therapy bereavement care following suicide: Action research single case study of amplified cardiopulmonary recordings for continuity of care. Action Research, 0(0). https://doi.org/10.1177/14767503231207993  

Pharmascope
Épisode 149 – Le Gala des grands crus et des piquettes 2024

Pharmascope

Play Episode Listen Later Jan 4, 2025 48:12


Qui dit fin d'année dit Gala des grands crus et des piquettes du Pharmascope! Ne manquez pas cette 8e édition du Gala au velours des plus sérieux, le grand retour de Sébastien, des effets sonores entraînants, l'inclusion de nouvelles catégories exotiques… ** Veuillez noter que cet épisode ne rencontre pas les critères d'admissibilité pour l'octroi d'unités de formation continue ou de crédits Mainpro+** Ressources pertinentes en lien avec l'épisode La catégorie « L'éditorial de l'année »van Dijk SHB, Bui M, Eijkelboom AH. Living happily ever after? The hidden health risks of Disney princesses. BMJ. 2024;387:q2497. La catégorie « Nouvelles études de vieilles affaires pour de vieilles maladies »Kingsbury SR, Tharmanathan P, Keding A, et al. Pain Reduction With Oral Methotrexate in Knee Osteoarthritis : A Randomized, Placebo-Controlled Clinical Trial. Ann Intern Med. 2024;177(9):1145-1156. Wang Y, Jones G, Keen HI, et al. Methotrexate to treat hand osteoarthritis with synovitis (METHODS): an Australian, multisite, parallel-group, double-blind, randomised, placebo-controlled trial. Lancet. 2023;402(10414):1764-1772. La catégorie « Patente à gosse incroyable »Bartholdy C, Døssing A, Stisen ZR, et al. Effect of heated mittens on physical hand function in people with hand osteoarthritis: randomised controlled trial. BMJ. 2024;387:e078222. La catégorie « Je pleure tellement je ris »Li J, Liao Y, Zhang SY, et al. Effect of laughter exercise versus 0.1% sodium hyaluronic acid on ocular surface discomfort in dry eye disease: non-inferiority randomised controlled trial. BMJ. 2024;386:e080474. La catégorie « Alimentaire »Hakam N, Guzman Fuentes JL, Nabavizadeh B, et al. Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake: A Systematic Review. JAMA Netw Open. 2024;7(11):e2447621. Hodder RK, O'Brien KM, Wyse RJ, et al. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev. 2024;9(9):CD008552. La catégorie « On n'est plus capable! »Duarte Romero B, Waterhouse M, Baxter C, et al. The effect of three years of vitamin D supplementation on erectile dysfunction: Results from the randomized placebo-controlled D-Health Trial. Clin Nutr ESPEN. 2024;60:109-115. La catégorie « L'étude ayant pris le plus de temps à être publiée »Hammond J, Fountaine RJ, Yunis C, et al. Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19. N Engl J Med. 2024;390(13):1186-1195. La catégorie « Visuospatial »R Patel V, Liu M, Worsham CM, Jena AB. Alzheimer's disease mortality among taxi and ambulance drivers: population based cross sectional study. BMJ. 2024;387:e082194. Published 2024 Dec 17. La catégorie « Hommage »Yndigegn T, Lindahl B, Mars K, et al. Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction. N Engl J Med. 2024;390(15):1372-1381. Silvain J, Cayla G, Ferrari E, et al. Beta-Blocker Interruption or Continuation after Myocardial Infarction. N Engl J Med. 2024;391(14):1277-1286.

Pharmascope
Épisode 148 – Quand les temps sont durs…ou pas

Pharmascope

Play Episode Listen Later Dec 24, 2024 54:29


Un nouvel épisode du Pharmascope est disponible! Dans ce 148e épisode, Nicolas, Isabelle et Olivier discutent d'un problème qui affectera plus de la moitié des hommes au cours de leur vie : la dysfonction érectile! Les objectifs pour cet épisode sont les suivants: Expliquer l'épidémiologie, la présentation clinique et l'évaluation de la dysfonction érectile. Conseiller des mesures non-pharmacologiques pour aider les personnes avec une dysfonction érectile.  Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques de la dysfonction érectile.  Ressources pertinentes en lien avec l'épisode  Domes T et coll. Canadian Urological Association guideline: Erectile dysfunction. Can Urol Assoc J. 2021 Oct;15(10):310-322. Yafi FA et coll. Erectile dysfunction. Nat Rev Dis Primers. 2016 Feb 4;2:16003 Yuan J et coll. Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis. Eur Urol. 2013 May;63(5):902-12. Corona G, Rastrelli G, Morgentaler A, Sforza A, Mannucci E, Maggi M. Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores. Eur Urol. 2017 Dec;72(6):1000-1011 Lee H et coll. Testosterone replacement in men with sexual dysfunction. Cochrane Database Syst Rev. 2024 Jan 15;1(1):CD013071. Linet OI, Ogrinc FG. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. The Alprostadil Study Group. N Engl J Med. 1996 Apr 4;334(14):873-7. Lee HW, Lee MS, Kim TH, Alraek T, Zaslawski C, Kim JW, Moon DG. Ginseng for Erectile Dysfunction: A Cochrane Systematic Review. World J Mens Health. 2022 Apr;40(2):264-269. Yang YJ, Yang EJ, Choi SY. Scoping review exploring advancements in topical agent therapies for erectile dysfunction. Sex Med Rev. 2024 Sep 25;12(4):731-738.

Ta de Clinicagem
TdC 264: Diabetes mellitus tipo 1

Ta de Clinicagem

Play Episode Listen Later Dec 18, 2024 63:18


Marcela Belleza e Letícia Angoleri convidam Nathalie Santana para falar de um tema inédito no TdC: diabetes tipo 1! O episódio está dividido em 4 partes:1. Como fazer o diagnóstico? 2. Como insulinizar?3. Quais são as metas do tratamento?4. Como seguir?Referências:1. Silva Júnior WS, Gabbay M, Lamounier R, Bertoluci M. Insulinoterapia no diabetes mellitus tipo 1 (DM1). Diretriz Oficial da Sociedade Brasileira de Diabetes (2023). DOI: 10.29327/557753.2022-5, ISBN: 978-85-5722-906-8. 2. American Diabetes Association, novembro/23. https://diabetesjournals.org/care/issue/47/Supplement_13. https://steno.shinyapps.io/T1RiskEngine/ 4. Siebenhofer A, Plank J, Berghold A, Jeitler K, Horvath K, Narath M, et al. Short acting insulin analogues versus regular human insulin in patients with diabetes mellitus. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD0032875. Siebenhofer, A et al. “Short acting insulin analogues versus regular human insulin in patients with diabetes mellitus.” The Cochrane database of systematic reviews ,2 CD003287. 19 Apr. 2006, doi:10.1002/14651858.CD003287.pub4

Pharmascope
Épisode 145 – Les tremblements essentiels, sûrement pas si essentiels que ça!

Pharmascope

Play Episode Listen Later Nov 7, 2024 60:20


Un nouvel épisode du Pharmascope est disponible! Dans ce 145e épisode, Nicolas, Isabelle et Olivier essaient de ne pas trop vous faire trembler en revisitant une vieille littérature et un problème incommodant : le tremblement essentiel. Les objectifs pour cet épisode sont les suivants: Expliquer l'épidémiologie, la présentation clinique et l'évaluation du tremblement essentiel. Conseiller des mesures non-pharmacologiques pour aider les personnes avec un tremblement essentiel. Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques du tremblement essentiel. Ressources pertinentes en lien avec l'épisode  Shanker V. Essential tremor: diagnosis and management. BMJ. 2019 Aug 5;366:14485 Welton T, Cardoso F, Carr JA, Chan LL, Deuschl G, Jankovic J, Tan EK. Essential tremor. Nat Rev Dis Primers. 2021 Nov 11;7(1):83. Baizabal-Carvallo JF, Morgan JC. Drug-induced tremor, clinical features, diagnostic approach and management. J Neurol Sci. 2022 Apr 15;435:120192 Ferreira JJ et coll. MDS Task Force on Tremor and the MDS Evidence Based Medicine Committee. MDS evidence-based review of treatments for essential tremor. Mov Disord. 2019 Jul;34(7):950-958. Serrano-Dueñas M. Use of primidone in low doses (250 mg/day) versus high doses (750 mg/day) in the management of essential tremor. Double-blind comparative study with one-year follow-up. Parkinsonism Relat Disord. 2003 Oct;10(1):29-33. Bruno E, Nicoletti A, Quattrocchi G, Allegra R, Filippini G, Colosimo C, Zappia M. Topiramate for essential tremor. Cochrane Database Syst Rev. 2017 Apr 14;4(4):CD009683. Ondo WG, Jankovic J, Connor GS, Pahwa R, Elble R, Stacy MA, Koller WC, Schwarzman L, Wu SC, Hulihan JF; Topiramate Essential Tremor Study Investigators. Topiramate in essential tremor: a double-blind, placebo-controlled trial. Neurology. 2006 Mar 14;66(5):672-7. Bruno E, Nicoletti A, Quattrocchi G, Filippini G, Colosimo C, Zappia M. Pregabalin for essential tremor. Cochrane Database Syst Rev. 2016 Oct 20;10(10):CD009682 Bruno E, Nicoletti A, Quattrocchi G, Filippini G, Zappia M, Colosimo C. Alprazolam for essential tremor. Cochrane Database Syst Rev. 2015 Dec 6;2015(12):CD009681. Marques A et coll. Trial of Botulinum Toxin for Isolated or Essential Head Tremor. N Engl J Med. 2023 Nov 9;389(19):1753-1765. Yetimalar Y, Irtman G, Kurt T, Başoğlu M. Olanzapine versus propranolol in essential tremor. Clin Neurol Neurosurg. 2005 Dec;108(1):32-5.

The Body of Evidence
115 - Quitting Smoking

The Body of Evidence

Play Episode Listen Later Nov 6, 2024 49:59


What does the body of evidence say about smoking cessation? Does counselling make a difference and, if so, what kind? Is vaping effective as a way to quit smoking? And did you know there are drugs that have been shown to help give up the habit? Chris attempts to pronounce their names and is left with one question: is his veranda clean?   Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Email us your questions at thebodyofevidence@gmail.com.   Assistant researcher: Aigul Zaripova, MD Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer   Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.   References: Reducing vs. quitting smoking 1) Gerber Y, Myers V, Goldbourt U. Smoking reduction at midlife and lifetime mortality risk in men: a prospective cohort study. Am J Epidemiol. 2012 May 15;175(10):1006-12. doi: 10.1093/aje/kwr466. Epub 2012 Feb 3. PMID: 22306566. 2) Nina S. Godtfredsen, Claus Holst, Eva Prescott, Jørgen Vestbo, Merete Osler, Smoking Reduction, Smoking Cessation, and Mortality: A 16-year Follow-up of 19,732 Men and Women from the Copenhagen Centre for Prospective Population Studies, American Journal of Epidemiology, Volume 156, Issue 11, 1 December 2002, Pages 994–1001, https://doi.org/10.1093/aje/kwf150   Behavioural interventions for smoking cessation 3) Cahill K, Lancaster T, Green N. Stage-based interventions for smoking cessation. Cochrane Database Syst Rev. 2010 Nov 10;(11):CD004492. doi: 10.1002/14651858.CD004492.pub4. PMID: 21069681. 4) Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2016 Mar 24;3(3):CD008286. doi: 10.1002/14651858.CD008286.pub3. PMID: 27009521; PMCID: PMC10042551. 5) Hartmann-Boyce J, Hong B, Livingstone-Banks J, Wheat H, Fanshawe TR. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev. 2019 Jun 5;6(6):CD009670. doi: 10.1002/14651858.CD009670.pub4. PMID: 31166007; PMCID: PMC6549450. 6) Hartmann-Boyce J, Livingstone-Banks J, Ordóñez-Mena JM, Fanshawe TR, Lindson N, Freeman SC, Sutton AJ, Theodoulou A, Aveyard P. Behavioural interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2021 Jan 4;1(1):CD013229. doi: 10.1002/14651858.CD013229.pub2. PMID: 33411338; PMCID: PMC11354481. 7) Anthenelli RM, Benowitz NL, West R, St Aubin L, McRae T, Lawrence D, Ascher J, Russ C, Krishen A, Evins AE. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet. 2016 Jun 18;387(10037):2507-20. doi: 10.1016/S0140-6736(16)30272-0. Epub 2016 Apr 22. PMID: 27116918.   Network meta-analysis of medications and e-cigarettes 8) Lindson N, Theodoulou A, Ordóñez-Mena JM, Fanshawe TR, Sutton AJ, Livingstone-Banks J, Hajizadeh A, Zhu S, Aveyard P, Freeman SC, Agrawal S, Hartmann-Boyce J. Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta‐analyses. Cochrane Database of Systematic Reviews 2023, Issue 9. Art. No.: CD015226. DOI: 10.1002/14651858.CD015226.pub2. Accessed 04 November 2024.  

Diabetes Core Update
Special Edition - Diabetes Core Update - Oral Health Part 2

Diabetes Core Update

Play Episode Listen Later Oct 10, 2024 36:53


In this special episode on Oral Health our host, Dr. Neil Skolnik will discuss practical approaches to helping patients achieve oral health which is of critical importance for people with diabetes.  His guest for this episode is Dr. Wenche Borgnakke, and expert in public health and dentistry.  This special episode is supported by an independent educational grant from Haleon. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Wenche Borgnakke.  Dr Borgnakke, DDS, MPH, PhD ,  Adjunct Clinical Assistant Professor of Dentistry in the department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry. References: 1) American Dental Association. Gum disease can raise your blood sugar level. J Am Dent Assoc 2013;144(7):860. https://jada.ada.org/article/S0002-8177(14)60555-9/pdf   2) Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. Front Clin Diabetes Healthc 2024;4:257087. https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1257087/full   3) Borgnakke WS, Poudel P. Diabetes and oral health: summary of current scientific evidence for why transdisciplinary collaboration is needed. Front Dent Med 2021;2(50):#709831. https://www.frontiersin.org/articles/10.3389/fdmed.2021.709831/full   4) Simpson TC, Clarkson JE, Worthington HV, et al. Treatment of periodontitis for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev 2022;4(4):CD004714. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004714.pub4/full    

The Incubator
#245 - [Journal Club Shorts] -

The Incubator

Play Episode Listen Later Oct 6, 2024 6:45


Send us a textAntenatal magnesium sulphate reduces cerebral palsy after preterm birth, implementation into clinical practice needs to be accelerated globally to benefit preterm babies.Luyt K.Cochrane Database Syst Rev. 2024 Sep 24;9:ED000168. doi: 10.1002/14651858.ED000168.PMID: 39315530 No abstract available.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Breakpoints
#104 – Dosing Consult: Rifampin Part 1

Breakpoints

Play Episode Listen Later Oct 4, 2024 38:50


In this episode of Breakpoints' Dosing Consult series, Drs. Chuck Peloquin and Gerry Davies join Dr. Megan Klatt to discuss rifampin dosing for mycobacterial infections. Hear from the experts on if higher doses are really better, toxicity thresholds, and the role of alternative rifamycins for patients with MTB and NTMs. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp References: Efficacy and Safety of High-Dose Rifampin in Pulmonary Tuberculosis. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2018 Sep 1;198(5):657-666. doi: 10.1164/rccm.201712-2524OC. Rifampin vs. rifapentine: what is the preferred rifamycin for tuberculosis? Expert Rev Clin Pharmacol. 2017 Oct;10(10):1027-1036. doi: 10.1080/17512433.2017.1366311. Rifabutin for treating pulmonary tuberculosis. Cochrane Database Syst Rev. 2007 Oct; 2007(4): CD005159. doi: 10.1002/14651858.CD005159.pub2. Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease. Clin Infect Dis. 2023 Oct 5;77(7):1053-1062. doi: 10.1093/cid/ciad312. This podcast is powered by Pinecast.

Frankly Speaking About Family Medicine
Vapor Trail—The Latest on E-Cigarette Risks - Frankly Speaking Ep 396

Frankly Speaking About Family Medicine

Play Episode Listen Later Sep 2, 2024 14:31


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-396 Overview: Listen in as we discuss the health risks of e-cigarette use and dual use, emphasizing the importance of primary prevention and supporting patients in their cessation efforts. Discover the latest evidence on vaping's impact on addiction, cardiovascular health, and lung cancer, and gain essential insights to better advise your patients. Episode resource links: Bittoni MA, et al. Abstract 2213. Presented at: American Association for Cancer Research Annual Meeting; April 5-10, 2024; San Diego. (AACR 2024: Ohio State experts share new findings at annual meeting (press release). Available at: https://cancer.osu.edu/news/aacr-2024-ohio-state-experts-share-new-findings. Posted April 5,2024. Accessed May 3, 2024.) Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5 Hopkinson NS, et al "Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study" Thorax 2024: DOI:10.1136/ thorax-2023-220569. Y.W. Kim, E.J. Park, K.I. Kwak, A.-R. Choi, B.J. Lee, Y.J. Lee, J.S. Park, Y.-J. Cho, J.H. Lee, and C.-T. Lee. Association of Electronic Cigarette Use After Conventional Smoking Cessation With Lung Cancer Risk: A Nationwide Cohort Study (abstract). Am J Respir Crit Care Med 2024;209:A3051. CDC: Health Effects of Vaping; https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html CDC:Dual Use of Tobacco Products; https://www.cdc.gov/tobacco/campaign/tips/diseases/dual-tobacco-use.html Guest: Susan Feeney, DNP, FNP-BC, NP-C  Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Pri-Med Podcasts
Vapor Trail—The Latest on E-Cigarette Risks - Frankly Speaking Ep 396

Pri-Med Podcasts

Play Episode Listen Later Sep 2, 2024 14:31


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-396 Overview: Listen in as we discuss the health risks of e-cigarette use and dual use, emphasizing the importance of primary prevention and supporting patients in their cessation efforts. Discover the latest evidence on vaping's impact on addiction, cardiovascular health, and lung cancer, and gain essential insights to better advise your patients. Episode resource links: Bittoni MA, et al. Abstract 2213. Presented at: American Association for Cancer Research Annual Meeting; April 5-10, 2024; San Diego. (AACR 2024: Ohio State experts share new findings at annual meeting (press release). Available at: https://cancer.osu.edu/news/aacr-2024-ohio-state-experts-share-new-findings. Posted April 5,2024. Accessed May 3, 2024.) Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5 Hopkinson NS, et al "Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study" Thorax 2024: DOI:10.1136/ thorax-2023-220569. Y.W. Kim, E.J. Park, K.I. Kwak, A.-R. Choi, B.J. Lee, Y.J. Lee, J.S. Park, Y.-J. Cho, J.H. Lee, and C.-T. Lee. Association of Electronic Cigarette Use After Conventional Smoking Cessation With Lung Cancer Risk: A Nationwide Cohort Study (abstract). Am J Respir Crit Care Med 2024;209:A3051. CDC: Health Effects of Vaping; https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html CDC:Dual Use of Tobacco Products; https://www.cdc.gov/tobacco/campaign/tips/diseases/dual-tobacco-use.html Guest: Susan Feeney, DNP, FNP-BC, NP-C  Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Evidence Based Birth®
EBB 325 - Surviving HELLP Syndrome and Planning a VBAC in a Subsequent Pregnancy with Jolene Brink, EBB Childbirth Class Graduate

Evidence Based Birth®

Play Episode Listen Later Aug 28, 2024 41:00


Following an emergency c-section due to HELLP syndrome in her first pregnancy, Jolene Brink was determined to have a different birthing experience with her second child. Through the support of a knowledgeable medical team and insights gained from her EBB Childbirth Class, she successfully achieved her goal of an unmedicated VBAC with the birth of her son, Guthrie, in 2022. Jolene's journey towards a VBAC was a transformative process of healing, empowerment, and reclaiming her birthing experience, showcasing the importance of advocacy and informed decision-making in maternal healthcare. Resources: Check out Doulas of Duluth to learn from her instructors Cooper Orth and Dana Morrison, and follow them on Instagram! Learn about Jolene's work here! Read The Preeclampsia Foundation's article on HELLP Syndrome Follow the Preeclampsia Foundation on Instagram van Oostwaard, M. F. et al. (2015). "Recurrence of hypertensive disorders of pregnancy: An individual patient data meta-analysis." Am J Obstet Gynecol 212(5): 624.e1-17. https://pubmed.ncbi.nlm.nih.gov/25582098/ Duley, L., et al. (2019). "Antiplatelet agents for preventing pre-eclampsia and its complications." Cochrane Database Syst Rev. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820858/ Listen to the Evidence on VBAC - EBB 113 EBB Childbirth Class now includes a module all about planning a VBAC! Learn more about the EBB Childbirth class here. For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Behind The Knife: The Surgery Podcast
Journal Review in Minimally Invasive Surgery: Robotic Cholecystectomy and Bile Duct Injury

Behind The Knife: The Surgery Podcast

Play Episode Listen Later Jun 10, 2024 32:07


Laparoscopic cholecystectomy was introduced approximately 30 years ago and quickly became the gold standard due to multiple benefits over open cholecystectomy. It ushered in the laparoscopic revolution but also increased the number of bile duct injuries. Through the dedicated efforts of many the rate of bile duct injury has been reduced, now mirroring open cholecystectomy. The robotic surgery revolution is well underway and unsurprisingly this technology has been applied to cholecystectomy. Given the devastating nature of bile duct injury and the history of increased injury with the last major shift in operative approach, we examine the current literature on the comparative safety of robotic-assisted cholecystectomy vs. laparoscopic cholecystectomy. 1.     Andrew Wright, UW Medical Center – Montlake and Northwest, @andrewswright  2.     Nick Cetrulo, UW Medical Center - Northwest, @Trules25  3.     Nicole White, UW Medical Center - Northwest  4.     Paul Herman, UW General Surgery Resident PGY-3, @paul_herm  5.     Ben Vierra, UW General Surgery Resident PGY-2 @benvierra95  Learning objectives:   1.     Examine the history of the laparoscopic cholecystectomy and review the efforts to reduce bile duct injury (SAGES Safe Cholecystectomy Task Force and Multi-Society Practice Guideline)  2.     Review literature on causes and prevention of bile duct injury  3.     Review a recent article on robotic cholecystectomy vs laparoscopic cholecystectomy outcomes  4.     Describe precautions that might mitigate expected increase in bile duct injury as a new approach is applied  References  1.     https://www.sages.org/publications/guidelines/safe-cholecystectomy-multi-society-practice-guideline/ 2.     https://www.sages.org/safe-cholecystectomy-program/  3.     MacFadyen BV Jr, Vecchio R, Ricardo AE, Mathis CR. Bile duct injury after laparoscopic cholecystectomy. The United States experience. Surg Endosc. 1998 Apr;12(4):315-21. doi: 10.1007/s004649900661. PMID: 9543520. https://pubmed.ncbi.nlm.nih.gov/9543520/ 4.     Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD006231. doi: 10.1002/14651858.CD006231. PMID: 17054285. https://pubmed.ncbi.nlm.nih.gov/17054285/ 5.     Way LW, Stewart L, Gantert W, Liu K, Lee CM, Whang K, Hunter JG. Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg. 2003 Apr;237(4):460-9. doi: 10.1097/01.SLA.0000060680.92690.E9. PMID: 12677139; PMCID: PMC1514483. https://pubmed.ncbi.nlm.nih.gov/12677139/ 6.     Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH. Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy. JAMA Surg. 2023;158(12):1303–1310. doi:10.1001/jamasurg.2023.4389 https://pubmed.ncbi.nlm.nih.gov/37728932/  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

The Skeptics Guide to Emergency Medicine
SGEM#441: Searching Searching for the best Clinical Decision Rule to Detect Pediatric C-Spine Injury

The Skeptics Guide to Emergency Medicine

Play Episode Listen Later Jun 1, 2024


Reference: Tavender E, et al. Triage tools for detecting cervical spine injury in paediatric trauma patients. Cochrane Database Syst Rev. 2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children's National Hospital and The George Washington School of Medicine […] The post SGEM#441: Searching Searching for the best Clinical Decision Rule to Detect Pediatric C-Spine Injury first appeared on The Skeptics Guide to Emergency Medicine.

Ta de Clinicagem
TdC Report: Profilaxia para Leptospirose

Ta de Clinicagem

Play Episode Listen Later May 14, 2024 11:07


Episódio sobre um tema importante após os eventos climáticos no Rio Grande do Sul. O que as sociedades dizem sobre profilaxia de leptospirose? Quais as evidências? Confira nesse episódio. Nota técnica (Indicações de quimioprofilaxia) SBI+Sociedade Gaúcha de Infectologia+Secretaria de Saúde do Rio Grande do Sul 07/05/24 ⁠⁠https://infectologia.org.br/wp-content/uploads/2024/05/NT_Quimioprofilaxia_Leptospirose_vRS_Serenita.pdf⁠⁠ Nota técnica (Critérios de alto risco) SBI+Sociedade Gaúcha de Infectologia+Secretaria de Saúde do Rio Grande do Sul 07/05/24 ⁠⁠https://infectologia.org.br/wp-content/uploads/2024/05/Esclarecimentos_NT_Quimioprofilaxia_Leptospirose-1.pdf⁠⁠ Nota técnica Ministério da Saúde 07/05/24 ⁠⁠https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/notas-tecnicas/2024/nota-tecnica-no-26-2024-cgzv-dedt-svsa-ms.pdf⁠⁠ Nota técnica ABRAMEDE 10/05/24 ⁠https://www.conferencebr.com/conteudo/arquivo/recomendacoes-leptospirose--abramede--02-1715386757.pdf⁠ Gonsalez CR, Casseb J, Monteiro FG, Paula-Neto JB, Fernandez RB, Silva MV, Camargo ED, Mairinque JM, Tavares LC. Use of doxycycline for leptospirosis after high-risk exposure in São Paulo, Brazil. Rev Inst Med Trop Sao Paulo. 1998 Jan-Feb;40(1):59-61. doi: 10.1590/s0036-46651998000100012. PMID: 9713140. Takafuji ET, Kirkpatrick JW, Miller RN, Karwacki JJ, Kelley PW, Gray MR, McNeill KM, Timboe HL, Kane RE, Sanchez JL. An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N Engl J Med. 1984 Feb 23;310(8):497-500. doi: 10.1056/NEJM198402233100805. PMID: 6363930. Alikhani A, Salehifar E, Zameni F, Rafiei A, Yazdani-Charati J, Delavaryan L, Akbari A, Babamahmoudi F. Comparison of azithromycin vs doxycycline prophylaxis in leptospirosis, A randomized double blind placebo-controlled trial. J Infect Dev Ctries. 2018 Nov 30;12(11):991-995. doi: 10.3855/jidc.10126. PMID: 32012129. Win TZ, Perinpanathan T, Mukadi P, Smith C, Edwards T, Han SM, Maung HT, Brett-Major DM, Lee N. Antibiotic prophylaxis for leptospirosis. Cochrane Database Syst Rev. 2024 Mar 14;3(3):CD014959. doi: 10.1002/14651858.CD014959.pub2. PMID: 38483067; PMCID: PMC10938880. Takafuji ET, Kirkpatrick JW, Miller RN, Karwacki JJ, Kelley PW, Gray MR, McNeill KM, Timboe HL, Kane RE, Sanchez JL. An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N Engl J Med. 1984 Feb 23;310(8):497-500. doi: 10.1056/NEJM198402233100805. PMID: 6363930. Illangasekera VL, Kularatne SA, Kumarasiri PV, Pussepitiya D, Premaratne MD. Is oral penicillin an effective chemoprophylaxis against leptospirosis? A placebo controlled field study in the Kandy District, Sri Lanka. Southeast Asian J Trop Med Public Health. 2008 Sep;39(5):882-4. PMID: 19058584.

MedLink Neurology Podcast
BrainWaves #152 It's not over yet…part 2: Post-publication peer-review

MedLink Neurology Podcast

Play Episode Listen Later May 10, 2024 20:30


MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021. Originally released: November 28, 2019 Peer review prior to publication of medical data dates back to the 9th century CE but has only really gained steam in the past 70 or 80 years. Ideally, peer review would serve as an initial filter for data that enter a permanent public scientific record. But peer review is not without flaws. In the second installment of the BrainWaves segment, “It's not over yet…,” we discuss publication as a potential source of bias and highlight the reasons why it should not be the final step of the peer review process. Produced by James E Siegler. Music courtesy of Cullah, Lee Rosevere, John Bartmann, Kevin McLeod, and Jon Watts. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast. REFERENCES Bingham C, van der Weyden MB. Peer review on the Internet: launching eMJA peer review study 2. Med J Aust 1998;169(5):240-1. PMID 9762058Godlee F, Gale CR, Martyn CN. Effect on the quality of peer review of blinding reviewers and asking them to sign their reports: a randomized controlled trial. JAMA 1998;280(3):237-40. PMID 9676667Haffar S, Bazerbachi F, Murad MH. Peer review bias: a critical review. Mayo Clin Proc 2019;94(4):670-6. PMID 30797567Jefferson T, Alderson P, Wager E, Davidoff F. Effects of editorial peer review: a systematic review. JAMA 2002;287(21):2784-6. PMID 12038911Jefferson T, Rudin M, Brodney Folse S, Davidoff F. Editorial peer review for improving the quality of reports of biomedical studies. Cochrane Database Syst Rev 2007;2007(2):MR000016. PMID 17443635Mandavilli A. Peer review: Trial by Twitter. Nature 2011;469(7330):286-7. PMID 21248816Ware M. Peer review: Benefits, perspectives, and alternatives. Publishing Research Consortium, 2008. We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Your Fertility Pharmacist
Letrozole vs. Clomiphene: the OG Study

Your Fertility Pharmacist

Play Episode Listen Later Apr 24, 2024 669:00


ResourcesBronson R. and Kruljac I, Butorac D, Vrkljan M. and Legro RS, Zhang H; Eunice Kennedy Shriver NICHD Reproductive Medicine Network. Letrozole or clomiphene for infertility in the polycystic ovary syndrome. N Engl J Med. 2014;371(15):1463-1464. doi:10.1056/NEJMc1409550Centers for Disease Control and Prevention. PCOS (Polycystic Ovary Syndrome) and Diabetes. https://www.cdc.gov/diabetes/basics/pcos.html. Accessed April 21, 2024.Franik S, Kremer JA, Nelen WL, Farquhar C. Aromatase inhibitors for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2014;(2):CD010287. Published 2014 Feb 24. doi:10.1002/14651858.CD010287.pub2Franik S, Le QK, Kremer JA, Kiesel L, Farquhar C. Aromatase inhibitors (letrozole) for ovulation induction in infertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2022;9(9):CD010287. Published 2022 Sep 27. doi:10.1002/14651858.CD010287.pub4Legro RS, Brzyski RG, Diamond MP, et al. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome [published correction appears in N Engl J Med. 2014 Oct 9;317(15):1465]. N Engl J Med. 2014;371(2):119-129. doi:10.1056/NEJMoa1313517Legro RS, Diamond MP, Coutifaris C, et al. Pregnancy registry: three-year follow-up of children conceived from letrozole, clomiphene, or gonadotropins. Fertil Steril. 2020;113(5):1005-1013. doi:10.1016/j.fertnstert.2019.12.023Palomba S, Santagni S, Falbo A, La Sala GB. Complications and challenges associated with polycystic ovary syndrome: current perspectives. Int J Womens Health. 2015;7:745-763https://doi.org/10.2147/IJWH.S70314World Health Organization. Polycystic Ovary Syndrome. World Health Organization; 2023. Accessed April 21, 2024. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndromeZhang H. Pregnancy in Polycystic Ovary Syndrome II (PPCOSII). ClinicalTrials.gov identifier: NCT00719186 . Updated June 14, 2018. Accessed April 20, 2020. https://classic.clinicaltrials.gov/ct2/show/NCT00719186

Frankly Speaking About Family Medicine
To Treat or Not to Treat: Do Antibiotics Make a Difference with OME? - Frankly Speaking Ep 377

Frankly Speaking About Family Medicine

Play Episode Listen Later Apr 23, 2024 10:45


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-377 Overview: Fluid in the middle ear, or otitis media with effusion (OME), is common in children with upper respiratory infections and typically resolves without treatment. Most guidelines do not recommend antibiotics for treatment; however, they are often prescribed, and the persistence of effusion can cause a significant impact on quality of life. Join us as we discuss recent review findings on antibiotics in OME treatment and the potential impact on your practice. Episode resource links: Mulvaney CA, Galbraith K, Webster KE, et al. Antibiotics for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2023;10(10):CD015254. Published 2023 Oct 23. doi:10.1002/14651858.CD015254.pub2 Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., Hoelting, D., Hunter, L. L., Kummer, A. W., Payne, S. C., Poe, D. S., Veling, M., Vila, P. M., Walsh, S. A., & Corrigan, M. D. (2016). Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 154(1 Suppl), S1–S41. https://doi.org/10.1177/0194599815623467 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

Pri-Med Podcasts
To Treat or Not to Treat: Do Antibiotics Make a Difference with OME? - Frankly Speaking Ep 377

Pri-Med Podcasts

Play Episode Listen Later Apr 23, 2024 10:45


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-377 Overview: Fluid in the middle ear, or otitis media with effusion (OME), is common in children with upper respiratory infections and typically resolves without treatment. Most guidelines do not recommend antibiotics for treatment; however, they are often prescribed, and the persistence of effusion can cause a significant impact on quality of life. Join us as we discuss recent review findings on antibiotics in OME treatment and the potential impact on your practice. Episode resource links: Mulvaney CA, Galbraith K, Webster KE, et al. Antibiotics for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2023;10(10):CD015254. Published 2023 Oct 23. doi:10.1002/14651858.CD015254.pub2 Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., Hoelting, D., Hunter, L. L., Kummer, A. W., Payne, S. C., Poe, D. S., Veling, M., Vila, P. M., Walsh, S. A., & Corrigan, M. D. (2016). Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 154(1 Suppl), S1–S41. https://doi.org/10.1177/0194599815623467 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

Crohn's Fitness Food
Dr. Natalie Scheeler: Naturopathic medicine, FMT, and Helminthic therapies (E97)

Crohn's Fitness Food

Play Episode Listen Later Apr 19, 2024 44:28


Dr. Natalie Scheeler, a naturopathic doctor specializing in integrative treatments for gastrointestinal conditions, shares her perspective and valuable insights on gut health. She discusses the difference between naturopathic doctors and traditional MDs, the use of fecal microbiota transplant (FMT) and Helminthic therapies in treating inflammatory bowel disease (IBD), the impact of food and probiotics on IBD, and trends in flare management and remission. Dr. Scheeler also provides information about her practice, Modrn Med, and offers a final message of hope and encouragement for patients seeking alternative or complementary treatment options. Takeaways Naturopathic doctors focus on preventative medicine and finding the root cause through a whole person approach using integrative treatments that can be used alongside conventional therapies. Fecal microbiota transplant (FMT) and Helminthic therapies are alternative treatments for IBD that show promise in inducing remission and maintaining gut health. Diet plays a significant role in creating a diverse microbiome. Modrn Med is an integrative and functional medicine practice that offers telehealth consultations and works in collaboration with other healthcare providers. There are other treatment options available for patients who have not found success with conventional therapies, and it is important to work with a knowledgeable practitioner to explore these options. Topics covered in the interview Difference Between Naturopathic Doctors (ND) and traditional doctors (MD or DO) Integrative Treatments for Gastrointestinal Conditions Fecal Microbiota Transplant (FMT) Impact of Food and Probiotics on IBD Trends in Flare Management and Remission Helminthic Therapies About Modrn Med From the show Stephanie: What are some of the trends that you've seen with helping people to get out of a flare and into remission? Dr. Scheeler: …the dietary aspect is a large trend I'm seeing I think, too, with social media. There's just the ability to spread so much information and so that is oftentimes how people coming into our office and have said, ‘I've tried these diets' or ‘I've done these diets' versus us kind of introducing them to that idea. So that's interesting. The other one is an herb called Qing Dai. It's a Chinese herb…which is an herb that can be really helpful for inducing remission, typically. We usually reserve it for remission induction versus maintenance therapy because there are some safety risks to that…I would always, always recommend working with a provider who's familiar with that herb…something that is important to say is that natural medicine isn't always safer, and it isn't always safe in general. There is risks associated with any treatments that you do. And so knowing those risks, having somebody who is familiar with those risks is important, especially if you are on the kind of quote-unquote conventional medications and add this stuff in, there could be interactions. Stephanie: Can you talk a little bit about the Modrn Med practice and what types of patients you see? Dr. Scheeler: Yeah, so ModernMed, we are a practice, we are all naturopathic doctors. There's four of us there. And we do integrative and functional medicine. A large part of our practice is gastrointestinal disease, including inflammatory bowel disease. I personally see patients exclusively via telehealth…but there is a location in LA, too, if people are interested. With that, since I do telehealth, I'm licensed in California, Arizona, Maryland, Vermont, and Connecticut, as of now. But all of us depending can either see you as patient if we're licensed in that state or do what we consider educational consults. So with patients who live out of state, we can share some of this information with you and help you do things safely or talk with your provider too…it's very common for us to work with other providers, especially myself working with gastroenterologists. I think when we all work as a team is when we get the best outcomes. And so patients, who may be in a state that we're not licensed in, we're comfortable talking to providers and usually there's no issues with that as long as we explain what we're doing. We always do evidence-based medicine. So as long as we share, even if they're not familiar with it off the bat, most people are open to working together and helping the patient out. Links and studies from the show Modern Med: https://www.modrnmed.com/dr-natalie-scheeler FMT for UC: Nishida A, Inoue R, Inatomi O, Bamba S, Naito Y, Andoh A. Gut microbiota in the pathogenesis of inflammatory bowel disease. Clin J Gastroenterol. 2018;11(1):1-10. doi:10.1007/s12328-017-0813-5 (PMID: 29285689)  FMT for CD: Zhou S, Cui Y, Zhang Y, Zhao T, Cong J. Fecal microbiota transplantation for induction of remission in Crohn's disease: a systematic review and meta-analysis. Int J Colorectal Dis. 2023;38(1):62. Published 2023 Mar 8. doi:10.1007/s00384-023-04354-4 (PMID: 36882658)  Helminthic Therapy in CD (Trichuris suis specific): Schölmerich J, Fellermann K, Seibold FW, et al. A Randomised, Double-blind, Placebo-controlled Trial of Trichuris suis ova in Active Crohn's Disease. J Crohns Colitis. 2017;11(4):390-399. doi:10.1093/ecco-jcc/jjw184 (PMID: 27707789)  Helminthic Therapy in CD (Trichuris suis specific):  Garg SK, Croft AM, Bager P. Helminth therapy (worms) for induction of remission in inflammatory bowel disease. Cochrane Database Syst Rev. 2014;2014(1):CD009400. Published 2014 Jan 20. doi:10.1002/14651858.CD009400.pub2 (PMID: 24442917)  Paper co-written by Dr. Scheeler on Qing Dai (Pronounced "Ching Dye") a.k.a. Indigo Naturalis: https://www.naturalmedicinejournal.com/journal/clinical-application-of-indigo-naturalis Support the podcast ❤️ at https://www.crohnsfitnessfood.com Get your copy of Crohn's Fitness Food and My Rocky Road to Health, Shop my favorite products, Read my favorite books, Subscribe to the podcast, Send a little love/coffee

Breakpoints
#94 – Lock, Stock, & Sterilize: Strategies to Optimize Antimicrobial Lock Therapy & Prevent/Treat Catheter-Related Bloodstream Infections

Breakpoints

Play Episode Listen Later Mar 22, 2024 65:25


It's time to arm yourselves with all the resources on antimicrobial locks! Join our experts, Drs. Louise-Marie Oleksiuk (@CanRowPharm), Nasia Safdar (@NasiaSafdar), Joel Topf (@kidney_boy), and our wonderful host, Dr. Julie Justo (@julie_justo), to discuss the ins and outs of antimicrobial locks and how to implement them! Funding for this podcast was provided by CorMedix Inc Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp References https://drive.google.com/file/d/1K0A4Bomhbcn7AZJ1JFOWW8EdEZq-aZcd/view?usp=sharing https://drive.google.com/file/d/1PRoQzEKJ1c0pa1XFc4yasxsMhx2A1DFU/view?usp=sharing Helpful antimicrobial lock review: Justo JA, Bookstaver PB. Infect Drug Resist. 2014 Dec 12;7:343-63. doi: 10.2147/IDR.S51388. PMID: 25548523. LOCK IT-100 Trial: Agarwal AK, et al. Clin J Am Soc Nephrol. 2023 Nov 1;18(11):1446-1455. doi: 10.2215/CJN.0000000000000278. PMID: 37678222. Cochrane review: Arechabala MC, et al. Cochrane Database Syst Rev. 2018 Apr 3;4(4):CD010597. doi: 10.1002/14651858.CD010597.pub2. PMID: 29611180. Cost-effectiveness of ethanol lock ppx with newer dehydrated alcohol product: Raghu VK, et al. JPEN J Parenter Enteral Nutr. 2022 Feb;46(2):324-329. doi: 10.1002/jpen.2130. PMID: 33908050. Antimicrobial lock development/implementation in a pediatric hospital: Zembles TN, et al. Am J Health Syst Pharm. 2018 Mar 1;75(5):299-303. doi: 10.2146/ajhp161056. PMID: 29472511. Dr. Topf's tweet surveying the prevalence of antimicrobial lock use in dialysis units CRBSIs in hemodialysis patients before and during the COVID-19 pandemic: Johansen KL, et al. Clin J Am Soc Nephrol. 2022 Mar;17(3):429-433. doi: 10.2215/CJN.11360821. PMID: 35110377. Antiseptic barrier caps review and meta-analysis: Gillis VELM, et al. Am J Infect Control. 2023 Jul;51(7):827-835. doi: 10.1016/j.ajic.2022.09.005. PMID: 36116679. Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

The Incubator
#183 - [Journal Club Shorts] -

The Incubator

Play Episode Listen Later Feb 11, 2024 5:04


Non-pharmacological interventions for the prevention of pain during endotracheal suctioning in ventilated neonates.Pirlotte S, Beeckman K, Ooms I, Cools F.Cochrane Database Syst Rev. 2024 Jan 18;1(1):CD013353. doi: 10.1002/14651858.CD013353.pub2.PMID: 38235838As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

The Incubator
  #175 - [Journal Club Shorts] -

The Incubator

Play Episode Listen Later Jan 14, 2024 3:28


Positioning for lumbar puncture in newborn infants. Pessano S, Bruschettini M, Prescott MG, Romantsik O.Cochrane Database Syst Rev. 2023 Dec 14;12(12):CD015592. doi: 10.1002/14651858.CD015592.pub3.PMID: 38096386 Review.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Psychiatry Boot Camp
Delirium

Psychiatry Boot Camp

Play Episode Listen Later Dec 3, 2023 106:07 Very Popular


Dr. Mark Oldham, Associate Professor of Psychiatry at University of Rochester Medical Center, President-Elect of the American Delirium Society, and Deputy Editor of the Journal of the Academy of Consultation-Liaison Psychiatry, takes us through a deep dive on delirium. This episode covers an enormous amount of material. Contrast  encephalopathy and delirium before diving into the dangerousness of delirium and prevention strategies. Explore the neurobiology of delirium and tie it to validated assessment tools and treatment approaches. We also discuss areas for future research, and learn to appreciate the evolutionary function that delirium serves.This episode also deserves some references! (3:38) Lipowski ZJ. Delirium: Acute Brain Failure in Man. Springfield, IL: Charles C Thomas, 1980.  (7:55) Slooter AJC, Otte WM, Devlin JW, et al. Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies. Intensive Care Med. 2020;46(5):1020-1022.  (21:46)  Marcantonio ER, Ngo LH, O'Connor M, et al. 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study [published correction appears in Ann Intern Med. 2014 Nov 18;161(10):764]. Ann Intern Med. 2014;161(8):554-561.   (29:50) Kunicki ZJ, Ngo LH, Marcantonio ER, et al. Six-Year Cognitive Trajectory in Older Adults Following Major Surgery and Delirium. JAMA Intern Med. 2023;183(5):442-450.   (41:40) Mews MR, Tauch D, Erdur H, Quante A. Comparing consultation-liaison psychiatrist's and neurologist's approaches to delirium - A retrospective analysis. Int J Psychiatry Med. 2016;51(3):284-301. = (1:08:08) Girard TD, Exline MC, Carson SS, et al. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. N Engl J Med. 2018;379(26):2506-2516.   (1:09:33) Hui D, Frisbee-Hume S, Wilson A, et al. Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. JAMA. 2017;318(11):1047-1056.   (1:31:36) By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081.  (1:33:54) Burton JK, Craig LE, Yong SQ, et al. Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2021;7(7):CD013307. Published 2021 Jul 19.   (1:35:41) Skrobik Y, Duprey MS, Hill NS, Devlin JW. Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial. Am J Respir Crit Care Med. 2018;197(9):1147-1156.   (1:36:00) Subramaniam B, Shankar P, Shaefi S, et al. Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial [published correction appears in JAMA. 2019 Jul 16;322(3):276]. JAMA. 2019;321(7):686-696. 

Dietetyka oparta na faktach
Zielona herbata (EGCG) na odchudzanie - krótko i na temat

Dietetyka oparta na faktach

Play Episode Listen Later Dec 2, 2023 6:05


Zielona herbata uchodzi często za produkt sprzyjający odchudzaniu. Wiele suplementów na odchudzanie zawiera ekstrakty z zielonej herbaty. Co w niej jest takiego co może pomagać w redukcji masy ciała? Czy picie zielonej herbaty lub przyjmowanie suplementów z EGCG jest skuteczne? A jeśli tak to w jakich dawkach? __

MedLink Neurology Podcast
BrainWaves #55 The sickle cell-stroke connection

MedLink Neurology Podcast

Play Episode Listen Later Nov 20, 2023 17:44


MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 If you have sickle cell disease, you have a 1 in 10 chance of experiencing a stroke before college. And if you don't think that's going to hold you back, you don't know stroke. This week on BrainWaves, Dr. Erica Jones shares her experience with the neurologic complications of sickle cell anemia and the latest guidelines for managing patients with this condition. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. REFERENCES Bang OY, Fujimura M, Kim SK. The pathophysiology of Moyamoya disease: an update. J Stroke 2016;18(1):12-20. PMID 26846756“Data & Statistics." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/datastatistics/index.html. 2016.Gueguen A, Mahevas M, Nzouakou R, et al. Sickle-cell disease stroke throughout life: a retrospective study in an adult referral center. Am J Hematol 2014;89(3):267-72. PMID 24779035Lionnet F, Hammoudi N, Stojanovic KS, et al. Hemoglobin sickle cell disease complications: a clinical study of 179 cases. Haematologica 2012;97(8):1136-41. PMID 22315500Motulsky AG. Frequency of sickling disorders in U.S. blacks. N Engl J Med 1973;288(1):31-3. PMID 4681897Ohene-Frempong K, Weiner SJ, Sleeper LA, et al. Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood 1998;91(1):288-94. PMID 9414296Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med 2009;360(12):1226-37. PMID 19297575Strouse JJ, Lanzkron S, Urrutia V. The epidemiology, evaluation and treatment of stroke in adults with sickle cell disease. Expert Rev Hematol 2011;4(6):597-606. PMID 22077524Switzer JA, Hess DC, Nichols FT, Adams RJ. Pathophysiology and treatment of stroke in sickle-cell disease: present and future. Lancet Neurol 2006;5(6):501-12. PMID 16713922Verduzco LA, Nathan DG. Sickle cell disease and stroke. Blood 2009;114(25):5117-25. PMID 19797523Wang WC, Dwan K. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease. Cochrane Database Syst Rev 2013;(11):CD003146. PMID 24226646Ware RE, Helms RW; SWiTCH Investigators. Stroke With Transfusions Changing to Hydroxyurea (SWiTCH). Blood 2012;119(17):3925-32. PMID 22318199 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast
BrainWaves #50 The large vessel is the best vessel

MedLink Neurology Podcast

Play Episode Listen Later Nov 7, 2023 20:11


MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 I can't imagine a better way to celebrate our FIFTIETH episode than to discuss my favorite subject: large vessel disease. Although we only cover one aspect of this stroke mechanism--atherosclerosis--and technically many of these trials may be somewhat outdated, the matter discussed in this episode remains the most up-to-date in the field. Take a listen. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. REFERENCES Chambers BR, Donnan GA. Carotid endarterectomy for asymptomatic carotid stenosis. Cochrane Database Syst Rev 2005;2005(4):CD001923. PMID 16235289Chaturvedi S, Bruno A, Feasby T, et al. Carotid endarterectomy--an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2005;65(6):794-801. PMID 16186516Hosseini AA, Kandiyil N, Macsweeney ST, Altaf N, Auer DP. Carotid plaque hemorrhage on magnetic resonance imaging strongly predicts recurrent ischemia and stroke. Ann Neurol 2013;73(6):774-84. PMID 23463579Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44(3):870-947. PMID 23370205Kakkos SK, Nicolaides AN, Charalambous I, et al. Predictors and clinical significance of progression or regression of asymptomatic carotid stenosis. J Vasc Surg 2014;59(4):956-967.e1. PMID 24377944Lovett JK, Coull AJ, Rothwell PM. Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies. Neurology 2004;62(4):569-73. PMID 14981172Mantese VA, Timaran CH, Chiu D, Begg RJ, Brott TG; CREST Investigators. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke 2010;41(10 Suppl):S31-4. PMID 20876500Rothwell PM, Eliasziw M, Gutnikov SA, et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet 2003;361(9352):107-16. PMID 12531577 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Evidence Based Birth®
EBB 287 - A Positive Hospital Waterbirth Story with EBB Childbirth Class Graduate, Katrina Hull

Evidence Based Birth®

Play Episode Listen Later Oct 18, 2023 66:36


Content Warning: postpartum hemorrhage, GBS Positive, antibiotics for GBS,   On this episode of the EBB podcast, I talk with Katrina Hull, a graduate of the EBB childbirth class about her positive hospital water birth story.   Katrina Hull is a former high school math and engineering teacher with over a decade of experience in the classroom. Her passion for education and entrepreneurship has led her to her current role as coordinating producer at PBS NewsHour Classroom where she develops lesson materials and resources for integrating invention education into classrooms across the country.   Katrina shares her experiences taking the EBB childbirth class and discusses in depth the education and work she put into preparing for her desired hospital water birth. In addition to finding her “Golden Ticket” birth team and desired location, she shares the details of her amazing and empowering birth story, despite having a few complications, including finding out she was Group B Strep Positive and handling a postpartum hemorrhage.   Resources: Learn more about Marnellie Bishop's Evidence Based Birth® Childbirth Class here Learn more about the GentleBirth Pregnancy app here Read more about Rebecca's experience with Hypnobabies in Babies are Not Pizza's Learn more about the Evidence on Hypnosis for Pain Management here Learn more about the Evidence on water immersion for Pain Management here Learn about the research evidence on combining hypnosis and water immersion for pain: Madden, K., Middleton, P., Cyna, A. M., et al. (2016). Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev(5), CD009356. Listen to Evidence Based Birth Podcasts: EBB 131: Evidence on: Pitocin During the 3rd Stage of Labor or read the Signature Article here https://evidencebasedbirth.com/evidence-on-pitocin-during-the-third-stage-of-labor/ EBB 267: Debunking Myths about Fundal Massage with Barbie Christianson, RN   Learn more about joining our Pro Membership for birth workers here, to take take our class on emergency management of PPH

MedLink Neurology Podcast
BrainWaves #10 Cryptogenic stroke: 2019 update

MedLink Neurology Podcast

Play Episode Listen Later Oct 13, 2023 23:35


MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.Originally released: December 5, 2019In 2016, when we first launched the BrainWaves podcast, cryptogenic stroke was a poorly understood concept. Three years later, it remains poorly understood. But we are making progress. In this week's update of episode 10, we review the progress that has been made in the pathogenesis, diagnosis, and management of these patients.Produced by James E Siegler. The original 2016 version of this show was also produced by Dr. Noah Levinson. Music courtesy of Josh Woodward, Julie Maxwell, Dan Lebowitz, and this group called E's Jammy Jams. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWavesaudio for the latest updates to the podcast.REFERENCESDi Tullio M, Sacco RL, Gopal A, Mohr JP, Homma S. Patent foramen ovale as a risk factor for cryptogenic stroke. Ann Intern Med 1992;117(6):461-5. PMID 1503349Diener HC, Sacco RL, Easton JD, et al. Dabigatran for prevention of stroke after embolic stroke of undetermined source. N Engl J Med 2019;380(20):1906-17. PMID 31091372Fonseca AC, Ferro JM. Drug abuse and stroke. Curr Neurol Neurosci Rep 2013;13(2):325. PMID 23299821Hart RG, Sharma M, Mundl H, et al. Rivaroxaban for stroke prevention after embolic stroke of undetermined source. N Engl J Med 2018;378(23):2191-201. PMID 29766772Jacobs BS, Boden-Albala B, Lin IF, Sacco RL. Stroke in the young in the northern Manhattan stroke study. Stroke 2002;33(12):2789-93. PMID 12468771Juul K, Tybjaerg-Hansen A, Steffensen R, Kofoed S, Jensen G, Nordestgaard BG. Factor V Leiden: The Copenhagen City Heart Study and 2 meta-analyses. Blood 2002;100(1):3-10. PMID 12070000Kaku DA, Lowenstein DH. Emergence of recreational drug abuse as a major risk factor for stroke in young adults. Ann Intern Med 1990;113(11):821-7. PMID 2240897Li J, Liu J, Liu M, et al. Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack. Cochrane Database Syst Rev 2015;2015(9):CD009938. PMID 26346232Mas JL, Derumeaux G, Guillon B, et al. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med 2017;377(11):1011-21. PMID 28902593Overell JR, Bone I, Lees KR. Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies. Neurology 2000;55(8):1172-9. PMID 11071496Perera KS, Ng KK, Nayar S, et al. Association between low-dose rivaroxaban with or without aspirin and ischemic stroke subtypes: a secondary analysis of the COMPASS Trial. JAMA Neurol 2020;77(1):43-8. PMID 31524941Saver JL, Carroll JD, Thaler DE, et al. Long-term outcomes of patent foramen ovale closure or medical thera

PsychEd: educational psychiatry podcast
PsychEd Episode 58: Depression in Children and Adolescents with Dr. Darren Courtney

PsychEd: educational psychiatry podcast

Play Episode Listen Later Oct 1, 2023 57:16


Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers depression in children and adolescents with Dr. Darren Courtney, a scientist with the Cundill Centre for Child and Youth Depression and the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and a staff psychiatrist in the Youth Addictions and Concurrent Disorders Service at the Centre for Addiction and Mental Health (CAMH) in Toronto. He is also an associate professor in the Department of Psychiatry at the University of Toronto.   Dr. Courtney earned his MD in 2004 at Queen's University and completed psychiatry residency in 2009 at the University of Ottawa. He was the clinical director of the Youth Inpatient Unit at the Royal Ottawa Mental Health Centre from 2009 to 2014 and moved to Toronto in 2014, where he worked on the Concurrent Youth Inpatient Unit at the Centre for Addiction and Mental Health until 2017 and where his clinical work with concurrent disorders continues now with outpatient youth.   Dr. Courtney's research focus is on the treatment of adolescent depression through the use of an integrated care pathway — a collaboratively developed treatment algorithm based on high-quality clinical practice guidelines. Through his research, he works on identifying quality practice guidelines and corresponding multi-disciplinary care pathways to facilitate evidence-based and measurement-based care for adolescents with depression. He has also participated in a systematic review and quality appraisal of clinical practice guidelines for psychiatric disorders in children and adolescents. Additionally, he has an interest in the management of concurrent disorders, where young people are affected by both primary psychiatric disorders and substance use disorders.   The learning objectives for this episode are as follows:   By the end of this episode, you should be able to… Outline the prevalence and risk factors for depression in children and adolescents Explain how children and adolescents with depression present in clinical practice Discuss the use of screening tools for depression in this population Describe an approach to the management of depression in children and adolescents Outline the management of an adolescent with suicidal thoughts or behaviours   Guest: Dr. Darren Courtney Hosts: Kate Braithwaite (MD) and Nikhita Singhal (PGY5) Audio editing by: Nikhita Singhal Show notes by: Kate Braithwaite and Nikhita Singhal   Interview Content: Introduction - 0:00 Learning objectives - 02:11 Prevalence of depression in youth - 03:11 Risk factors for depression in youth - 06:25 Diagnosing depression in youth - 08:30 Screening tools - 14:24 Approach to taking a history from youth - 19:45 Management of depression in youth - 30:12 Psychotherapies - 33:20 Medications - 37:37 Assessing and managing suicidality in youth - 44:00 Measurement based care - 51:00 Final thoughts - 55:10   Resources: Previous PsychEd episodes: PsychEd Episode 1: Diagnosis of Depression with Dr. Ilana Shawn PsychEd Episode 2: Treatment of Depression with Dr. Sidney Kennedy PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer ICHOM Set of Patient-Centered Outcome Measures for Children & Young People with Depression & Anxiety Screening tools/rating scales: Revised Children's Anxiety and Depression Scale (RCADS) Mood and Feelings Questionnaire (MFQ) NICE guideline: Depression in children and young people: identification and management NICE guideline: Self-harm: assessment, management and preventing recurrence The CARIBOU Pathway by CAMH: A youth-centered program for the treatment of depression Includes links to download free clinician-specific and youth-specific resources co-developed with youth and mental health clinicians Clinical Innovations and Tools | Cundill Centre for Child and Youth Depression | CAMH Includes links to various tools for health care providers, researchers, youth, and other stakeholders (such as teachers and family members) informed by research evidence   References: Bennett K, Courtney D, Duda S, Henderson J, Szatmari P. An appraisal of the trustworthiness of practice guidelines for depression and anxiety in children and youth. Depress Anxiety. 2018 Jun;35(6):530-540. https://doi.org/10.1002/da.22752 Courtney D, Bennett K, Henderson J, Darnay K, Battaglia M, Strauss J, Watson P, Szatmari P. A Way through the woods: Development of an integrated care pathway for adolescents with depression. Early Interv Psychiatry. 2020 Aug;14(4):486-494. https://doi.org/10.1111/eip.12918 Georgiades K, Duncan L, Wang L, Comeau J, Boyle MH; 2014 Ontario Child Health Study Team. Six-Month Prevalence of Mental Disorders and Service Contacts among Children and Youth in Ontario: Evidence from the 2014 Ontario Child Health Study. Can J Psychiatry. 2019 Apr;64(4):246-255. https://doi.org/10.1177%2F0706743719830024 Goodyer IM, Reynolds S, Barrett B, Byford S, Dubicka B, Hill J, Holland F, Kelvin R, Midgley N, Roberts C, Senior R, Target M, Widmer B, Wilkinson P, Fonagy P. Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial. Health Technol Assess. 2017 Mar;21(12):1-94. https://doi.org/10.3310/hta21120 Hetrick SE, McKenzie JE, Bailey AP, Sharma V, Moller CI, Badcock PB, Cox GR, Merry SN, Meader N. New generation antidepressants for depression in children and adolescents: a network meta-analysis. Cochrane Database Syst Rev. 2021 May 24;5(5):CD013674. https://doi.org/10.1002/14651858.CD013674.pub2 MacQueen GM, Frey BN, Ismail Z, Jaworska N, Steiner M, Lieshout RJ, Kennedy SH, Lam RW, Milev RV, Parikh SV, Ravindran AV; CANMAT Depression Work Group. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly. Can J Psychiatry. 2016 Sep;61(9):588-603. https://doi.org/10.1177%2F0706743716659276 National Institute for Health and Care Excellence. Depression in children and young people: Identification and management NG134 [Internet]. London: NICE; 2019 Jun 25 [cited 2023 Sep 22]. Available from: https://www.nice.org.uk/guidance/ng134. Parikh A, Fristad MA, Axelson D, Krishna R. Evidence Base for Measurement-Based Care in Child and Adolescent Psychiatry. Child Adolesc Psychiatr Clin N Am. 2020 Oct;29(4):587-599. https://doi.org/10.1016/j.chc.2020.06.001 Walter HJ, Abright AR, Bukstein OG, Diamond J, Keable H, Ripperger-Suhler J, Rockhill C. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders. J Am Acad Child Adolesc Psychiatry. 2023 May;62(5):479-502. https://doi.org/10.1016/j.jaac.2022.10.001 Wiens K, Bhattarai A, Pedram P, Dores A, Williams J, Bulloch A, Patten S. A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018. Epidemiol Psychiatr Sci. 2020 Apr 17;29:e115. https://doi.org/10.1017%2FS2045796020000281 World Health Organization. Mental health of adolescents [Internet]. 2021 [cited 2023 Sep 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health   CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

The Critical Care Triad - The Ventilator Podcast
Episode #11 - Case Study: The Asthmatic Patient

The Critical Care Triad - The Ventilator Podcast

Play Episode Play 19 sec Highlight Listen Later Aug 21, 2023 55:25


In this episode we discuss a case scenario of Asthma exacerbation. This can be one of the most challenging patients to manage on the ventilator. If at all possible we try not to intubate these patients, however there are times when this happens. We will discuss clinical treatment, ventilator management, and what our rolls are as transport clinicians in the transport of these patients. References: 1) National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on September 19, 2018).2) McFadden ER Jr, Lyons HA. Arterial-blood gas tension in asthma. N Engl J Med. 1968 May 9;278(19):1027-32. doi: 10.1056/NEJM196805092781901. PMID: 5644962.3) Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. www.ginasthma.org (Accessed on February 13, 2022)4) National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on September 19, 2018).5) Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev. 2001;(1):CD002178. doi: 10.1002/14651858.CD002178. PMID: 11279756.6) Menzies-Gow A, Busse WW, Castro M, Jackson DJ. Prevention and Treatment of Asthma Exacerbations in Adults. J Allergy Clin Immunol Pract. 2021 Jul;9(7):2578-2586. doi: 10.1016/j.jaip.2021.05.016. PMID: 34246434.7) Nanchal R, Kumar G, Majumdar T, et al. Utilization of mechanical ventilation for asthma exacerbations: analysis of a national database. Respir Care 2014; 59:644.

Depth of Anesthesia
35. Does spinal anesthesia decrease the risk of postoperative delirium?

Depth of Anesthesia

Play Episode Listen Later Jul 30, 2023 58:07


Dr. Mark Neuman and Dr. Sam Falkson join the show to discuss the literature around risks of regional versus general anesthesia for postoperative delirium. Dr. Neuman is the founding Director of the Center for Perioperative Outcomes Research and Transformation and Professor of Anesthesiology at Penn Medicine. Dr. Sam Falkson is an anesthesia resident at the Massachusetts General Hospital. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your colleagues. — Follow us on Instagram @DepthofAnesthesia and on Twitter (X) @DepthAnesthesia for podcast and literature updates. Email us at depthofanesthesia@gmail.com with episode ideas or if you'd like to join our team. Music by Stephen Campbell, MD. — References Guay J, Parker MJ, Gajendragadkar PR, Kopp S. Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2016;2(2):CD000521. Ravi B, Pincus D, Choi S, Jenkinson R, Wasserstein DN, Redelmeier DA. Association of duration of surgery with postoperative delirium among patients receiving hip fracture repair. JAMA Netw Open. 2019;2(2):e190111. Patel V, Champaneria R, Dretzke J, Yeung J. Effect of regional versus general anaesthesia on postoperative delirium in elderly patients undergoing surgery for hip fracture: a systematic review. BMJ Open. 2018;8(12):e020757. Zheng X, Tan Y, Gao Y, Liu Z. Comparative efficacy of Neuraxial and general anesthesia for hip fracture surgery: a meta-analysis of randomized clinical trials. BMC Anesthesiol. 2020 Jun 30;20(1):162. Neuman MD, Feng R, Carson JL, et al. Spinal anesthesia or general anesthesia for hip surgery in older adults. N Engl J Med. 2021;385(22):2025-2035. Rathmell JP, Avidan MS. Patient-centered outcomes after general and spinal anesthesia. N Engl J Med. 2021 Nov 25;385(22):2088–9. Stone AB, Poeran J, Memtsoudis SG. There remains a role for neuraxial anesthesia for hip fracture surgery in the post-REGAIN era. Reg Anesth Pain Med. 2023 Aug;48(8):430-432. doi: 10.1136/rapm-2022-104071. Epub 2023 Mar 28. PMID: 36977527. Li T, Li J, Yuan L, et al. Effect of regional vs general anesthesia on incidence of postoperative delirium in older patients undergoing hip fracture surgery: the raga randomized trial. JAMA. 2022;327(1):50-58.

Evidence Based Birth®
Replay - EBB 166 The Experience of a Powerful and Miraculous Birth with Brooklynn and Hoang Pham

Evidence Based Birth®

Play Episode Listen Later Jan 18, 2023 58:34


Today, I am excited to share a replay of one of my favorite birth stories featured on the Evidence Based Birth® podcast. EBB childbirth class graduates, Brooklyn and Hoang Pham, share their power and miraculous birth story, which became an instant classic and truly touched my heart.   As a content warning, we talk about the significantly high rates of maternal mortality among Black and Brown individuals and racism in birth work.  On today's podcast, we will be talking with Brooklynn and Hoang Pham. Brooklynn and Hoang currently live in Davis, California, and are the parents to Marvel, who turned seven months last December. Brooklynn is the senior managing director of Teach For America in Sacramento, and Hoang is finishing up his final year of law school at UC Davis School of Law. They took the Evidence Based Birth® Childbirth class with EBB instructor, Shalin Butterworth, and are here to share their birth story. We will talk about Brooklynn's and Hoang's empowering experience when they attended the Evidence Based Birth® Childbirth class and how it prepared them to feel ready for their powerful and miraculous birth with their doula and EBB instructor, Shalin.  Resources:  Sign up for the EBB Newsletter here.  Learn more about the EBB Instructor program here and find an instructor or course here.  Hoang and Brooklyn's YouTube: https://www.youtube.com/channel/UCOBNp5cuEQpBDY3-3Bnl6eQ/ Instagram: @_hoangpham Twitter: @_hoangpham Birthplace Lab: You can explore the maps at https://www.birthplacelab.org/maps/. There is a How To video with tips on using the interactive maps: https://www.birthplacelab.org/how-to-explore-the-maps/. Visit BirthPlaceLab.org to learn about your state's score! Research References: Balde, M. D., Nasiri, K., Mehrtash, H., et al. (2020). Labour companionship and women's experiences of mistreatment during childbirth: results from a multi-country community-based survey. BMJ Glob Health. 2020 Nov;5(Suppl 2):e003564. Click here.   Bohren, M. A., Berger, B. O., Munthe-Kaas, H., et al. (2019). Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2019, Issue 3. Art. No.: CD012449. Click here.   Bohren, M. A., Hofmeyr, G. J., Sakala, C., et al. (2017). Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017 Jul 6;7(7):CD003766. Click here.   Vedam, S., Stoll, K., MacDorman, M., et al. (2018). Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLoS One. 2018 Feb 21;13(2):e0192523. Click here. Go to our YouTube channel to see video versions of the episode listed above!! For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on:  TikTok Instagram Pinterest Ready to get involved?  Check out our Professional membership (including scholarship options) here  Find an EBB Instructor here  Click here to learn more about the Evidence Based Birth® Childbirth Class.