Podcasts about complications

Erika and Kristen react to one of the most harrowing posts from the r/regretfulparents subreddit — a woman's decade-long battle with serious birth injury damage after a midwife failed to suture a second-degree tear, leaving her with permanent physical damage, no sensation during sex, and a medical system that keeps turning her away.This one is NOT for the faint of heart. (You've been warned.

Gat the free guided meditations that I reference at exploreifs.comThe episode addresses the intersection of internal family systems (IFS) with racism, harm, and human dignity. It emphasizes the importance of welcoming all parts while confronting harmful behavior, opposing harmful systems without dehumanization, and the role of self-leadership in healing. The nuanced and uncomfortable work of holding all these aspects together is highlighted.TakeawaysWelcoming all parts while confronting harmful behaviorOpposing harmful systems without dehumanizationChapters00:00 Addressing Important Matters06:16 Welcoming All Parts, Confronting Harmful Behavior14:00 Ongoing Self-Examination and Complications

Voting rights advocates say a bill to overhaul elections could disenfranchise millions of Americans, especially Native American and other minority voters.  Among other things, the SAVE Act requires all voters to prove their U.S. citizenship, either with a passport or a birth certificate. Numerous studies show Native Americans are less likely to have a valid passport or other documents readily available that prove their place of birth than other groups. It would have major implications for mail-in ballots. The bill passed the House. President Donald Trump added new pressure on members of his own party in the Senate, saying he will not sign any other legislation until the SAVE Act clears Congress. We'll find out the details of the legislation and look ahead to how this and other measures might complicate the Midterm Elections. Allison Renville (Photo: video screen capture) We'll also hear from Allison Renville (Sisseton-Wahpeton Dakota) about her decision to suspend her campaign for governor of South Dakota. Renville was running as an independent voice in the state that also elected Kristi Noem as governor. She cites the enormous cost of running a major campaign as a deterrent to welcoming diverse political voices. GUESTS Jacqueline De León (Isleta Pueblo), senior staff attorney for the Native American Rights Fund Lenny Fineday (Leech Lake Band of Ojibwe), general counsel for the National Congress of American Indians Jaynie Parrish (Diné), executive director and founder of Arizona Native Vote Allison Renville (Sisseton and Hunkpapa Lakota and Omaha and Haudenosaunee), activist and political strategist

Voting rights advocates say a bill to overhaul elections could disenfranchise millions of Americans, especially Native American and other minority voters.  Among other things, the SAVE Act requires all voters to prove their U.S. citizenship, either with a passport or a birth certificate. Numerous studies show Native Americans are less likely to have a valid passport or other documents readily available that prove their place of birth than other groups. It would have major implications for mail-in ballots. The bill passed the House. President Donald Trump added new pressure on members of his own party in the Senate, saying he will not sign any other legislation until the SAVE Act clears Congress. We'll find out the details of the legislation and look ahead to how this and other measures might complicate the Midterm Elections. Allison Renville (Photo: video screen capture) We'll also hear from Allison Renville (Sisseton-Wahpeton Dakota) about her decision to suspend her campaign for governor of South Dakota. Renville was running as an independent voice in the state that also elected Kristi Noem as governor. She cites the enormous cost of running a major campaign as a deterrent to welcoming diverse political voices. GUESTS Jacqueline De León (Isleta Pueblo), senior staff attorney for the Native American Rights Fund Lenny Fineday (Leech Lake Band of Ojibwe), general counsel for the National Congress of American Indians Jaynie Parrish (Diné), executive director and founder of Arizona Native Vote Allison Renville (Sisseton and Hunkpapa Lakota and Omaha and Haudenosaunee), activist and political strategist

The Operation of the Century - Why Total Hip Replacement Keeps Getting Better Interview with Adolph V. Lombardi, Jr., MD, FACS who has performed 38,000+ joint replacements. Topics discussed: Why total hip replacement is considered the “operation of the century” (as described in The Lancet); Modern hips use cementless fixation, advanced ceramics, and highly cross-linked polyethylene, dramatically improving durability to 25–30+ years (or more); Complications like infection, fracture, and dislocation are rare (~1%) and aggressively addressed through patient optimization and surgical advances. Timing now depends on symptoms and quality of life, not just X-rays or age. Emerging innovations, including AI-guided robotics and a promising “reverse hip” design, aim to further improve stability and outcomes. Link to sign up to learn more or enter the ongoing Clinical Trial for this new Technology (https://hipinnovationtechnology.com/) To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Episode 215: Meth-associated HFrEF.   Abishak and Zat (medical students) explain the cardiotoxic effect of methamphetamine and the diagnosis and treatment of heart failure with reduced ejection fraction (HFrEF). Dr. Arreaza adds insight into the reversibility of meth-associated HFrEF.   Written by Abishak Govindarajan, MSIV and Zat Akbar Shaw. American University of the Caribbean. Edits and comments by Hector Arreaza, MD. Welcome Dr. Arreaza: Welcome to Rio Bravo qWeek. My name is Hector Arreaza, family physician, faculty and associate program director of the Clinica Sierra Vista/Rio Bravo Family Medicine Residency Program. Today we will explore heart failure with reduced ejection fraction, a high-yield and clinically relevant topic in medicine. We will discuss the role of methamphetamine use in the development of HFrEF. This is a pressing issue because about 0.8% of the population 12 and older in the US reported using methamphetamine within the past 12 months in 2024 (National Survey on Drug Use and Health, NSDUH), that's about ≈2.4 million people!We are joined by two aspiring physicians who will help explore this topic. By the way, we will refer to methamphetamine in this episode as “meth”. [Abishak and Akbar introduce themselves] Abishak: [Introduce yourself] The role of meth in HFrEF Dr. Arreaza: Meth is a growing problem in many places, including Bakersfield, where we live. Meth is also known as Meth Crystal, Poor man's cocaine, Ice, Glass, Crank, Speed, Chalk, and Tina. How does meth contribute to the development of HFrEF? Abishak: So, first, let's understand how methamphetamine works. It has a chemical structure similar to dopamine and norepinephrine, and it gets taken up through the neuron transporter proteins. Once it enters the synaptic vesicles (storage sacs for neurotransmitters), it displaces and forces the release of large amounts of dopamine, norepinephrine, and serotonin into the synapse (the space between neurons). Additionally, meth blocks the reuptake of those neurotransmitters into the neuron, ensuring they remain in the synapse for a prolonged period. All this causes a downstream effect of increased sympathetic pathways in the body. Diagnosis Dr. Arreaza: The diagnosis starts with collecting a good history and performing a complete physical exam, and then we confirm with an echocardiogram.  Abishak: Yes, diagnosis requires both symptoms consistent with heart failure and objective evidence of reduced ejection fraction. Echocardiography is the primary diagnostic tool. We also measure BNP. In certain cases, cardiac MRI is used to evaluate myocardial fibrosis and exclude infiltrative or inflammatory etiologies. Coronary angiography may be performed if ischemic disease is suspected.Guideline-Directed Medical Therapy Dr. Arreaza: GDMT Guideline-Directed Medical Therapy started around 1987 when ACE inhibitors were proven to improve mortality in patients with heart failure. Then, during the following decades, many medications have been added to GDMT. Until around 2019–2022 we came out with the main 4 groups of medications that we know as GDMT. Let's talk about GDMT. Akbar: There are four core pillars in GDMT. First, an angiotensin receptor-neprilysin inhibitor, such as sacubitril with valsartan (Entresto), is preferred over ACE inhibitors when tolerated. This medication reduces mortality and heart failure hospitalizations. Second, evidence-based beta blockers including carvedilol, metoprolol succinate, or bisoprolol are used to reduce sympathetic overactivity and improve ventricular remodeling. Third, mineralocorticoid receptor antagonists such as spironolactone or eplerenone reduce fibrosis and improve survival. The Fourth pillar is SGLT2 inhibitors such as dapagliflozin or empagliflozin, which provide significant reductions in heart failure hospitalizations and cardiovascular mortality, regardless of diabetes status. Abishak: Other main parts of the treatment are diuretics, which are used for symptom control but do not reduce long-term mortality. Dr. Arreaza: As a recap: The current 4 pillars of GDMT are: ARNI/ACEi + β-blocker + MRA + SGLT2i)  Beta Blocker Considerations Dr. Arreaza: Sometimes we may be concerned about using beta blockers in active meth users. What did you read about it? Abishak: Historically, there was concern about unopposed alpha stimulation. However, in chronic heart failure, beta blockers remain essential. Carvedilol is often favored because it provides both alpha and beta blockade. Careful titration and close monitoring are critical.Reversibility and Remodeling Dr. Arreaza: Regarding meth-associated HFrEF, we have good news for meth users. Tell us about how reversible this condition is.  Akbar: It can be reversible. One of the most important aspects of this condition is that significant reverse remodeling may occur if the patient stops methamphetamine use and adheres to medical therapy. The Left ventricular ejection fraction can improve substantially and, in some cases, normalize. On the other end of the spectrum, continued meth use may lead to progressive fibrosis, ventricular dilation, and potentially irreversible damage, leading to death.Complications of meth-associated HFrEF Abishak: These patients are at increased risk for ventricular arrhythmias, sudden cardiac death, left ventricular thrombus formation, and progressive pulmonary hypertension. If the ejection fraction remains below 35 percent after at least three months of optimized therapy, implantable cardioverter-defibrillator (known as ICD) placement should be considered for primary prevention.Addiction Treatment as Core Therapy Dr. Arreaza: It sounds like GDMT cannot be done without talking about meth use disorder treatment. Akbar: Absolutely. Treating the myocardium without addressing the substance use disorder is ineffective. Primary care providers can be trained to manage addictions, but if resources are available, you can place a referral to addiction medicine, psychiatric support, behavioral therapy, and social support services. This is an essential part of the treatment. Sustained abstinence is the single most powerful predictor of recovery.Prognosis Abishak: Prognosis is highly dependent on abstinence. Patients who stop using methamphetamine often experience meaningful improvement in EF and even return to normal.  Dr. Arreaza: Yes, the key factor is complete abstinence, plus standard heart failure treatment. If the damage is mostly functional and inflammatory, recovery is possible. If there is extensive fibrosis (scar) recovery is less likely. Observational studies have shown that patients with meth-associated cardiomyopathy who stop using meth have significant improvement in EF over 3–12 months, fewer hospitalizations, and lower mortality. Akbar: Absolutely. Not all meth-associated cardiomyopathy behaves the same way. The extent of fibrosis determines recovery potential. Cardiac MRI with late gadolinium enhancement can help us estimate scar burden. Patients with minimal fibrosis often have better improvement with abstinence and medical therapy. Dr. Arreaza: So, MRI can actually help us determine the prognosis. Abishak: Yes, very much so. If MRI shows extensive fibrosis, the likelihood of full EF recovery is lower. That information helps us counsel patients more accurately. Akbar: Another key issue is right ventricular involvement. Methamphetamine can affect both ventricles. When the right ventricle fails, patients may develop severe peripheral edema, ascites, and hepatic congestion. Right ventricular dysfunction also worsens prognosis significantly. Dr. Arreaza: And pulmonary hypertension can also worsen the whole picture.  Akbar: That's correct. Meth is associated with pulmonary arterial hypertension independently of left-sided heart failure. In some patients, you may see a combined picture of both pulmonary vascular disease and right ventricular dysfunction. That can make management more complicated because pulmonary pressures may remain elevated even after EF improves. Dr. Arreaza: Tells us about the role of BNP in monitoring these patients.  Abishak: Serial BNP levels can help track response to therapy. Additionally, troponin may be elevated at times in meth users due to myocardial injury. Monitoring renal function is critical because many heart failure medications affect kidney function and potassium levels. Akbar:Other lifestyle modifications include sodium restriction, regular follow-ups, vaccination, and avoidance of other cardiotoxic substances such as alcohol or cocaine. Sleep disorders, especially OSA, should be evaluated because untreated OSA worsens heart failure outcomes. Dr. Arreaza: WhatIs there any role for wearable devices or remote monitoring? Abishak: Yes, increasingly so. Remote weight monitoring, blood pressure tracking, and symptom reporting can reduce hospitalization. In select patients, implantable hemodynamic monitors may help detect rising filling pressures before symptoms occur. Dr. Arreaza: It was a great discussion. Thank you, Abishak and Akbar for bringing all that valuable information to us. Let's wrap it up.     

In this episode of the PFC Podcast, the discussion revolves around pneumothorax and hemothorax, focusing on their definitions, causes, and management strategies. The speakers delve into the implications of tension physiology, the importance of patient assessment, and the role of ultrasound in diagnosis. They also explore the complexities of trauma management, emphasizing the need for vigilance and preparedness in emergency situations. TakeawaysPneumothorax can become an emergency due to oxygenation issues.Tension physiology occurs when blood return to the heart is impaired.Stable patients with pneumothorax can often be observed.COVID-19 led to increased cases of pneumothorax due to lung scarring.Traumatic pneumothorax usually indicates damage to the thorax.Ultrasound is the preferred diagnostic tool for pneumothorax.Medical management focuses on minimizing positive pressure ventilation.Emergent interventions may be necessary for significant pneumothorax.Understanding the difference between pneumothorax and hemothorax is crucial.Vigilance is key in managing chest trauma effectively.Chapters00:00 Understanding Tension Physiology and Shock03:10 Management of Pneumothoraces and Haemothoraces06:09 Impact of COVID-19 on Lung Health09:02 Trauma and Pneumothorax: Diagnosis and Treatment11:39 Ventilation Strategies in Pneumothorax Management14:58 Assessing Patient Stability and Intervention Timing17:41 Complications of Chest Trauma and Hemothorax20:53 Vigilance in Trauma Management24:04 Final Thoughts on Chest Trauma ManagementFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This is The Briefing, a daily analysis of news and events from a Christian worldview.On today's edition of The Briefing, Dr. Mohler discusses who is in command of Iran's military forces, if President Trump's attacks in Iran were constitutional, if inaction in Iran would have been worse, and the death of Khamenei and prediction markets.Part I (00:14 – 07:44)Who is in Command and Control of Iranian Forces? Iran's Military is Likely Still Following the Orders of Ayatollah KhameneiPart II (07:44 – 18:56)Was the President's Action Constitutional or Not? The Complications of President Trump's Decision in Light of the Controversial (And Unconstitutional?) War Powers ActWar and Peace Cannot Be Left to One Man — Especially Not This Man by The New York Times (David French)Secretary of State Rubio on Iran Strikes by C-Span (Marco Rubio)Part III (18:56 – 21:20)What Would Be Worse in Iran, Action or Inaction? Inaction on Iran Assuredly Would Have Been a Failed PolicyPart IV (21:20 – 25:52)Are the Prediction Markets Turning into Death Markets? The Death of Iran's Khamenei in the Prediction Markets is Raising Massive QuestionsBets on Fate of Iran's Khamenei Spark Uproar at Leading Prediction Markets by The Wall Street Journal (Kevin T. Dugan and Krystal Hur)Sign up to receive The Briefing in your inbox every weekday morning.Follow Dr. Mohler:X | Instagram | Facebook | YouTubeFor more information on The Southern Baptist Theological Seminary, go to sbts.edu.For more information on Boyce College, just go to BoyceCollege.com.To write Dr. Mohler or submit a question for The Mailbox, go here.

With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease. --- TIMESTAMPS 00:00 - Introduction04:30 - Role of Local Therapy in Systemic Disease09:49 - Patient Selection and Treatment Modalities13:15 - Challenging Lesion Characteristics and Locations19:56 - Y-90 Radioembolization versus Microwave Ablation23:04 - Intraoperative Ablation and Combining Locoregional Modalities29:36 - Complications of Microwave Ablation in the Liver36:43 - Future of Ablation and Liver Metastases Treatment39:25 - Final Thoughts and Closing Remarks --- RESOURCES UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.https://clinicaltrials.ucsd.edu/trial/NCT06710223 COLLISION trialhttps://clinicaltrials.gov/study/NCT03088150 ACCLAIM trialhttps://clinicaltrials.gov/study/NCT05265169

Host Gerard Slobogean, MD chats with paper author Dennis Den Hartog, MD, PhD about the findings of his research: "Hemiarthroplasty Versus Nonoperative Treatment of Comminuted Proximal Humeral Fractures: Results of the Procon Multicenter Randomized Controlled Trial" in the first part of the episode. In the second part, Dr. Slobogean discusses study findings with paper author Jad Lawand, MD-Candidate from the paper entitled: "Nonunion and Post-operative Complications Associated with Intramedullary Nailing Versus Plate Fixation of Humeral Shaft Fractures" Live from the 2025 OTA Annual Meeting. For additional educational resources visit OTA.org

Commentary by Dr.  Jian'an Wang.

Commentary by Dr. Qin LU.

FIRST WITH YESTERDAY'S NEWS (highlights from the weekend on Newstalk ZB) This Probably Means Something to Someone/Sport's All Gone Wrong/Coding for Idiots/How It All Works/He's BluffingSee omnystudio.com/listener for privacy information.

En este episodio nos adentramos en uno de los territorios más complejos del sistema nervioso periférico adulto: las plexopatías braquiales. ¿Qué significa realmente que el plexo se lesione? ¿Es solo un cable roto o algo mucho más complejo? Exploramos cómo se organiza un nervio, qué ocurre en lesiones por tracción, compresión o inflamación y por qué muchas plexopatías son auténticos mosaicos intraneurales. Revisamos las clasificaciones de Seddon, Sunderland, el grado VI de Mackinnon y la clasificación quirúrgica por niveles de Chuang, entendiendo que no es solo anatomía, sino estrategia y pronóstico. Hablamos de degeneración Walleriana, regeneración axonal, diferencias entre lesiones pre y postganglionares, prioridades reconstructivas y del papel clave de la neurorrehabilitación tras las transferencias nerviosas. Porque integrar cirugía, electrodiagnóstico y rehabilitación es esencial para comprender realmente el plexo braquial desde una mirada clínica y neurofisiológica. Referencias del episodio: 1. Baradaran, A., El-Hawary, H., Efanov, J. I., & Xu, L. (2021). Peripheral Nerve Healing: So Near and Yet So Far. Seminars in plastic surgery, 35(3), 204–210. https://doi.org/10.1055/s-0041-1731630 (https://pubmed.ncbi.nlm.nih.gov/34526869/). 2. Chaudhry, V., & Cornblath, D. R. (1992). Wallerian degeneration in human nerves: serial electrophysiological studies. Muscle & nerve, 15(6), 687–693. https://doi.org/10.1002/mus.880150610 (https://pubmed.ncbi.nlm.nih.gov/1324426/). 3. Chim, H., & Hagan, R. R. (2024). Consensus Recommendations for Neurogenic Thoracic Outlet Syndrome from the INTOS Workgroup. Plastic and reconstructive surgery. Global open, 12(8), e6107. https://doi.org/10.1097/GOX.0000000000006107 (https://pubmed.ncbi.nlm.nih.gov/39206209/). 4. Chuang D. C. (2010). Brachial plexus injury: nerve reconstruction and functioning muscle transplantation. Seminars in plastic surgery, 24(1), 57–66. https://doi.org/10.1055/s-0030-1253242 (https://pmc.ncbi.nlm.nih.gov/articles/PMC2887004/). 5. Fisher, S., Wadhwa, V., Manthuruthil, C., Cheng, J., & Chhabra, A. (2016). Clinical impact of magnetic resonance neurography in patients with brachial plexus neuropathies. The British journal of radiology, 89(1067), 20160503. https://doi.org/10.1259/bjr.20160503 (https://pubmed.ncbi.nlm.nih.gov/27558928/). 6. Grinsell, D., & Keating, C. P. (2014). Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies. BioMed research international, 2014, 698256. https://doi.org/10.1155/2014/698256 (https://pubmed.ncbi.nlm.nih.gov/25276813/). 7. Massie, R., Mauermann, M. L., Staff, N. P., Amrami, K. K., Mandrekar, J. N., Dyck, P. J., Klein, C. J., & Dyck, P. J. (2012). Diabetic cervical radiculoplexus neuropathy: a distinct syndrome expanding the spectrum of diabetic radiculoplexus neuropathies. Brain : a journal of neurology, 135(Pt 10), 3074–3088. https://doi.org/10.1093/brain/aws244 (https://pubmed.ncbi.nlm.nih.gov/23065793/). 8. Novak C. B. (2008). Rehabilitation following motor nerve transfers. Hand clinics, 24(4), 417–vi. https://doi.org/10.1016/j.hcl.2008.06.001 (https://pubmed.ncbi.nlm.nih.gov/18928890/). 9. Larkin, M. B., Goethe, E. A., Mohammad, M., Tummala, S., & North, R. Y. (2023). Ulnar fascicle to brachialis branch of musculocutaneous nerve for restoration of elbow flexion associated with spinal cord tumor and radiation-induced lower motor neuron disease. Neurosurgical focus: Video, 8(1), V9. https://doi.org/10.3171/2022.10.FOCVID2299 (https://pubmed.ncbi.nlm.nih.gov/36628102/). 10. Ray, W. Z., & Mackinnon, S. E. (2010). Management of nerve gaps: autografts, allografts, nerve transfers, and end-to-side neurorrhaphy. Experimental neurology, 223(1), 77–85. https://doi.org/10.1016/j.expneurol.2009.03.031 (https://pubmed.ncbi.nlm.nih.gov/19348799/). 11. Rocks, M. C., Comunale, V., Sanchez-Navarro, G. E., Nicholas, R. S., Hacquebord, J. H., & Adler, R. S. (2025). Diagnostic Capability of Ultrasonography in Evaluating Peripheral Nerve Injuries of the Brachial Plexus. Hand (New York, N.Y.), 20(8), 1252–1258. https://doi.org/10.1177/15589447241277844 (https://pubmed.ncbi.nlm.nih.gov/39289880/). 12. Rubin D. I. (2020). Brachial and lumbosacral plexopathies: A review. Clinical neurophysiology practice, 5, 173–193. https://doi.org/10.1016/j.cnp.2020.07.005 (https://pubmed.ncbi.nlm.nih.gov/32954064/). 13. Sakellariou, V. I., Badilas, N. K., Mazis, G. A., Stavropoulos, N. A., Kotoulas, H. K., Kyriakopoulos, S., Tagkalegkas, I., & Sofianos, I. P. (2014). Brachial plexus injuries in adults: evaluation and diagnostic approach. ISRN orthopedics, 2014, 726103. https://doi.org/10.1155/2014/726103 (https://pubmed.ncbi.nlm.nih.gov/24967130/). 14. Schierle, C., & Winograd, J. M. (2004). Radiation-induced brachial plexopathy: review. Complication without a cure. Journal of reconstructive microsurgery, 20(2), 149–152. https://doi.org/10.1055/s-2004-820771 (https://pubmed.ncbi.nlm.nih.gov/15011123/). 15. Segal, D., Cornwall, R., & Little, K. J. (2019). Outcomes of Spinal Accessory-to-Suprascapular Nerve Transfers for Brachial Plexus Birth Injury. The Journal of hand surgery, 44(7), 578–587. https://doi.org/10.1016/j.jhsa.2019.02.004 (https://pubmed.ncbi.nlm.nih.gov/30898464/). 16. Sturma, A., Hruby, L. A., Farina, D., & Aszmann, O. C. (2019). Structured Motor Rehabilitation After Selective Nerve Transfers. Journal of visualized experiments : JoVE, (150), 10.3791/59840. https://doi.org/10.3791/59840 (https://pubmed.ncbi.nlm.nih.gov/31475970/). 17. Tjoumakaris, F. P., Anakwenze, O. A., Kancherla, V., & Pulos, N. (2012). Neuralgic amyotrophy (Parsonage-Turner syndrome). The Journal of the American Academy of Orthopaedic Surgeons, 20(7), 443–449. https://doi.org/10.5435/JAAOS-20-07-443 (https://pubmed.ncbi.nlm.nih.gov/22751163/). 18. Vancea, C. V., Hodea, F. V., Bordeanu-Diaconescu, E. M., Cacior, S., Dumitru, C. S., Ratoiu, V. A., Stoian, A., Lascar, I., & Zamfirescu, D. (2025). Functional outcomes following nerve transfers for shoulder and elbow reanimation in brachial plexus injuries: a 10-year retrospective study. Journal of medicine and life, 18(4), 375–386. https://doi.org/10.25122/jml-2025-0079 (https://pubmed.ncbi.nlm.nih.gov/40405933/). 19. Van Eijk, J. J., Groothuis, J. T., & Van Alfen, N. (2016). Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment. Muscle & nerve, 53(3), 337–350. https://doi.org/10.1002/mus.25008 (https://pubmed.ncbi.nlm.nih.gov/26662794/). 20. Wade, R. G., Takwoingi, Y., Wormald, J. C. R., Ridgway, J. P., Tanner, S., Rankine, J. J., & Bourke, G. (2019). MRI for Detecting Root Avulsions in Traumatic Adult Brachial Plexus Injuries: A Systematic Review and Meta-Analysis of Diagnostic Accuracy. Radiology, 293(1), 125–133. https://doi.org/10.1148/radiol.2019190218 (https://pubmed.ncbi.nlm.nih.gov/31429680/). 21. Willmott, A. D., White, C., & Dukelow, S. P. (2012). Fibrillation potential onset in peripheral nerve injury. Muscle & nerve, 46(3), 332–340. https://doi.org/10.1002/mus.23310 (https://pubmed.ncbi.nlm.nih.gov/22907222/).

Episode 214: Valley Fever Complications. Dr. Arreaza:
Welcome back to the podcast. I'm Dr. Arreaza, and today we're talking about a topic that's very relevant here in the Central Valley but often not well known in the rest of the country, it is called ValleyFever, or coccidioidomycosis. For more info about the Valley Fever diagnosis and initial treatment, please go to our previous podcast on the subject! Episode 143, recorded by wonderful Dr. Lovedip Kooner.  To help us walk through this, I'm joined by Jordan, a medical student. Jordan, welcome back and Dr. Schlaerth, please introduce yourself.  Jordan:
Thanks, Dr. Arreaza. This is such an important topic, especially in endemic areas like where we live, the Central Valley of California, and Arizona. The public may think of Valley Fever as a mild pneumonia that just goes away eventually. But that's not always the case. Some patients develop serious, life-altering complications, and a small but important number develop disseminated disease. Dr. Arreaza:
Exactly. So today, we're going to break this down systematically: pulmonary complications, dissemination to other organs, CNS disease, musculoskeletal involvement, systemic symptoms, and then we'll touch on treatment principles and why follow-up matters so much. Dr. Schlaerth: Valley Fever can be missed in areas where it is not as common as in the Valley. 1989, earthquake in LA.Pneumonias that is not responding to treatment can be pulmonary cocci. Dr. Arreaza:
Before we dive into specific complications, let's zoom out. What percentage of patients get a complicated disease? Jordan:
So, most infections are self-limited, but about 5–10% of patients develop chronic or progressive pulmonary disease, and 1% develop extrapulmonary disseminated disease. That sounds small, but given how common Valley Fever is in endemic areas, that's still a lot of people. Dr. Arreaza:
And the complications can be devastating, and they are not always in primary infection. Dr. Schlaerth: Dissemination can be silent. We don't know exactly why dissemination happens; some ethnicities are more susceptible or other groups. Dr. Arreaza:
Let's start where Valley Fever usually begins: the lungs. What are the major pulmonary complications clinicians should know about? Jordan:
The most common long-term complications are chronic pulmonary sequelae. These include: cavitary disease, pulmonary nodules, bronchiectasis, pulmonary fibrosis, and pleural complications like effusions, empyema, or pneumothorax. Dr. Arreaza:
Cavitary disease comes up a lot. What does that look like clinically? Jordan:
Cavities form in about 5–15% of cases. Many are asymptomatic, but symptomatic cavities can cause fever, fatigue, cough, sputum production, dyspnea, and hemoptysis. The tricky part is that symptoms often wax and wane, and even with treatment, current antifungals don't eradicate the organism from chronic cavities. Dr. Arreaza:
That's very unfortunate, and sometimes those cavities remain and patients might not know that they have them, and those cavitary lesions may rupture. Jordan:
Yes, rupture can lead to pyopneumothorax, which is a surgical emergency requiring prompt intervention. Dr. Kooner: Hello everyone, this is Dr. Kooner, and today I want to talk about one of my favorite topics: coccidioidal cavitary disease—because nothing says “fun lung pathology” like a hole in the lung that refuses to leave. Coccidioidal cavitary disease is a chronic pulmonary manifestation of infection. Many times, it's found incidentally on imaging. Sometimes patients are being evaluated for respiratory symptoms, sometimes for systemic complaints, and sometimes for something completely unrelated—like when a chest X-ray was ordered for a pre-op clearance and suddenly… surprise cavity. Pulmonary cavities develop in about 5-10% of patients with Valley Fever. Most of the time, they appear as thin-walled residual lesions. They can be solitary or multiple, and they can range from a few centimeters to much larger. And while textbooks love to show the “classic look,” in real life they can be a little more… creative. These cavities can persist for years. Some patients feel completely fine and never know they have one. Others develop chronic symptoms or complications like rupture into the pleural space, secondary infection, or bleeding, which is when everyone suddenly becomes very interested in that cavity. Here's an important teaching point: about 20% of patients with cavitary disease also have disseminated infection, most commonly involving bone. This challenges the old-school teaching that cavitary lung disease and dissemination rarely happen together.  One major risk factor for cavitary disease—and for more severe or complicated infection overall—is diabetes mellitus. So how do patients usually present? Symptoms often overlap with classic Valley Fever symptoms. The most common presenting symptoms for cavitary disease that usually trigger evaluation are cough, hemoptysis, fever, and shortness of breath. Diagnosis and monitoring rely heavily on chest imaging. Plain chest X-rays are usually enough for stable disease. CT scans are typically saved for when you're worried about complications. Serologic testing is also key, especially complement fixation titers. In general, higher titers correlate with more severe disease and higher relapse risk. Management depends on symptoms and host factors.If the patient is asymptomatic and immunocompetent, they often don't need antifungal therapy. These patients can usually be followed with periodic clinical and imaging monitoring watch closely and don't panic. Symptomatic patients are typically treated with oral triazoles, most commonly fluconazole or itraconazole. Treatment is long—usually at least 6 to 12 months, and often longer—because symptoms love to come back once therapy stops. These medications are usually suppressive rather than curative, although newer data suggests triazoles may help with cavity closure in some patients. Relapses happen in about 25 to 33% of immunocompetent patients, and even more often in immunocompromised patients or transplant recipients. Many of these patients end up needing long-term or even indefinite therapy. Not ideal—but still better than uncontrolled disease. Surgery still has a role, but it's more selective now. It's usually reserved for complications like life-threatening hemoptysis or rupture into the pleural space. Early ruptures might be managed with chest tube drainage. More complicated or delayed cases may need decortication or lung resection. So, the big picture: symptomatic coccidioidal cavitary disease can be a chronic management challenge. It requires individualized treatment decisions, prolonged therapy for many patients, and long-term follow-up with imaging and serologic monitoring to catch relapses early and prevent complications. And if there's one takeaway, it's this: if you find a stable cavity in someone known to have Valley Fever, sometimes the best move is careful monitoring—not chasing it with endless tests that make everyone nervous, including the patient. Thanks for listening—and remember, sometimes the lung keeps souvenirs from infections… and sometimes those souvenirs stick around for years. Now, let's continue with the discussion about pulmonary nodules. This is Dr. Kooner, signing off.    

This PedsCases episode will review the Canadian Paediatric Society Position Statement from November 2022, "Acute complications in children with sickle cell disease: Prevention and management". By the end of this podcast, listeners will be able to 1) understand how to prevent mortality and morbidity associated with SCD, 2) recognize and manage the common complications of SCD, and 3) know the basic principles of transfusion for patients with SCD. Today's episode was created by Audrey Slater, a fourth-year medical student at the Université de Montréal, in collaboration with the authors of the CPS statement, including Dr. Carolyn E. Beck, a hospitalist pediatrician at SickKids hospital, Dr. Evelyne D. Trottier, a pediatric emergency physician at CHUSJ, Dr. Melanie Kirby-Allen, a haematologist at SickKids Hospital, and Dr. Yves Pastore, a haematologist at CHUSJ. There are no conflicts of interest to disclose by the authors.

Neurologic complications of hematologic disorders are frequently encountered in clinical practice and can involve both the central and peripheral nervous systems. Early recognition and appropriate management in collaboration with a hematologist are essential to reduce morbidity and mortality. In this episode, Kait Nevel, MD, speaks with Lauren Patrick, MD, and Mark Terrelonge, MD, MPH, authors of the article "Neurologic Complications of Hematologic Disorders" in the Continuum® February 2026 Neurology of Systemic Disease issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Patrick is an assistant professor of neurology at the University of California, San Francisco, in San Francisco, California. Dr. Terrelonge is an associate professor of neurology at the University of California, San Francisco, in San Francisco, California. Additional Resources Read the article: Neurologic Complications of Hematologic Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Full episode transcript available here Dr Nevel: Thick blood, thin blood. These are terms often used by patients and caregivers to describe some of the hematologic disorders that can lead to neurological diseases such as stroke. So, when should we consider a hematologic disorder as a potential cause for neurological conditions, such as stroke or neuropathy. Today I have the opportunity to interview Drs Lauren Patrick and Mark Terrelonge to learn more about neurologic complications of hematologic disorders in their recent article in Continuum. Dr Jones: This is Dr Lyell Jones, editor-in-chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kate Nevel. Today I'm interviewing Drs Lauren Patrick and Mark Terrelonge about their article on neurologic complications of hematologic disorders. This article appears in the February 2026 Continuum issue on neurology of systemic disease. Welcome to the podcast, and please introduce yourself to the audience. Dr Patrick: Thank you for having us. We're both thrilled to be here. I'm Lauren Patrick, a vascular neurologist and assistant professor at the University of California, San Francisco, and program director for the Vascular Neurology Fellowship here. Dr Terrelonge: And I'm Mark Terrelonge, I'm an associate professor of neurology and neuromuscular medicine here at UCSF and one of the associate program directors for the adult neurology residency. Nice to meet you. Dr Nevel: Nice to meet you both. Really looking forward to getting into your article and learning more. So, to kind of kick us off, I always like to ask what do you think is the most important takeaway from your article for the practicing neurologist? And maybe since there are two of you and I suspect you covered slightly different aspects of this article, maybe you could give us two most important takeaways. Dr Patrick: Sure. I think the biggest takeaway is to keep hematologic disorders on the differential when evaluating patients with neurologic symptoms. Conditions like sickle cell disease, myeloproliferative neoplasms, or plasma cell dyscrasias and paraproteinemia can cause strokes or peripheral neuropathies, and many have specific and targetable treatments. The early recognition and collaboration with our hematology colleagues can truly change patient outcomes, whether that's by initiating cytoreductive therapy, managing thrombocytopenia, or optimizing antithrombotic therapy. Dr Nevel: Great. So, this is a really big and diverse topic. As always, I'm going to urge our listeners to read the article because there is a lot of really good stuff in your article that we just don't have time to get into during this interview today. But you cover a lot of different hematological disorders and how they can cause neurological complications. One of the major neurological complications of hematological disorders is cerebral vascular events. So, I'm hoping, Warren, that you can walk us through a little bit. When should we consider workup of potential hematologic disorder as a cause when we see a patient with ischemic stroke, because certainly not all patients with ischemic stroke should be getting a broad hematological disorder work up. So how can we kind of identify early on that there might be something else at play? Dr Patrick: Absolutely, great question. So, in many cases, the underlying hematologic disorder is already known, such as sickle cell disease or polycythemia vera. But sometimes stroke is the initial presentation or manifestation of the disease. So red flags can include young age, recurrent cryptogenic strokes or thrombosis, and unusual locations like the cerebral venous system. Laboratory clues such as unexplained erythrocytosis, thrombocytosis, thrombocytopenia, or hemolytic anemia should raise suspicion for an occult hematologic disorder. In the setting of acute illness, immune-mediated or heparin-induced thrombocytopenia or thrombotic microangiopathies should be suspected in patients that have hemorrhagic and or thrombotic complications, particularly when relevant lab disturbances are present. Acquired thrombophilia such as anti-phospholipid antibody syndrome should be considered in young patients with autoimmune disease, prior venous or arterial thrombotic complications, or pregnancy morbidity. Now, these are rare causes overall, but they're important to catch because the management can differ dramatically from our typical stroke care. Dr Nevel: Great. And what are some of the most common inherited or acquired thrombophilias and when should we be sending these labs? Dr Patrick: The hematologic causes really account for small minority of arterial strokes approximately one to two percent, but among those, sickle cell disease, anti-phospholipid antibody syndrome and the myeloproliferative neoplasms are the most common. Timing of testing is key. So, the genetic thrombophilia panels can be drawn at presentation, but lab values such as protein C, protein S, and antithrombin levels may be falsely low during acute thrombosis, so they're often repeated weeks later. Similarly, for anti-phospholipid antibody testing that should be done at presentation and when positive, confirmed at twelve weeks, since transient positivity can occur with affections or acute events. So, in patients that are already anticoagulated for anti-phospholipid antibody syndrome, testing becomes particularly tricky, especially with lupus anticoagulant assays. Some results need to be interpreted carefully or repeated when feasible. The main message is to collaborate early with our hematology colleagues to guide the timing and interpretation of these studies. Dr Nevel: Yeah, wonderful. Thank you. I'll ask some similar questions about neuropathy. So when should we consider an underlying hematologic disorder as being the cause for someone's neuropathy? Dr Terrelonge: So, luckily for a neurologist, then serum protein electrophoresis or an SPEP is already a part of the first pass evaluation for even the most common neuropathies we see, technically already considered every time we do an evaluation. However, we do know that most neuropathies progress very slowly and don't really lead to significant limitations in patient activities of daily living. And for those, the initial workup step, you may not need to do any additional search for any hematologic diseases after that first step. Within patients who start to have more unusual features with their neuropathy, including a rapid progression, early proximal weakness, significant and extremely painful neuropathies, significant ataxia, or new tremor or anything that's kind of outside of the garden variety neuropathy, then you should start to think about a hematologic cause. Additionally, if a patient already has a known hematologic malignancy or process before their neuropathy, there should be some form of assessment to see through exam or electrodiagnostically if the two are correlated. I do have to add one caveat, though, and that's just because someone has a hematologic malignancy or a paraprotein seen in their blood, their neuropathy and the neurologic syndrome don't necessarily have to be causally related. So, we have to do some additional testing to determine if the patient's presentation of the paraprotein are actually linked. Dr Nevel: Can you walk us through a little bit how we determine if they're associated or just coincidental? Dr Terrelonge: Yeah. So, for some of the proteins, there's a specific phenotype that will come with the specific protein. For example, an anti MAG proteinopathies or MAG standing for a myelin associated glycoprotein, it usually leads to a distal sensor and motor polyneuropathy where the most distal portions of nerves are affected. So, in that case, people might notice that they have numbness and weakness in their toes and their fingers, and it doesn't follow that typical length dependent pattern. So, in that case, if you have the anti mag neuropathy and the electrodiagnostic signature of an anti mag neuropathy along with the symptoms, you're more likely to think that the two are related then if not. Dr Nevel: Great. Thank you. And I was hoping you could speak a little bit more about amyloidosis just because I think that that's one that can be really tricky to diagnose. And I see patients, you know, have sometimes more drawn out evaluations or see multiple providers before a diagnosis is reached. So, can you speak a little bit more to how we diagnose amyloidosis in relationship to neuropathy or other neurological conditions and when we should push for more invasive testing like a nerve biopsy? Dr Terrelonge: So, amyloidosis certainly is a tricky diagnosis. I've been tricked by it and I think most of my neuromuscular colleagues have probably been tricked by it at least once. It's a hard diagnosis to make is it usually requires a pretty high index of suspicion, and also requires a tissue diagnosis to cinch. There're some patients who will come in with a prior history of amyloidosis and they're a little bit easier to figure out if the neuropathy is related. Maybe it's started in their heart or their kidney first and then you can just see if the type of amyloid they have usually deposits in nerve, and that may be enough. But if there's any diagnostic uncertainty, you could go forward with tissue biopsy. But it's patients in which the neuropathy is the first symptom that amyloidosis can be especially tricky to diagnose. It's a primarily light chain disease. So, if you do only an SPEP as a part of your initial neuropathy evaluation, you could miss it. But usually, the patients will have either a severely painful neuropathy, early autonomic dysfunction, or really prominent bilateral carpal tunnel syndrome. So, if they have any of those, usually we'll add in an amyloid workup as a part of that of the rest of the workup, which would include both light chain evaluations to see if there's any increase in Lambda or Kappa light chains and then also biopsy. Biopsy can be of the skin or fat pad first, which have reasonable sensitivity for picking up disease, but they're not necessarily a hundred percent. So if the suspicion remains high in those cases, a nerve biopsy should be considered. And the reason why this is important is that the chemotherapeutic agents that we have now can actually help arrest a lot of these diseases and stop further organ involvement. So, if you think about it, it is important to keep pushing and looking until you find it. Dr Nevel: Thank you so much for that. And a follow up question to that, once patients are started on appropriate therapy, the diagnosis is made, chemotherapy is started, what's the typical clinical course that you see in terms of their neuropathy? Do you ever see improvement or is it arrest of worsening? Dr Terrelonge: Usually for amyloid, there is an arrest of disease, but in some patients, they could have some improvement, not necessarily a dramatic improvement, but some patients could see some reversal of symptoms. That may not necessarily be because nerves injured nerves are regrowing, but because of reorganization of nerves to muscle, they could have some strength increases or at least less pain. Dr Nevel: Yeah, thank you. So, when should we involve a hematologist in aiding in the evaluation of patients we suspect may have an underlying hematological disorder? You guys really outlined very nicely in your article some of the laboratory workup or other workup like you just talked about with amyloidosis. But at what point in that workup should we reach out to our hematology colleagues? Dr Patrick: I would say almost always. So, these disorders are inherently multi-system and benefit from early co-management. In acute sickle cell stroke, for example, hematology helps direct emergent exchange transfusion. For myeloproliferative disorders they guide cyto reduction and long term antithrombotic strategy. And for antibody mediated or plasma cell disorders, hematology determines disease specific therapies. So, neurology may help with identifying the presentation, but the definitive management is almost always shared with our hematology colleagues. Dr Nevel: And as you both have mentioned that a lot of times in these cases, their hematologic disorder may be already known before they present with their neurological symptoms. So, I imagine obviously in those cases that a hematologist hopefully is already heavily involved in their care. What do you think is the most difficult aspect of identifying and diagnosing patients with neurologic illness as having an underlying hematological disorder? Dr Patrick: The hardest part is maintaining a high index of suspicion, especially since hematologic causes account for a very small minority of arterial strokes. Most strokes are from traditional vascular risk factors like you mentioned, or cardio embolism, so it's easy to stop diagnostic evaluation after standard studies have been performed. An example of a challenging case is a patient that's young, they've had recurrent cryptogenic stroke, and they could have antiphospholipid antibody syndrome, but it can be easy to miss if their antibody titers are borderline or if they're already anticoagulated, which would complicate retesting. So, it's about balancing the urge to over-test with recognizing the few cases where identifying A hematologic cause truly changes that management. Dr Terrelonge: And then on the neuropathy side, probably the hardest part is deciding what's causal and what's coincidence. Monoclonal gammopathy of unknown significance, or MGUS, is really common in older adults, so not every M-spike on an SPEP explains a neuropathy. And even sometimes there's times when the neurologic picture will develop a little bit faster than the hematologic one. So, it's hard to put the two together. Dr Nevel: Yeah. What's the most rewarding aspect of taking care of patients with complications from their hematologic disorders? Dr Patrick: It's deeply rewarding when a targeted diagnosis leads to a tangible improvement in that patient's care. For example, identifying A cryptogenic stroke is being due to myeloproliferative neoplasm or an inherited thrombophilia allows us to move from empiric treatment to possible disease specific strategy. It's really gratifying to give patients that clarity, to give them a diagnosis and in some cases prevent future events. Dr Terrelonge: Agreed. And even on the neuropathy side, almost all of the neuropathies that are hematologically related are treatable. So, it's so satisfying whenever you have a patient with say an anti-MAG neuropathy or Waldenström can start the patient on therapy, and you can see someone who's been having a progressive decline to stability and in those cases sometimes even significant recovery. Dr Nevel: Yeah, absolutely. Very rewarding when you can identify the problem and make it better. That's what it's all about. So, what are the future areas of research in this area? What do we still need to learn? Dr Patrick: There's still a lot to learn. I think we need better data on the safety of acute reperfusion therapy and antithrombotic agents, particularly in patients that are at dual risk for bleeding and thrombosis. Other examples, secondary prevention strategies and anti-phospholipid antibody syndrome. What's the best target INR? Do you add aspirin to warfarin or not? All of that is often left up to expert opinion. What's the best management for adults with sickle cell stroke? There are many open questions there. A lot of the protocols that we have in place for sickle cell patients that are adults as derived from pediatric literature and there's vast potential in terms of disease modifying therapies, especially in the fields of sickle cell disease and amyloidosis. And we'll need to reassess how those treatments may change neurologic outcomes. Dr Terrelonge: I think on the neuropathy side that having some form of new biomarkers to help us clearly know of the neuropathy and that hematologic illness are associated would be very helpful. On the treatment side, a lot of this is really being driven by the hematology space, but new therapies that treat hematologic plasma cell disorders, including some of the new BTK inhibitor, may be incorporated relatively soon into the algorithm for how we treat many of our patients. I'm excited to see what's to come from this. Dr Nevel: Wonderful. Thank you so much for sharing your knowledge with us today. I know I've certainly learned a lot by reading your article and through our discussion today. Highly encourage our listeners to read your wonderful article, which is a very thorough review of hematologic disorders and neurological complications. Again, today I've been interviewing Dr Lauren Patrick and Dr Mark Terrelonge on their article Neurologic Complications of Hematologic Disorders, which appears in the February 2026 Continuum issue on Neurology of Systemic Disease. Please be sure to check out Continuum Audio episodes from this and other issues. And as always, thank you so much to our listeners for joining today, and thank you so much to Lauren and Mark. Dr Terrelonge: Yeah, thank you so much for having us. Dr Patrick: Thank you so much for having us and for highlighting this topic. We hope the issue encourages clinicians to think broadly about hematologic causes of neurologic disease and to continue collaborating closely with our hematology colleagues. It's a complex but very fascinating intersection for both of our fields. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.

Rich — a leukemia survivor, nurse practitioner, and longtime oncology clinician — to talk about what it's really like to survive cancer, rebuild your life after treatment, and live with long-term side effects.Rich was diagnosed with leukemia at age 28, underwent an allogeneic stem cell transplant at Dana-Farber / Brigham and Women's, and is now a 29-year survivor. His experience as both a patient and provider offers a rare, honest look at cancer survivorship, prostate cancer side effects, sexual health, mental health, and post-traumatic growth.In this conversation, we cover:What it's like to be told you have leukemia in your 20sStem cell transplant and long-term survivalTurning cancer into purpose and becoming an oncology NPCommon prostate cancer side effects (urination, bowel changes, erectile dysfunction)How doctors actually manage these symptomsSexual health after cancer treatmentMental health, grief, and post-traumatic growthHow to rebuild your life after active treatmentThis episode is for patients, survivors, caregivers, and anyone navigating life after a cancer diagnosis.

Update Series (2026) Lesson 5: Long-term Urinary Catheters: Their Role & Management of Complications Now in its 45th installment, the AUA Update Series is renowned for delivering high-quality lessons to practicing urologists, fellows and residents. All content is developed by internationally recognized experts in urology, making the AUA Update Series the most professional and sought-after self-study program available. Improve your practice and patient care by staying abreast of the latest treatments and surgical techniques in urology. For more information or to subscribe to the AUA Update Series, please visit https://cme.auanet.org/URL/US2026

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Increasing Awareness and Reducing Occupational Hazards in the Cardiac Catheterization and Electrophysiology Laboratories: Working to Eliminate Lead and Complications of Radiation in Cardiovascular Team Study.

Host: Darryl S. Chutka, M.D.  Guest: Balaji Tamarappoo, M.D., Ph.D.  With advances in oncology, patients are living longer than ever following a diagnosis of cancer. Newer treatments have dramatically improved survival. However, we're also seeing an increasing number of cancer survivors who are at risk for cardiovascular complications; at times during treatment, and sometimes years later. Complications such as heart failure, cardiac arrhythmias, hypertension, and accelerated coronary disease are not uncommonly seen in our primary care practice.  As primary care clinicians, what do we need to know? I'm joined today by Dr. Balaji Tamarappoo, M.D., Ph.D., a cardiologist with expertise in cardio-oncology. We'll discuss which cancer therapies pose the highest cardiac risks, what baseline and surveillance testing is recommended, if the risk of cardiotoxicity be decreased, and how primary care can partner effectively with oncology and cardiology to protect our patients' hearts while they battle their malignancy. The topic for today's podcast is “Cardiotoxicity of Cancer Therapies.”  Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

We're all excited about the possibilities of the 2026 MLB season but the clouds of labor war are percolating even in spring training. Luke Jones and Nestor discuss the complicated complications of six decades of Major League Baseball labor history and the bubbling situation for a salary cap. And what will the role of the new Baltimore Orioles ownership be in the looming dogfight? The post Luke Jones and Nestor discuss the complicated complications of MLB labor situation and Orioles role first appeared on Baltimore Positive WNST.

Join Digital Education Committee Vice-Chair and podcast host Tina Baykaner, MD, MPH, along with this week's guest contributors, Jackson J. Liang, DO and Edward P. Gerstenfeld, MD, MS, FHRS for this week's episode. This study evaluates the relationship between hospital ventricular tachycardia (VT) ablation volume and post-procedural complications, examining whether institutional procedural experience influences patient outcomes. The authors analyze complication rates across centers with varying VT ablation volumes to assess potential volume–outcome associations. Findings from this work provide important insights into procedural risk, quality metrics, and the potential impact of case volume on VT ablation safety.    Learning Objectives Describe the relationship between hospital VT ablation procedural volume and post-procedural complication rates. Identify patient, procedural, and institutional factors that may contribute to complications following ventricular tachycardia ablation. Discuss how volume–outcome findings can inform quality improvement initiatives, referral patterns, and procedural planning for VT ablation programs.    Article Authors Agam Bansal, Anirudh Nandan, Jakub Sroubek, Justin Lee, Koji Higuchi, Ayman Hussein, Shady Nakhla, Mina Chung, Niraj Varma, Walid Saliba, Mandeep Bhargava, Tyler Taigen, Mohamed Kanj, Oussama Wazni, and Pasquale Santangeli Podcast Contributors Tina Baykaner, MD, MPH Jackson J. Liang, DO Edward P. Gerstenfeld, MD, MS, FHRS   All relevant financial relationships have been mitigated. Host and Contributor Disclosure(s): T. Baykaner•Honoraria/Speaking/Consulting: Volta Medical, Medtronic, Pacemate, Johnson and Johnson, Abbot Medical, Boston Scientific •Research: NIH   E. Gerstenfeld •Speaking/Teaching/Consulting: Medtronic, Adiago Medical, Biosense Webster, Inc., Abbott, Boston Scientific, Abbott Medical, Varian Medical Systems •Research: Boston Scientific, Abbott Medical •Board Membership: American College of Cardiology Foundation   J. Liang •Speaking/Teaching/Consulting: Biotronik, Abbott, Bionsense Webster, Inc.   Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.

Postpartum Complications in Dogs: Dr. Marty's Whelping Survival Guide Whelping doesn't always end with a tidy pile of healthy puppies and a relaxed, glowing mama dog. Host Laura Reeves is joined by our favorite best friend in veterinary medicine, Dr. Marty Greer, to walk through the most common (and most dangerous) postpartum complications breeders face — from retained puppies and metritis to mastitis, eclampsia, and even the terrifying “SIPS” bleeding that shows up weeks later. If you've ever had a bitch crash after delivery… or you're hoping you never will… this is the episode that helps you stay calm, prepared and ready to act fast. The conversation begins with one of the biggest preventable tragedies: retained puppies. Dr. Greer emphasizes the importance of a properly timed puppy-count x-ray (day 55–60) and shares practical tips for improving accuracy, including using digital x-ray equipment, taking two views, and ensuring the bitch has an empty stomach and colon before imaging. Her bottom line is simple: know your count — and don't go to bed if you're missing a puppy. From there, Marty and Laura tackle early postpartum red flags, including aggression toward puppies, which can be linked to low calcium. They discuss proactive tools like calcium gel during labor (not before), pheromone support collars, and the surprisingly effective trick of saving placental fluids after a C-section to help “switch on” maternal behavior once puppies get home. Next up: poor milk production, dehydration, and what to do when a bitch simply won't lactate. Dr. Greer shares her go-to strategies — from metoclopramide and OxyMama to boosting fluid intake with creative options like starter mousse mixed into water. And yes… even bratwurst makes an appearance as a lactation hack that longtime breeders swear by. The episode also dives into the “big three” postpartum medical complications: metritis, mastitis, and eclampsia. Dr. Greer explains what to watch for, why fever is never something to ignore, and why antibiotics should always be vet-directed — not pulled from leftover bottles in the cabinet. Finally, Marty demystifies normal postpartum discharge (lochia) versus SIPS (sub-involution of placental sites), a dramatic but usually benign bleeding episode that can happen around eight weeks after delivery. If you...

In this timely episode of I Am Refocused Radio, host Shamiah Reed sits down with Sue Liebel, Director of State Affairs for Susan B. Anthony Pro-Life America, to unpack the escalating controversies surrounding mail-order abortion pills like mifepristone. They discuss the high complication rates (including 1 in 25 women requiring emergency room care per FDA labels), the rise of coercion cases—highlighted by Rosalie Markezich's (referred to as Rosalie Marquette in discussion) traumatic experience where her boyfriend allegedly forced her to take pills mailed from a California doctor—and Louisiana's lawsuits against out-of-state providers shielded by California's laws. Liebel addresses shield laws protecting providers, the Biden-era policy changes allowing mailing, calls for the Trump administration and FDA to reinstate in-person requirements and review updated science, congressional efforts, public support for medical oversight (7 in 10 voters), the shift to 65% of abortions being chemical, and broader concerns over women's health, coercion by abusers, and interstate conflicts exemplified by Gov. Gavin Newsom's heated response. A must-listen for insights into this public health and policy flashpoint—visit sbaprolife.org and abortiondrugfacts.org for more.Become a supporter of this podcast: https://www.spreaker.com/podcast/i-am-refocused-radio--2671113/support.Subscribe now at YouTube.com/@RefocusedNetworkThank you for your time. 

Chuck and Chris begin a new initiative working with The Journal of Hand Surgery on a quarterly journal club.  Nash and Macerena will choose the articles from the previous quarter and Chris and Chuck will review the articles and discuss practical implications.  This first episode includes discussion of the following articles from Q4 of 2025:Portney DA, Lee CP, Wolf JM, Strelzow JA, Stepan JG. A Changing Landscape in Surgical Treatment of Basilar Thumb Arthritis: Is the Rate of Denervation Increasing? J Hand Surg Am. 2025 Oct;50(10):1280.e1-1280.e8. PMID: 39918526.Earp BE, Zhang D, Benavent KA, Ostergaard PJ, Blazar PE. The Use of Telemedicine Postoperative Visits Following Carpal Tunnel and Trigger Digit Releases: A Randomized Clinical Trial. J Hand Surg Am. 2025 Dec;50(12):1431-1437. PMID: 41117725.Amen TB, Ibrahim LI, Gillinov SM, Torabian KA, Dean MC, Liimakka A, Lee SK. Glucagon-like peptide-1 Agonists and Common Hand Procedures: Perioperative and Postoperative Risks and Complications. J Hand Surg Am. 2025 Nov;50(11):1297-1303. PMID: 41055617.We are in need of a podcast intern!  We would appreciate any referrals!See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Let's try to make sense of the jobs numbers that just came out. Plus, the president seems to have abandoned any kind of governing philosophy as he heads towards lame duck status.

The crew gets "Upper Crust" this week as we attempt to stay classy while drinking a bottle of wine apiece—one glass every thirty minutes, no exceptions. Danny plays sommelier, teaching us how to sniff and swirl like the elite, while we roast your wine choice: from the "adult grape juice" Moscato crowd to the Shiraz lovers who live for group chat drama. On the menu: Rich Speak: Decoding terms like Coxswain, Complications, and Escrow. Service Stories: What really happens behind the scenes at high-end weddings and Marriott events. Loud vs. Old Money: Why Jeff Bezos rents out Venice while Warren Buffett lives in a $31k house. It's a deep dive into the "King of Wines," the "King of Egos," and why the elite suck. Sorry in advance for the slurring by the final glass.

Click to Subscribe: https://bit.ly/Youtube-Subscribe-SoapDirt General Hospital 2-week spoilers for February 2 -13, 2026 reveal Jason Morgan (Steve Burton) will find himself torn between his loyalty to Britt Westbourne (Kelly Thiebaud) and his commitments to Sonny Corinthos (Maurice Benard) and Carly Corinthos (Laura Wright). Simultaneously, Willow Tait (Katelyn MacMullen) is determined to regain custody of her children and makes a bold move that might involve Alexis Davis (Nancy Lee Grahn). Michael Corinthos (Rory Gibson), on the other hand, is in the hot seat as he faces interrogation, potentially from DA Justus Ward (Joseph C. Phillips) or Nathan West (Ryan Paevey) at the PCPD. GH spoilers give a twist as Drew Cain Quartermaine (Cameron Mathison) finds himself at Willow's mercy after being discharged from the hospital. Meanwhile, Lucas Jones (Van Hansis) expresses discomfort about a situation involving Culm, possibly leading him to consider moving away from Spoon Island. Complications also arise when Josslyn Jacks (Eden McCoy) starts digging into Cullum's background. Spoilers for General Hospital indicate Lulu Spencer (Alexa Havins) confesses to Laura Spencer (Genie Francis) about her kiss with Nathan, stirring feelings of guilt. This confession coincides with Nathan confessing to his own mother, Nina Reeves (Cynthia Watros), setting the stage for potential conflict when Maxie Jones (Kirsten Storms) wakes up from her coma. More GH spoilers suggest Curtis Ashford (Donnell Turner) seeks Alexis's help, possibly to expedite his divorce from Portia Robinson (Brook Kerr). The week ends on a romantic note with Curtis and Jordan Ashford (Tanisha Harper) igniting sparks, and Jason and Britt celebrating Valentine's Day together the weeks of 2/02- 2/13, 2026. The Soap Dirt podcast made the Top 100 List for Apple Podcast's Entertainment News Category. Visit our General Hospital section of Soap Dirt: https://soapdirt.com/category/general-hospital/ Listen to our Podcasts: https://soapdirt.podbean.com/ Check out our always up-to-date General Hospital Spoilers page at: https://soapdirt.com/general-hospital-spoilers/ Check Out our Social Media... Twitter: https://twitter.com/SoapDirtTV Facebook: https://www.facebook.com/SoapDirt Pinterest: https://www.pinterest.com/soapdirt/ TikTok: https://www.tiktok.com/@soapdirt Instagram: https://www.instagram.com/soapdirt/

Medical professionals can oftentimes fall under the category of "second victims", as they experience burnout and moral injury from the impacts of their work. Over the course of a neurointerventionalist's medical career, serious complications in procedures are sadly inevitable. These can be difficult to process, and there are not always the systems in place to provide the support needed, either inside or outside of the hospital. A new survey has been carried out to assess the severity and prevalence of negative psychological effects on physicians who have experienced these complications. Dr. Ansaar Rai¹ joins JNIS Editor-in-Chief Dr. Michael Chen to discuss the original research piece, "Unseen wounds: a multinational investigation of neurointerventionalists on the psychological toll of complications".  (1) Interventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Preeclampsia is one of those pregnancy conditions that gets mentioned often, explained poorly, and frequently dismissed until it suddenly isn't. In this episode, HeHe sits down with Dr. Dallas Reed to pull back the curtain on what preeclampsia actually is, how it shows up, and what expectant parents deserve to understand long before things feel urgent. Together, they break down the basics in a way that's clear and human, including how common preeclampsia really is, what symptoms to take seriously, and how to make sense of blood pressure readings and pregnancy-related hypertension diagnoses. Dr. Reed explains the differences between severe and non-severe preeclampsia, what monitoring can look like before and after 37 weeks, and why postpartum preeclampsia deserves more attention than it often gets. The conversation also explores prevention and management, including lifestyle considerations, aspirin use, and how care plans may differ depending on risk level, gestational age, and whether someone is being monitored inpatient or outpatient. A major focus of the episode is the future of personalized maternal care, including a deep dive into the Encompass test. This new RNA-based blood test, available between 18 and 22 weeks, helps identify pregnancies at higher risk for preeclampsia and pairs that insight with an evidence-based action plan and virtual support. Dr. Reed shares how this type of testing may change the way providers and families approach monitoring, communication, and early intervention, including potential benefits for out-of-hospital birth settings. This episode is grounded, evidence-based, and empowering, offering expectant parents tools, language, and understanding so they can participate confidently in their care rather than feeling blindsided by it.   TIMESTAMPS 00:00 Introduction to Preeclampsia 00:56 Welcome to The Birth Lounge Podcast 01:39 Features of The Birth Lounge App 03:00 Pregnancy and Postpartum Articles 04:54 Introduction to Today's Episode 07:47 Discussion with Dr. Dallas Reed 08:35 Understanding Preeclampsia 10:46 Symptoms and Diagnosis 18:56 Managing Blood Pressure During Pregnancy 22:37 Risk Factors and Prevention 31:59 Strategies to Prevent Preeclampsia 32:29 Healthy Lifestyle Recommendations 33:37 Monitoring and Follow-Up 35:05 Risks and Complications of Preeclampsia 37:05 Postpartum Preeclampsia 39:20 Managing Preeclampsia Before 37 Weeks 41:20 Inpatient Care and Medications 46:22 Understanding the Encompass Test 53:06 Benefits of the Encompass Test for Home Births 58:19 Final Thoughts and Resources   Guest Bio: Dr. Dallas Reed, practicing OBGYN, medical geneticist and advisor to Mirvie, a company delivering data-driven solutions for predictive and preventive care in pregnancy. Mirvie recently launched Encompass, which is the first RNA-based blood test to predict preeclampsia risk, combined with an evidence-based preventive action plan and virtual assistant to guide individualized support and care.    SOCIAL MEDIA: Connect with HeHe on Instagram  Connect with Mirvie on IG    BIRTH EDUCATION: Join The Birth Lounge for judgment-free, evidence-based childbirth education that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere. And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor.  

3pm: I Was Thinking: a Storm is coming (Capitol Flight) // This Day in History // 1985 - Music stars gather to record “We Are the World” // 1986 - The space shuttle Challenger explodes after liftoff // Trump Accounts’ for Kids Come With $1,000—and Tax Complications

In this episode, Dr. Rena Malik explores the complexities of whole body MRI screening with guest Dr. Matthew Davenport. They discuss the pros and cons of using contrast material, the risks of overdiagnosis, and the potential harms of detecting indolent cancers or incidental findings in low-risk populations. Through vivid examples and expert explanation, the conversation highlights the importance of targeted cancer screening and making informed choices about imaging. Become a Member to Receive Exclusive Content: renamalik.supercast.com Schedule an appointment with me: https://www.renamalikmd.com/appointments ▶️Chapters: 00:00 Use of contrast in MRIs00:25 Trade-offs: accuracy vs. harm00:59 Substantial harm from findings01:51 Thyroid nodules and overdiagnosis03:15 Retrospective outcomes and unintended harm04:41 Screening for aggressive vs. indolent cancers07:06 Prostate cancer screening example08:24 Complications from incidental findings09:33 Cascade of care after incidental findings Stay connected with Dr. Matthew Davenport on social media for daily insights and updates. Don't miss out—follow him now and check out these links! LinkedIn profile: https://www.linkedin.com/in/matthew-davenport-md-mba-037184286 Work profile: https://medschool.umich.edu/profile/2315/matthew-s-davenport Most relevant article: https://www.ajronline.org/doi/10.2214/AJR.22.28926 Next event is grand rounds speaker at Stanford: https://med.stanford.edu/radiology/education/grandrounds/2025-26.html#january Let's Connect!: WEBSITE: http://www.renamalikmd.com YOUTUBE: https://www.youtube.com/@RenaMalikMD INSTAGRAM: http://www.instagram.com/RenaMalikMD TWITTER: http://twitter.com/RenaMalikMD FACEBOOK: https://www.facebook.com/RenaMalikMD/ LINKEDIN: https://www.linkedin.com/in/renadmalik PINTEREST: https://www.pinterest.com/renamalikmd/ TIKTOK: https://www.tiktok.com/RenaMalikMD ------------------------------------------------------ DISCLAIMER: This podcast is purely educational and does not constitute medical advice. The content of this podcast is my personal opinion, and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of information contained in this podcast including but not limited to economic loss, injury, illness or death. Learn more about your ad choices. Visit megaphone.fm/adchoices

Cleo Paskal Paskal discusses the geopolitical and legal complications regarding the transfer of the Chagos Islands (which include Diego Garcia) from the UK to Mauritius. She highlights a critical oversight: a 1966 agreement between the US and the UK mandates that sovereignty over the Chagos archipelago must remain British for 50 years plus an additional 20 years, meaning the territory should legally remain British until 2036. Paskal notes that Washington has recently "woken up" to the dangers of the transfer—which President Trump has labeled as "stupid"—largely due to concerns regarding the heavy influence of the Chinese Communist Party in Mauritius.1939 guam

In this powerful Listener Series episode of The Birth Trauma Mama Podcast, Kayleigh is joined by Andrea, who shares her story of an unexpected pregnancy complicated by severe placenta accreta, a nine-hour delivery surgery, massive hemorrhage, ICU recovery, and a long, complex postpartum healing journey.Andrea walks listeners through receiving a terrifying accreta diagnosis at her anatomy scan, navigating the fear of life-threatening hemorrhage, and making the critical decision to transfer care to a specialized accreta center. Her story highlights the importance of self-advocacy, multidisciplinary care, and listening to your instincts, especially when your life is on the line.This episode also tenderly explores the emotional aftermath of survival: delayed bonding after general anesthesia, prolonged separation from her baby, months of physical complications, depression, and the long road to processing trauma once the body finally stabilizes.In this episode, we discuss:

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/TCA865. CME/NCPD/CPE/AAPA/IPCE credit will be available until January 11, 2027.Frameworks for Identifying Systemic Sclerosis and Its Complications: From Pathophysiology to Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/TCA865. CME/NCPD/CPE/AAPA/IPCE credit will be available until January 11, 2027.Frameworks for Identifying Systemic Sclerosis and Its Complications: From Pathophysiology to Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

In this listener-commissioned bonus episode, we break down the internet's favorite hockey romance through a gymnastics lens — rivalry, pressure, secrecy, slow burns, and why elite athletes are like this. It's an adult conversation with minor spoilers, wheeze giggles, and Oscar's for butt. Commissioned by Karla. This is her fault. Thank you, Alyssa for proving our point with her Ilya speech. UP NEXT Fantasy Gymnastics podcast every Wednesday College & Cocktails : Sunday Jan 25th, 12:00 PT after UCLA at Michigan State (FOX) 2026 Cocktail and Mocktail menu here Add exclusive Club Content like College & Cocktails to your favorite podcast player (instructions here). SUPPORT OUR WORK Club Gym Nerd: Join Here Fantasy: GymCastic 2026 College Fantasy Game now open. Never too late to join! Merch: Shop Now Newsletters The Balance Beam Situation: Spencer's GIF Code of Points Gymnastics History and Code of Points Archive from Uncle Tim Resistance Resources CHAPTERS 00:00 – Kentucky Gymnastics Recreates the Heated Rivalry Pump-Up Speech 00:00:17 – Welcome to GymCastic (Bonus Episode) 00:00:45 – You Don't Need to Know This Show (We'll Explain Everything) 00:01:04 – Adult Conversation Warning (Minor Spoilers) 00:01:38 – What Is Heated Rivalry? 00:03:05 – Hockey the Way Jade Carey's Floor Is Choreography 00:04:40 – Why Are We Doing a Podcast About This? 00:06:10 – The Books: Game Changers Series by Rachel Reid 00:07:05 – Why People Are Obsessed With This Show 00:10:00 – Secret Romance, Gay Panic, and Years of Tension 00:13:25 – The Stairs Scene, Chirping, and Competitive Flirting 00:17:05 – Gay and Bi Representation That Feels Real 00:20:20 – From Coco Gauff to SNL to Massive Fan Edits 00:25:40 – Casting Heated Rivalry for Gymnastics 00:29:30 – Greatest of All Time Criteria (Hot, Dominant, Iconic) 00:33:40 – If Not Russian, then who?  00:37:10 – Why a Lesbian Version Wouldn't Work (Sue Bird Was Right) 00:40:20 – Khorkina for Maximum Chaos Casting 00:43:30 – Why Sports Movies Are Never Realistic (And That's Fine) 00:46:40 – The Gym Mom vs Kip's Dad: Loyalty and Support 00:49:50 – Secret Relationships vs The Closet 00:53:10 – Panic, Fear, and Being Recognized 00:56:10 – Complications of Secret Hookups (Spring Break Story) 00:59:50 – Sub Dom Dynamics in Elite Sports 01:06:40 – Is This a Turning Point for Sports Fan Fic Smut?  

Think beyond the esophagus. Up to 75% of eosinophilic esophagitis (EoE) patients have ENT-relevant atopic disease that is often best managed with a multidisciplinary approach. Get caught up on best practices in EoE diagnosis and treatment with this episode of the BackTable ENT Podcast, featuring dual board-certified gastroenterologist and allergist-immunologist Dr. John Leung and host Dr. Basil Kahwash. --- SYNPOSIS The discussion covers the definition, symptoms, and diagnosis of EoE, highlighting the role of food and environmental allergies. Dr. Leung and Dr. Kahwash cover diagnostic techniques like endoscopy and emerging non-invasive methods, as well as various treatment options including dietary modifications, pharmacology, and biologics. The doctors also emphasize the importance of multidisciplinary collaboration between gastroenterologists, allergists, and otolaryngologists to provide optimal care for patients with EoE. --- TIMESTAMPS 00:00 - Introduction 03:13 - Understanding Eosinophilic Esophagitis (EoE)05:45 - EoE Symptoms and Diagnosis08:41 - Role of ENT in EoE Diagnosis11:32 - Diagnostic Criteria for EoE16:34 - Treatment Options for EoE20:55 - Role of Allergists and Environmental Allergies23:24 - Pharmacological Management of EoE29:38 - Complications and Risks of EoE36:21 - Follow-Up Endoscopies and Surveillance40:34 - Future Directions in EoE Management45:21 - Conclusion and Final Thoughts --- RESOURCES Dr. John Leunghttps://www.bostonspecialists.org/dr-leung-full-profile

In just three seasons, a small-town club from central Luxembourg have gone from third-tier obscurity to challenging for the top-flight title.   At the heart of their rise is president Carlos Teixeira, a construction entrepreneur who literally built the club's stadium himself before reluctantly taking over the reins.  On this episode, we tell Atert Bissen's story – before heading to the Netherlands, where an amateur club in the KNVB Beker are guaranteed to lift a trophy whether they win the competition or not.  To complete the Benelux trio we finish off in Belgium, where an angry father, a potential Iraqi investor and a revolving door of coaches have allegedly turned Olympic Charleroi into a hot mess.  Chapters00:00 – Intro00:45 – Atert Bissen's remarkable rise06:35 – Rapid risers across the globe08:40 – De Treffers & the Blue Pine Cone14:40 – Amateur rewards worldwide18:00 – Chaos at Olympic Charleroi22:20 – Special Sweeper announcement

In their fourth episode, the BTK Surgical Endoscopy team delves into the endoscopic management of the dreaded and unexpected. They review how to take care of high-risk surgical complications and introduce the use of a number of endoscopic tools including suturing, stent placement, clips, and the EndoVac. Following a review of a variety of endoscopic techniques, they present case-based scenarios that allow the listeners to understand the application of the endoscopic interventions in everyday practice. Becoming facile with endoscopic interventions may give surgeons the ability to nonoperatively take care of the most complex patients. Hosts:-  Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgeon, Dell Medical School, University of Texas at Austin (Austin, TX), @SAyusoMD (Twitter)- Dr. H. Mason Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL)-  Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) -  Dr. Zachary Callahan, Minimally Invasive Surgeon, Nashville Surgical Associates (Nashville, TN), @zmcallahan (Twitter)Video Link: https://app.behindtheknife.org/video/surgical-endoscopy-series-ep-4-endoscopic-management-of-complicationsPlease 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://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

"We proposed a concept to the American Society of Clinical Oncology (ASCO), recognizing that extravasation management requires significant interdisciplinary collaboration and rapid action. There can occasionally be uncertainty or lack of clear guidance when an extravasation event occurs, and our objective was to look at this evidence with the expert panel to create a resource to support oncology teams overall. We hope that the guideline can help mitigate harm and improve patient outcomes," Caroline Clark, MSN, APRN, AGCNS-BC, OCN®, EBP-C, director of guidelines and quality at ONS, told Chelsea Backler, MSN, APRN, AGCNS-BC, AOCNS®, VA-BC, oncology clinical specialist at ONS, during a conversation about the ONS/ASCO Guideline on the Management of Antineoplastic Extravasation. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 2, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the management of antineoplastic extravasation. Episode Notes  Complete this evaluation for free NCPD. ONS/ASCO Guideline on the Management of Antineoplastic Extravasation ONS Podcast™ episodes: Episode 391: Pharmacology 101: Antibody–Drug Conjugates Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting Episode 145: Administer Taxane Chemotherapies With Confidence Episode 127: Reduce and Manage Extravasations When Administering Cancer Treatments ONS Voice articles: Access Devices and Central Lines: New Evidence and Innovations Are Changing Practice, but Individual Patient Needs Always Come First New Extravasation Guidelines Provide Recommendations for Protecting Patients and Standardizing Care Standardizing Venous Access Assessment and Validating Safe Chemo Administration Drastically Lowers Rates of Adverse Venous Events This Organization's Program Trains Non-Oncology Nurses to Deliver Antineoplastic Agents Safely ONS books: Access Device Guidelines: Recommendations for Nursing Practice and Education (fourth edition) Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) ONS courses: Complications of Vascular Access Devices (VAD) and IV Therapy ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ ONS Oncology Treatment Modalities Clinical Journal of Oncology Nursing articles: Chemotherapy Extravasation: Incidence of and Factors Associated With Events in a Community Cancer Center Standardized Venous Access Assessment and Safe Chemotherapy Administration to Reduce Adverse Venous Events Oncology Nursing Forum article: Management of Extravasation of Antineoplastic Agents in Patients Undergoing Treatment for Cancer: A Systematic Review ONS huddle cards: Antineoplastic Administration Chemotherapy Immunotherapy Implanted Venous Port ONS position statements: Administration (Infusion and Injection) of Antineoplastic Therapies in the Home Education of the Nurse Who Administers and Cares for the Individual Receiving Antineoplastic Therapies ONS Guidelines™ for Extravasation Management ONS Oncologic Emergencies Learning Library ONS/ASCO Algorithm on the Management of Antineoplastic Extravasation of Vesicant or Irritant With Vesicant Properties in Adults American Society of Clinical Oncology (ASCO) Podcast: Management of Antineoplastic Extravasation: ONS-ASCO Guideline To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The focus of this guideline was specifically on intravenous antineoplastic extravasation or when a vesicant or an irritant with vesicant properties leaks out of the vascular space. This can cause an injury to the patient that's influenced by several factors including the specific drug that was involved in the extravasation, whether it was DNA binding, how much extravasated, the affected area, and individual patient characteristics." TS 1:48 "The panel identified and ranked outcomes that mattered most with extravasation. Not surprising, one of the first was tissue necrosis. Like, 'How are we going to prevent tissue necrosis and preserve tissue?' The next were pain, quality of life, delays in cancer treatment: How is an extravasation going to delay cancer treatment that's vital to the patient? Is an extravasation also going to result in hospitalization or additional surgical interventions that would be burdensome to the patient? ... We had a systematic review team that then went in and summarized the data, and the panel applied the grading of recommendations, assessment, development, and evaluation (GRADE) criteria, grading quality of evidence and weighing factors like patient preferences, cost, and feasibility of an intervention. From there, they developed their recommendations." TS 7:35 "The panel, from the onset, wanted to make sure we had something visual for our readers to reference. They combined evidence from the systematic review, other scholarly sources, and their real-world clinical experience to make this one-page supplementary algorithm. They wanted it to be comprehensive and easy to follow, and they included not only those acute management steps but also guidance on 'How do I document this and what are the objective and subjective assessment factors to look at? What am I going to tell the patient?' In practice, for use of that, I would compare it to your current processes and identify any gaps to inform policies in your individual organizations." TS 16:34 "The guidelines don't take place of clinician expertise; they're not intended to cover every situation, but a situation that keeps coming up that we should talk about as a limitation, is we're seeing these case reports of tissue injury with antibody–drug conjugate extravasation. There's still not enough evidence to inform care around the use of antidotes with those agents, so this still needs to be addressed on a case-by-case basis. We still need publication of those case studies, what was done, and outcomes to help inform direction." TS 19:24 "Beyond the acute management is to ensure thorough documentation regarding extravasation. Whether you're on electronic documentation or on paper, are the prompts there for the nurse to capture all of the factors that should be captured regarding that extravasation? The size, the measurement, the patient's complaints. Is there redness? Things like that. And then within the teams, everyone should know where to find that initial extravasation assessment so that later on, if they're in a different clinic, they have something to go by to see how the extravasation is healing or progressing. ... I think there's an importance here, too, to our novice oncology nurses and their preceptors. This could be anxiety-provoking for the whole team and the patient, so we want to increase confidence in management. So, I think using these resources for onboarding novice oncology nurses is important." TS 22:34

In today's VETgirl online veterinary continuing education podcast, we review a recent paper out of France by Robin et al entitled “A systematic review and meta-analysis of prevalence of complications after tracheal stenting in dogs”. You're probably asking – what's a meta-analysis study, and is this podcast going to be boring and just about statistics? Well, first, a meta-analysis is an article that combines and analyzes multiple independent studies, then statistically critically reviews them to draw a more comprehensive conclusion. As there aren't very big studies in veterinary medicine looking at tracheal collapse in dogs, this one is important!

In today's VETgirl online veterinary continuing education podcast, we review a recent paper out of France by Robin et al entitled “A systematic review and meta-analysis of prevalence of complications after tracheal stenting in dogs”. You're probably asking – what's a meta-analysis study, and is this podcast going to be boring and just about statistics? Well, first, a meta-analysis is an article that combines and analyzes multiple independent studies, then statistically critically reviews them to draw a more comprehensive conclusion. As there aren't very big studies in veterinary medicine looking at tracheal collapse in dogs, this one is important!

Mens Room Question: What's The Sickest You've Ever Been?

James I's Male Favorites and the Madrid Adventure: Colleague Clare Jackson explores James I's intense relationships with male favorites like Robert Carr and George Villiers, noting the political complications these caused, describing the bizarre, risky journey Prince Charles and Villiers took to Madrid in disguise to woo the Spanish Infanta. MARCH 1960