Podcasts about contralateral

Check out this week's QuadCast as we highlight the benefits or lack thereof for prophylactic contralateral mastectomy, the benefits of bone marrow sparing IMRT in cervical cancer, the best concurrent cisplatin dosing regimen for H&N cancer, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

We open by recapping some Memorial Day adventures, then get into our topic, Ronald Acuna Jr and a torn ACL. What is interesting here, other than one of the best players on the planet getting injured, is that he tore his ACL in his other knee in 2021. Additionally, he "sprained" the ACL in this knee 2018. Can these all be related....

Michael Meola is a NASM-Certified Corrective Exercise Specialist helping people achieve the best versions of themselves! IG: m_meola WEBSITE:  https://www.trainwithkickoff.com/coaches/MichaelMeola?ref=cr_ig&fbclid=PAAaYBcgdDmHBdSQwYrRFXYnenMxiuYkRFpgiG_5ctNLKFfF1AAwsSaGLZFyo_aem_AR6kilDtJZkksx2fbw8NFhim3lm21KlGSBQunXf1sHqls-kc4ZiBI0AhQ7r99DYNtPs#coach TIME STAMPS: 01:00 Quick recap of Mike's recent LION DIET and how he feels about his upcoming powerlifting meet “THE IRON ASYLUM” in 23 days! 01:21 Colt's AC SEPARATION & personally-written PT program overview to train around this injury. 02:20 Coach Mike's bio! E224 - From 308 lbs to a Lean, Mean, Ribeye-Eating Machine, with Michael Meola E235 - Coach Mike's Lion Diet Results, Keto Powerlifting, & Tips for Beginners 04:13 “PAUSE SETS” in powerlifting; how to use this technique to improve form on your core lifts. 11:11 ASCENDING REPS on the SMITH MACHINE for VERTICAL LEG PRESSES - try this leg day burnout if your man/woman enough!!! 14:30 Mike's experience REINTRODUCING CARBS after having been on ZERO FIBER and low carb through his bulk and beginning of his cut! 15:02 Why KETO POWERLIFTING and KETO BODYBUILDING are both in their infancy particularly among NATURAL athletes. 17:02 OVERVIEW & BREAKDOWN of Coach Mike's MACROS and MEAL PLAN. 20:20 BODYBUILDING REFEEDS and POWERLIFTING REFEEDS for KETO ATHLETES. 23:04 PEAK WEEK POWERLIFTING. 31:45 Tips on making your grocery hauls as cheap as possible!!! 35:02 Also called “cross training” or “opposite limb training” / THE OBJECTIVE: When you train one side of the body, the other side is also stimulated; stimulates MPS on the OPPOSITE LIMB being trained; thought it was BRO SCIENCE but it's actually backed by some eye opening literature!!! PMID28630570 “Contralateral Effects After Unilateral Strength Training: A Meta-Analysis Comparing Training Loads” 38:32 Colt's CONTRALATERAL TRAINING WORKOUTS to rehabilitate his shoulder! 49:16 Ways Mike has been teaching his clients to build sustainable habits around their meal plans, treating them like a MARATHON and not a SPRINT. 49:49 Listener question on CHEAT DAYS - Bojan Zivkovic @ bz.welding.ab - from Sweden! 54:02 Your “WHY” is your FOUNDATION to sticking to your meal plan!!! 57:07 “There is no talent here. This is hard work. This is an OBSESSION.” -Conor McGregor  Do you like RIBEYES? Search Carnivore Coaches Corner (the #1 bodybuilding podcast in England) on any platform for our NUTRITION PODCAST co-hosted with Coach Mark Ennis! SUPERSET Coaching membership inquiries: https://calendly.com/ssyl/meet-greet

This episode of SurgOnc Today®, features guest faculty, Astrid Botty Van Den Bruele, MD, and Meghan Flanagan, MD, MPH. In a contemporary group of patients diagnosed with contralateral axillary metastases (CAM), those selected for treatment with presumed curative intent experienced improved OS when compared to stage IV (M1) patients. The current literature, as well as some forthcoming data, adds additional support for re-evaluating the stage IV designation, in favor of N3, and consideration of curative intent treatment in this disease entity.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.06.28.546857v1?rss=1 Authors: Watanabe, H., Kobikov, Y., Nosova, O., Sarkisyan, D., Galatenko, V., Carvalho, L., Maia, G. H., Lukoyanov, N., Lavrov, I., Hallberg, M., Schouenborg, J., Zhang, M., Bakalkin, G. Abstract: The crossed descending neural tracts set a basis for contralateral effects of brain injury. In addition, the left-right side-specific effects of the unilateral brain lesions may be mediated by neurohormones through the humoral pathway as discovered in animals with disabled descending motor tracts. We here examined if counterparts of the endocrine system that convey signals from the left and right brain injuries differ in neural and molecular mechanisms. In rats with completely transected cervical spinal cords a unilateral injury of the hindlimb sensorimotor cortex produced hindlimb postural asymmetry with contralateral hindlimb flexion, a proxy for neurological deficit. The effects of the left and right side brain lesions were differently inhibited by antagonists of the sigma-, kappa- and micro-opioid receptors suggesting differential neuroendocrine control of the left-right side-specific hormonal signaling. Bilateral deafferentation of the lumbar spinal cord eliminated hormone-mediated effects of the left-side brain injury but not the right-side lesion suggesting their afferent and efferent mechanisms, respectively. Analysis of gene-gene co-expression patterns identified the left and right side-specific gene regulatory networks that were coordinated across the hypothalamus and lumbar spinal cord through the humoral pathway. The coordination was ipsilateral and perturbed by brain injury. These findings suggest that the neuroendocrine system that conveys left-right side-specific hormonal messages from injured brain is bipartite, contributes to contralateral neurological deficits through asymmetric neural mechanisms, and enables ipsilateral coordination of molecular processes across neural areas along the neuraxis. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Join Dr. Steve Gard, editor-and-chief for the Journal of Prosthetics and Orthotics, as he chats with Linda Resnik, about her research on contralateral limb pain among veterans with unilateral upper-limb amputation. The two discuss the motivation behind one of the largest studies of its kind, primary findings, and clinical takeaways. This episode is sponsored by Ottobock.   Show Notes JPO article: Contralateral Limb Pain Is Prevalent, Persistent, and Impacts Quality of Life of Veterans with Unilateral Upper-Limb Amputation Co-Authors: Resnik, Linda PT, PhD, FAPTA; Borgia, Matthew MA; Clark, Melissa A. PhD This episode is produced by Association Briefings.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.16.528842v1?rss=1 Authors: Laflamme, O. D., Markin, S. N., Banks, R., Zhang, Y., Danner, S. M., Akay, T. Abstract: Crossed reflexes (CR) are mediated by commissural pathways transmitting sensory information to the contralateral side of the body, but the underlying network is not fully understood. Commissural pathways coordinating the activities of spinal locomotor circuits during locomotion have been characterized in mice, but their relationship to CR is unknown. We show the involvement of two genetically distinct groups of commissural interneurons (CINs) described in mice, V0 and V3 CINs, in the CR pathways. Our data suggest that the exclusively excitatory V3 CINs are directly involved in the excitatory CR, and show that they are essential for the inhibitory CR. In contrast, the V0 CINs, a population that includes excitatory and inhibitory CINs, are not directly involved in excitatory or inhibitory CRs but down-regulate the inhibitory CR. Our data provide insights into the spinal circuitry underlying CR in mice, describing the roles of V0 and V3 CINs in CR. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

The correct graft choice for ACL reconstruction remains a topic of debate.  Dr. Shelbourne and his group have published extensively on the merits of the contralateral patellar tendon autograft.  They presented their impressive results in this large-scale study published in OJSM in November and join us in this podcast to discuss their rationale, protocol, experience, and keys for success.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: August 16, 2018Lesion localization is a critical skill for any neurologist. The so-called "cortical signs" are symptoms or examination findings, which are often associated with cortical neuron injury--aphasia, neglect, gaze preference. But they are also seen after injury to subcortical structures, including white matter tracts, the thalamus, and basal ganglia. In this week's installment of the BrainWaves podcast, we'll attempt to localize subcortical lesions based on these major cortical signs. Produced by James E Siegler. Music by Aussenseiter, Gnagno, Yshwa, and Kevin McLeod. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. REFERENCES Bogousslavsky J, Regli F, Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology 1988;38(6):837-48. Erratum in: Neurology 1988;38(8):1335. PMID 3368064 Fridriksson J, den Ouden DB, Hillis AE, et al. Anatomy of aphasia revisited. Brain 2018;141(3):848-62. PMID 29360947 Karnath HO, Himmelbach M, Rorden C. The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar. Brain 2002;125(Pt 2):350-60. PMID 11844735 Lam YW, Sherman SM. Functional organization of the thalamic input to the thalamic reticular nucleus. J Neurosci 2011;31(18):6791-9. PMID 21543609 Maeshima S, Osawa A. Thalamic lesions and aphasia or neglect. Curr Neurol Neurosci Rep 2018;18(7):39. PMID 29789957 Nadeau SE, Crosson B. Subcortical aphasia. Brain Lang 1997;58(3):355-402; discussion 418-23. PMID 9222518 Tijssen CC. Contralateral conjugate eye deviation in acute supratentorial lesions. Stroke 1994;25(7):1516-9. PMID 8023372  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.14.528521v1?rss=1 Authors: Dikecligil, G. N., Yang, A. I., Sanghani, N., Lucas, T., Chen, H. I., Davis, K. A., Gottfried, J. A. Abstract: The human olfactory system has two discrete channels of sensory input, arising from olfactory epithelia housed in the left and right nostrils. Here, we asked whether primary olfactory cortex (piriform cortex, PC) encodes odor information arising from the two nostrils as unified or distinct stimuli. We recorded intracranial EEG signals directly from PC while human subjects participated in an odor identification task where odors were delivered to the left, right, or both nostrils. We analyzed the time-course of odor-identity coding using machine learning approaches, and found that odor inputs from the ipsilateral nostril are encoded ~480 ms faster than odor inputs from the contralateral nostril. This temporal staggering across the nostrils gave rise to two non-overlapping epochs of odor coding within a single sniff when odors were sampled through both nostrils. These findings reveal that PC maintains distinct representations from each nostril by temporally segregating odor information, highlighting an olfactory coding scheme at the cortical level that can parse odor information across nostrils within a single sniff. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

In this episode of Coin Flips & Controversies, we present the case of TOpen Floating Knee with Contralateral Closed Tibia Shaft Fx in 38F and feature expert faculty from the upcoming 2023 Evolving Concepts in Orthopaedic Trauma Course Drs. Michael Beltran, James Blair, and Richard Yoon. Important Links: Vote on Case Full Video Register for 2023 Evolving Concepts in Orthopaedic Trauma Course --- Send in a voice message: https://anchor.fm/orthobullets/message

Host Dr. Steve Morris speaks with study lead investigator Helen Mackie about her important findings related to compensatory lymphatic drainage in lower extremity lymphedema, particularly among those with a history of cancer. The findings of this study suggest support for manual lymph drainage to move lymph to the contralateral inguinal drainage region.

Andrew talks about a recent Cervical Fusion case. The patient had surgery for left sided cervical and radiating complaints. However, a few shorts weeks afterward, specific nerve type complaints in the brachial plexus area are now occurring on the contralateral side. Have you ever seen anything like this in your practice? What would you do or look at? Untold Physio Stories is sponsored by Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started. Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual - https://edgemobsys.com/bestsellers My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link. https://myptinsurance.com/edge

Roger is status post cerebrovascular accident and is being evaluated by physical therapy. The patient seems to disregard safety and repeatedly falls onto their weak side. Which of the following is a diagnostic factor of Pusher Syndrome: A. Contralateral loss of pain and temperature sensation B. Trunk lean towards the uninvolved side C. Abduction of the uninvolved extremities D. Inability to push through involved upper extremity LINKS MENTIONED: Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck. Are you looking for a bundle of Coach K's Top MSK Cheatsheets? Look no further: www.nptecheatsheets.com --- Support this podcast: https://anchor.fm/thepthustle/support

Hosted by: S. Diane Yamada, MD, Deputy Editor of Gynecologic Oncology Featuring: Maaike Oonk, MD, University Medical Center Groningen, University of Groningen, The Netherlands Akila Viswanathan, MD, MPH, Johns Hopkins Medicine Editor's Choice Paper: Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe Editorial:When is it safe to omit contralateral groin management in unilateral sentinel node-positive early stage vulvar cancer?

Factors Associated With Disease Progression in the Contralateral Hip of Patients With Symptomatic Femoroacetabular Impingement: A Minimum 5-Year Analysis Khan AZ, Abu-Amer W, Thapa S, et al. Am J Sports Med. 2022;50(12):3174-3183. doi:10.1177/03635465221119509 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

Drs Spiker and Aoki discuss Previous Arthroscopic Hip Surgery Increases Axial Distractibility Compared to the Native Contralateral Hip and May Suggest Instability

Yes, your load positioning does matter when you take on unilateral workouts.

Episode 74: Breast Cancer Screening. Salwa and Veronic discuss who, how, and when to screen for breast cancer. The Pfizer COVID-19 vaccine was authorized for use in children 5-11 years of age.Introduction: Pediatric COVID-19 VaccinesBy Lam Chau, MS3, Ross University School of MedicineOn November 2nd, 2021, the CDC endorsed a unanimous recommendation to allow the use of the Pfizer COVID-19 vaccine for children ages 5-11 years of age. The White House has secured 28 million pediatric doses of the Pfizer vaccine, enough to cover every child ages 5-11 within the United States without cost. The official CDC recommendation is that all children aged 5 and older get vaccinated, regardless of past infection history. The Pfizer vaccine for children is given in two doses, 3 weeks apart.Individuals older than 12 are given a 30-microgram dose, while pediatric individuals are given a 10-microgram dose. For extra precaution, the pediatric vaccine vials are being shipped with a unique orange cap to clearly distinguish itself from higher dose vaccines. Clinical trials with the lower dose vaccine demonstrated a strong antibody response and a prevention rate of symptomatic COVID-19 of 90%. The reported side effects were minimal, and no serious adverse events or myocarditis were reported during the trials. The vaccination of children cannot be understated. The benefits go well beyond just the physiological processes of vaccination. It will foster a safer environment for our children and help improve their emotional and social development. While there is still a lot to be done to end the pandemic, this recent announcement is an enormous step in the right direction in returning to normalcy. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Breast Cancer.   By Salwa Sadiqali, MS3, Ross University Medical School; Veronica Phung, MS3, Ross University School of Medicine; and Hector Arreaza, MD.   Salwa: Welcome back from Spooky season! Did you see all the flyers and advertisements about Breast cancer awareness last month? Veronica: I did! It's because October was breast cancer awareness month.Salwa: And spooky season, and of course pumpkin spice season! I got my dose of pumpkin spice this morning. Well, every morning to be exact, Starbucks is my second home. What do you know about breast cancer? Veronica: Well...breast cancer is the most commonly diagnosed cancer worldwide. And, fun fact, I know that Angelina Jolie had an increased risk of breast cancer, so she had surgery to remove them.Arreaza: I remember it being all over the news back in 2013. It caused “The Angelina Effect.” There was an increase in people searching about breast cancer on the internet. Let's dive into this topic a bit more. What exactly is breast cancer?Salwa: It's a process in which normal cells of the breast start growing too quickly, out of control. It can happen in males too, but it's much rarer.Veronica: And there are different types of breast cancers that originate from the different types of tissue in the breast. There's ductal carcinoma, lobular, inflammatory, Paget's, and phyllodes to name a few. Salwa: Not only are there different types of breast cancers, but some can also be hereditary meaning mutated genetic information is passed on from generation to generation.Arreaza: That's what happened with Angelina Jolie. She had a BRCA1 gene mutation. Veronica: BRCA1 and BRCA2 mutations are the most common causes of hereditary breast cancer. Normally, the BRCA gene helps make proteins that repair damaged DNA. When this gene is mutated, it can't make those proteins, so damaged DNA stays damaged. But this only makes up 5-10% of all breast cancers.Salwa: Exactly! Here's an interesting fact, women of Ashkenazi Jewish heritage are at a much higher risk of developing a BRCA mutation. There are several other genes that are also linked to hereditary breast cancer. But those genes aren't that common. Non-hereditary breast cancers are much more common - they make up about 85% of breast cancers. Arreaza: Ok so you two gave us a lot of good information, but do you know how to screen for breast cancer?Salwa: When and how often you screen depends on which guidelines your physician is following. Generally, you'll get a mammogram, basically an X Ray of the breast. Veronica: The US Preventative Screening Task Force or USPSTF is a panel of experts that uses medicine-based evidence to make screening and vaccination guidelines. These guidelines are reviewed and updated yearly. For breast cancer, the USPSTF recommends women ages 50-74 have a mammogram every other year. Salwa: The American College of Obstetrics and Gynecologists recommends mammograms starting at the age of 40 and repeating the test every year or every other year. While the American Cancer Society recommends annual mammograms from 40 to 54 years of age and then every other year for women 55 years or older. Veronica: Dr. Arreaza, you see a lot of patients and I'm sure you've referred plenty of them for breast cancer screening. How do you decide which guidelines to follow? Arreaza: When you have a patient between 40-50 years old, you have an opportunity to talk about screening, and make a shared decision. The USPSTF recommends that women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or an ancestry associated with BRCA1/2 gene mutation be screened with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing.Some instruments use to assess the need for BRCA mutation screening include Ontario Family History Assessment Tool, Manchester Scoring System, Referral Screening Tool, Pedigree Assessment Tool, 7-Question Family History Screening Tool, International Breast Cancer Intervention Study instrument (Tyrer-Cuzick).Salwa: What about the self-breast exams? I remember those were recommended all the time.Veronica: That's a great question! Current research suggests that doing a self-breast exam doesn't necessarily help detect tumors early – whether cancerous or not. And, sometimes, while doing self-breast exams you may feel a lump that's actually normal breast tissue and it may cause unnecessary anxiety. That being said, you should always know how your breasts normally look - as in are they symmetrical, how the nipples look, how the skin normally looks. And of course, if you notice any changes or have any concerns, please visit your primary care provider. Arreaza: Breast awareness. The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects.Salwa: As medical students, we have the opportunity to work with different departments in the hospital. I'm currently doing my surgery rotation and Veronica completed hers in September. As part of the rotation, we had the opportunity to work at the Breast Clinic with Dr. Snyder. We saw a lot of patients from CSV because their PCPs were screening them for breast cancer and all those women were able to get the higher level of care they needed. Find available resources in your community for free screening mammograms. For example, Cancer Detection Program/Every Woman Counts by Clinica Sierra Vista.____________________________Now we conclude our episode number 74 “Breast Cancer Screening.” October was breast cancer awareness month, but it is not too late to remind everyone of the need to screen for breast cancer. Whether you follow the American Cancer Society, the USPSTF or the ACOG guidelines, just do not forget to screen. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Lam Chau, Salwa Sadiqali, and Veronica Phung. Audio edition: Suraj Amrutia. See you next week! _____________________References:AAFP Signs Off on Pediatric COVID-19 Vaccine Recommendations, American Academy of Family Physicians, November 3, 2021. https://www.aafp.org/news/health-of-the-public/20211103covidvaccchildren.html?%20cid=DM63464&bid=188450701 ACS Breast Cancer Early Detection Recommendations. American Cancer Society. (n.d.). Retrieved October 11, 2021, from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Basu, N.N., Hodson, J., Chatterjee, S. et al. The Angelina Jolie effect: Contralateral risk-reducing mastectomy trends in patients at increased risk of breast cancer. Sci Rep 11, 2847 (2021). https://doi.org/10.1038/s41598-021-82654-x Breast cancer information and support. Breastcancer.org. (n.d.). Retrieved October 10, 2021, from https://www.breastcancer.org/. Breast cancer: Screening. Recommendation: Breast Cancer: Screening | United States Preventive Services Taskforce. (2016, January 11). Retrieved October 10, 2021, from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening.  Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women. (2017). Obstetrics and gynecology, 130(1), e1–e16. https://doi.org/10.1097/AOG.0000000000002158 

In this special interview with Dr. Taylor Reif of the Limb Lengthening and Complex Reconstruction Service at Hospital for Special Surgery in New York City, NY - USA - we get to hear his take on multiple topics of limb lengthening as well as bone cancer as he's also a leading expert in orthopedic oncology. Dr. Reif, is a world class orthopedic surgeon and partners with the great Dr. Rozbruch and Dr. Fragomen. His kind demeanor and "safety-first to remain healthy in the long run" mentality helps his patients know they're in the best possible care for their procedure. We spoke on a variety of topics as shown in the time-stamps below... 2:00 - Dr. Reif's interest in orthopedic disciplines 3:20 - What is bone cancer 4:50 - Does limb lengthening pose risk of cancer to patients 6:20 - Could Stryde nail corrosion cause cancer down the line 8:00 - Are taller patients after stature lengthening at risk of developing cancer 10:40 - Muscle imbalances due to LLD 12:20 - Cosmetic stature lengthening onboarding process 13:55 - Risk of pin-site infections due to external fixators 15:50 - Pros and cons of Contralateral cross lengthening 18:00 - Importance of physical therapy 19:50 - How to contact Dr. Reif for consultation 21:10 - Dr. Reif's final words of advice to prospective patientsy

It's been a long time but he's finally back! Dr. Shahab Mahboubian of Height Lengthening in Los Angeles, California is here to answer your questions on all things limb lengthening and deformity correction. Contact information for Dr. M for consultation: 1. Site: https://heightlengthening.com/ 2. Email: info@heightlengthening.com 3. Follow on IG or TikTok: @heightlengthening Time-Stamps: 0:00 - Intro 2:00 - LL Discrepancy muscle imbalances 4:00 - Femoral Acetabular Impingement before LL 5:15 - Will Tattoos get distorted due to lengthening 6:30 - Potential Long term LL complications 8:55 - Can you get LL with Hashimoto's autoimmune disease 10:25 - When can you drive after LL surgery 11:30 - Potential short term LL complications 13:45 - Care Credit or other loans 15:00 - Mobility with Precice nails during lengthening; when to use a wheelchair vs walker 17:45 - Height threshold for limb lengthening 19:35 - Is LL possible after spine surgery 20:45 - Phases of LL - surgery-distraction-consolidation 22:15 - How to navigate the stairs during LL 23:30 - Rate of bone healing due to age 26:00 - When is the final checkup before farewell 27:45 - How will lengthening affect proportions 28:45 - Contralateral lengthening- one leg and then the other later on 30:05 - Regaining a normal walking gait after LL 31:10 - What pain medication is recommended and for how long 32:45 - Precice vs Stryde nail 35:10 - Thoughts on the LON technique #limblengthening #drmahboubian #heightlengthening

Are you looking for a bundle of Coach K's Top MSK Cheatsheets? Look no further: www.nptecheatsheets.com Gary presents status post anterior cerebral artery stroke. Which of the following is the LEAST likely to be a clinical manifestation of anterior cerebral artery syndrome? A. Homonymous hemianopsia B. Contralateral hemiparesis involving mainly the LE C. Contralateral hemisensory loss involving mainly the LE D. Urinary incontinence Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck. --- Support this podcast: https://anchor.fm/thepthustle/support

To learn more and apply to work one-on-one with Rachel, visit her website: https://www.metflexlife.com/ Join Rachel's weekly newsletter: https://www.metflexlife.com/newsletter  In this episode, Rachel chats about stubborn body fat areas, how to persevere through workouts while healing an injury, prioritizing your training schedule around your goals, overtraining, stress gut, and more! “If you've been so focused on just losing body fat, and you haven't spent a good amount of time actually focused on building muscle...then you're not going to look how you want to look when you do lose that body fat.” Rachel Gregory Today's Questions: If I'm cutting, how do I know if I'm under-muscled or have not cut far enough? I hurt my shoulder. Do I rest my arms or work around it? Recovery may take a while. Should strength training be completed before a walk/hike? Or does order not matter? Have you heard of stress gut? Can too much training cause GERD or other problems? Top Takeaways: Two components to invest your mindset in for the areas that seem to be the last areas to lose body fat Lower body movements that might work with minimal shoulder involvement to train while avoiding an injury Concentric vs. eccentric training benefits When it might be beneficial to add a greens supplement  Show Notes: [0:00] Welcome back to MetFlex and Chill! Today's Q&A episode is answering questions from IG and The Friday Flex. If you haven't signed up for The Friday Flex yet and are interested... sign up at www.metflexlife.com/newsletter [0:30] Question: If I'm cutting, how do I know if I'm under-muscled or have not cut far enough? [1:30] “If you've been so focused on just losing body fat, losing weight, all of that and you haven't spent a good amount of time actually focused on building muscle, then you're not going to look how you want to look when you do lose that body fat.” [5:00] If you're interested in one-on-one coaching with Rachel go to www.metflexlife.com/apply [6:00] Two key components to focus on during a fat loss phase [6:30] Episode 104: 8-Month Building Phase Results & Plan For Next Cut [7:00]  “The time that it takes to lose body fat is actually a lot less time than it takes to put on muscle mass.” [8:30] Question: I hurt my shoulder. Do I rest my arms or work around it? Recovery may take a while. [10:00] Lower body movements that might work when recovering from an upper-body injury [11:00] Safety bar for squats [13:00] What is cross-education or the cross-training effect? [14:00] Contralateral effects of eccentric resistance training on immobilized arm, Cross education: possible mechanisms for the contralateral effects of unilateral resistance training [16:00] Concentric vs. eccentric training benefits [17:00] “The biggest thing is to focus on what you can do, not what you can't do.” [18:00] Question: Should strength training be completed before a walk/hike? Or does order not matter? [18:30] Hiking vs. walking is very different in terms of exertion [21:30] If your goal is to build muscle, do that first. If your goal is to get better at walking or hiking, do that first. ;)  [22:00] Question: What do you think of using a super greens supplement in a smoothie? [24:30] Check out Organifi by going to www.organifi.com/metflex and use code METFLEX for 15% off any of their products [26:00] Question: Have you ever heard of stress gut? Can too much training cause GERD or other problems? [30:30] Your body is smart and it will do what it needs to do to get you out of the stressful situation  [34:00] Importance of paying attention to when your fueling pre and post-workout [36:00] The anabolic window [40:30]  If you haven't signed up for The Friday Flex yet and are interested, sign up at www.metflexlife.com/newsletter. Rachel shares tips, recipes, exercises, and more each Friday! THINGS MENTIONED IN THIS EPISODE: Episode 107: Fasting & Muscle Preservation, Early Morning Training, How To Build Your Pre & Post-Workout Meals Episode 52: Most Common Causes of Bloating, Intermittent Fasting vs. Time Restricted Feeding, and Training While Fasted Episode 85: All Things GUT HEALTH with Sam Miller --- Join the FREE MetFLex Life Course: www.metflexandchill.com Rachel Gregory (@rachelgregory.cns) is a Board-Certified Nutrition Specialist, Strength and Conditioning Specialist, and Author of the best-selling book, 21-Day Ketogenic Diet Weight Loss Challenge. She received her Master's Degree in Nutrition & Exercise Physiology from James Madison University and Bachelor's Degree in Sports Medicine from the University of Miami. Rachel helps her clients transform their lives by starting with the physical (body), realizing the power of the mental (mindset), and ultimately gaining massive confidence that bleeds into every aspect of their lives (family, relationships, work, etc.).

In Upfit Podcast #83 haben wir Ultratrail-Läufer und Trainer Michael Arend von fatboysrun zu Gast. Seine Leidenschaft: das Laufen! Und genau darum geht es in der heutigen Podcastfolge. Denn Laufen ist auf den ersten Blick der wohl 'einfachste' Sport - Jeder kann jeder Zeit ohne Equipment und ohne viel Vorbereitung anfangen zu Laufen. Und trotzdem scheitern viele daran. Woran liegt das? Wie sollte man mit dem Laufen anfangen? Wie geht man mit Verletzungen um? Wie steigert man sich und wie schafft man es am Ball zu bleiben? Michael Arend weiß wie, denn er war jahrelang selbst erfolgreicher Ultratrail-Läufer und trainiert nun selber viele Athleten - von blutigen Anfängern, bis hin zu Profis. Heute teilt er sein Wissen und seine Tipps und Tricks mit uns. Mehr zu Michael: Instagram: https://www.instagram.com/michaelarendtraining/?hl=de Website: https://www.michael-arend.de/ Podcast "FatBoysRun": https://fatboysrun.de/ Studien und Bücher: Contralateral effects of unilateral resistance training: a meta-analysis: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00541.2003 Yoga für Läufer: Einfach besser laufen: https://www.amazon.de/Yoga-f%C3%BCr-L%C3%A4ufer-Einfach-besser/dp/3840377293/ref=asc_df_3840377293/ Burn: The Misunderstood Science of Metabolism: https://www.amazon.de/Burn-Misunderstood-Metabolism-Herman-Pontzer/dp/0241388422/ The Physiology of the World Record Holder for the Women's Marathon: https://www.exeter.ac.uk/media/universityofexeter/internationalexeter/documents/iss/paula_ijssc_paper.pdf Kommentiert fleißig, stellt Fragen und abonniert unseren Kanal, um zukünftig keine Folge mehr zu verpassen. Webseite: upfit.de Instagram: instagram.com/upfit.de Facebook: facebook.com/upfit.de Youtube: youtube.com/channel/UCWRBa7-h8uCpfoXlbv1pdbQ Pinterest: pinterest.de/upfitme --- Send in a voice message: https://anchor.fm/upfit/message

A complete guide to split squat biomechanics  The split squat is incredibly versatile, but how can I most effectively use it to drive the range of motions I need. Or why in the heck is my person compensating in that way when they do the split squat? We will answer that with this post, as the split squat can vary its rotational qualities depending on factors such as depth, arm positioning, and more! If you are ready to absolutely crush all things split squat, then check out Movement Debrief Episode 152 below to find out! Watch the video here for your viewing pleasure. If you want to watch these live, add me on Instagram. Show notes Check out Human Matrix promo video here. Here are some testimonials for the class.  Want to sign up? Click on the following locations below: May 29th-30th, 2021 Boston, MA (Early bird ends May 7th at 11:55 pm!) August 14th-15th, 2021, Ann Arbor, MI (Early bird ends July 18th at 11:55 pm!) September 25th-26th, 2021, Wyckoff, NJ (Early bird ends August 22nd at 11:55 pm) October 23rd-24th, Philadelphia, PA (Early bird ends September 26th at 11:55pm) November 6th-7th, 2021, Charlotte, NC (Early bird ends October 3rd at 11:55 pm) November 20th-21st, 2021 – Colorado Springs, CO (Early bird ends October 22nd at 11:55 pm) Or check out this little teaser for Human Matrix home study. Best part is if you attend the live course you'll get this bad boy for free! (Release date not known yet :(  Here's a signup for my newsletter to get nearly 5 hours and 50 pages of content, access to my free breathing and body mechanics course, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies. Hand and Wrist Rehabilitation - The bible for all things elbow and wrist Foot Compensation Patterns - This post goes over many of the common foot compensations we may see and what to do about it.  Kinesiology of the hip: a focus on muscular actions - If you want to understand hip biomechanics, getting your hands on this paper is a must.  Trunk Position Influences the Kinematics, Kinetics, and Muscle Activity of the Lead Lower Extremity During the Forward Lunge Exercise - This article outlines how altering trunk position can influence muscle activity as the split squat occurs.  Pelvic and femoral split squat mechanics  Question: During Split squat which mechanics can be observed? Nutation on the front leg? Counternutation back leg?  Watch the answer here. Answer: It depends on what we are talking about respective to the point in the split squat. So, fam, let's dive into the various aspects of the split squat. For all positions, let's assume we are talking about a split squat with the left leg in front.  [caption id="attachment_14459" align="aligncenter" width="810"] No asses outta me or you fam![/caption] Split squat start position At the start, the sacrum is right facing, but beginning to turn to the left.  Based on the relative rotation that occurs throughout the movement of flexion, the front leg will have a relative external rotation bias. This bias is due to the top leg being at around 20-30 degrees of hip flexion.  [caption id="attachment_14460" align="aligncenter" width="515"] Sacrum turns left, front leg ER'd, back leg IR'd.[/caption] The back leg will have a relative internal rotation bias due to being at around 0 degrees of hip extension.  Split squat descent As I descend through the squat, the sacrum will progressively turn more and more left, kinda like that one song by Joe but less seductive.  In order for this turn to occur, there will be progressive counternutation on the left side of the sacrum and nutation on the right. As we move downward, we start to see a shift in the rotational influences of the femurs. On the front, once the femur passes around 60 degrees of hip flexion, there is a progressive move towards internal rotation.  The back femur, staying at roughly 0 degrees of hip flexion, maintains slight internal rotation bias throughout the course of the movement.  Bottom of the split squat Once we are at the bottom of the split squat, we've officially reached internal rotation city. Congratulations, you are the mayor.  The influence of 90 degrees of hip flexion on the front leg and maintenance of 0 degrees of hip flexion on the right both lends towards internal rotation occurring at the femurs. Although the sacrum is continually turning to the left, this rotational influence causes the sacrum to perform the act of nutation. That doesn't mean that the sacrum is nutated, but this is the direction it is moving.  Split Squat ascent As I push out of the bottom of the split squat, the sacrum rotates back to the “start” position via external rotation of the front leg and maintenance of back leg internal rotation.  [caption id="attachment_14462" align="alignnone" width="810"] The rotational  difference on the way up creates the turn back to the start[/caption] How do offset loads influence mechanics? All of the above points assume that there is no change with load distribution, but what if I hold a weight in one hand. How does that change things? I'M GLAD YOU ASKED!!!!!! Think of whatever arm I hold the weight in as creating a reach. Whatever arm I reach with will aid in driving rotation in the opposite direction: Ipsilateral load: rotate away from the front leg Contralateral load: rotate towards the front leg [caption id="attachment_14463" align="alignnone" width="810"] Think of the weight distribution as reaching[/caption] Therefore, an ipsilateral load will limit the sacral rotation towards the front leg, and a contralateral load will increase the sacral rotation towards the front leg. Femoral, tibial, and foot split squat mechanics  Question: I watched the video of the Front Foot Elevate Split Squat Shift for driving supination/calcaneal inversion. Does this happen as a result of femoral internal rotation --> tibial external rotation -->supination--> calcaneal inversion. Would this line of thinking be correct? If so, I am having a tough time wrapping my head around the fact that femoral IR (an exhalation measure) would bias supination (an inhalation measure) further down the chain, would it be possible to clarify?  Watch the answer here. Answer: Your line of thinking is tots mcgoats correct. The reason why we have alternating actions occurring with the femur, tibia, and foot has to do with the relative motion occurring between the bones as I bend the knee. There is this concept at the knee joint called the screwhome mechanism. As the knee extends fully, the tibia externally rotates to glide along the condylar grooves. This creates a relative femoral internal rotation. As the knee unlocks from extension, we see the reverse of this mechanism. The tibia internally rotates, and the femur externally rotates. These actions roughly "cancel" each other out to create what appears to us as a purely sagittal movement at the knee (but it's not, folks). According to these two studies (here and here), we actually see these rotational differences throughout the range of knee flexion: Knee hyperextension: tibial external rotation & femoral internal rotation 0-30 knee flexion: tibial internal rotation & femoral external rotation 30-90 knee flexion: tibial external rotation & femoral internal rotation 90 to full knee flexion: tibial internal rotation & femoral external rotation Taking into consideration what is happening as I drop into the bottom of the split squat, we hit roughly Taking into consideration what is happening as I drop into the bottom of the split squat, we hit roughly 90 degrees of hip flexion and knee flexion. Therefore, we can see that we will be moving toward a tibial external rotation and femoral internal rotation orientation.  Given that tibial external rotation is paired with calcaneal inversion and subsequent supination, we now have a way to link a pairing of inhalation and exhalation orientations. What doesn't necessarily change in this orientation is what is going on at the pelvis. There will still be the turn towards the front leg occurring.  One thing we have to be clear on is that although we have biases of specific movements, there are likely inhalation and exhalation actions happening simultaneously everywhere. So too with internal and external rotation. The combination of these movements working together is what provides us several movement options to put our bodies where we need to. Deep hip flexion in a split squat  Question: Would mechanics change if I can dip below 90 degrees of hip flexion in a split squat? Watch the answer here. Answer: As we pass 100 degrees of hip flexion, the femur begins to externally rotate again, and the sacral will turn even further towards the front leg, which will alter the mechanics at the bottom of the split squat to reflect in this fashion. Peep this article to learn more!  Hip shifting in the split squat  Question: Do you consider hip shifting in the lead leg of the split squat more external or internal rotation? Watch the answer here. Answer: The rotation driven will depend on the range at which the shift occurs. Heuristic: Hip shifting will increase the relative rotation in a given direction Given that higher ranges of hip flexion have more external rotation bias, shifting here will increase external rotation. If I shift towards the bottom of the split squat, more internal rotation will be driven in the motion.  What direction should the knee move in a split squat?  Question: In the descent of the split squat, do we want to cue the knee to go toward the big toe? Watch the answer here. Answer: The midline of the foot is the second toe, so I generally want the knee to go over this position. To keep it simple, I just cue my supreme clientele to keep the knee centered over the foot.   Lumbopelvic compensation during a split squat  Question: What happens on a split squat if someone throws the front hip in front of the thorax and the pelvis is overtucked? Watch the answer here. Answer: The split squat requires relative motions to occur at the various joints of the pelvis to create the motion. If you can't create these motions, body regions will begin to move as one unit, and definitely not the cool G-Unit. A common one you might say is the back hip flexed forward as opposed to going straight down. When this happens, the pelvis and lumbar spine posteriorly orient as a unit, which flexes both hips forward. This allows me to attain depth while minimizing the sacral turn towards the front leg.  You could also see shifting backwards of the hip, which is essentially the sacrum turning away from the front leg.  What's more, you could also see a long stance that anteriorly orients the pelvis to create intenral rotation and depth.  In each of these instances, the major key is to keep the stance length shorter, stack, push the front knee forward and the back knee down. One can use a foam roller as a target can help with this latter cue.  Front foot elevated split squats can be good starting points for this: Watch the answer here. Split squats for powerlifting? Question: Split squats for powerlifting? Answer: Since powerlifting involves restricting motion and increasing tension to some degree, the rotational nature of splits squats can be useful to restore any lost range of motion to reduce the risk of tissue overload.  The difference between front heel elevated and front foot elevated split squats  Question: What are the differences in mechanics between front heel and front foot elevation in a split squat? Watch the answer here. Answer: The front foot elevation helps shift weight backwards to reduce front leg loading. A front heel elevation biases calcaneal inversion, which will drive further external rotation through the leg and sacral counternutation.  Lateral split squat vs regular split squat  Question: What biomechanically changes in a lateral split squat versus a regular split squat? Watch the answer here. Answer: A lateral split squat induces more pelvic lateral tilt, whereas a regular split squat provides more pelvic rotation.  A lateral tilt will drive even greater internal rotation bias than your traditional split squats.  Dorsiflexion loss in a split squat Question: Would a heels elevated split squat be better than squatting for a dorsiflexion loss? Answer: Anytime you can use rotation and do it savagely well, you. can drive both anterior and posterior expansion. This will generate WAY more motion than bilateral stuff, whcih is why it's easier for peeps to generate more motion.  Back leg position in a rear-foot elevated split squat  Question: What position do I like for the back foot in a rear foot elevated split squat? Watch the answer here. Answer: As I lower into the squat, the back knee is going to be in a relative tibial external rotation and femoral internal rotation position, which will bias calcaneal inversion. Inversion is associated with plantarflexion, which is a good reason to keep the back foot plantarflexed when. you are using this modality.  Sum up The split squat starts with an external rotation bias, but progresses towards an internal rotation as we hit the bottom; the sacrum progressively turns towards the front leg Ipsilateral loads decrease rotation towards the front leg. Contralateral load increases rotation towards the front leg With progressive knee flexion, femoral and tibial movements rotate in opposing directions. The deeper the hip flexion in a split squat, the more the sacrum turns towards the front leg. Hip shifting magnifies the sacral turning depending on the depth at which it occurs.  The knee should be centered over the second toe in a split squat. Loss of "ideal" motion in the split squat often results in the lumbopelvic complex moving as one unit.  Lateral split squats create lateral pelvic tilts; regular split squats create pelvic rotation Front foot elevation shifts bodyweight posteriorly; heel elevation increases leg external rotation The back foot in a rear-foot elevated split squat should be plantarflexed, as this promotes the foot, tibial, and hip position needed throughout the range of motion.   

CHEST April 2021, Volume 159, Issue 4 David E. Ost, MD, MPH, joins CHEST Podcast Moderator, Dominique Pepper, MD, to discuss if contralateral hilar N3 nodes should be omitted from staging. DOI: https://doi.org/10.1016/j.chest.2020.10.041

Commentary by Dr. Valentin Fuster

Quando lesionamos um membro, seja um braço ou uma perna e ficamos impossibilitados de treinar musculação, talvez a primeira coisa que passa pela nossa cabeça seja não treinar o outro lado, pois isso possivelmente criaria uma diferença de força e tamanho muscular, resultando em uma assimetria funcional e estética. Será que o exercício de força de um membro pode conduzir ganhos de força no membro contralateral não treinado? @fabiodominski Fonte: Manca, A., Dragone, D., Dvir, Z., & Deriu, F. (2017). Cross-education of muscular strength following unilateral resistance training: a meta-analysis. European journal of applied physiology, 117(11), 2335-2354. Carroll TJ, Herbert RD, Munn J, Lee M, Gandevia SC (2006) Contralateral effects of unilateral strength training: evidence and possible mechanisms. J Appl Physiol 101:1514–1522 Lara A. Green & David A. Gabriel (2018) The effect of unilateral training on contralateral limb strength in young, older, and patient populations: a meta-analysis of cross education, Physical Therapy Reviews, 23:4-5, 238-249. --- Support this podcast: https://anchor.fm/fabio-dominski/support

Can't turn your head? Find out why So the neck, thorax, shoulders, and more are all related, but is there a convenient way to illustrate the interconnectedness of these areas? I think there is one test that can provide TONS of insight here. That test? Lower cervical rotation The ability to rotate the lower part of the neck can demonstrate how well you can move the uppermost parts of the thorax and can help differentiate if you need to drive interventions either below or above the neck.  Want to know all about the importance of this often-overlooked test? Check out Movement Debrief Episode 142 to learn more! Watch the video here for your viewing pleasure. If you want to watch these live, add me on Instagram. t Show notes Check out Human Matrix promo video here. Here are some testimonials for the class. Want to sign up? Click on the following locations below: February 20th-21st, 2021, Atlanta, GA (Early bird ends January 17th at 11:55 pm!) April 10th-11th, 2021, Warren, OH (Early bird ends March 14th at 11:55 pm) May 29th-30th, 2021 Boston, MA (Early bird ends April 25th at 11:55 pm!) August 14th-15th, 2021, Ann Arbor, MI (Early bird ends July 18th at 11:55 pm!) September 25th-26th, 2021, Wyckoff, NJ (Early bird ends August 22nd at 11:55 pm) November 6th-7th, 2021, Charlotte, NC (Early bird ends October 3rd at 11:55 pm) Dickinson College in Carlisle PA (POSTPONED DUE TO COVID-19) [Approved for 14 Category A CEUs for athletic trainers] Montreal, Canada (POSTPONED DUE TO COVID-19) [6 CEUs approved for Athletic Therapists by CATA!] Or check out this little teaser for Human Matrix home study. Best part is if you attend the live course you'll get this bad boy for free! (Release date not known yet :( Here's a signup for my newsletter to get nearly 5 hours and 50 pages of content, access to my free breathing and body mechanics course, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies.   Introduction to Orofacial Myofunctional Therapy Course Review - If you want to dive into myofunctional therapy and tongue posture, this is the post for you. If you want to peep some exercises for your tongue, check out the playlist here. Covd.org - If you want to find a neuro or behavioral optometrist, one who looks beyond vision clarity, this is the place to find them. Spinal Manipulation Institute - My go-to place to learn how to do joint manipulations. Risk of Vertebrobasilar Stroke and Chiropractic Care - Does joint manipulation pose a risk for vertebral artery breaking? Not as much as going to your primary care physician. Read this article and prepare to have your mind blown. Cervical rotation assessment and treatment Question: "Hey Zac, What do you look for when you assess neck rotation and needs for lower cervical rotation?" Answer: Cervical rotation is an excellent measure that bridges that gap between craniocervical and thorax limitations. We will be separating measuring this area into upper and lower cervical contributions. The bulk of cervical rotation happens at C1-C2, which accounts for about 45 degrees of motion in each direction. The remaining 45 or so degrees happens in the rest of the cervical spine. You'll also get some thoracic spine movement down to T5-ish with cervical rotation. An easy way to measure upper cervical rotation is the classic flexion-rotation test. Here, you'll flex the neck until the chin is touching the chest, then rotate the head, shooting for 45 degrees each way. But how in the heck do you measure the remaining cervical rotation contributions? I'm glad you asked!!! There is a test called lower cervical rotation, where you essentially grab the neck and rotate it as a unit. The way you perform the test is by approximating your index fingers up against C7. Grasp the neck and rotate it as a unit, as you can see in the video here. There isn't really a "normal" degree on this test. You have to go by feel. Usually, the test is restricted if you feel an abrupt halt or block as you into the rotation. If you can't test someone manually, you can simply look at seated cervical rotation, then have the client actively perform the flexion-rotation test, and note the difference. So we have two areas to target: lower cervical rotation vs upper cervical rotation Lower cervical rotation If there is a limitation in cervical rotation in one direction, that means you'll have reductions in: ipsilateral posterior expansion Contralateral anterior expansion This limitation will occur all the way down to T5. Meaning that this test can be another test to determine if one needs upper thorax (T2-4) expansion. This test is especially useful if your supreme clientele has REALLY FLEXIBLE shoulders. Can't trust 'em! If you see a restriction here and you've already stacked, then you want to drive activities that isolate rotation here. Movements such as cross-connects, where the thorax rotates one direction and the head rotates the opposite direction, can be a useful way of targeting this region. You can also combine head rotation with humeral rotation, like with an armbar screwdriver. Upper cervical rotation If you have cleared up everything else, yet you notice there is still a restriction in upper cervical rotation, you'll likely need to either drive upper cervical mobility or target the cranial sensory systems. Most people are either biased towards a forward head posture or a military posture. For the former, you'll need to drive slight OA flexion. You can accomplish this position easily with a drunken turtle. If you need OA extension, simply cueing undouble chin during any move can be enough. Looking ahead in a chair and wall squat can do the trick. You can also utilize manual therapy in this area to attain desired outcomes. Let's suppose that you've tried this to no avail, you may have to consider affecting different sensory systems. This "fix" could either involves a dental (or myofunctional) to improve palatal tongue posture, working with a neuro-optometrist, or potentially impacting other sensory systems. When should I refer to an optometrist? Question: "How do you know if vision is a factor in limited cervical movement?" Watch the answer here. Answer: There aren't really hard and fast rules when it comes to determining when you need to make the optometric referral. It's usually a cluster of exhausting conservative options and history indicating visual disturbance. I cannot stress this enough: make the vision referral AFTER exhausting all conservative options. Meaning, you've stacked and taught other basic movement skills. If I bold and italicize at the same time, you know I mean bidness! The reason why I say this is because many times you can refer someone who doesn't necessarily need this discipline or doesn't have the fundamental movement skills needed to build upon visual training. Do the basics first. Now if you've gone after conservative measures and things just aren't bopping, you might consider a referral to a neuro optometrist if you see some of the following medical history indicators: High prescription (4.0+/- or more) strabismus Lazy eye concussion history cataracts monovision Abrupt changes in prescription difficulty focusing, brain fog, have to consistently re-read, poor penmanship LASIK/PRK surgery, especially if botched blind in one eye There are likely others that I'll be able to contribute as I work on this referral source and knowledge base more. There isn't really a specific test that would point you towards seeing an optometrist, but one thing that I've seen is severely limited straight leg raise that doesn't improve with interventions. If you need to make an optometry referral, again, try to find a neuro optometrist. Working on visual skills other than sight is critical for influencing movement options. Sum up Lower cervical rotation involves addressing upper thorax rotation to improve mobility Upper cervical rotation involves address OA movement or sensory systems to improve mobility Vision therapy is pursued when all other options are exhausted and medical history poses signs that would warrant a consult. Image by Barbora Hnyková from Pixabay

Defining kinetics and kinematics, factors influencing injury risk, interventions to correct injury risk factors 1:06 What is kinetics 1:16 What is kinematics 1:31 Ground reaction force contribution to injury risk 3:44 Excessive hip adduction and injury risk 6:27 Contralateral hip drop and injury risk 9:06 Dorsiflexion restriction and injury risk 13:21 Interventions Check out the article citations for this episode! https://atcornerds.wixsite.com/home/blog Join our AT Corner Facebook Group to comment on this episode and join the conversation with other listeners of the show! https://www.facebook.com/groups/atcornerpodcast Listen on Spotify, Apple Podcasts, or your favorite podcast directory! Linktr.ee/atcornerpodcast Instagram, Website, and other links: linktr.ee/atcornerpodcast Medbridge: Use code ATCORNER to get $175 off your subscription Email us your stories, questions to answer on the show, topics you would like to hear, or just say hi! atcornerds@gmail.com Music: Jahzzar (betterwithmusic.com) CC BY-SA -Sandy & Randy

Invitado: Dr. Leopoldo Alvarado Acosta Trombosis venosa profunda contralateral posterior a la colocación de stent en la confluencia iliocava en enfermedad venosa oclusiva crónica: Revisión sistemática. Contralateral deep vein thrombosis after stenting across the iliocaval confluence in chronic venous disease – A systematic review. Duarte-Gamas L, Rocha-Neves JP, Pereira-Neves A, Dias-Neto M, Baekgaard N. Phlebology. 2020 May;35(4):221-230. doi: 10.1177/0268355519889873. Epub 2019 Dec 2. (02:40) Seguridad de la colocación de stent venoso ilio-cavo (04:13) Metodología (05:05) Requerimiento de extensión de stent a la vena cava (07:25) Resultados de trombosis contralateral (08:50) Importancia de la anticoagulación en la colocación de stent venoso (12:35) Tipos de stent en la enfermedad venosa oclusiva (17:21) Desarrollo de nuevas tecnologías

In this episode of Quah (Q & A), Sal, Adam & Justin answer Pump Head questions about contralateral training, the value of Alkaline & PH water, whether foam rolling is good for recovery, and credibility of out of shape personal trainers. Morning moodiness is a real thing. (5:01) The potential value of bullies. (8:20) Mind Pump Recommends, My Octopus Teacher on Netflix. (18:28) The value of debate and why Sal recommends Allsides.com. (24:03) The at-home workout “bike wars.” Who will win?! (28:27) Compass pathways, psilocybin-therapy firm, goes public. (33:56) It's pumpkin spice season! (35:53) Is Halloween canceled this year? (36:32) The benefits of tea tree oil for the scalp and how Adam has been using Dr. Squatch to remedy it.  (39:00) Going to the movies in the COVID era. (42:14) #Quah question #1 – What is contralateral training and who does it benefit? (45:03) #Quah question #2 – Are alkaline & PH water another processed item on the market? Or are they worth the money? (51:07) #Quah question #3 – Is foam rolling good for recovery and can it help you recover faster? (55:59) #Quah question #4 – In your opinion, how credible is a personal trainer if they're not in their best shape at the moment? (1:00:12) Related Links/Products Mentioned MAPS Fitness Products Cobra Kai | Netflix Official Site My Octopus Teacher | Netflix Official Site AllSides | Balanced news via media bias ratings Peloton Shares Rebound After Amazon Denies Echelon Partnership Apple Fitness Plus comes after Peloton with streaming workouts that sync with Apple Watch Compass Pathways Takes Investors on a Trip to Higher Prices Compass Pathways (NASDAQ: CMPS) Begins Trading on Nasdaq Global Select Market Visit Organifi for the exclusive offer for Mind Pump listeners! **Code “mindpump” at checkout** Are Halloween, Thanksgiving Cancelled? CDC Releases 2020 Guidelines For Fall Holidays Visit Dr. Squatch for an exclusive offer for Mind Pump listeners! *Promo code “MINDPUMP” at checkout for 20% off sitewide* Tenet (2020) - Rotten Tomatoes 3 Exercises To Decrease Lower Back Pain | FREE Back Pain Guide How To Foam Roll PROPERLY (AVOID THESE MISTAKES) | MIND PUMP Lets Talk About The TRUE Value of Foam Rolling Mind Pump Podcast - YouTube Mind Pump Free Resources   

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.30.228361v1?rss=1 Authors: Silson, E. H., Zeidman, P., Knapen, T. H., Baker, C. I. Abstract: The initial encoding of visual information primarily from the contralateral visual field is a fundamental organizing principle of the primate visual system. Recently, the presence of such retinotopic sensitivity has been shown to extend well beyond early visual cortex to regions not historically considered retinotopically sensitive. In particular, human scene-selective regions in parahippocampal and medial parietal cortex exhibit prominent biases for the contralateral visual field. Here we used fMRI to test the hypothesis that the human hippocampus, which is thought to be anatomically connected with these scene-selective regions, would also exhibit a biased representation of contralateral visual space. First, population receptive field mapping with scene stimuli revealed strong biases for the contralateral visual field in bilateral hippocampus. Second, the distribution of retinotopic sensitivity suggested a more prominent representation in anterior medial portions of the hippocampus. Finally, the contralateral bias was confirmed in independent data taken from the Human Connectome Project initiative. The presence of contralateral biases in the hippocampus, a structure considered by many as the apex of the visual hierarchy, highlights the truly pervasive influence of retinotopy. Moreover, this finding has important implications for understanding how this information relates to the allocentric global spatial representations known to be encoded therein. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.21.213751v1?rss=1 Authors: Kusnir, F., Pesin, S., Landau, A. N. Abstract: Our sense of touch is unique in that our tactile receptors are spread across our body surface and constantly receive different inputs at the same time. These inputs vary in relevance according to our current goals, but there is little research on how simultaneous stimulation to different body sites affects the perception of touch. In this series of studies, we characterised how irrelevant tactile sensations across the body-midline affect tactile detection in a constantly-attended body site. Participants had to detect a target on their dominant index finger, while receiving irrelevant stimulation to another body site (homologous and non-homologous fingers, and the contralateral ankle). We document robust interference effects on all measured body-sites. Its impact on detection-performance was unaffected by body posture, exacerbated by the intensity of the irrelevant stimulation, and ameliorated by embedding a target-like signal in the irrelevant stimulation. In addition, we generalise our findings beyond the target stimulus (i.e., a vibration intensity decrement) and report similar effects when employing a target-increment. In light of our findings, we propose that tactile inputs may be pooled together early in the hierarchy of somatosensory processing, resulting in an integrated percept. The rules for integration across body sides are likely not described by a simple summation, but rather may be governed by more complex interactions between fingers and according to the corresponding perceived, as well as actual, intensities of the stimulation. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.16.207316v1?rss=1 Authors: Moss, M. M., Zatka-Haas, P., Harris, K. D., Carandini, M., Lak, A. Abstract: Midbrain dopamine neurons play key roles in decision-making by regulating reward valuation and actions. These roles are thought to depend on dopamine neurons innervating striatum. In addition to actions and rewards, however, efficient decisions often involve consideration of uncertain sensory signals. The functions of striatal dopamine during sensory decisions remains unknown. We trained mice in a task that probed decisions based on sensory evidence and reward value, and recorded the activity of striatal dopamine axons. Dopamine axons in ventral striatum (VS) responded to bilateral stimuli and trial outcomes, encoding prediction errors that scaled with decision confidence and reward value. By contrast, dopamine axons in dorsal striatum (DS) responded to contralateral stimuli and contralateral actions. Thus, during sensory decisions, striatal dopamine signals are anatomically organized. VS dopamine resembles prediction errors suitable for reward maximization under sensory uncertainty whereas DS dopamine encodes specific combinations of stimuli and actions in a lateralized fashion. Copy rights belong to original authors. Visit the link for more info

"Contralateral Oblique View for Epidural Access: A Coalescence of Precision and Ease," by Jatinder S. Gill, MD, Assistant Professor; and Thomas Simopoulos, MD, MA, Division Chief of Pain Medicine; both of Beth Israel Deaconess Medical Center, Boston, MA. From ASRA News, February 2020, pp. 17-20. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.

Remember the Choose Your Own Adventure Books? You know the ones where you read a page and had to make a decision on what to do next. Well, this workout is kinda like that. I'm providing you with a timer and you get to make your own workout from the template below. All of the exercises are body weight based so you don't need any equipment to get your workout in while you're stuck inside.  This episode is very basic, besides the program below. It is a downloadable timer for you to perform the workout below to. You will only hear the starting and stopping beeps.  We're breaking this workout into 5 blocks containing 5 exercises each. You'll perform each one for 45 seconds, with a 15 second break in between.  BLOCK 1 Full Body #1 (Pick from List Below) Legs #1 (Pick from List Below) Chest & Back #1 (Pick from List Below) Shoulders & Arms #1 (Pick from List Below) Core #1 (Pick from List Below)  *Repeat Block 1 BLOCK 2 Full Body #2 (Pick from List Below) Legs #2 (Pick from List Below) Chest & Back #2 (Pick from List Below) Shoulders & Arms #2 (Pick from List Below) Core #2 (Pick from List Below) * Repeat Block 2 BLOCK 3 Full Body #3 (Pick from List Below) Legs #3 (Pick from List Below) Chest & Back #3 (Pick from List Below) Shoulders & Arms #3 (Pick from List Below) Core #3 (Pick from List Below)     Full body 1. Inchworm Stand up tall with legs straight, making sure your knees aren’t locked. Slowly lower torso toward the floor, then walk hands forward. Once in a push up position, start taking tiny steps so feet meet hands. 2. Tuck jump Stand with your knees slightly bent, then jump up as high as possible. Bring knees in toward chest while extending arms straight out. Land with knees slightly bent and quickly jump again! 3. Bear crawl Embrace that inner grizzly. Starting on hands and knees, rise up onto your toes, tighten your core, and slowly reach forward with right arm and right knee, followed by the left side. 4. Mountain climber Start on your hands and knees. Bring left foot forward, directly under chest, while straightening right leg. Keeping hands on the floor and core tight, jump and switch legs.  Your left leg should now be extended behind you, with your right knee forward. Next up? Everest. 5. Plyometric push-up Ready to catch some air? Start on a well-padded surface and complete a traditional push-up. In an explosive motion, push up hard enough to come off the floor (and hang ten for a second!). Once back on solid ground, immediately head into the next repetition. 6. Stair climb with biceps curl Turn those stairs into a cardio machine — no magic wand necessary. Grab some dumbbells (or household objects) and briskly walk up and down the stairs while simultaneously doing biceps curls to work the whole body. 7. Prone walkout Start on all fours with your core engaged. Slowly walk hands forward, staying on toes but not moving them forward. Next, gradually walk hands backward to the starting position, maintaining stability and balance.  Share on Pinterest 8. Burpee One of the most effective full-body exercises around, this one starts in a low squat position with your hands on the floor. Next, kick your feet back to a push-up position.  Complete one push-up, then immediately return your feet to the squat position. Leap up as high as possible before squatting and moving back into the push-up portion of the show. 9. Plank Lie face down with forearms on the floor and hands clasped. Extend legs behind you and rise up on toes. Keeping back straight, tighten core and hold the position. 10. Plank to push-up Start in a plank position. Place one hand at a time on the floor to lift up into a push-up position, with your back straight and core engaged. Move one arm at a time back into the plank position (forearms on the floor). Repeat, alternating the arm that makes the first move.   Legs 11. Wall sit Who needs a chair when there’s a wall?  Slowly slide your back down a wall until your thighs are parallel to the floor. Make sure knees are directly above ankles and keep back straight. Share on Pinterest 12. Lunge Stand with hands on hips and feet hip-width apart. Step your right leg forward and slowly lower your body until left (back) knee is close to or touching the floor and bent at least 90 degrees.  Return to the starting position and repeat on the other side. For a variation, try stepping backward into the lunge 13. Clock lunge Time for a challenge. Complete a traditional forward lunge, then take a big step to the right and lunge again. Finish off the semicircle with a backward lunge, then return to standing. 14. Lunge to row Start by doing a normal lunge. Instead of bringing that forward leg back to the starting position, raise it off the floor while lifting your arms overhead. The leg should remain bent at about 90 degrees. Add weights to really bring the heat. 15. Pistol squat There may be no gun permit necessary for this one, but it’s still no joke.  Stand holding your arms straight out in front of your body. Raise right leg, flexing right ankle and pushing hips back. Lower your body while keeping right leg raised. Hold (have fun with that), then return to standing. 16. Lunge jump Ready to impress some friends? Stand with feet together and lunge forward with right foot. Jump straight up, propelling arms forward while keeping elbows bent. While in the air, switch legs and land in a lunge with the opposite leg forward. Repeat and continue switching legs. 17. Curtsy lunge Let’s show a little respect. When lunging, step left leg back behind right leg, bending knees and lowering hips until right thigh is almost parallel to the floor. Remember to keep your torso upright and your hips square. 18. Squat Stand with feet parallel or turned out 15 degrees — whatever is most comfortable. Slowly start to crouch by bending hips and knees until thighs are at least parallel to the floor.  Make sure your heels do not rise off the floor. Press through your heels to return to a standing position. 19. Single-leg deadlift Start in a standing position with feet together. Lift right leg slightly. Lower arms and torso while raising right leg behind you. Keep left knee slightly bent and reach arms as close to the floor as possible. Raise torso while lowering right leg. Switch legs.  Share on Pinterest 20. Squat reach and jump Ready to add some pizzazz (and cardio!) to that squat? Perform a normal squat, but immediately jump up, reaching your arms straight overhead. 21. Chair Pose squat Stand with feet hip-width apart and squat until thighs are parallel to the floor while swinging arms up. Straighten legs, then lift right knee while swinging left arm outside right knee. Return to standing and repeat on the other side. 22. Quadruped leg lift Start on hands and knees, with back flat and core engaged. Raise left leg straight back, stopping when foot is at hip level and thigh is parallel to the floor.  Balance for as long as possible, then raise your bottom right toe off the floor, tightening butt, back, and abs — try to be graceful here! 23. Step-up Find a step or bench. Place right foot on the elevated surface. Step up until right leg is straight, then return to the starting position. 24. Calf raise From a standing position, slowly rise up on your toes, keeping knees straight and heels off the floor. Hold briefly, then come back down. Aaaand repeat. Try standing on something elevated (like a step) to achieve a wider range of motion.  Share on Pinterest   Chest and back 25. Standard push-up There’s a reason this one’s a classic. With hands shoulder-width apart, keep feet flexed at hip distance and tighten your core. Bend elbows until chest reaches the floor, then push back up. Make sure to keep your elbows tucked close to your body. 26. Dolphin push-up Start out in Dolphin pose (think Downward-Facing Dog Pose with elbows on the floor). Lean forward, lowering shoulders until head is over hands. Push up with your arms and return to the starting position. No ocean necessary. 27. Contralateral limb raise Sounds fancy, huh? Here’s the breakdown: Lie face down with arms outstretched and palms facing each other.  Slowly lift one arm a few inches off the floor, keeping it straight without rotating your shoulders and keeping head and torso still. Hold the position, then lower your arm back down. Repeat on the other side.  For an extra challenge, lift the opposite leg a few inches off the floor at the same time. Share on Pinterest 28. Donkey kick It’s time to embrace that wild side. Start in a push-up position with your legs together. Tighten core and kick both legs into the air with knees bent, reaching feet back toward glutes. Try to land gently when returning to the starting position. 29. Handstand push-up Fair warning: This move is for the pros. Get set in a handstand position against a wall. Bend your elbows at a 90-degree angle, doing an upside-down push-up so your head moves toward the floor and your legs remain against the wall. First-timer? Grab a friend to spot you — safety first!  Share on Pinterest 30. Judo push-up From a push-up position, raise those hips and in one swift movement — hai-yah! — use your arms to lower the front of your body until your chin comes close to the floor.  Swoop head and shoulders upward and lower hips, keeping knees off the floor. Reverse the move to come back to the raised-hip position. 31. Reverse fly For DIY dumbbells, grab two cans or bottles of water. Stand up straight, with one foot in front of the other and your front knee slightly bent.  With palms facing each other and abs engaged, bend forward slightly from your waist and extend arms out to the sides, squeezing shoulder blades. Repeat. 32. Superman Want some superpowers? Lie face down with arms and legs extended. Keeping the torso as still as possible, simultaneously raise your arms and legs to form a small curve in your body. Cape optional.  Share on Pinterest   Shoulders and arms 33. Triceps dip Sit on the floor near a step or bench, with knees slightly bent. Grab the edge of the elevated surface and straighten your arms.  Bend your arms to a 90-degree angle and straighten again while your heels push into the floor. For some extra fire, reach right arm out while lifting left leg. 34. Diamond push-up Rhianna would approve of this one! Get into a push-up position with diamond-shaped hands, so that your thumbs and index fingers touch. Then do push-ups!  This hand position will give those triceps some extra (burning) love. 35. Boxer Time to make Muhammad Ali proud. Stand with feet hip-width apart and knees bent. Bend forward until your torso is almost parallel to the floor.  Keep your elbows in and extend one arm forward and the other arm back. Hug your arms back in and switch arms like you’re in the ring! Share on Pinterest 36. Shoulder stabilization series (I-Y-T-W-O) OK, it may look ridiculous, but stay with us. Lie face down with arms extended overhead and palms facing each other. Move your arms into each letter formation. Gimme a Y — you know you want to! 37. Arm circles Remember PE class? Stand with arms extended by your sides, perpendicular to your torso. Slowly make clockwise circles about 1 foot in diameter for 20 to 30 seconds. Then reverse the movement, going counterclockwise.  Share on Pinterest   Core 38. L seat Take a load off (well, not exactly). Sit with legs extended and feet flexed. Place your hands on the floor and slightly round your torso. Lift your hips off the floor, hold for 5 seconds, and release. Repeat! 39. Rotational push-up Standard push-ups not cutting it? For a variation, after coming back up into a starting push-up position, rotate your body to the right and extend your right hand overhead, forming a T with your arms and torso. Return to the starting position, do a regular push-up, and then rotate to the left. 40. Flutter kick Lie faceup with arms at your sides and palms facing down. With legs extended, lift your heels about 6 inches off the floor. Make quick, small up-and-down pulses with your legs while keeping your core engaged. 41. Dynamic prone plank Starting in a standard plank position, raise your hips as high as they can go, then lower them back down. Continue this movement for as long as possible. Make sure your back stays straight and your hips don’t droop. 42. Side plank Lie faceup and roll to the side. Come up onto one foot and elbow. Make sure your hips are lifted and your core is engaged. 43. Russian twist Sit on the floor with knees bent and feet together, lifted a few inches off the floor. With your back at a 45-degree angle to the floor, move your arms from side to side in a twisting motion.  Here, slow and steady wins the race: The slower the twist, the deeper the burn. 44. Bicycle Lie faceup with knees bent and hands behind your head. Bring knees in toward chest. Bring right elbow toward left knee as right leg straightens. Continue alternating sides like you’re peddling a bike. Share on Pinterest 45. Crunch Before anyone’s crowned Cap’n Crunch, remember: Form is key. Lie faceup with knees bent and feet flat on the floor. With hands behind head, lower your chin slightly. Peel head and shoulders off the floor while engaging your core. Continue curling up until your upper back is off the mat. Hold briefly, then slowly lower torso back toward the floor. 46. Segmental rotation Let’s target those obliques! Lying faceup with your knees bent and core tight, let your knees fall gradually to the left until you feel a good stretch. Hold for 5 seconds, return to center, and repeat on the right. 47. Shoulder bridge Lie faceup with knees bent and feet hip-width apart. Place arms at your sides and lift your spine and hips. Only your head, feet, arms, and shoulders should be on the floor.  Lift one leg, keeping your core tight. Slowly bring leg back down, then lift back up. Share on Pinterest 48. Single-leg abdominal press Lie faceup with knees bent and feet flat on the floor. Tighten abs and raise right leg, with knee bent at a 90-degree angle.  Push right hand on top of lifted knee, using core to create pressure between hand and knee. Hold for 5 seconds, then lower back down. Repeat with left hand and knee. 49. Double-leg abdominal press Two legs are twice the fun! Follow the same rundown for the single-leg press (see No. 48), but bring both legs up at the same time, pushing hands against knees. 50. Sprinter situp Want to be a speed demon without getting off the floor? Lie faceup with legs straight and arms by your sides, elbows bent at a 90-degree angle. Now, sit up and bring left knee toward right elbow. Return to the starting position. Repeat on the other side.

The Suicide Headache:Cluster Headaches  The sun rises over the San Joaquin Valley, California, today is March 18, 2020. Last week marked the 5thanniversary since we opened our home at East Niles Community Health Center. The grand opening was on March 6, 2015. Also, Match Day 2020 is coming soon! We are happy to inform that we matched all 8 positions. We will know the residents’ names in a few days. This will be our 6th class. We are excited to welcome a new group of motivated residents starting in June 2020.  Also, COVID-19 has infected over 200,000 and caused almost 9,000 deaths worldwide. A few hours ago, a non-resident in Kern County was confirmed to be positive for coronavirus(1). This pandemic continues to evolve every day, but we will not talk about it any further today. Visit the CDC website, or contact your local public health department for accurate and updated information.___________“If you think education is expensive, try ignorance.” (Unknown author, possibly Ann Landers)Headache is among the top 10 chief complaints among primary care visits, we are happy to address this relevant topic with one of our chief residents. Today our guest is Lisa Manzanares. Lisa is on her third year. I am pleased to see you today. By the way, she has also been the voice of our “Speaking Medical” section. How are you doing today?You know we ask 5 questions in this podcast. We’ll start with the first question.Question number 1: Who are you?You want the short or the long answer? I have to talk for 20 minutes they say, so you’re getting the ‘long.’  I’m a U.S. Navy veteran, mom of 3 little girls, a wife, a rock climber, explorer of the Sierras, a long board enthusiast, and a ….right, and a third year family medicine resident in the Rio Bravo Family Medicine Program.  I took the circuitous route here: after graduating medical school in 2013 from Western University of Health Sciences in Pomona, CA, I did an Intern year at Naval Medical Center San Diego. After that, the Navy sent me to the Central Valley where I practiced outpatient general medicine.  I took care of Active Duty members and their families while stationed at the Naval Hospital in Lemoore.  Comment: What a nice bio, we are happy to have you as one of our residents. Question number 2: What did you learn this week?I learned about the acute treatment cluster headaches in the clinic. 100% oxygen via nonrebreather facial mask with flow of at least 12L/min.   You should continue x 15 minutes to prevent the attack from returning, though the patient may feel better in as little as 5 minutes.  As for medications: subcutaneous sumatriptan 6mg is beneficial in about 75% of patients, intranasal sumatriptan  or zolmitriptan can also be used but is slower in onset.  Sometimes only 3mg sumatriptan SQ can benefit patients.  Intranasal triptans are administered CONTRALATERAL to the pain side, because patients with cluster headache often have rhinorrhea and congestion on the side ipsilateral to the pain, impeding the delivery of the medication.  Intranasal lidocaine in a 4-10% solution can also be used, and is effective in about 1/3 of patients.  The lidocaine is administered on the IPSILATERAL side. Comment: We may not see the patient during the acute pain, but if you see a patient with acute cluster headache this is the treatment that needs to be given. Some patients have chronic cluster headache without remission periods.Cluster headache is more prevalent in men and typically begins between 20 and 40 years of age. Trigeminal autonomic cephalgia: Unilateral, located on the temporal or periorbital area, accompanied by at least one ipsilateral symptom in the eye, nose, or face (rhinorrhea, conjunctival injection); it causes restlessness or agitation, duration of 15 to 180 minutes, One episode every other day to eight episodes per day. It is a severe headache(2). One of my patients explained it to me in a very painful way. He put a pen on his eye and stabbed himself on the eye, thankfully he only injured the medial aspect of his eye lid, but you can tell how intense the pain is if your patient is willing to stab himself in the eye to describe it.Prophylaxis:As for prophylaxis of cluster headache, verapamil is the first-line therapy. Other meds that aren’t 1st line but may work: glucocorticoids, lithium, topiramate; more invasive treatments such as nerve stimulation and surgery may be helpful in refractory cases.Question number 3: Why is that knowledge important for you and your patients?Cluster headaches are miserable.  In fact, the pain is described as a severe ‘suicide headache’ under diagnostic criteria in journal articles on cluster headache. My job as a family physician is to reduce common miseries.  About 1 in 1000 US adults has experienced a cluster headache, and cluster headache has a large associated morbidity: 80% of these patients report restricting daily activities. Common + miserable =something we need to learn about for the sake of our patients. Plus, oxygen is something that is in every clinic. This is one way to be able to treat the patient on the spot, and have them walking out of the clinic feeling better.Comment: Tell us about the triggers of cluster headaches.Triggers include vasodilators (e.g., alcohol, nitroglycerin) and histamine, tobacco exposure (first hand or second hand)  Question number 4: How did you get that knowledge?There’s always that question about 100% oxygen and cluster headaches on the boards, on shelf exams.  This is probably not news to anyone listening to the podcast. So the oxygen thing was something that actually stuck from med school.  In terms of finding out more of what to do with the patient, how to make her feel better, I had to look some stuff up.  My trusty sources in clinic are 1.) Up to Date and 2.) Faculty.  3.) Review/Journal articles. Not necessarily in that order.  Question number 5: Where did that knowledge come from?The info is an amalgam of: knowledge from Dr. Schlareth, our faculty member here, “Cluster Headache” by Dr. Weaver-Agostoni downloaded from the AAFP website, and “Cluster Headache: Treatment and Prognosis” on Up-to-Date(3). See details in our website.Now we conclude our episode number 3 “The Suicide Headache”. Cluster headache is no joke. When you encounter a patient with a cluster headache, remember to use oxygen and abortive treatment as explained before. Do not forget to prescribe prophylaxis treatment if indicated.________________Speaking Medical (Medical word of the Day) by Monica Kumar, MDHi, my name is Dr Kumar, today I want to teach you the medical word of the day. Since everyone is fighting over toilet paper, we thought it was only appropriate to introduce to you the explosive medical term of the week. Steatorrhea. “Steatorrhea” is the excess of fat in the stools often due to the impaired transport of nutrients across the apical membrane of the enterocytes, that results in oily, foul smelling stools.Some of the underlying causes of steatorrhea are celiac disease, cystic fibrosis, pancreatitis, lactose intolerance and gastrointestinal infections. If you see a patient with steatorrhea (not caused by the consumption of unhealthy amounts of burger and fries), please investigate further by asking onset, duration, frequency, triggers, and travel history, perform a complete physical exam, and order additional studies based on your assessment.  In young children presenting with failure to thrive and steatorrhea, do not forget about cystic fibrosis. Remember the medical word of the day steatorrhea.   _________________Espanish Por Favor (Spanish Word of the Day) by Greg FernandezWelcome to your section Espanish Por Favor, this is Dr Fernandez and today’s Spanish word of the day which is “Piquete”. “Piquete” is translated as a prick, shot, jab, injection or a stinging pain or discomfort. The scenario where someone would use this word would sound like this: “Doctor, me da un piquete en el pecho” or “Doctor, tengo piquetes en las piernas”. It means “Doctor, I have a shot-like pain on my chest” or “Doctor, I have pricks on my legs.”  People can use this word to refer to an acute, sudden, short-duration, stinging, sharp pain. It is like a “bird bite”. The etiology of this pain can be very broad and can include muscle spasms, neuropathy, leg cramps, or many other conditions. It may also be a sign of no disease at all. Now you know the Espanish word of the day, “piquete”. All you have to do is go and assess your patient’s “piquetes”. That’s all for today, have a great week, and remember to wash your hands, avoid touching your face and avoid crowded places. Thank you.  ____________________ For your Sanity (Medical joke of the day)by Simron Gill, MS4 and Monica Kumar, MD--Why did the teacher with tertiary syphilis get fired? --Why?--He couldn't control his pupils--What is an EKG finding of hypospadias? --It doesn’t make sense, what does an EKG shows in hypospadias?--Inverted P waves Duck Hunting A family medicine doc, an internist, a surgeon, and a pathologist are out one day duck hunting. First up is the family doc, he raises his gun to take aim at a flock of birds passing overhead and says to himself, "It looks like a duck, flies like a duck, quacks like a duck, it must be a duck." BANG! He bags himself a duck.The internal medicine doctor then steps up, raises his gun to take aim at a second flock of birds flying overhead. He says to himself, "Looks like a duck, flies like a duck, quacks like a duck, rule out quail, rule out pheasant, goose versus duck likely." BANG! He, too, bags himself a duck.A third flock of birds then flies overhead and the surgeon steps up and raises his gun at the flock. BANG! BANG! BANG! BANG! BANG! He fires multiple rounds at the flock and dead birds are dropping all around. The surgeon lowers his gun, walks over to one of the dead birds, picks it up, hands it to the pathologist and says, "Tell me if this is a duck." References:The Bakersfield Californian, Non-resident tests positive for coronavirus in Kern County, https://www.bakersfield.com/news/non-resident-tests-positive-for-coronavirus-in-kern-county/article_618b45b2-686c-11ea-ab78-e70420b5c2fd.html , accessed on March 17, 2020.Jacqueline Weaver-Agostoni, DO, MPH, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, Pennsylvania. Am Fam Physician. 2013 Jul 15; 88(2):122-128. https://www.aafp.org/afp/2013/0715/p122.html#afp20130715p122-t1Arne May, MD,  Cluster headache: Treatment and prognosis, Up to Date, https://www.uptodate.com/contents/cluster-headache-treatment-and-prognosis?search=cluster%20headache%20treatment&source=search_result&selectedTitle=1~72&usage_type=default&display_rank=1, accessed on March 17, 2020.

Lesions of the subthalamic nucleus & contralateral hemiballism

Lesion localization is a critical skill for any neurologist. The so-called "cortical signs" are symptoms or exam findings which are often associated with cortical neuron injury--aphasia, neglect, gaze preference. But they are also seen after injury to subcortical structures, including white matter tracts, the thalamus, and basal ganglia. In this week's installment of the BrainWaves podcast, we'll attempt to localize subcortical lesions based on these major cortical signs. Produced by James E. Siegler. Music by Aussenseiter, Gnagno, Yshwa, and Kevin McLeod. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. REFERENCES Maeshima S and Osawa A. Thalamic Lesions and Aphasia or Neglect. Current neurology and neuroscience reports. 2018;18:39. Bogousslavsky J, Regli F and Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology. 1988;38:837-48. Karnath HO, Himmelbach M and Rorden C. The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar. Brain. 2002;125:350-60. Lam YW and Sherman SM. Functional organization of the thalamic input to the thalamic reticular nucleus. J Neurosci. 2011;31:6791-9. Tijssen CC. Contralateral conjugate eye deviation in acute supratentorial lesions. Stroke; a journal of cerebral circulation. 1994;25:1516-9. Fridriksson J, den Ouden DB, Hillis AE, Hickok G, Rorden C, Basilakos A, Yourganov G and Bonilha L. Anatomy of aphasia revisited. Brain. 2018. Epub ahead of print. Nadeau SE and Crosson B. Subcortical aphasia. Brain Lang. 1997;58:355-402; discussion 418-23.

Discussion of a recent study that evaluated prospectively psychosocial well being measures in breast cancer patients before and after receipt of CPM. Read the related article "Prospective Study of Psychosocial Outcomes of Having Contralateral Prophylactic Mastectomy Among Women With Nonhereditary Breast Cancer" on JCO.org

Today I’m joined by two guests, Eric Leija and Francheska Martinez. Eric is an Annit Academy Senior Kettlebell Coach, coach ate the Onnit Gym in Austin, Texas, and specialist in all things related to kettlebell flow. Francheska is an animal flow instructor and master, Onnit kettlebell specialist, Onnit Mace specialist , stretch therapist, coach, and bodyweight movement expert. I’ve always found the kettlebell to be such a valuable, versatile piece of equipment, and getting to explore the creativity of movement with it is something I’ve enjoyed. Today we discuss the many ways we can explore movement in a gym beyond barbells, animal and kettlebell flows, the art, style, and grace of movement, what a flow might look like, how to spot a practice, and much more. Show notes: (4:04)- Exploring movement beyond barbells in the gym (5:46)- Doing more with less (7:34)- Kettlebells vs other discipline (11:51)- Flowing/ dancing (15:47)- Making heavyweight look light/ being graceful (18:28)- What does a flow look like (23:15)- Explore your body in movement patterns (26:59)-Contralateral movement patterns (28:57)- Who does animal and kettlebell flow attract? (36:25)- Adopting a practice (40:35)- Grace on the floor (42:58)- Simple flow workout (45:50)- Buying time (47:58)- Graceful movement/ Ido (50:50)- lateral ape, jump squat, side kick through (54:24)- If you could give 1-3 pieces of content to the world, who would they be? (58:08)- Story similar to taking a leap off a cliff before you knew what the landing would be (1:02:44)- What is something you don’t get asked about enough? (1:05:30)- Kettlebell course Resources we may have talked about Ido Movement How you can connect with Eric & Francheska Instagram: @francheskafit, @primal.swoledier https://www.ericleija.com This episode is brought to you by Revive-Rx. Their supplements help me stay fueled and help me live the motto of #lookgoodmovewell. I personally am a huge fan of the Recover Strawberry, which I use immediately after my training sessions. Use the code “miz10” to get 10% off your purchase. If you wanna grab any book we’ve talked about in the past, head over to theairbornemind.com/readinglist. You’ll see all the books recommended from each guest. And if you want you can get a free audiobook and 30 day free trial there as well. If you enjoyed this episode, please leave a review on iTunes and lemme know what you think. It would really help me out so I can continue creating awesome stuff for you. And remember the greatest compliment you can give is by sharing this with someone else who might enjoy it or somewhere on the web. Once again thank you for being a listener and supporting the show. Until next time.  

CHICAGO—Prophylactic contralateral (CLT) breast radiotherapy was associated with significantly fewer and delayed cases of breast cancer in women having standard therapy for their ipsilateral BRCA mutation-associated breast cancers in a study from Israel reported in a poster session at the …Ella Evron PRODUCTION MASTER for AJO

Clinical Tuesdays  www.ptonice.com 

Interview with Gretchen L. Gierach, PhD, author of Association of Adjuvant Tamoxifen and Aromatase Inhibitor Therapy With Contralateral Breast Cancer Risk Among US Women With Breast Cancer in a General Community Setting

We dive into what to do on holiday to not lose all your gains or shredded look, tom gives out some holiday workout advice with a limited gym. We get our geek on with Ipsilateral Vs Contralateral Loading, what is it? find out so your client can stop asking, What arm do I hold the weight with? What leg goes forward? Why the hell am I doing this?? and Mexican beef and Gary Taubes make it on stupid things.

Dr. David Harpole, Duke University Medical Center, describes the mediastinoscopy and its use in lung cancer staging.

Dr. David Harpole, Duke University Medical Center, describes the mediastinoscopy and its use in lung cancer staging.

Dr. David Harpole, Duke University Medical Center, describes the mediastinoscopy and its use in lung cancer staging.

July 16, 2014 Podcast: 5 Ways To Get Fit With an iTunes Gift Card, How To Workout If Your Hands Are Broken, Why A Vegan Diet Helped Bill Clinton, Natural Remedies for Alopecia, and Standing Lawn Mower Fitness. Have a podcast question for Ben? Click the tab on the right, use the Contact button on the app, call 1-877-209-9439, Skype “pacificfit” or use the “” form...but be prepared to wait - we prioritize audio questions over text questions. ----------------------------------------------------- News Flashes: You can get these News Flashes hot off the presses if you follow Ben on , and . I love crazy Kickstarters - Yet another use for ----------------------------------------------------- Special Announcements: The Rock Star Triathlete Academy has relaunched with a lifestyle membership card! Check out the Ben will be speaking on nutrition myths and alternative methods of fueling Ironman. Go ask your burning Obstacle Racing questions at for the brand new Obstacle Dominator podcast. Grab this package that comes with a tech shirt, a beanie and a water bottle. And of course, this week's top iTunes review - gets some BG Fitness swag straight from Ben - ! ----------------------------------------------------- Listener Q&A: As compiled, deciphered, edited and sometimes read by , the Podcast Sidekick and Audio Ninja. 5 Ways To Get Fit With an iTunes Gift Card Tim asks: He was given a VERY generous gift of a $1000 gift card for iTunes from one of his customers. He wants to know what we would spend it on. What health, wellness or fitness apps - high end or low end - would we buy? In my response I recommend: - - - - How To Workout If Your Hands Are Broken Lee asks: Two weeks ago he broke both of his hands in a bicycle accident (went over the handlebars) and is now looking for ways to exercise and stay in shape. He is a triathlete who also lift weights, rock climbs and plays racquetball - all things that involve grip strength which he no longer has. In my response I recommend: -Leg exercises and even Zercher squats -Flies, pullovers, cables -Contralateral training - Why A Vegan Diet Helped Bill Clinton Bob asks: He wants to know why people like Bill Clinton and George W. Bush seem to have health improvements after they switch from a meat based diet to a vegan or vegetarian diet. Why do you think that happens? In my response I recommend: -My book chapter on Natural Remedies for Alopecia Eyebrows asks: He recently ran his first marathon. While he was training he lost his eyebrows and was diagnosed with alopecia. The doc said it was likely from the stress of training for the race but he topped out at 35 miles per week so he doesn't think the training caused it. Right now he is getting shots every month to stimulate hair growth (seems like a band aid solution) but is looking for other ways to deal with the autoimmune problem. He eats mostly paleo but with a few carbs and some dairy. In my response I recommend: - - Standing Lawn Mower Fitness Jeff asks: He has a unique standing workstation which is attached to a large commercial mower. It's like lawn surfing. He is in constant movement - hips, knees and feet all moving and shaking. How would he take this kind of "exercise" (he does feel fatigued at the end of the day) into account when training for a marathon? In my response I recommend: -Compression -Inversion -Vibration - ----------------------------------------------------- -- And don't forget to go to -- Prior to asking your question, do a search in upper right hand corner of this website for the keywords associated with your question. Many of the questions we receive have already been answered here at Ben Greenfield Fitness! Podcast music from 80s Fitness (Reso Remix) by KOAN Sound. !

Introduction: Hormone receptor (HR) status has become an established target in treatment strategies of breast cancer. Population-based estimates of contralateral breast cancer (CBC) incidence by HR subtype in particular are limited. The aim of this study was to provide detailed data on CBC incidence for Germany. Methods: Invasive breast cancer data were extracted on 49,804 women yielding 594 second primaries from the cancer registries of the Federal States of Brandenburg and Saarland and the area of Munich for the period from 1998 to 2007. Multiple imputation was used on missing values for HR status. We estimated standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). Results: SIR estimates of CBC among women diagnosed with an invasive first primary breast cancer (FBC) of any HR subtype ranged from 1.0 to 1.5 in the three registries. Pooling three registries' data, the SIR of HR-positive CBC was 0.7 (95% CI: 0.6 to 0.8) among women with HR-positive FBC. For those women with HR-negative FBC, the SIR of HR-negative CBC was 8.9 (95% CI: 7.1 to 11.1). Among women with FBC diagnosed before the age of 50 years, incidence of CBC was increased, especially for HR-negative FBC (SIR: 9.2; 95% CI: 7.1 to 11.9). Conclusions: HR status of the first primary and age at first diagnosis is relevant for predicting risk of CBC. Particularly, patients with HR-negative FBC had elevated risks.

This podcast discusses approaches to risk assessment of contralateral breast cancer and factors which predict the risk.

Introduction: While it has been reported that the risk of contralateral breast cancer in patients from BRCA1 or BRCA2 positive families is elevated, little is known about contralateral breast cancer risk in patients from high risk families that tested negative for BRCA1/2 mutations. Methods: A retrospective, multicenter cohort study was performed from 1996 to 2011 and comprised 6,235 women with unilateral breast cancer from 6,230 high risk families that had tested positive for BRCA1 (n = 1,154) or BRCA2 (n = 575) mutations or tested negative (n = 4,501). Cumulative contralateral breast cancer risks were calculated using the Kaplan-Meier product-limit method and were compared between groups using the log-rank test. Cox regression analysis was applied to assess the impact of the age at first breast cancer and the familial history stratified by mutation status. Results: The cumulative risk of contralateral breast cancer 25 years after first breast cancer was 44.1% (95% CI, 37.6% to 50.6%) for patients from BRCA1 positive families, 33.5% (95% CI, 22.4% to 44.7%) for patients from BRCA2 positive families and 17.2% (95% CI, 14.5% to 19.9%) for patients from families that tested negative for BRCA1/2 mutations. Younger age at first breast cancer was associated with a higher risk of contralateral breast cancer. For women who had their first breast cancer before the age of 40 years, the cumulative risk of contralateral breast cancer after 25 years was 55.1% for BRCA1, 38.4% for BRCA2, and 28.4% for patients from BRCA1/2 negative families. If the first breast cancer was diagnosed at the age of 50 or later, 25-year cumulative risks were 21.6% for BRCA1, 15.5% for BRCA2, and 12.9% for BRCA1/2 negative families. Conclusions: Contralateral breast cancer risk in patients from high risk families that tested negative for BRCA1/2 mutations is similar to the risk in patients with sporadic breast cancer. Thus, the mutation status should guide decision making for contralateral mastectomy.

Non-pulsatile tinnitus is considered a subjective auditory phantom phenomenon present in 10 to 15% of the population. Tinnitus as a phantom phenomenon is related to hyperactivity and reorganization of the auditory cortex. Magnetoencephalography studies demonstrate a correlation between gamma band activity in the contralateral auditory cortex and the presence of tinnitus. The present study aims to investigate the relation between objective gamma-band activity in the contralateral auditory cortex and subjective tinnitus loudness scores. In unilateral tinnitus patients (N = 15; 10 right, 5 left) source analysis of resting state electroencephalographic gamma band oscillations shows a strong positive correlation with Visual Analogue Scale loudness scores in the contralateral auditory cortex (max r = 0.73, p

Hosted by: S. Diane Yamada, MD, Deputy Editor of Gynecologic OncologyFeaturing:Maaike Oonk, MD, University Medical Center Groningen, University of Groningen, The NetherlandsAkila Viswanathan, MD, MPH, Johns Hopkins MedicineEditor's Choice Paper: Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe Editorial: When is it safe to omit contralateral groin management in unilateral sentinel node-positive early stage vulvar cancer?