Podcasts about cureus

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

En lo último en salud y fitness edición de mayo 2025, damos un paseo por las últimas tendencias, investigaciones y noticias en el mundo de la salud y el fitness.Hoy tenemos un episodio especial con temas que van desde cómo el ejercicio al aire libre puede mejorar tu pensamiento, hasta descubrir que tu taza de café diaria podría estar haciendo más por tu cerebro de lo que imaginas. También veremos cómo un simple bloqueo en tu celular podría ser la clave para mejorar tu bienestar mental, y exploraremos datos importantes sobre ejercicio y cáncer de mama que pueden cambiar vidas.Atajos Del Episodio02:00 - ¿Quieres pensar mejor? Juega al aire libre [1]04:27 - ¿Y si tu paz mental está a un bloqueo de distancia?[2]07:51 - El ejercicio no cura el cáncer… pero sí puede cambiar todo lo demás[3]10:06 - ¿Y si tu café de la mañana también estuviera protegiendo tu cerebro? [4]12:29 - Melatonina: el héroe silencioso que podría proteger tu ADN mientras duermes de día [5]Grace Walters, Karah J. Dring, Ryan A. Williams, Robert Needham, Simon B. Cooper. (2025). Outdoor physical activity is more beneficial than indoor physical activity for cognition in young people. hysiology & Behavior. Volume 295, 2025, 114888, ISSN 0031-9384, https://doi.org/10.1016/j.physbeh.2025.114888.Castelo, N., Kushlev, K., Ward, A. F., Esterman, M., & Reiner, P. B. (2025). Blocking mobile internet on smartphones improves sustained attention, mental health, and subjective well-being. PNAS nexus, 4(2), pgaf017. https://doi.org/10.1093/pnasnexus/pgaf017Lee, J., & Hwang, Y. (2025). The effects of exercise interventions on fatigue, body composition, physical fitness, and biomarkers in breast cancer patients during and after treatment: a systematic review and meta-analysis of randomized controlled trials. Journal of cancer survivorship : research and practice, 10.1007/s11764-025-01772-x. Advance online publication. https://doi.org/10.1007/s11764-025-01772-xAshfaq, Z., Younas, Z., Nathaniel, E., Rehman, A., Siddiqi, A., Rasool, N., & Amir, M. (2025). Association Between Caffeine Intake and Alzheimer's Disease Progression: A Systematic Review. Cureus, 17(3), e80923. https://doi.org/10.7759/cureus.80923Zanif, U., Lai, A. S., Parks, J., Roenningen, A., McLeod, C. B., Ayas, N., Wang, X., Lin, Y., Zhang, J. J., & Bhatti, P. (2025). Melatonin supplementation and oxidative DNA damage repair capacity among night shift workers: a randomised placebo-controlled trial. Occupational and environmental medicine, 82(1), 1–6. https://doi.org/10.1136/oemed-2024-109824

Have you ever found yourself standing in front of the pantry during a stressful moment, reaching for something sweet, salty, or crunchy—just to take the edge off? If so, you're not alone. In this episode of the Better Than Before Breast Cancer podcast, I open up about my own experience with emotional eating during cancer recovery and share gentle, compassionate strategies to help you understand and shift this pattern—without guilt or shame. We'll explore: -How cortisol (your stress hormone) drives cravings -What emotional triggers might be signaling -How to respond to your body's needs with love and presence You'll learn mindful, doable ways to support yourself when stress eating feels like the only option, plus calming alternatives that nourish both body and soul. Whether you're fresh out of treatment or navigating long-term survivorship, this episode is a supportive space for reflection, kindness, and taking small steps toward healing.  

We all know about the medical school curriculum. But what about the hidden curriculum, or how students learn about the unspoken culture of medicine through everyday, informal interactions? In this episode, Dr. Sandra Quezada and Dr. Sarah Dubbs explore the hidden curriculum with some examples, chat about whether the hidden curriculum can be positive or negative, and offer guidance on how students can best navigate the hidden curriculum and thrive within it.   References: Lawrence C, Mhlaba T, Stewart KA, et al. The Hidden Curricula of Medical Education: A Scoping Review. Acad Med. 2018 Apr;93(4):648-656. PMID: 29116981. Bandini J, Mitchell C, Epstein-Peterson ZD, et al. Student and Faculty Reflections of the Hidden Curriculum. Am J Hosp Palliat Care. 2017 Feb;34(1):57-63. Epub 2016 Jul 11. PMID: 26566929. Martimianakis MA, Michalec B, Lam J, et al. Humanism, the Hidden Curriculum, and Educational Reform: A Scoping Review and Thematic Analysis. Acad Med. 2015 Nov;90(11 Suppl):S5-S13. PMID: 26505101. Hopkins L, Saciragic L, Kim J, Posner G. The Hidden Curriculum: Exposing the Unintended Lessons of Medical Education. Cureus. 2016 Oct 25;8(10):e845. PMID: 27909633 Kalter L. Navigating the Hidden Curriculum in Medical School. AAMC News. Published July 13, 2019. Accessed December 10, 2024. Link.  Freedman D. The Hidden Curriculum. NYU Langone Health Hub. Accessed December 10, 2024. Link.   

Contributor: Ricky Dhaliwal, MD Educational Pearls: What factors are considered in a COVID-19 infection? The viral load: Understood as the impact of SARS-CoV-2 viral particles infecting host cell tissue itself (utilizing ACE-2 receptors). Pro-Inflammatory Response: Post-infection, the body's downstream systemic cytokine release (can be both normal or hyperactive, aka “cytokine storm”). What cardiac impacts have been observed with COVID-19? Arrhythmias: The mechanism of COVID-19 infection and arrhythmias is believed to be multifactorial. However, evidence suggests T-cell-mediated toxicity and cytokine storm may contribute to cardiac myocyte damage, precipitating proarrhythmias instead of direct viral entry. Bradycardia: Increased prevalence in patients with severe COVID-19 infection, but not associated with increased adverse outcomes. Atrial Fibrillation: Most common cardiac complication and risk factor for worsened outcomes in patients with COVID-19. Biggest associated risk is strokes, and may require heightened monitoring and anticoagulation therapy to mitigate stroke risk. Fibrosis of Cardiac Tissue: Similar to arrhythmias, believed to be inflammation-mediated in COVID-19. Fibrosis of cardiac tissue increases the risk that any arrhythmias that develop during infection may persist after the infection has resolved. Ventricular damage: Also inflammation mediated by an active infection and contributes to myocarditis. No evidence suggests that COVID-19 vaccination contributes to myocarditis.  Sinus node dysfunction induced by inflammation that may lead to or be similar to Postural Orthostatic Tachycardia Syndrome (POTS).  Big takeaway? Patients who have had or currently have COVID-19 are at an increased risk of developing arrhythmias and sustaining them post-infection. However, a majority of patients will recover. Due to atrial fibrillation being the most prevalent arrhythmia associated with COVID-19 infection, increased monitoring and potential anticoagulation therapy are required.  References Gopinathannair R, Olshansky B, Chung MK, Gordon S, Joglar JA, Marcus GM, et al. Cardiac Arrhythmias and Autonomic Dysfunction Associated With COVID-19: A Scientific Statement From the American Heart Association. Circulation. 2024 Nov 19;150(21):e449–65. Khan Z, Pabani UK, Gul A, Muhammad SA, Yousif Y, Abumedian M, et al. COVID-19 Vaccine-Induced Myocarditis: A Systemic Review and Literature Search. Cureus. 14(7):e27408. Summarized by Dan Orbidan, OMS1 | Edited by Dan Orbidan & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/

When it comes to fertility nutrition, it's easy to feel like you're drowning in “rules” about what you can and can't eat. But supporting your fertility isn't about restriction - it's about adding in foods that help nourish your hormones and body.In today's episode, we're highlighting 5 foods you can add to your week to support hormones, egg quality, and overall reproductive health. No hard rules, no overwhelm - just simple, powerful ways to increase your chances of pregnancy. If this episode resonated with you, we'd love for you to share and leave a review!Download our Free Hormone + Gut Health Toolkit here!References:Chavarro JE, Rich-Edwards JW, Rosner B, Willett WC. A prospective study of dairy foods intake and anovulatory infertility. Hum Reprod. 2007 May;22(5):1340-7. doi: 10.1093/humrep/dem019. Epub 2007 Feb 28. PMID: 17329264.Jaiswal A, Dewani D, Reddy LS, Patel A. Choline Supplementation in Pregnancy: Current Evidence and Implications. Cureus. 2023 Nov 8;15(11):e48538. doi: 10.7759/cureus.48538. PMID: 38074049; PMCID: PMC10709661.Nguyen HT, Oktayani PPI, Lee SD, Huang LC. Choline in pregnant women: a systematic review and meta-analysis. Nutr Rev. 2025 Feb 1;83(2):e273-e289. doi: 10.1093/nutrit/nuae026. PMID: 38607338.Muffone ARMC, de Oliveira Lübke PDP, Rabito EI. Mediterranean diet and infertility: a systematic review with meta-analysis of cohort studies. Nutr Rev. 2023 Jun 9;81(7):775-789. doi: 10.1093/nutrit/nuac087. PMID: 36346903.Trop-Steinberg S, Gal M, Azar Y, Kilav-Levin R, Heifetz EM. Effect of omega-3 supplements or diets on fertility in women: A meta-analysis. Heliyon. 2024 Apr 6;10(8):e29324. doi: 10.1016/j.heliyon.2024.e29324. PMID: 38628754; PMCID: PMC11019195.

En este vídeo respondo a una consulta muy profunda sobre el asma, la ansiedad y los ataques de pánico, compartiendo mi experiencia personal y mis conocimientos como profesional de la salud. Explico la delgada línea entre el asma y los ataques de pánico, y cómo la dieta cetogénica, la pérdida de grasa, el ayuno, la suplementación y la gestión del estrés pueden ser claves para mejorar estos síntomas.También hablo sobre la relación entre la inflamación intestinal y las enfermedades autoinmunes como el asma, así como la importancia de una dieta baja en carbohidratos, rica en magnesio y con alimentos antiinflamatorios. Todo esto forma parte de una visión integrativa que puede ayudarte a mejorar tu salud respiratoria y emocional.Estudios:Dieta keto en asmaAl-Rebdi, M., & Rabbani, U. (2023). Alleviation of asthma symptoms after ketogenic diet: A case report. Cureus, 15(2), e34526. https://doi.org/10.7759/cureus.34526Dieta keto en enfermedades respiratoriasNorwitz, N. G., Winwood, R., Stubbs, B. J., D'Agostino, D. P., & Barnes, P. J. (2021). Case report: Ketogenic diet is associated with improvements in chronic obstructive pulmonary disease. Frontiers in Medicine, 8, 699427. https://doi.org/10.3389/fmed.2021.699427La dieta keto es antiinflamatoriaJi, J., Fotros, D., Sohouli, M. H., Velu, P., Fatahi, S., & Liu, Y. (2025). The effect of a ketogenic diet on inflammation-related markers: A systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews, 83(1), 40–58. https://doi.org/10.1093/nutrit/nuaad175

Alex and Venk discuss the fundamental differences of caring for people during an in-flight emergency: what changes with oxygen and pressure, what is available to you, what are the expectations, and more. Both have been teaching about this scenario to others and have been present for several such encounters. They bring their expertise and the available literature to establish this level-setting chapter of the Always on EM Podcast. By the end of this, hopefully, you'll have zero hesitation standing with confidence that you can provide assistance in any event that arises and be as well prepared as anyone to do it. So, buckle up, put your seatbacks up, stow your laptops, and tune in to this high-flying chapter of Always on EM!   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Kim Y, Bae SC, Song YS. Exploring the potential of telehealth in-flight medical emergencies. Digit Health. 2025 Mar 13;11:20552076251326666. doi: 10.1177/20552076251326666. PMID: 40093698; PMCID: PMC11907535. Hawati SM, Binobaid F, Alsaeigh A, Alameer W, Al Ajmi AM, Alghamdi MK, Alqarni AA, Al-Harthi SN, Almelaifi A, Al Shehri AA. Assessing Emergency Medicine, Family Medicine, and ICU Doctors' Knowledge, Confidence, and Attitude in Managing In-Flight Medical Emergencies in the Kingdom of Saudi Arabia Hospitals: A Cross-Sectional Study. Cureus. 2025 Feb 1;17(2):e78359. doi: 10.7759/cureus.78359. PMID: 40046350; PMCID: PMC11880637. Hu JS, Smith JK. In-flight Medical Emergencies. Am Fam Physician. 2021 May 1;103(9):547-552. PMID: 33929167. Martin-Gill C, Doyle TJ, Yealy DM. In-Flight Medical Emergencies: A Review. JAMA. 2018 Dec 25;320(24):2580-2590. doi: 10.1001/jama.2018.19842. PMID: 30575886.

Chuck and Chris discuss a radial nerve palsy associated with a humerus fracture.  We discuss diagnosis, examination, and preliminary treatment options.  Part 2 will follow after the IFSSH meeting.  We also discuss upcoming, IFSSH- related episodes.Some citations1: Lieberdorfer A, Shivakumar N, Stonner MM, Brogan DM, Ray WZ, Mackinnon SE, DyCJ. Expectant Management, Tendon Transfer, or Nerve Transfer Surgery for RadialNerve Injury: A Qualitative Study Exploring Patient Expectations, Goals, andTreatment Experiences. J Bone Joint Surg Am. 2023 Apr 19;105(8):600-606. doi:10.2106/JBJS.22.01201. Epub 2023 Feb 16. PMID: 36795855. 2: Malikowski T, Micklesen PJ, Robinson LR. Prognostic values ofelectrodiagnostic studies in traumatic radial neuropathy. Muscle Nerve. 2007Sep;36(3):364-7. doi: 10.1002/mus.20848. PMID: 17587226. 3: Steenbeek ED, Pondaag W, Tannemaat MR, Van Zwet EW, Malessy MJA, Groen JL.Optimal timing of needle electromyography to diagnose lesion severity intraumatic radial nerve injury. Muscle Nerve. 2023 Apr;67(4):314-319. doi:10.1002/mus.27787. Epub 2023 Jan 22. PMID: 36625338.4.  PMID: 31714418Radial Nerve Palsy Recovery With Fractures of the Humerus: An Updated Systematic Review.Ilyas AM, Mangan JJ, Graham J.J Am Acad Orthop Surg. 2020 Mar 15;28(6):e263-e269. doi: 10.5435/JAAOS-D-18-00142.5. PMID: 32285189Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients.Hendrickx LAM, Hilgersom NFJ, Alkaduhimi H, Doornberg JN, van den Bekerom MPJ.Arch Orthop Trauma Surg. 2021 Apr;141(4):561-568. doi: 10.1007/s00402-020-03446-y. Epub 2020 Apr 13.6.  PMID: 33335819Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review.Hegeman EM, Polmear M, Scanaliato JP, Nesti L, Dunn JC.Cureus. 2020 Nov 15;12(11):e11490. doi: 10.7759/cureus.11490.PMID: 33335819 Free PMC article. Review.Please complete our survey:  https://bit.ly/3iHGFpDSee www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. Subscribe to our newsletter: bit.ly/3X0Gq89As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

This episode on the pellagra epidemic focuses on its prevalence in the U.S. in the early 20th century. Some of the scientific work done to understand it involves self-experimentation, and some of it is ethically problematic by today’s standards. Research: Akst, Daniel. “Pellagra: The Forgotten Plague.” American Heritage. December 2000. https://www.americanheritage.com/pellagra-forgotten-plague Baird Rattini, Kristin. “A Deadly Diet.” Discover. Mar2018, Vol. 39 Issue 2, p70-72. Bridges, Kenneth. “Pellagra.” Encyclopedia of Arkansas. https://encyclopediaofarkansas.net/entries/pellagra-2230/ Clay, Karen et al. “The Rise and Fall of Pellagra in the American South.” National Bureau of Economic Research Working Paper 23730. 2018. http://www.nber.org/papers/w23730 Cleveland Clinic. “Pellagra.” 07/18/2022. https://my.clevelandclinic.org/health/diseases/23905-pellagra Crabb, Mary Katherine. “An Epidemic of Pride: Pellagra and the Culture of the American South.” Anthropologica , 1992, Vol. 34, No. 1 (1992), pp. 89-103. Via JSTOR. https://www.jstor.org/stable/25605634 Flannery, Michael A. “’Frauds,’ ‘Filth Parties,’ ‘Yeast Fads,’ and ‘Black Boxes’: Pellagra and Southern Pride, 1906-2003.” The Southern Quarterly. Vol. 53, no.3/4 (Spring/Summer 2016). Gentilcore, David and Egidio Priani. “Pellagra and Pellagrous Insanity During the Long Nineteenth Century.” Mental Health in Historical Perspective. Palgrave Macmillan. 2023. Ginnaio, Monica. “Pellagra in Late Nineteenth Century Italy: Effects of a Deficiency Disease.” Population-E, 66 (3-4), 2011, 583-610. Hung, Putzer J. “Pellagra: A medical whodunit.” Hektoen International: A Journal of Medical Humanities. https://hekint.org/2018/09/18/pellagra-a-medical-whodunit/ Jaworek, Andrzej K. et al. “The history of pellagra.” Dermatol Rev/Przegl Dermatol 2021, 108, 554–566 DOI: https://doi.org/10.5114/dr.2021.114610 Kean, Sam. “Joseph Goldberger’s Filth Parties.” Science History Institute Museum and Library. https://www.sciencehistory.org/stories/magazine/joseph-goldbergers-filth-parties/ Kiple, Kenneth F. and Virginia H. “Black Tongue and Black Men: Pellagra and Slavery in the Antebellum South.” The Journal of Southern History , Aug., 1977, Vol. 43, No. 3. https://www.jstor.org/stable/2207649 Kraut, Alan. “Dr. Joseph Goldberger & the War on Pellagra.” National Institutes of Health Office of NIH History and Stetten Museum. https://history.nih.gov/pages/viewpage.action?pageId=8883184 Marks, Harry M. “Epidemiologists Explain Pellagra: Gender, Race and Political Economy in the Work of Edgar Sydenstricker.” Journal of the History of Medicine and Allied Sciences , JANUARY 2003. https://www.jstor.org/stable/24623836 Morabia, Alfredo. “Joseph Goldberger’s research on the prevention of pellagra.” J R Soc Med 2008: 101: 566–568. DOI 10.1258/jrsm.2008.08k010. Park, Youngmee K. et al. “Effectiveness of Food Fortification in the United States: The Case of Pellagra.” American Journal of Public Health. May 2U(H). Vol. 90. No. 5. Peres, Tanya M. “Malnourished.” Gravy. Southern Foodways Alliance. Fall 2016. https://www.southernfoodways.org/malnourished-cultural-ignorance-paved-the-way-for-pellagra/ Pinheiro, Hugo et al. “Hidden Hunger: A Pellagra Case Report.” Cureus vol. 13,4 e14682. 25 Apr. 2021, doi:10.7759/cureus.14682 A. C. Wollenberg. “Pellagra in Italy.” Public Health Reports (1896-1970), vol. 24, no. 30, 1909, pp. 1051–54. JSTOR, https://doi.org/10.2307/4563397. Accessed 13 Feb. 2025. Rajakumar, Kumaravel. “Pellagra in the United States: A Historical Perspective.” SOUTHERN MEDICAL JOURNAL • Vol. 93, No. 3. March 2020. Savvidou, Savvoula. “Pellagra: a non-eradicated old disease.” Clinics and practice vol. 4,1 637. 28 Apr. 2014, doi:10.4081/cp.2014.637 SEARCY GH. AN EPIDEMIC OF ACUTE PELLAGRA. JAMA. 1907;XLIX(1):37–38. doi:10.1001/jama.1907.25320010037002j Skelton, John. “Poverty or Privies? The Pellagra Controversy in America.” Fairmount Folio: Journal of History. Vol. 15 (2014). https://journals.wichita.edu/index.php/ff/article/view/151 Tharian, Bindu. "Pellagra." New Georgia Encyclopedia, 20 September 2004, https://www.georgiaencyclopedia.org/articles/science-medicine/pellagra/. University Libraries, University of South Carolina. “A Gospel of Health: Hilla Sheriff's Crusade Against Malnutrition in South Carolina.” https://digital.library.sc.edu/exhibits/hillasheriff/history-of-pellagra/ University of Alabama at Birmingham. “Pellagra in Alabama.” https://library.uab.edu/locations/reynolds/collections/regional-history/pellagra Wheeler, G.A. “A Note on the History of Pellagra in the United States.” Public Health Reports (1896-1970) , Sep. 18, 1931, Vol. 46, No. 38. Via JSTOR. https://www.jstor.org/stable/4580180 See omnystudio.com/listener for privacy information.

The pellagra epidemic of the early 20th century may have been the deadliest epidemic of a specific nutrient deficiency in U.S. history. Part one covers what it is, its appearance in 19th-century Italy, and the first reports of it in the U.S. Research: Akst, Daniel. “Pellagra: The Forgotten Plague.” American Heritage. December 2000. https://www.americanheritage.com/pellagra-forgotten-plague Baird Rattini, Kristin. “A Deadly Diet.” Discover. Mar2018, Vol. 39 Issue 2, p70-72. Bridges, Kenneth. “Pellagra.” Encyclopedia of Arkansas. https://encyclopediaofarkansas.net/entries/pellagra-2230/ Clay, Karen et al. “The Rise and Fall of Pellagra in the American South.” National Bureau of Economic Research Working Paper 23730. 2018. http://www.nber.org/papers/w23730 Cleveland Clinic. “Pellagra.” 07/18/2022. https://my.clevelandclinic.org/health/diseases/23905-pellagra Crabb, Mary Katherine. “An Epidemic of Pride: Pellagra and the Culture of the American South.” Anthropologica , 1992, Vol. 34, No. 1 (1992), pp. 89-103. Via JSTOR. https://www.jstor.org/stable/25605634 Flannery, Michael A. “’Frauds,’ ‘Filth Parties,’ ‘Yeast Fads,’ and ‘Black Boxes’: Pellagra and Southern Pride, 1906-2003.” The Southern Quarterly. Vol. 53, no.3/4 (Spring/Summer 2016). Gentilcore, David and Egidio Priani. “Pellagra and Pellagrous Insanity During the Long Nineteenth Century.” Mental Health in Historical Perspective. Palgrave Macmillan. 2023. Ginnaio, Monica. “Pellagra in Late Nineteenth Century Italy: Effects of a Deficiency Disease.” Population-E, 66 (3-4), 2011, 583-610. Hung, Putzer J. “Pellagra: A medical whodunit.” Hektoen International: A Journal of Medical Humanities. https://hekint.org/2018/09/18/pellagra-a-medical-whodunit/ Jaworek, Andrzej K. et al. “The history of pellagra.” Dermatol Rev/Przegl Dermatol 2021, 108, 554–566 DOI: https://doi.org/10.5114/dr.2021.114610 Kean, Sam. “Joseph Goldberger’s Filth Parties.” Science History Institute Museum and Library. https://www.sciencehistory.org/stories/magazine/joseph-goldbergers-filth-parties/ Kiple, Kenneth F. and Virginia H. “Black Tongue and Black Men: Pellagra and Slavery in the Antebellum South.” The Journal of Southern History , Aug., 1977, Vol. 43, No. 3. https://www.jstor.org/stable/2207649 Kraut, Alan. “Dr. Joseph Goldberger & the War on Pellagra.” National Institutes of Health Office of NIH History and Stetten Museum. https://history.nih.gov/pages/viewpage.action?pageId=8883184 Marks, Harry M. “Epidemiologists Explain Pellagra: Gender, Race and Political Economy in the Work of Edgar Sydenstricker.” Journal of the History of Medicine and Allied Sciences , JANUARY 2003. https://www.jstor.org/stable/24623836 Morabia, Alfredo. “Joseph Goldberger’s research on the prevention of pellagra.” J R Soc Med 2008: 101: 566–568. DOI 10.1258/jrsm.2008.08k010. Park, Youngmee K. et al. “Effectiveness of Food Fortification in the United States: The Case of Pellagra.” American Journal of Public Health. May 2U(H). Vol. 90. No. 5. Peres, Tanya M. “Malnourished.” Gravy. Southern Foodways Alliance. Fall 2016. https://www.southernfoodways.org/malnourished-cultural-ignorance-paved-the-way-for-pellagra/ Pinheiro, Hugo et al. “Hidden Hunger: A Pellagra Case Report.” Cureus vol. 13,4 e14682. 25 Apr. 2021, doi:10.7759/cureus.14682 A. C. Wollenberg. “Pellagra in Italy.” Public Health Reports (1896-1970), vol. 24, no. 30, 1909, pp. 1051–54. JSTOR, https://doi.org/10.2307/4563397. Accessed 13 Feb. 2025. Rajakumar, Kumaravel. “Pellagra in the United States: A Historical Perspective.” SOUTHERN MEDICAL JOURNAL • Vol. 93, No. 3. March 2020. Savvidou, Savvoula. “Pellagra: a non-eradicated old disease.” Clinics and practice vol. 4,1 637. 28 Apr. 2014, doi:10.4081/cp.2014.637 SEARCY GH. AN EPIDEMIC OF ACUTE PELLAGRA. JAMA. 1907;XLIX(1):37–38. doi:10.1001/jama.1907.25320010037002j Skelton, John. “Poverty or Privies? The Pellagra Controversy in America.” Fairmount Folio: Journal of History. Vol. 15 (2014). https://journals.wichita.edu/index.php/ff/article/view/151 Tharian, Bindu. "Pellagra." New Georgia Encyclopedia, 20 September 2004, https://www.georgiaencyclopedia.org/articles/science-medicine/pellagra/. University Libraries, University of South Carolina. “A Gospel of Health: Hilla Sheriff's Crusade Against Malnutrition in South Carolina.” https://digital.library.sc.edu/exhibits/hillasheriff/history-of-pellagra/ University of Alabama at Birmingham. “Pellagra in Alabama.” https://library.uab.edu/locations/reynolds/collections/regional-history/pellagra Wheeler, G.A. “A Note on the History of Pellagra in the United States.” Public Health Reports (1896-1970) , Sep. 18, 1931, Vol. 46, No. 38. Via JSTOR. https://www.jstor.org/stable/4580180 See omnystudio.com/listener for privacy information.

Thorsten Waloschek is CEO of NeoPredics AG, a Swiss digital health startup revolutionizing neonatal and maternal care through predictive analytics. Its first product, BiliPredics, predicts neonatal jaundice progression and is already available in both European and U.S. markets. By analyzing biomarker data, BiliPredics can forecast a baby's bilirubin levels for up to two and a half days after hospital discharge, enabling healthcare providers to make more informed decisions about when to send newborns home.  "The very last thing you want to do is rush back to the hospital within two days,” Thorsten explains. Such returns disrupt crucial parent-child bonding and lactation and can cause unnecessary stress for new families. Hospitals can provide preventive treatment by identifying at-risk infants before discharge, ensuring a smoother transition to home life.  Building upon BiliPredics' success, NeoPredics is currently in development of a similar solution for preeclampsia, a hypertensive disorder that affects 2% to 10% of pregnancies globally, according to the World Health Organization (WHO). The exact numbers vary according to geographic region, but on average, the WHO attributes 70,000 maternal deaths and half a million fetal deaths to the condition annually. (Khan B, et al. Preeclampsia Incidence and Its Maternal and Neonatal Outcomes With Associated Risk Factors. Cureus. 2022 Nov 6;14(11). PMCID: PMC9723483, PMID: 36483900.) NeoPredics' technology aims to identify high-risk pregnancies as early as 12 weeks into gestation, prompting proactive medical intervention.  In this episode, Thorsten describes the whirlwind process of building a global healthcare business, particularly when navigating regulatory environments and cultural nuances across different markets.  Strategic Global Expansion  Founded in 2020 in Switzerland, NeoPredics took an early international approach, establishing their U.S. subsidiary just one year later. This quick expansion into the American market wasn't merely opportunistic; it was strategic:  Why the US? Because it's still the single, unified, biggest medical device market in the world. We entered the United States and then went back into Europe, which was the second step because of regulatory challenges. But in the end, it's global. We want to help every newborn baby, young family, and pregnant woman. It's not only about healthcare disparities and racial discrimination; it happens everywhere in the world. Pregnant women and newborn babies are always the least taken care of by the population, no matter where.    In addition to strategic market selection, Thorsten emphasizes the importance of local partnerships, especially for startups with limited resources. "I would never try it on my own," he says about entering new markets. "I would always look for a partner that helps us as a company to enter that market."  Local partnerships will help with cultural Integration, which is integral to global business success. Thorsten describes how different regulatory approaches reflect more profound cultural distinctions; for instance, the contrast between European "black and white" regulatory environments and the more negotiation-friendly American system reflects how each culture conducts business. Thorsten provides additional insight into managing cross-cultural communication, including translation. His approach combines several key elements:  Local language integration. Instead of solely relying on interpreters, NeoPredics seeks partners or consultants who speak the local language and understand the medical industry. This approach ensures both linguistic accuracy and cultural relevance.  Layered translation process. For technical documentation, the company employs a two-step process: First, professional translation services provide a grammatically correct translation, and then local, native-speaking subject matter experts review it to refine the cultural nuances.  Cultural context. For example, Thorsten points out that direct-to-consumer medical marketing, common in the U.S., remains prohibited in Germany, necessitating different marketing approaches in each market.  Navigating Regulatory Challenges  Thorsten explains that regulatory frameworks worldwide were formulated primarily around hardware-based medical devices, creating unique challenges for software-based solutions like predictive analytics. "And suddenly, not suddenly, but for the last 10, 15, 20 years, more and more software is coming," he adds. This disconnect has led to interesting developments in market entry strategies. While Europe was traditionally considered an easier first market for medical devices, that dynamic has shifted, with many companies now finding the FDA process more straightforward for software-based solutions.  Thorsten's best advice is to "Pick a country where you want to get your foot in, where you have your anchor point, and go from there. Don't ‘go into Europe'. That doesn't mean anything. Go into one country in Europe." Listen to the full episode to learn more about balancing technical innovation, strategic market selection, and cross-cultural communication. 

In this episode, podcast hosts Dr. Josh Roshal, Dr. Darian Hoagland, and Dr. Maya Hunt discuss the ins and outs of professional development time (PDT) and professional identity formation (PIF) during surgical training. Joined by insights from fellow CoSEF members, the team dives into key topics such as mentorship, timing, and making the most of this critical phase in residency. From rapid-fire tips to personal reflections, this episode offers a wealth of advice for trainees considering their PDT and PIF.. Episode Hosts: –Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, jaroshal@utmb.edu –Dr. Darian Hoagland, Beth Israel Deaconess Medical Center, @DHoaglandMD, dlhoagla@bidmc.harvard.edu –Dr. Maya Hunt, Indiana University, @dr_mayathehunt, mayahunt@iu.edu –CoSEF: @surgedfellows, cosef.org Guests:  -Dr. Ariana Naaseh, Washington University in St. Louis, @ariananaaseh, a.naaseh@wustl.edu -Dr. Colleen McDermott, University of Utah, @ColleenMcDMD, Colleen.McDermott@hsc.utah.edu -Dr. Shahnur Ahmed, Indiana University, shahme@iu.edu -Dr. Xinyi “Cathy” Luo, Tulane University, @DoctorSoySauce, xluo@tulane.edu -Dr. Ananya Anand, Stanford University, @AnanyaAnandMD, aa24@stanford.edu References: Smith SM, Chugh PV, Song C, Kim K, Whang E, Kristo G. Perspectives of Surgical Research Residents on Improving Their Reentry Into Clinical Training. J Surg Educ. 2024 Nov;81(11):1491-1497. doi: 10.1016/j.jsurg.2024.07.005. Epub 2024 Aug 31. PMID: 39217679. https://pubmed.ncbi.nlm.nih.gov/39217679/ Kochis MA, Cron DC, Coe TM, Secor JD, Guyer RA, Brownlee SA, Carney K, Mullen JT, Lillemoe KD, Liao EC, Boland GM. Implementation and Evaluation of an Academic Development Rotation for Surgery Residents. J Surg Educ. 2024 Nov;81(11):1748-1755. doi: 10.1016/j.jsurg.2024.08.015. Epub 2024 Sep 23. PMID: 39317122. https://pubmed.ncbi.nlm.nih.gov/39317122/ Gkiousias V. Scalpel Please! A Scoping Review Dissecting the Factors and Influences on Professional Identity Development of Trainees Within Surgical Programs. Cureus. 2021;13(12):e20105. doi:10.7759/cureus.20105 https://pubmed.ncbi.nlm.nih.gov/35003955/ Rivard SJ, Vitous CA, De Roo AC, et al. “The captain of the ship.” A qualitative investigation of surgeon identity formation. Am J Surg. 2022;224(1 Pt B):284-291. doi:10.1016/j.amjsurg.2022.01.010 https://pubmed.ncbi.nlm.nih.gov/35168761/ Irby DM, Cooke M, O'Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med J Assoc Am Med Coll. 2010;85(2):220-227. doi:10.1097/ACM.0b013e3181c88449 https://pubmed.ncbi.nlm.nih.gov/20107346/ Veazey Brooks J, Bosk CL. Remaking surgical socialization: work hour restrictions, rites of passage, and occupational identity. Soc Sci Med 1982. 2012;75(9):1625-1632.doi:10.1016/j.socscimed.2012.07.007 https://pubmed.ncbi.nlm.nih.gov/22863331/ Cruess RL, Cruess SR, Boudreau JD, Snell L, Steinert Y. A schematic representation of the professional identity formation and socialization of medical students and residents: a guide for medical educators. Acad Med J Assoc Am Med Coll.2015;90(6):718-725.doi:10.1097/ACM.0000000000000700 https://pubmed.ncbi.nlm.nih.gov/25785682/ Huffman EM, Anderson TN, Choi JN, Smith BK. Why the Lab? What is Really Motivating General Surgery Residents to Take Time for Dedicated Research. J SurgEduc.2020;77(6):e39-e46.doi:10.1016/j.jsurg.2020.07.034 https://pubmed.ncbi.nlm.nih.gov/32768383/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Welcome to the Evidence-Based Hair Podcast, hosted by dermatologist and hair loss specialist Dr. Jeff Donovan. In this episode, Dr. Donovan explores a groundbreaking study published in the journal Curious, highlighting the effectiveness of the JAK1 inhibitor, upadacitinib, in treating recalcitrant dissecting cellulitis of the scalp. Dissecting cellulitis, a challenging form of scarring alopecia, often affects males and presents with debilitating symptoms. While traditional treatments like isotretinoin and antibiotics offer relief for some, they aren't always effective. The study discusses a case where upadacitinib brought significant improvement after conventional options were exhausted. Dr. Donovan provides a comprehensive overview of the study, emphasizing the potential of JAK inhibitors as third-line treatments in managing persistent dissecting cellulitis. He also shares insights on the broader implications for future research and treatment strategies. Join Dr. Donovan next week for an analysis of a study on alopecia areata and cardiovascular comorbidities, and don't miss the annual "Top 20 of 2024" event on December 30th. For more information about the Donovan Hair Academy's programs, visit their website.     STUDY REFERENCED IN THIS EPISODE Zahidul Islam, Michelle Toker, Isha M Gandhi, Ariel Sher, Kristina Campto. Improvement of Recalcitrant Dissecting Cellulitis of the Scalp After a Trial of Upadacitinib. Cureus . 2024 Jan 16;16(1):e52377. doi: 10.7759/cureus.52377. eCollection 2024 Jan.  

Osteopathic education in surgery has undergone significant changes, especially with the transition to a single ACGME accreditation system in 2020. Despite initial concerns about equitable access and representation, studies have highlighted increasing competitiveness of osteopathic medical students in surgical residency matches and comparable outcomes between allopathic and osteopathic surgeons, affirming the quality of osteopathic training. In this episode, we talk with Dr. Kristen Conrad-Schnetz, recent president of the American College of Osteopathic Surgeons (ACOS) and General Surgery program director at Cleveland Clinic South Pointe Hospital, about osteopathy in general surgery. We delve into the role of osteopathic principles in surgical training and practice and the impact of transitioning to a single accreditation system. Dr. Conrad-Schnetz shares insights on overcoming misconceptions about DO surgeons and her vision for the future of osteopathic recognition in surgery.  Join hosts Pooja Varman MD, Judith French PhD, and Jeremy Lipman MD, MHPE for this exciting conversation with Kristen Conrad-Schnetz, DO.  Learning Objectives By the end of this episode, listeners will be able to  1.     List the four tenets of osteopathic medicine 2.     Identify how osteopathic principles and practices can be incorporated into surgical practice 3.     Explain the significance of osteopathic recognition in residency programs 4.     Discuss strategies for promoting equity for DO surgery residents References 1.  Williamson TK, Martinez VH, Ojo DE, et al. An analysis of osteopathic medical students applying to surgical residencies following transition to a single graduate medical education accreditation system. Journal of Osteopathic Medicine. 2024;124(2):51-59. doi:10.1515/jom-2023-0118 https://pubmed.ncbi.nlm.nih.gov/37921195/ 2.  Russell TA, Yoshida R, Men M, et al. Comparison of Outcomes for Patients Treated by Allopathic vs Osteopathic Surgeons. JAMA Surgery. Published online October 16, 2024. doi:10.1001/jamasurg.2024.4580 https://pubmed.ncbi.nlm.nih.gov/39412774/ 3.  Etheart I, Krise SM, Burns JB, Conrad-Schnetz K. The Effect of Single Accreditation on Medical Student Match Rates in Surgical Specialties. Cureus. 2021;13(4):e14301. doi:10.7759/cureus.14301 https://pubmed.ncbi.nlm.nih.gov/33968513/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nail Discoloration following the Chronic use of Skin-Depigmenting Creams. Bandara M. Liyanage A. Cureus. 2024 Aug 25; 16(8):e67770Nail Pigmentation May Be an Early Sign of Minocycline Associated Cutaneous Pigmentation: A Systemic Review. Axler E, Malik S, Lu A, Hong S, Desai AD, Malik S, Lipner SR. JAAD. 2024 Aug 26:S0190-9622(24)

PainExam Podcast Show  Episode Title: Exploring PRP and BMAC in Pain Managemen  Host:   David Rosenblum, MD           Release Date:    November 27, 2024    Episode Overview:  In this episode of the PainExam Podcast, Dr. David Rosenblum, a New York-based pain physician, examines the latest research surrounding Platelet-Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) in pain management for the knee, shoulder, and spine. Dr. Rosenblum reviews several key studies, providing insights into the efficacy of these regenerative treatments and their implications for clinical practice. Featured Studies:  1.  A Comparison of Functional Outcomes in Rotator Cuff Repairs Using Adjunctive Bone Marrow Aspirate Concentrate vs. Bone Marrow Aspirate Concentrate With Platelet-Rich Plasma: A Systematic Review and Meta-Analysis**      -     Authors:       Seth J. Spicer, Sara Soliman, Robert Malek, Mitchell Kaplan, Jensen Clark, Nicholas Averell, Brandon Goodwin, Richard Jermyn      -  Published in:  Cureus. 2024 Aug 23;16(8):e67594. doi: 10.7759/cureus.67594      -  Summary: This systematic review evaluates the outcomes of rotator cuff repairs (RCR) using BMAC alone versus BMAC combined with PRP. The analysis included three studies and found no significant difference in functional outcomes between the two groups, suggesting that BMAC alone may be adequate, potentially reducing costs and resource use. 2.        Bone Marrow Aspirate Concentrate Versus Platelet-Rich Plasma for Treating Knee Osteoarthritis: A One-Year Non-Randomized Retrospective Comparative Study            -  Authors: Abed El-Hakim El-Kadiry, Carlos Lumbao, Natasha Salame, Moutih Rafei, Riam Shammaa      -  Published in:  BMC Musculoskeletal Disorders, 2022.      -  Summary:   This study compared the effectiveness of intra-articular BMAC and PRP injections in patients with knee osteoarthritis (OA). Results indicated that patients receiving BMAC experienced significant improvements in pain and functionality scores over 12 months, while the PRP group showed nonsignificant improvements. BMAC was found to be more effective than PRP in managing knee OA symptoms. 3.  Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis**      -     Authors:  John W. Belk, Joseph J. Lim, Carson Keeter, Patrick C. McCulloch, Darby A. Houck, Eric C. McCarty, Rachel M. Frank, Matthew J. Kraeutler      -       Published in:   World Journal of Stem Cells, 2021.      -    Summary:  This systematic review assessed the efficacy of PRP and BMAC compared to hyaluronic acid (HA) injections for knee OA. The findings demonstrated that both PRP and BMAC led to significantly better patient-reported outcomes (PROs) compared to HA, with no significant differences between PRP and BMAC in terms of effectiveness. 4.          Platelet-Rich Plasma vs Bone Marrow Aspirate Concentrate: An Overview of Mechanisms of Action and Orthobiologic Synergistic Effects             - Authors: José Fábio Santos Duarte Lana, Lucas Furtado da Fonseca, Rafael da Rocha Macedo, Tomas Mosaner, William Murrell, Ashok Kumar, Joseph Purita, Marco Antonio Percope de Andrade      -  Published in:  World Journal of Stem Cells, 2021.      - **Summary:** This overview discusses the mechanisms of action for PRP and BMAC and their potential synergistic effects in musculoskeletal healing. The authors highlight that while both therapies show promise, further research is needed to standardize treatment protocols and fully understand their combined effects on healing processes. 5.  PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers*       -   Authors:       Fabio S. M. Yamaguchi, Shahin Shams, Eduardo A. Silva, Roberta S. Stilhano      -   Published in:** International Journal of Molecular Sciences, 2019.      -     Summary:  This review focuses on the use of biomaterial carriers in conjunction with PRP and BMAC to enhance regenerative processes for musculoskeletal injuries. The authors emphasize the growing interest in these therapies as alternatives for treating cartilage, muscle, and bone injuries, and discuss the various biomaterials used in clinical trials.  Key Takeaways:  - The efficacy of BMAC compared to PRP in various orthopedic applications. - Insights into the mechanisms of action and potential synergistic effects of PRP and BMAC. - The importance of research in optimizing treatment protocols for knee osteoarthritis and other musculoskeletal conditions.    Upcoming Events:  Visit        NRAPpain.org  to learn about the virtual pain fellowship and other educational resources. Additionally, check out our live courses designed for healthcare professionals looking to enhance their skills in pain management and regenerative therapies.  Listen to the Episode:   Join Dr. Rosenblum as he provides expert analysis on these studies and discusses the implications for pain management and regenerative medicine.  Connect with Us:  For more information, resources, and to access past episodes, visit our website or follow us on social media. Your feedback and questions are always welcome!         Disclaimer   The content of this podcast is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for any medical concerns.

PainExam Podcast Show  Episode Title: Exploring PRP and BMAC in Pain Managemen  Host:   David Rosenblum, MD           Release Date:    November 27, 2024    Episode Overview:  In this episode of the PainExam Podcast, Dr. David Rosenblum, a New York-based pain physician, examines the latest research surrounding Platelet-Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) in pain management for the knee, shoulder, and spine. Dr. Rosenblum reviews several key studies, providing insights into the efficacy of these regenerative treatments and their implications for clinical practice. Featured Studies:  1.  A Comparison of Functional Outcomes in Rotator Cuff Repairs Using Adjunctive Bone Marrow Aspirate Concentrate vs. Bone Marrow Aspirate Concentrate With Platelet-Rich Plasma: A Systematic Review and Meta-Analysis**      -     Authors:       Seth J. Spicer, Sara Soliman, Robert Malek, Mitchell Kaplan, Jensen Clark, Nicholas Averell, Brandon Goodwin, Richard Jermyn      -  Published in:  Cureus. 2024 Aug 23;16(8):e67594. doi: 10.7759/cureus.67594      -  Summary: This systematic review evaluates the outcomes of rotator cuff repairs (RCR) using BMAC alone versus BMAC combined with PRP. The analysis included three studies and found no significant difference in functional outcomes between the two groups, suggesting that BMAC alone may be adequate, potentially reducing costs and resource use. 2.        Bone Marrow Aspirate Concentrate Versus Platelet-Rich Plasma for Treating Knee Osteoarthritis: A One-Year Non-Randomized Retrospective Comparative Study            -  Authors: Abed El-Hakim El-Kadiry, Carlos Lumbao, Natasha Salame, Moutih Rafei, Riam Shammaa      -  Published in:  BMC Musculoskeletal Disorders, 2022.      -  Summary:   This study compared the effectiveness of intra-articular BMAC and PRP injections in patients with knee osteoarthritis (OA). Results indicated that patients receiving BMAC experienced significant improvements in pain and functionality scores over 12 months, while the PRP group showed nonsignificant improvements. BMAC was found to be more effective than PRP in managing knee OA symptoms. 3.  Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis**      -     Authors:  John W. Belk, Joseph J. Lim, Carson Keeter, Patrick C. McCulloch, Darby A. Houck, Eric C. McCarty, Rachel M. Frank, Matthew J. Kraeutler      -       Published in:   World Journal of Stem Cells, 2021.      -    Summary:  This systematic review assessed the efficacy of PRP and BMAC compared to hyaluronic acid (HA) injections for knee OA. The findings demonstrated that both PRP and BMAC led to significantly better patient-reported outcomes (PROs) compared to HA, with no significant differences between PRP and BMAC in terms of effectiveness. 4.          Platelet-Rich Plasma vs Bone Marrow Aspirate Concentrate: An Overview of Mechanisms of Action and Orthobiologic Synergistic Effects             - Authors: José Fábio Santos Duarte Lana, Lucas Furtado da Fonseca, Rafael da Rocha Macedo, Tomas Mosaner, William Murrell, Ashok Kumar, Joseph Purita, Marco Antonio Percope de Andrade      -  Published in:  World Journal of Stem Cells, 2021.      - **Summary:** This overview discusses the mechanisms of action for PRP and BMAC and their potential synergistic effects in musculoskeletal healing. The authors highlight that while both therapies show promise, further research is needed to standardize treatment protocols and fully understand their combined effects on healing processes. 5.  PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers*       -   Authors:       Fabio S. M. Yamaguchi, Shahin Shams, Eduardo A. Silva, Roberta S. Stilhano      -   Published in:** International Journal of Molecular Sciences, 2019.      -     Summary:  This review focuses on the use of biomaterial carriers in conjunction with PRP and BMAC to enhance regenerative processes for musculoskeletal injuries. The authors emphasize the growing interest in these therapies as alternatives for treating cartilage, muscle, and bone injuries, and discuss the various biomaterials used in clinical trials.  Key Takeaways:  - The efficacy of BMAC compared to PRP in various orthopedic applications. - Insights into the mechanisms of action and potential synergistic effects of PRP and BMAC. - The importance of research in optimizing treatment protocols for knee osteoarthritis and other musculoskeletal conditions.    Upcoming Events:  Visit        NRAPpain.org  to learn about the virtual pain fellowship and other educational resources. Additionally, check out our live courses designed for healthcare professionals looking to enhance their skills in pain management and regenerative therapies.  Listen to the Episode:   Join Dr. Rosenblum as he provides expert analysis on these studies and discusses the implications for pain management and regenerative medicine.  Connect with Us:  For more information, resources, and to access past episodes, visit our website or follow us on social media. Your feedback and questions are always welcome!         Disclaimer   The content of this podcast is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for any medical concerns.

A client has a history of a very unusual and somewhat alarming condition: pyoderma gangrenosum. Can massage therapy be applied in this situation? Probably yes, but in specific circumstances. Listen to this episode of “I Have a Client Who . . .” to learn more and to hear host Ruth Werner get on one of her favorite soapboxes: the language of massage therapy.   Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                                   Resources:    Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app   Brooklyn, T., Dunnill, G. and Probert, C. (2006) ‘Diagnosis and treatment of pyoderma gangrenosum', BMJ : British Medical Journal, 333(7560), p. 181. Available at: https://doi.org/10.1136/bmj.333.7560.181.   Mohd, A.B. et al. (2022) ‘COVID-19 Vaccine: A Possible Trigger for Pyoderma Gangrenosum', Cureus, 14(5), p. e25295. Available at: https://doi.org/10.7759/cureus.25295.   Pyoderma gangrenosum (no date) Autoimmune Association. Available at: https://autoimmune.org/disease-information/pyoderma-gangrenosum/ (Accessed: 23 October 2024).   Pyoderma Gangrenosum - Symptoms, Causes, Treatment | NORD (no date). Available at: https://rarediseases.org/rare-diseases/pyoderma-gangrenosum/ (Accessed: 23 October 2024).   Schmieder, S.J. and Krishnamurthy, K. (2024) ‘Pyoderma Gangrenosum', in StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: http://www.ncbi.nlm.nih.gov/books/NBK482223/ (Accessed: 24 October 2024).   Zou, H. and Daveluy, S. (2023) ‘Pyoderma gangrenosum after COVID-19 infection and vaccination', Clinics in Dermatology, 41(1), pp. 129–131. Available at: https://doi.org/10.1016/j.clindermatol.2022.11.003.     About our Sponsors:   Anatomy Trains: www.anatomytrains.com      MassageBook: www.massagebook.com  

Was man teilweise über Vitamin D hört, klingt fast zu schön, um wahr zu sein. Andererseits deuten hunderte verschiedener Forschungsarbeiten darauf hin, dass Vitamin D zur Vorbeugung einer Reihe von Krankheiten beitragen kann – darunter Osteoporose, Depression, Autoimmun- und Herz-Kreislauf-Erkrankungen. Ärzte empfehlen es. Gesundheits- und Fitnesspodcaster sprechen darüber. Vielleicht geht Dir sogar Deine Lieblingstante damit auf die Nerven. Bei all dem Hype ist die Frage berechtigt: "Solltest Du Vitamin D einnehmen?" Hier sind die Antworten – und die neuesten Fakten über ein faszinierendes Vitamin, das ein wahrer Verwandlungskünstler ist. ____________ *WERBUNG: KoRoDrogerie.de: 5% Ermäßigung auf alles mit dem Code „FMM“ beim Checkout. ____________ Ressourcen zur Folge: Literatur: Ratgeber Nahrungsergänzung – Mark Maslow (kostenlos auf MarathonFitness) Blut: Die Geheimnisse unseres flüssigen Organs* – Ulrich Strunz (Heyne) Vitamin D* – Uwe Gröber, Michael F. Holick (Wissenschaftl. Verlagsgesellschaft) Blutuntersuchung (Selbsttest): Vitamin D Test* von Medivere Präparate: D-Form 2.000 K2+* von FormMed D-Form 2.000 K2+ vegan* von FormMed ____________

Unlocking Tess's Potential: How a Simple Diet Change Transformed Her Health - Part 2 of 2Have you ever wondered how the right diet could drastically improve your child's health, especially if they're dealing with complex medical conditions?For parents of children with rare diseases, balancing nutrition while managing symptoms like GERD and eczema can be overwhelming. In this episode, I dive into how we've customized Tess's diet over the years, using scientific research to guide our choices and making practical tweaks to keep her feeling her best.1. Learn how specific foods, backed by scientific studies, can help manage common symptoms like reflux and inflammation.2. Discover which simple dietary adjustments can improve digestion and prevent food sensitivities from disrupting daily life.3. Get practical advice on using nutrient-dense foods and healthy fats to keep your child satisfied and energized longer.Don't miss out on these essential tips--play this episode now and start optimizing your child's diet today!SCIENCE! "Gluten and FODMAP Relationship with Mental Disorders: A Systematic Review" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228761/Aranburu E, Matias S, Simón E, Larretxi I, Martínez O, Bustamante MÁ, Fernández-Gil MDP, Miranda J. Gluten and FODMAPs Relationship with Mental Disorders: Systematic Review. Nutrients. 2021 May 31;13(6):1894. doi: 10.3390/nu13061894. PMID: 34072914; PMCID: PMC8228761."Vegan Diet and Dermatology: A Review" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531971/Lee H, Sim N, Fotouhi A, Daveluy S. Vegan Diet in Dermatology: A Review. J Clin Med. 2023 Sep 6;12(18):5800. doi: 10.3390/jcm12185800. PMID: 37762741; PMCID: PMC10531971."Dietary Habits and Their Impact on Gastroesophageal Reflux Disease (GERD)" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347905/Khan M, Shah K, Gill SK, Gul N, J JK, Valladares V, Khan LA, Raza M. Dietary Habits and Their Impact on Gastroesophageal Reflux Disease (GERD). Cureus. 2024 Jul 27;16(7):e65552. doi: 10.7759/cureus.65552. PMID: 39192902; PMCID: PMC11347905.

How many hours a day are your children using screens? How much of that time is spent passively watching videos or scrolling through social media? Why do studies find more screen time in Black children? Check out this episode of the podcast to hear more about how screen time affects your child's mental health and development. Here are some helpful references and resources for this episode: https://www.commonsensemedia.org/sites/default/files/research/report/2020-0-8-census-fact-sheet-black-children-final2.pdf https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/5cs-of-media-use/ https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx Nagata JM, Ganson KT, Iyer P, Chu J, Baker FC, Pettee Gabriel K, Garber AK, Murray SB, Bibbins-Domingo K. Sociodemographic Correlates of Contemporary Screen Time Use among 9- and 10-Year-Old Children. J Pediatr. 2022 Jan;240:213-220.e2. doi: 10.1016/j.jpeds.2021.08.077. Epub 2021 Sep 2. PMID: 34481807; PMCID: PMC9107378. Muppalla SK, Vuppalapati S, Reddy Pulliahgaru A, Sreenivasulu H. Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management. Cureus. 2023 Jun 18;15(6):e40608. doi: 10.7759/cureus.40608. PMID: 37476119; PMCID: PMC10353947.  

Welcome to Episode 37 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 37 of “The 2 View” – Pitfalls in Managing Pain in the ED with Sergey M. Motov, MD, FAAEM. Segment 1 Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL. Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996-2013. Am J Public Health. 2016;106(4):686-688. doi:10.2105/AJPH.2016.303061. https://pubmed.ncbi.nlm.nih.gov/26890165/ Bijur PE, Kenny MK, Gallagher EJ. Intravenous morphine at 0.1 mg/kg is not effective for controlling severe acute pain in the majority of patients. Ann Emerg Med. 2005;46(4):362-367. doi:10.1016/j.annemergmed.2005.03.010. https://pubmed.ncbi.nlm.nih.gov/16187470/ Evoy KE, Covvey JR, Peckham AM, Ochs L, Hultgren KE. Reports of gabapentin and pregabalin abuse, misuse, dependence, or overdose: An analysis of the Food And Drug Administration Adverse Events Reporting System (FAERS). Res Social Adm Pharm. 2019;15(8):953-958. doi:10.1016/j.sapharm.2018.06.018. https://pubmed.ncbi.nlm.nih.gov/31303196/ Kim HS, McCarthy DM, Hoppe JA, Mark Courtney D, Lambert BL. Emergency Department Provider Perspectives on Benzodiazepine-Opioid Coprescribing: A Qualitative Study. Acad Emerg Med. 2018;25(1):15-24. doi:10.1111/acem.13273. https://pubmed.ncbi.nlm.nih.gov/28791786/ Li Y, Delcher C, Wei YJ, et al. Risk of Opioid Overdose Associated With Concomitant Use of Opioids and Skeletal Muscle Relaxants: A Population-Based Cohort Study. Clin Pharmacol Ther. 2020;108(1):81-89. doi:10.1002/cpt.1807. https://pubmed.ncbi.nlm.nih.gov/32022906/ Peckham AM, Evoy KE, Covvey JR, Ochs L, Fairman KA, Sclar DA. Predictors of Gabapentin Overuse With or Without Concomitant Opioids in a Commercially Insured U.S. Population. Pharmacotherapy. 2018;38(4):436-443. doi:10.1002/phar.2096. https://pubmed.ncbi.nlm.nih.gov/29484686/ Smith RV, Havens JR, Walsh SL. Gabapentin misuse, abuse and diversion: a systematic review. Addiction. 2016;111(7):1160-1174. doi:10.1111/add.13324. https://pubmed.ncbi.nlm.nih.gov/27265421/ Suvada K, Zimmer A, Soodalter J, Malik JS, Kavalieratos D, Ali MK. Coprescribing of opioids and high-risk medications in the USA: a cross-sectional study with data from national ambulatory and emergency department settings. BMJ Open. 2022;12(6):e057588. Published 2022 Jun 16. doi:10.1136/bmjopen-2021-057588. https://pubmed.ncbi.nlm.nih.gov/35710252/ Segment 2 Caplan M, Friedman BW, Siebert J, et al. Use of clinical phenotypes to characterize emergency department patients administered intravenous opioids for acute pain. Clin Exp Emerg Med. 2023;10(3):327-332. doi:10.15441/ceem.23.018. https://pubmed.ncbi.nlm.nih.gov/37092185/ Connors NJ, Mazer-Amirshahi M, Motov S, Kim HK. Relative addictive potential of opioid analgesic agents. Pain Manag. 2021;11(2):201-215. doi:10.2217/pmt-2020-0048. https://pubmed.ncbi.nlm.nih.gov/33300384/ Fassassi C, Dove D, Davis A, et al. Analgesic efficacy of morphine sulfate immediate release vs. oxycodone/acetaminophen for acute pain in the emergency department. Am J Emerg Med. 2021;46:579-584. doi:10.1016/j.ajem.2020.11.034. https://pubmed.ncbi.nlm.nih.gov/33341323/ Irizarry E, Cho R, Williams A, et al. Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study. J Emerg Med. Published online March 14, 2024. doi:10.1016/j.jemermed.2024.03.018. https://pubmed.ncbi.nlm.nih.gov/38821847/ Sapkota A, Takematsu M, Adewunmi V, Gupta C, Williams AR, Friedman BW. Oxycodone induced euphoria in ED patients with acute musculoskeletal pain. A secondary analysis of data from a randomized trial. Am J Emerg Med. 2022;53:240-244. doi:10.1016/j.ajem.2022.01.016. https://pubmed.ncbi.nlm.nih.gov/35085877/ Wightman R, Perrone J, Portelli I, Nelson L. Likeability and abuse liability of commonly prescribed opioids. J Med Toxicol. 2012;8(4):335-340. doi:10.1007/s13181-012-0263-x. https://pubmed.ncbi.nlm.nih.gov/22992943/ Segment 3 Anshus AJ, Oswald J. Erector spinae plane block: a new option for managing acute axial low back pain in the emergency department. Pain Manag. 2021;11(6):631-637. doi:10.2217/pmt-2021-0004. https://pubmed.ncbi.nlm.nih.gov/34102865/ Chauhan G, Burke H, Srinivasan SK, Upadhyay A. Ultrasound-Guided Erector Spinae Block for Refractory Abdominal Pain Due to Acute on Chronic Pancreatitis. Cureus. 2022;14(11):e31817. Published 2022 Nov 23. doi:10.7759/cureus.31817. https://pubmed.ncbi.nlm.nih.gov/36579238/ Dove D, Fassassi C, Davis A, et al. Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial. Ann Emerg Med. 2021;78(6):779-787. doi:10.1016/j.annemergmed.2021.04.031. https://pubmed.ncbi.nlm.nih.gov/34226073/ Elkoundi A, Eloukkal Z, Bensghir M, Belyamani L, Lalaoui SJ. Erector Spinae Plane Block for Hyperalgesic Acute Pancreatitis. Pain Med. 2019;20(5):1055-1056. doi:10.1093/pm/pny232. https://pubmed.ncbi.nlm.nih.gov/30476275/ Finneran Iv JJ, Gabriel RA, Swisher MW, Berndtson AE, Godat LN, Costantini TW, Ilfeld BM. Ultrasound-guided percutaneous intercostal nerve cryoneurolysis for analgesia following traumatic rib fracture -a case series. Korean J Anesthesiol. 2020 Oct;73(5):455-459. doi: 10.4097/kja.19395. Epub 2019 Nov 5. PMID: 31684715; PMCID: PMC7533180. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533180/ Finneran JJ, Swisher MW, Gabriel RA, et al. Ultrasound-Guided Lateral Femoral Cutaneous Nerve Cryoneurolysis for Analgesia in Patients With Burns. J Burn Care Res. 2020;41(1):224-227. doi:10.1093/jbcr/irz192. https://pubmed.ncbi.nlm.nih.gov/31714578/ Gabriel RA, Finneran JJ, Asokan D, Trescot AM, Sandhu NS, Ilfeld BM. Ultrasound-Guided Percutaneous Cryoneurolysis for Acute Pain Management: A Case Report. A A Case Rep. 2017;9(5):129-132. doi:10.1213/XAA.0000000000000546. https://pubmed.ncbi.nlm.nih.gov/28509777/ Herring AA, Stone MB, Nagdev AD. Ultrasound-guided abdominal wall nerve blocks in the ED. Am J Emerg Med. 2012;30(5):759-764. doi:10.1016/j.ajem.2011.03.008. https://pubmed.ncbi.nlm.nih.gov/21570238/ Kampan S, Thong-On K, Sri-On J. A non-inferiority randomized controlled trial comparing nebulized ketamine to intravenous morphine for older adults in the emergency department with acute musculoskeletal pain. Age Ageing. 2024;53(1):afad255. doi:10.1093/ageing/afad255. https://pubmed.ncbi.nlm.nih.gov/38251742/ Mahmoud S, Miraflor E, Martin D, Mantuani D, Luftig J, Nagdev AD. Ultrasound-guided transverse abdominis plane block for ED appendicitis pain control. Am J Emerg Med. 2019;37(4):740-743. doi:10.1016/j.ajem.2019.01.024. https://pubmed.ncbi.nlm.nih.gov/30718116/ McCahill RJ, Nagle C, Clarke P. Use of Virtual Reality for minor procedures in the Emergency Department: A scoping review. Australas Emerg Care. 2021;24(3):174-178. doi:10.1016/j.auec.2020.06.006. https://pubmed.ncbi.nlm.nih.gov/32718907/ Nguyen T, Mai M, Choudhary A, et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Ann Emerg Med. Published online May 2, 2024. doi:10.1016/j.annemergmed.2024.03.024. https://pubmed.ncbi.nlm.nih.gov/38703175/ Sikka N, Shu L, Ritchie B, Amdur RL, Pourmand A. Virtual Reality-Assisted Pain, Anxiety, and Anger Management in the Emergency Department. Telemed J E Health. 2019;25(12):1207-1215. doi:10.1089/tmj.2018.0273. https://pubmed.ncbi.nlm.nih.gov/30785860/ Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

Dr. Adela Cope breaks down pelvic inflammatory disease, tubo-ovarian abscess, ovarian torsion, ectopic pregnancy and more in this densely packed chapter of Always on EM. Tune in as Alex and Venk also try to figure out which one has the correct mental model of PID and who will ask the first stupid question.    CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com   LEARN MORE ABOUT RESIDENCY: https://youtu.be/gCQ0zimhhhY?si=NpsyTruGM9N_UpVM https://college.mayo.edu/academics/residencies-and-fellowships/emergency-medicine-residency-minnesota/   REFERENCES: Williams T, Mortada R, Porter S. Diagnosis and Treatment of Polycystic Ovary Syndrome. Am Fam Physician. 2016;94(2):106-113 Rutz M, Boulger C. Early Pregnancy. Sonoguide - American College of Emergency Physicians. Accessed 8/20/2024 (https://www.acep.org/sonoguide/basic/early-pregnancy)  Rodgers SK, et al. A lexicon for first-trimester US: Society of radiologists in ultrasound consensus conference recommendations. Radiology. 2024; 312(2):e240122 Kreisel K, Flagg EW, Torrone E. Trends in pelic inflammatory disease emergnecy department visits, United STates, 2006-2013. Am J Obstet Gynecol 2018;218:117e1-e10 Adhikari S, Blaivas M, Lyon M. Role of bedside transvaginal ultrasonography in the diagnosis of tubo-ovarian abscess in the emergency department. JEM 2008. 34(4):429-433 Mohseni M, Simon LV, Sheele JM. Epidemiologic and clinical characteristics of tubo-ovarian abscess, hydrosalpinx, pyosalpinx, and oophoritis in emergency department patients. Cureus. 2020;12(11):e11647 CDC sexually transmitted infections treatment guidelines, 2021 - Pelvic Inflammatory Disease (PID) accessed 8-20-24 Linden JA. et al. Is the pelvic examination still crucial in patients presenting to the emergency department with vaginal bleeding or abdominal pain when an intrauterine pregnancy is identified on ultrasonography? A randomized tli. Annals of Emerg Med 2017(70):825-834 Stein JC, et al. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: A Meta-Analysis. Annals of Emerg Med. 2010;56:674-683 Robertson JJ, Long B, Koyfman A. Emergency Medicine Myths: Ectopic pregnancy, evaluation, risk factors, and presentation. JEM. 2017(53)6819-828 Brown J, Fleming R, Aristizabal J, Rocksolana G. Does pelvic exam in the emergency department add useful information? West J Emerg Med. 2011;12(2):208-212 Lee R, Dupuis C, Chen B, Smith A, Kim YH. Diagnosing ectopic pregnancy in the emergency setting. Ultrasonography. 2018;37:78-87  

Have you ever been confused about the concept of brain death, or struggled to explain brain death to a patient's family or your fellow clinicians? Join the Behind the Knife Surgical Palliative Care team and our special guest, neurologist & neurointensivist Dr. Sarah Wahlster, as we explore the 2023 Pediatric & Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline and what this updated guideline means for our practice in surgical palliative care! Hosts: Dr. Katie O'Connell (@katmo15) is an Associate Professor of Surgery at the University of Washington in the division of Trauma, Burn, and Critical Care Surgery. She is a trauma surgeon, palliative care physician, Director of Surgical Palliative Care, and founder of the Advance Care Planning for Surgery Clinic at Harborview Medical Center in Seattle, WA. Dr. Virginia Wang is a PGY-3 General Surgery resident at the University of Washington. Guest: Dr. Sarah Wahlster (@SWahlster) is an Associate Professor of Neurology at the University of Washington. She is a neurologist, neurointensivist, and Program Director of the Neurocritical Care Fellowship at Harborview Medical Center in Seattle, WA. Learning Objectives: ·      Understand the concept of assent and how it can be helpful in communicating with families of patients who have sustained brain death ·      Explain the main steps required for diagnosis of brain death (prerequisites, clinical exam, apnea testing, ancillary testing) ·      Understand key differences between the 2023 guideline and previous (2010 & 2011) guidelines ·      Be able to name the 3 accepted modalities of ancillary testing for brain death ·      Know basic communication best practices with families of patients who have sustained brain death from the surgical palliative care perspective (consistency of language & messaging; avoidance of phrases such as “life-sustaining treatment”, “comfort-focused measures”) References: 1.     Greer, D. M., Kirschen, M. P., Lewis, A., Gronseth, G. S., Rae-Grant, A., Ashwal, S., Babu, M. A., Bauer, D. F., Billinghurst, L., Corey, A., Partap, S., Rubin, M. A., Shutter, L., Takahashi, C., Tasker, R. C., Varelas, P. N., Wijdicks, E., Bennett, A., Wessels, S. R., & Halperin, J. J. (2023). Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline. Neurology, 101(24), 1112–1132. https://doi.org/10.1212/WNL.0000000000207740 2.     Lewis, A., Kirschen, M. P., & Greer, D. (2023). The 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline: A Comparison With the 2010 and 2011 Guidelines. Neurology. Clinical practice, 13(6), e200189. https://doi.org/10.1212/CPJ.0000000000200189 3.     AAN Interactive Brain Death/Death by Neurologic Criteria Evaluation Tool – https://www.aan.com/Guidelines/BDDNC 4.     AAN Brain Death/Death by Neurologic Criteria Checklist – https://www.aan.com/Guidelines/Home/GetGuidelineContent/1101 5.     Kirschen, M. P., Lewis, A., & Greer, D. M. (2024). The 2023 American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine Pediatric and Adult Brain Death/Death by Neurologic Criteria Determination Consensus Guidelines: What the Critical Care Team Needs to Know. Critical care medicine, 52(3), 376–386. https://doi.org/10.1097/CCM.0000000000006099 6.     Greer, D. M., Shemie, S. D., Lewis, A., Torrance, S., Varelas, P., Goldenberg, F. D., Bernat, J. L., Souter, M., Topcuoglu, M. A., Alexandrov, A. W., Baldisseri, M., Bleck, T., Citerio, G., Dawson, R., Hoppe, A., Jacobe, S., Manara, A., Nakagawa, T. A., Pope, T. M., Silvester, W., … Sung, G. (2020). Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project. JAMA, 324(11), 1078–1097. https://doi.org/10.1001/jama.2020.11586 7.     Lele, A. V., Brooks, A., Miyagawa, L. A., Tesfalem, A., Lundgren, K., Cano, R. E., Ferro-Gonzalez, N., Wongelemegist, Y., Abdullahi, A., Christianson, J. T., Huong, J. S., Nash, P. L., Wang, W. Y., Fong, C. T., Theard, M. A., Wahlster, S., Jannotta, G. E., & Vavilala, M. S. (2023). Caseworker Cultural Mediator Involvement in Neurocritical Care for Patients and Families With Non-English Language Preference: A Quality Improvement Project. Cureus, 15(4), e37687. https://doi.org/10.7759/cureus.37687 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Thyroid Talk with Dr. Angela Mazza, DORecorded: 8-2-2024SHOW NOTES EPISODE 32EMFS--Electro Magnetic FieldsHost: Dr. Angela Mazza, DOCo-host: Dawn Sheffield I'm Dr. Angela Mazza, D.O., a thyroid, endocrine, and metabolism specialist with a private practice in Central Florida.  My goal for this podcast is to define and demystify the thyroid gland, and thyroid-related medical conditions.  By providing information in an easy-to-understand format, we hope to help patients better understand the ways in which their bodies work, and to help them thrive.  My goal is to help us live more fulfilling lives by taking control of our health, to feel our best. I do this podcast to provide life-saving education and encourage patients to see a doctor in time to prevent or minimize damage.  That's deeply fulfilling.  I enjoy helping folks understand how all aspects of their lives are tied to both thyroid and overall health.  That's why I went into endocrinology.  It's a medical art that combines science with the study of our lives—and all that they encompass.   Here's some of what we covered today, not necessarily in this order: ·        What are EMFs?·        How are they helpful?·        What are some concerns?·        What are the possible thyroid effects?·        How to minimize excessive exposure;·        What protective action can we take--and why?·        What is some of the current research on EMFs?·        And best of all, we learned that we CAN impact our thyroid health!  My book, Thyroid Talk: An Integrative Guide to Optimal Thyroid Health, is available on Amazon.  For information on the related Webinar and online master course, see thrivethyroid.com.  Or forward your name and email to thyroidtalk.mazza@gmail.com or to our website: metaboliccenterforwellness.com  The webinar coordinates with the online master class.  The master class has modules that cover topics like diagnosis of thyroid issues, personalized treatment, gut healing, and much more--plus some bonuses.  Regarding supplements mentioned in various episodes of this podcast, visit the Wellness Store: metaboliccenterforwellness.com   Send your comments, show ideas, and questions to thyroidtalk.mazza@gmail.com  We may disclose your general location on air (the city or town, for example), but we will NOT read your name NOR your address on the show.  We reserve the right to edit your input as necessary.  Please stay in touch and send us your questions!  Check out the website at metaboliccenterforwellness.com, our YouTube channel at: Dr. Angela Mazza; as well as Facebook, Instagram, and TikTok.   The topic of our next episode, number 33, has yet to be announced--but it has been determined.  Citations, references, additional information:Alkayyali T, Ochuba O, Srivastava K, Sandhu JK, Joseph C, Ruo SW, Jain A, Waqar A, Poudel S. An Exploration of the Effects of Radiofrequency Radiation Emitted by Mobile Phones and Extremely Low Frequency Radiation on Thyroid Hormones and Thyroid Gland Histopathology. Cureus. 2021 Aug 20;13(8):e17329. doi: 10.7759/cureus.17329. PMID: 34567874; PMCID: PMC8451508. Cancer.gov. Electromagnetic Fields and Cancer.  Reviewed May 30, 2022.   Carnahan, J. “EMFs and Your Brain: TheirCheck out our YouTube channel - Dr. Angela Mazza, our website at Metabolic Center for Wellness, our FaceBook and our Instagram page.

Pregnancy leads to many physiologic changes, and thyroid and parathyroid disorders alter that physiology even more leading to complex laboratory interpretation and decision-making impacting both mother and fetus. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Vennila Padmanaban from The Ohio State University. Hear about normal and abnormal thyroid and parathyroid physiology and treatment of patients with thyroid cancer. The group discusses several articles focusing on current guidelines from the American Thyroid Association as well as other key studies.  Hosts: Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, John Phay, MD, Clinical Professor of Surgery, Priya H. Dedhia, MD, PhD, Assistant Professor of Surgery, Vennila Padmanaban, MD, Surgical Oncology Fellow, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Twitter handles:  Barbra Miller - @OSUEndosurgBSM John Phay – @JohnPhayMD Priya Dedhia – @priyaknows  Vennila Padmanaban - @vennilapadmanMD Learning objectives:  1)  Understand normal changes in thyroid and parathyroid physiology during pregnancy 2)  Describe the impact of thyroid and parathyroid dysregulation on maternal and fetal health 3)  Compare and contrast management of thyroid and parathyroid disorders during pregnancy vs. non-pregnancy   4)  Recognize the importance of multidisciplinary care of patients with thyroid and parathyroid disorders References: 1. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457. Erratum in: Thyroid. 2017 Sep;27(9):1212. doi: 10.1089/thy.2016.0457.correx. PMID: 28056690 https://pubmed.ncbi.nlm.nih.gov/28056690/ 2. Jee SB, Sawal A. Physiological Changes in Pregnant Women Due to Hormonal Changes. Cureus. 2024 Mar 5;16(3):e55544. doi: 10.7759/cureus.55544. PMID: 38576690; PMCID: PMC10993087 https://pubmed.ncbi.nlm.nih.gov/38576690/ 3. Patel, Kepal N. MD; Yip, Linwah MD; Lubitz, Carrie C. MD, MPH; Grubbs, Elizabeth G. MD; Miller, Barbra S. MD; Shen, Wen MD; Angelos, Peter MD; Chen, Herbert MD; Doherty, Gerard M. MD; Fahey, Thomas J. III MD; Kebebew, Electron MD; Livolsi, Virginia A. MD; Perrier, Nancy D. MD; Sipos, Jennifer A. MD; Sosa, Julie A. MD; Steward, David MD; Tufano, Ralph P. MD; McHenry, Christopher R. MD; Carty, Sally E. MD. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Annals of Surgery 271(3):p e21-e93, March 2020.  DOI: 10.1097/SLA.0000000000003580 https://pubmed.ncbi.nlm.nih.gov/32079830/ 4. Appelman-Dijkstra NM, Pilz S. Approach to the Patient: Management of Parathyroid Diseases Across Pregnancy. J Clin Endocrinol Metab. 2023 May 17;108(6):1505-1513. doi: 10.1210/clinem/dgac734. PMID: 36546344; PMCID: PMC10188304 https://pubmed.ncbi.nlm.nih.gov/36546344/  5. Eremkina A, Bibik E,  Mirnaya S, Krupinova J, Gorbacheva A, Dobreva E, Mokrysheva N. Different treatment strategies in primary hyperparathyroidism during pregnancy.  Endocrine. 2022 Sep;77(3):556-560. doi: 10.1007/s12020-022-03127-3. Epub 2022 Jul 12. PMID: 35821184 https://pubmed.ncbi.nlm.nih.gov/35821184/ TRUELEARN LINK: https://truelearn.referralrock.com/l/BTKPODCAST/ Discount code: BTKPODCAST Using the discount code, you can get a discount of $25 off our Residency (General surgery, anesthesiology, OBGYN, Psychiatry, Peds, Neurology, Emergency Medicine, Internal Medicine, and Family Medicine), USMLE, andCOMLEX SmartBank subscriptions of 90-days or more. The code can also be applied for 15% off our allied healthSmartBanks (PA, Nurse Practitioner, Pharmacy, PT, OT, etc.). Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

איך זה שב-2024, עם כל הידע שקיים, אתם עדיין מתקשים למצוא את הדיאטה שנכונה לכם, וגם אם נראה שמצאתם – קשה לכם להתמיד בה???   בפרק 91 בפודקאסט אני חושפת לכם את הכישלון המוצלח ביותר בעת שלנו: כישלון הדיאטות. לא כי הן לא עובדות! אלא כי מה שקורה לנו בתוכן – יכול להזיק לא פחות מאשר להועיל.   אז מה עושים? מוותרים על הכל ול***זל עם הבריאות? לא! כי אפשר בכל זאת ליצור שלום בחזרה עם הבריאות, הגוף והמשקל שלנו, ובדיוק על כך אני מדברת בפרק.   לחצו כאן להדרכה חינם – איך יוצרים לבד תפריט שבאמת אפשר לעמוד בו  לחצו כאן לפרטים על טיפולים תזונתיים ורגשיים במרכז שלי   עקבו אחריי לעוד המון מידע חינמי: אינסטגרם: https://www.instagram.com/rutifink/ טיק-טוק: https://www.tiktok.com/@rutifink פייסבוק: https://www.facebook.com/fink.ruti יוטיוב: https://www.youtube.com/@rutifink לקבלת מייל בכל פעם שיוצא פרק חדש של הפודקאסט: http://rutifink.vp4.me/podcast   רפרנסים: Mauldin K, May M, Clifford D. The consequences of a weight-centric approach to healthcare: A case for a paradigm shift in how clinicians address body weight. Nutr Clin Pract. 2022;37:1291-1306. Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC. Probability of an obese person attaining normal body weight: cohort study using electronic health records. Am J Public Health. 2015;105:e54‐e59 Pélissier L et al. Is dieting a risk for higher weight gain in normal-weight individual? A systematic review and meta-analysis. Br J Nutr. 2023 Jan 16:1-23 Tomiyama AJ, Ahlstrom B, Mann T. Long‐term effects of dieting: is weight loss related to health? Soc Personal Psychol Compass. 2013;7:861‐877 Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013 Jul 11;369(2):145-54. Memon AN, Gowda AS, Rallabhandi B, Bidika E, Fayyaz H, Salib M, Cancarevic I. Have Our Attempts to Curb Obesity Done More Harm Than Good? Cureus. 2020 Sep 6;12(9):e10275 Cameron JD, Goldfield GS, Doucet É. Appetite. 2012;58:978‐981. Thaiss CA, Itav S, Rothschild D, et al. Nature. 2016;540:544‐551. Zou, Huajie, et al. Journal of diabetes investigation  2021: 625-632.‏ Lee, Dong Hoon, et al. Cancer Causes & Control 2021: 1029-1038.‏ Zou, Huajie, et al. Frontiers in endocrinology (2019): 728.‏ Massey, Robert J., et al. Cardiovascular Diabetology 22.1 (2023): 1-12.‏ Rossi AP, Rubele S, Calugi S, et al. Obesity. 2019;27:1068–1075 Polivy J. Psychological consequences of food restriction. J Am Diet Assoc. 1996;96(6):589-92; quiz 593-4. Herman CP, Polivy J, Esses VM. The illusion of counter-regulation.. Appetite. 1987;9:161–169. Knight LJ, Boland FJ. Restrained eating: an experimental disentanglement of the disinhibiting variables of perceived calories and food type. J Abnorm Psychol. 1989 Nov;98(4):412-20 Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1999;318:765–768. Emmer C, Bosnjak M, Mata J. The association between weight stigma and mental health: A meta-analysis. Obesity Reviews. 2020; 21:e12935 Puhl, RM et al. Weight stigma as a psychosocial contributor to obesity. American Psychologist 2020;75(2):274–289  

- Today I'd like to tell you about a study by Alexandre Amato and Daniel Benitti, surgeons in Brazil.- The title of this open-access review article is *Efficacy of Liposuction in the Treatment of Lipedema: A Meta-Analysis*.- It was published in the peer-reviewed journal *Cureus* in February 2024.

It's Wednesday, May 29th, A.D. 2024. This is The Worldview in 5 Minutes heard at www.TheWorldview.com. I'm Adam McManus. (Adam@TheWorldview.com) By Jonathan Clark Kazakhstan officials raid Protestant churches Officials in Kazakhstan raided several Protestant churches in recent months. Police fined pastors and congregants for not being registered with the government. Pastors also faced charges of illegal missionary activity.  Last year, individuals and organizations in the Central Asian country faced over 200 cases of such prosecutions for exercising their freedom of religion.  The local Baptist Council of Churches said, “What has been happening in the last month . . . has aroused serious concern among Evangelical communities, which have experienced persecution for their religious activity.” According to Open Doors, Kazakhstan is the 47th most difficult country worldwide in which to be a Christian. Finnish Christian politician harassed by hostile court system A Christian politician is preparing to stand trial for the third time over her Biblical beliefs. As The Worldview reported on April 22nd, Päivi Räsänen is a former government minister and sitting Finnish parliamentarian. She recently submitted her defense to the Finnish Supreme Court.  Lower courts acquitted her of “hate speech” after she posted Bible verses online in opposition to sexually perverted lifestyles. However, the State prosecutor appealed the case to the country's Supreme Court.  Räsänen said, “An acquittal by the Supreme Court would … provide a clearer and stronger safeguard for the freedom of Christians to present the teachings of the Bible–and it would strengthen the principle of freedom of expression in general.”  More hurricanes on the way The U.S. National Oceanic and Atmospheric Administration is predicting more hurricanes this year than normal. The 2024 Atlantic hurricane season lasts from June 1 to November 30. The group predicts an 85% chance of an above-normal season.  The forecast includes 8 to 13 hurricanes. Four to seven of those are expected to be major hurricanes.  Job said in Job 26:12 and 14, “[God] stirs up the sea with His power, and by His understanding He breaks up the storm. … Indeed, these are the mere edges of His ways … the thunder of His power who can understand?” Political gender gap A new poll by the Institute of Politics at Harvard Kennedy School highlights the growing gender gap among young people. President Joe Biden leads former President Donald Trump by eight percentage points among Americans under 30. Among young women, Biden leads by 33 points. But among young men, Biden only leads by six points, down from 26 points in 2020. In 2020, 42% of young men identified as Democrat and 20% as Republican. Now, 32% identify as Democrat and 29% as Republican.  Transgender surgeries lead to suicide attempts Last month, researchers published a study in the medical science journal called Cureus, entitled “Risk of Suicide and Self-Harm Following Gender-Affirmation Surgery.” The study evaluated 90 million adults in the U.S. It found that people who get sex-mutilating surgeries are more likely to attempt suicide. The study noted, “Individuals who underwent gender-affirming surgery had a 12-fold higher suicide attempt risk than those who did not.”  Pro-life pregnancy centers provided $360 million of services in 2022 This month, the Charlotte Lozier Institute, a pro-life research group, released a report on the impact of pro-life centers in 2022. The U.S. had 2,750 pregnancy resource centers at the time. Overall, they provided over $360 million in pro-life services and goods to individuals and families. That's over $100 million than the services and goods provided in 2019. Demand for pro-life services has increased since the U.S. Supreme Court overturned Roe v. Wade in 2022. Despite this, pro-abortion attorneys general and lawmakers are targeting pro-life pregnancy centers.  Environmental activists vs. Christian New Jersey community For generations, Ocean Grove Camp Meeting Association, a Christian group in Ocean Grove, New Jersey, has closed its private beach on Sunday to honor the fourth commandment. Recently, the state's Department of Environmental Protection has been threatening the Christian camp group with fines of $25,000 for every Sunday that they remain closed because the group is allegedly violating beach access laws. As a result of the pressure, the Christian group has relented and opened their private beach on the Lord's Day. Ocean Grove Camp Meeting Association said it would challenge the order in court to “preserve our property rights and religious freedom.” Young adults embrace lying, abortion, and sexual perversion And finally, Dr. George Barna released his latest research on Biblical worldview in America. The study noted that younger generations are leading a big shift in our country's morals. Less than half of adults under 40 say the Bible is their guide to morality. Most adults under 40 reject absolute moral truth and embrace lying, abortion, and sexually perverted lifestyles.  Dr. Barna said, “By abandoning the absolute boundaries given to us in the Bible, we have opted for unpredictable and conflicting standards that serve us poorly. You always reap what you sow. America is now harvesting the sad product of what it has been cultivating for the last 40-plus years.” Isaiah 55:6-7 says, “Seek the LORD while He may be found, call upon Him while He is near. Let the wicked forsake his way, and the unrighteous man his thoughts; let him return to the LORD, and He will have mercy on him.” Close And that's The Worldview in 5 Minutes on this Wednesday, May 29th, in the year of our Lord 2024. Subscribe by iTunes or email to our unique Christian newscast at www.TheWorldview.com. Or get the Generations app through Google Play or The App Store. I'm Adam McManus (Adam@TheWorldview.com). Seize the day for Jesus Christ.

In this episode, we dive into a fascinating study conducted by Brazilian surgeon and researcher, Dr. Alexandre Amato. His paper, titled "The Association Between Lipedema and Attention-Deficit/Hyperactivity Disorder," was published in Cureus in February 2023. Join us as we explore the intriguing connection between these two conditions and what it could mean for future research and treatment.

In this episode, Matt and Jenn discuss the resurging popularity of sleeping in separate bedrooms. We'll consider the  reasons why a couple might choose this option and whether it might be wise for your marriage. In addition, we'll discuss some of the consequences of spouses who have separate bedtimes.Every step we take away from our spouses, especially physically, has inevitable negative long-term consequences for the relationship. The decision to sleep apart should be weighed carefully and be constantly reevaluated. As much as is within your power, eliminate the barriers to sleeping together so that you can get be in bed with each other as often as possible.Likewise, separate bedtimes also promote emotional and physical drift away from each other, allowing opportunity for selfishness and betrayal.As promised, here are the sources for the data that we referenced in this episode: Elsey, Taylor et al. “The role of couple sleep concordance in sleep quality: Attachment as a moderator of associations.” Journal of sleep research vol. 28,5 (2019): e12825. Drews HJ, Drews A. Couple Relationships Are Associated With Increased REM Sleep-A Proof-of-Concept Analysis of a Large Dataset Using Ambulatory Polysomnography. Front Psychiatry. 2021 May 10;12:641102.Richter, K., Adam, S., Geiss, L., Peter, L., & Niklewski, G. (2016). Two in a bed: The influence of couple sleeping and chronotypes on relationship and sleep. An overview. Chronobiology International, 33(10), 1464–1472. Troxel WM; Buysse DJ; Matthews KA; Kravitz HM; Bromberger JT; Sowers M; Hall MH. Marital/cohabitation status and history in relation to sleep in midlife women. SLEEP 2010;33(7):973-981.Chiao, Chi et al. “Loneliness in older parents: marital transitions, family and social connections, and separate bedrooms for sleep.” BMC geriatrics vol. 21,1 590. 22 Oct. 2021Larson JH, Crane DR, Smith CW. (1991). Morning and night couples: The effect of wake and sleep patterns on marital adjustment. J Marital Fam Ther. 17:53–65.Ulfberg J, Carter N, Talback M, Edling C. (2000). Adverse health effects among women living with heavy snorers. Health Care Women Int. 21:81–90.Gordon, A. M., & Chen, S. (2014). The Role of Sleep in Interpersonal Conflict: Do Sleepless Nights Mean Worse Fights? Social Psychological and Personality Science, 5(2), 168-175.Cartwright, R D, and S Knight. “Silent partners: the wives of sleep apneic patients.” Sleep vol. 10,3 (1987): 244-8. Cascais Costa C, Afreixo V, Cravo J. Impact of Obstructive Sleep Apnea Treatment on Marital Relationships: Sleeping Together Again? Cureus. 2023 Oct 5;15(10):e46513.Please support these companies that support Intimate Covenant:Married Dance — https://marrieddance.com/?aff=29  Shop from this link and part of your purchase will support Intimate Covenant.  Coconu — http://www.coconu.com  Your purchase helps support Intimate Covenant AND you get 15% OFF. Coupon Code: intimateconvenantTo send your comments, questions and suggestions, go to our website: www.intimatecovenant.com/podcast and click on the button: “Contact the Podcast” for an ANONYMOUS submission form. Or, send an email: podcast@intimatecovenant.com   Thanks for sharing, rating, reviewing and subscribing!   Cherishing,  Matt & Jenn www.intimatecovenant.com Intimate Covenant | Matt & Jenn Schmidt

In this episode of the Nutrition Edit Podcast, we delve into the unavoidable reality of stress and its impact on our lives. Stress comes in many forms, some of which we can control and others we can't, like political unrest or environmental toxins. But regardless of the source, stress affects us all differently, influenced by our circumstances and resilience levels.While we can't always eliminate stressors from our lives, we can manage our response to stress through healthy lifestyle choices. Today, we're focusing on how to use food and exercise to increase resilience and reduce stress, even when external stressors remain unchanged.Interested in working with Jeannie? Schedule a 30-minute Coffee Talk here.Connect with me on Instagram @joliverwellness and check out the options for my more affordable self-study programs here: https://www.joliverwellness.com/diy-programsMusic credit: Funk'd Up by Reaktor ProductionsA Podcast Launch Bestie productionDownload my Sleep Better Strategies cheat sheet here.References:Mock, S. E., & Arai, S. M. (2011). Childhood trauma and chronic illness in adulthood: mental health and socioeconomic status as explanatory factors and buffers. Frontiers in psychology, 1, 246. https://doi.org/10.3389/fpsyg.2010.00246UCSF Center to Advance Trauma Informed Health Care - How Trauma Affects Our HealthYale Medicine Fact Sheet: Chronic StressSelvaraj, R., Selvamani, T. Y., Zahra, A., Malla, J., Dhanoa, R. K., Venugopal, S., Shoukrie, S. I., Hamouda, R. K., & Hamid, P. (2022). Association Between Dietary Habits and Depression: A Systematic Review. Cureus, 14(12), e32359. https://doi.org/10.7759/cureus.32359Kris-Etherton, P. M., Petersen, K. S., Hibbeln, J. R., Hurley, D., Kolick, V., Peoples, S., Rodriguez, N., & Woodward-Lopez, G. (2021). Nutrition and behavioral health disorders: depression and anxiety. Nutrition reviews, 79(3), 247–260. https://doi.org/10.1093/nutrit/nuaa025Rao, T. S. Sathyanarayana; Asha, M. R.1; Ramesh, B. N.2; Rao, K. S. Jagannatha2. Understanding nutrition, depression and mental illnesses. Indian Journal of Psychiatry 50(2):p 77-82, Apr–Jun 2008. | DOI: 10.4103/0019-5545.42391Craft, L. L., & Perna, F. M. (2004). The Benefits of Exercise for the Clinically Depressed. Primary care companion to the Journal of clinical psychiatry, 6(3), 104–111. https://doi.org/10.4088/pcc.v06n0301Medical News Today article:

Welcome to Episode 25 of Optimal—the Podcast! In this episode, we discuss the concept of modifiable risk factors. Dr. Weatherby and Beth Ellen discuss modifiable risk factors related to lifestyle choices impacting health, pointing out the impact of unhealthy habits on conditions like cardiovascular disease and blood sugar dysregulation. Also, the lack of physical activity, poor sleep, smoking, excess alcohol intake, and stress management are highlighted as key modifiable factors affecting health. They emphasize the crucial importance of early risk recognition before diagnosis. They also discuss strategies for addressing risk factors like dietary improvements and emphasizing whole foods over processed items. Additionally, exercise routines and stress management techniques such as deep breathing and meditation are highlighted for better health outcomes, as these modifications significantly impact biomarkers associated with chronic diseases. Tune in to learn more about modifiable risk factors impacting your health! Don't miss out on valuable insights to enhance your well-being today! Episode Highlights: ( 01:50 ) Recognizing risks that are modifiable and lifestyle choices can become risk factors ( 03:13 ) Making choices and dealing with traditional approaches ( 08:26 ) Implementation of the DASH diet and translating it into dietary choices ( 14:11 ) Discussion on modifiable risk factors ( 16:36 ) Utilizing techniques like box breathing and meditation for stress management ( 22:05 ) Link between sleep duration and cardiovascular risk factors ( 26:26 ) Impact of sleep duration on biomarkers and metabolic health ( 32:07 ) About a research study on health coaching and disease biomarkers ( 35:51 ) Utilizing coaching sessions and supplements for health revival ( 40:29 ) Exploring a detailed study and blog post for comprehensive information Resources Discussed in This Podcast Lewis, Thomas J et al. “Reduction in Chronic Disease Risk and Burden in a 70-Individual Cohort Through Modification of Health Behaviors.” Cureus vol. 12,8 e10039. 26 Aug. 2020, doi:10.7759/cureus.10039  Link to download the article in PDF format: https://www.optimaldx.com/hubfs/pdf/Lewis_ChronicDisease%20TempAssess_2020_32983729.pdf    How Lifestyle Choices Affect Blood Chemistry Results https://www.optimaldx.com/blog/how-lifestyle-recommendations-related-to-lifestyle-factors-affect-blood-chemistry-results PROOF: Modification of Health Behaviors Reduces Chronic Disease Risk https://www.optimaldx.com/blog/proof-modification-of-health-behaviors-reduces-chronic-disease-risk Where to Reach Dr. Dicken Weatherby Dicken Weatherby LinkedIn Optimal DX Resource Center Optimal DX Blog The ODX Research Blog Where to Reach Beth Ellen DiLuglio Nutrition Mission Beth Ellen DiLuglio LinkedIn Did you find today's episode helpful? If you enjoy today's conversation, please click here to leave a review for Optimal - The Podcast. Get notified when a new episode comes out by subscribing to Optimal - The Podcast on your favorite podcast app! Education is the most effective way to make a change. Help others get the information they need by sharing this episode!

Episode SummaryTiming is everything! In this episode of the 80/20 Productivity Podcast, we delve deep into the science and art of aligning your activities with your body's natural rhythms to amplify your productivity, health, and overall well-being. Discover how timing isn't just a concept but a fundamental aspect of enhancing your life's quality and efficiency.Get an extra 20% off a 30-day supply of Magic Mind productivity shots. Go to https://magicmind.com/8020productivity and use CODE: PRD20 So, let's get into the details:The Vital Few (TVF) Timestamps: [00:00:00] - The Power of TimingExplore why timing is critical in maximizing the benefits and performance of your actions. A brief overview of what's to come in the episode.[00:00:40] - Working With Your Natural RhythmsUnveil the secrets to boosting your activity performance by syncing with your body's rhythms.[00:01:40] - Biological Rhythms ExplainedDive into what biological rhythms are, why they exist, and how they impact our daily lives.[00:02:27] - The Best Times for Daily ActivitiesA caveat about finding the perfect time for activities that matter and how it's more important to just do them.[00:03:30] - Timing, Chronos, and KairosUnderstanding the difference between Chronos (quantitative time) and Kairos (opportune time) in the context of productivity.[00:05:12] - Evolution and Our Biological ClocksHow evolution on Earth influenced the development of our internal clocks.[00:07:38] - Different Types of RhythmsIntroduction to circadian, diurnal, ultradian, and circa-annual rhythms.[00:12:14] - Circadian, Diurnal, and Ultradian Rhythms in Daily LifeHow these rhythms specifically influence our day-to-day activities and productivity.[00:18:29] - The Impact of Light and TemperatureThe role of light and temperature as key factors in syncing with our natural rhythms.[00:22:32] - Crafting an Ideal Daily RoutineStep-by-step guide through an optimal daily routine from morning till night based on scientific insights.[00:38:02] - Time-Restricted Eating and Its BenefitsDiscussion on how aligning eating times with your body's clock can enhance health and productivity.[00:47:18] - Evening Routines and Preparing for SleepTips for winding down effectively, aligning evening activities with natural rhythms for better sleep quality.[01:08:50] - Conclusion and Key TakeawaysWrapping up the insights shared in the episode and encouraging listeners to experiment with aligning their routines with their biological rhythms.Get an extra 20% off a 30-day supply of Magic Mind productivity shots. Go to https://magicmind.com/8020productivity and use CODE: PRD20 My favourite digital productivity tool (get double the trial period for free! No credit card required: https://try.sunsama.com/anthony Notes and References Biological Rhythms, Clock, Zeitgebers and Light's Influence on Biological Clocks: Merrow M (2023) Circadian clocks: It's time for chronobiology. PLoS Biol 21(11): e3002426. https://doi.org/10.1371/journal.pbio.3002426Circadian Rhythms Affect Metabolism: Circadian rhythms significantly impact human metabolism, suggesting optimal meal timing can improve health.Brown Adipose Tissue Activity: Maaike E. Straat, Rick Hogenboom, Mariëtte R. Boon, Patrick C.N. Rensen, Sander Kooijman, Circadian control of brown adipose tissue, Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids, Volume 1866, Issue 8, 2021, https://doi.org/10.1016/j.bbalip.2021.158961 Benefits of Early Time-Restricted Eating: L.S. Chow, E.N.C. Manoogian, A. Alvear, J.G. Fleischer, H. Thor, K. Dietsche, et al.Time-restricted eating effects on body composition and metabolic measures in humans who are overweight: a feasibility studyObesity (Silver Spring), 28 (5) (2020), pp. 860-869Optimal Exercise Timing for Performance: Exercise performance can vary by time of day, influenced by body temperature and hormone levels.Caffeine Consumption Timing for better sleep: Carissa Gardiner, Jonathon Weakley, Louise M. Burke, Gregory D. Roach, Charli Sargent, Nirav Maniar, Andrew Townshend, Shona L. Halson, The effect of caffeine on subsequent sleep: A systematic review and meta-analysis, Sleep Medicine Reviews, Volume 69, 2023, https://doi.org/10.1016/j.smrv.2023.101764 .Mental Performance Varies Throughout the Day: Schmidt C, Collette F, Cajochen C, Peigneux P. A time to think: circadian rhythms in human cognition. Cogn Neuropsychol. 2007 Oct;24(7):755-89. doi: 10.1080/02643290701754158. PMID: 18066734.L-Theanine and Caffeine cognitive effects: Anas Sohail A, Ortiz F, Varghese T, Fabara SP, Batth AS, Sandesara DP, Sabir A, Khurana M, Datta S, Patel UK. The Cognitive-Enhancing Outcomes of Caffeine and L-theanine: A Systematic Review. Cureus. 2021 Dec 30;13(12):e20828. doi: 10.7759/cureus.20828. PMID: 35111479; PMCID: PMC8794723Work/Break Ratio for Productivity: This is an updated article. But it still maintains the benefits of working in cycles of work and rest. https://desktime.com/blog/52-17-updated-people-are-now-working-and-breaking-longer-than-before Anthony's Book: The Law of The Vital Few

Vaping. E-cigarettes. Heat sticks. They're super popular (especially among young people)- an estimated 22 MILLION e-cigarettes are sold in the US every MONTH. As we have (thankfully) seen traditional combustible tobacco cigarette smoking decline over the past couple decades, the flip side is an astronomical increase in vaping. Many e-cigarette brands market themselves as a safer, healthier alternative to smoking cigarettes, calling their vape products "ENDS" or "electronic nicotine delivery systems". Is this reality? Is vaping less harmful to you than smoking? Your Doctor Friends want to clear the air, make the conversation about vaping a little less foggy. Today we will answer questions like: How does vaping affect our health directly? What does the research show about the risks of vaping with respect to cardiovascular problems, cancer, or lung disease? What the heck is "popcorn lung"? What about VAPI (vaping associated pulmonary injury)? What does nicotine alone do to our bodies? How much nicotine is in a vape? A cigarette? What's actually in vape aerosol/mist? How is it different than cigarette smoke? Is it bad for me? Is vaping instead of smoking actually good "harm reduction"? How are e-cigarettes marketed specifically to kids and young adults? Why? What should we do about it? Let's all inform ourselves about the issues surrounding vaping/e-cigarettes, so we can all breathe easier! Resources for today's episode include: A 2022 Tobacco Use Insights journal review of literature on e-cigarette harm vs harm reduction. A March 11, 2024 study and discussion in Pediatrics journal about disposable e-cigarettes, use patterns in youth, and how to counteract the tobacco industry's "reduced-harm" marketing tropes. An August 2023 JAMA article about youth flavored e-cigarette use before and after partial flavoring bans. A Guardian article about the amount of nicotine in vapes vs cigarettes. A 2023 article in Advances in Respiratory Medicine outlining the data on vaping and cancer risk. Results from the 2023 FDA Annual National Youth Tobacco Survey. A 2016 study in Environmental Health Perspectives about acrolein, diacetyl, and other chemicals found in flavored e-cigarettes. A 2019 Cureus article about vitamin E acetate as plausible cause of acute vaping-related lung illness. A 1/24/24 CNN article about the lack of progress on the US menthol cigarette ban. Wikipedia article on "bronchiolitis obliterans". A December 2023 WHO news release about the urgent need to protect children and prevent uptake of e-cigarettes. A 2023 Cureus meta-analysis on risks of vaping on cardiovascular disease. An October 2023 Pediatrics journal article outlining vaping cessation methods used by US adolescent e-cigarette users. Thanks for tuning in, folks! Please sign up for our "PULSE CHECK" monthly newsletter! Signup is easy, right on our website page, and we PROMISE we will not spam you! We just want to send you cool articles, videos and thoughts :) For more episodes, limited edition merch, or to become a Friend of Your Doctor Friends (and more), follow this link!   Find us at: Website: yourdoctorfriendspodcast.com  Email: yourdoctorfriendspodcast@gmail.com  Connect with us: @your_doctor_friends (IG) Send/DM us a voice memo/question and we might play it on the show! @yourdoctorfriendspodcast1013 (YouTube) @JeremyAllandMD (IG, FB, Twitter) @JuliaBrueneMD (IG) @HealthPodNet (IG)

Another foray into the wide world of SUPPLEMENTS, friends! Let's talk COLLAGEN this time. What IS collagen? Well, in short, it's, uh... us. Collagen is the most abundant protein in your body. It accounts for about 30% of your body's total protein.  It is the primary building block of your body's connective tissues: skin, muscles, bones, tendons, ligaments, etc. So.. does consuming it (as marketed by supplement companies) actually IMPROVE any of those parts of you?? Or is this just another trick by the "wellness" industry to freak us out (even more) about bodily changes that the majority of human beings will experience, to some degree, in the normal course of aging? This week Jeremy presents a detailed dissertation on collagen consumption! Your Doctor Friends aim to answer all your collagen questions! What does the research suggest? Can we even absorb collagen by eating it in supplement form? Can it improve your skin? What about your joints? Does it make arthritis better? Is there a particular TYPE of collagen that has potential positive impact on our health? Is it crazy expensive?? Am I eating BONES?? (listen in to find out ;) Resources for today's episode include: The Cleveland Clinic's informational page about collagen. An article/lit review/meta-analysis from the American Journal of Translational Research evaluating the efficacy of undenatured collagen in knee osteoarthritis. An International Journal of Dermatology systematic review/meta-analysis on the effects of hydrolyzed collagen supplementation on skin aging. A systematic review/meta-analysis in Nutrients on the effects of oral collagen for skin anti-aging. A 2023 Cureus meta-analysis on hydrolyzed oral collagen supplementation on skin rejuvenation. A Nutrients study on type-2 chicken hydrolyzed collagen supplements to alleviate joint discomfort. A Washington Post article from 1/29/24 titled "Should I be taking collagen supplements? Here's what the science says." An Elle News article from Feb 2024 all about collagen drinks. Thanks for tuning in, folks! Please sign up for our "PULSE CHECK" monthly newsletter! Signup is easy, right on our website page, and we PROMISE we will not spam you! We just want to send you cool articles, videos and thoughts :) For more episodes, limited edition merch, or to become a Friend of Your Doctor Friends (and more), follow this link!   Find us at: Website: yourdoctorfriendspodcast.com  Email: yourdoctorfriendspodcast@gmail.com  Connect with us: @your_doctor_friends (IG) Send/DM us a voice memo/question and we might play it on the show! @yourdoctorfriendspodcast1013 (YouTube) @JeremyAllandMD (IG, FB, Twitter) @JuliaBrueneMD (IG) @HealthPodNet (IG)

Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volume depletion Albumin repletes volume stores and reduces renal impairment Albumin binds inflammatory cytokines and expands plasma volume Reduced all-cause mortality if IV albumin is given with antibiotics Hepatorenal syndrome Cirrhosis of the liver causes the release of endogenous vasodilators The renin-angiotensin-aldosterone system (RAAS) fails systemically but maintains vasoconstriction at the kidneys, leading to decreased renal perfusion IV albumin expands plasma volume and prevents failure of the RAAS Large volume paracentesis Large-volume removal may lead to circulatory dysfunction IV albumin is associated with a reduced risk of paracentesis-associated circulatory dysfunction There are many other FDA-approved conditions for which to use exogenous albumin but the data are conflicted about the benefits on mortality References 1. Arroyo V, Fernandez J. Pathophysiological basis of albumin use in cirrhosis. Ann Hepatol. 2011;10(SUPPL. 1):S6-S14. doi:10.1016/s1665-2681(19)31600-x 2. Bai Z, Wang L, Wang R, et al. Use of human albumin infusion in cirrhotic patients: a systematic review and meta-analysis of randomized controlled trials. Hepatol Int. 2022;16(6):1468-1483. doi:10.1007/s12072-022-10374-z 3. Batool S, Waheed MD, Vuthaluru K, et al. Efficacy of Intravenous Albumin for Spontaneous Bacterial Peritonitis Infection Among Patients With Cirrhosis: A Meta-Analysis of Randomized Control Trials. Cureus. 2022;14(12). doi:10.7759/cureus.33124 4. Kwok CS, Krupa L, Mahtani A, et al. Albumin reduces paracentesis-induced circulatory dysfunction and reduces death and renal impairment among patients with cirrhosis and infection: A systematic review and meta-analysis. Biomed Res Int. 2013;2013. doi:10.1155/2013/295153 5. Sort P, Navasa M, Arroyo V, et al. Effect of Intravenous Albumin on Renal Impairment and Mortality in Patients with Cirrhosis and Spontaneous Bacterial Peritonitis. N Engl J Med. 1999;341(6):403-409. Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit  

Sponsor special: Up to $2,500 of FREE silver AND a FREE safe on qualifying orders - Call 855-862-3377 or text “AMERICAN” to 6-5-5-3-2“We're up to over 1.6 million reports in VAERS in the context of these products ... The numbers keep going up,” says Jessica Rose, an immunologist and independent researcher.She recently co-wrote a paper examining the data surrounding the COVID-19 vaccine adverse events. It was the first published paper to call for a global moratorium on the COVID-19 genetic vaccines.But a few weeks later, the journal Cureus decided to retract the paper.Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

CONTÁCTAME POR WHATSAPP https://wa.me/message/VLBJNM7KBBQDC1 DÉJAME CONOCER TU CASO HACIENDO CLIC AQUÍ - https://nelsonarturopsicologo.com/superar-ansiedad Mi página web https://nelsonarturopsicologo.com/ Se puede considerar a la ansiedad como un síntoma o manifestación de un problema mayor que debe ser tratado de una manera adecuada, por esta razón, para encontrar una cura para la ansiedad, es indudable que se debe abordar varios aspectos del paciente y ahondar en esfuerzos para tratarlos de la manera adecuada tal como se muestra a continuación. ¿EXISTE UNA FORMA DEFINITIVA DE SUPERAR LA ANSIEDAD? Tratar la ansiedad requiere esfuerzos importantes del terapeuta o psicólogo y en mayor medida del paciente, por ello, en virtud de dar una respuesta sencilla, si, es posible encontrar una cura de la ansiedad personal, sin embargo, es necesario invertir esfuerzos constantes en lograrlo. Recuerda que en Libre de Ansiedad contamos con un equipo de profesionales con nivel de Maestría y especialistas en terapia cognitivo conductual, que puede ayudarte a encontrar de forma definitiva una cura de la ansiedad. CÓMO SE LLEGA A LA CURA DE LA ANSIEDAD Descartar problemas médicos: existen diversas enfermedades que están estrechamente relacionadas con la ansiedad como la hipoglucemia, hipertiroidismo, o las afecciones estomacales provocadas por el helicobacter pylori y la producción de serotonina, por ello, es necesario saber si la ansiedad que padeces es producto de algún problema médico, ya que así, es más fácil saber que la provoca y saber cómo combatirla efectivamente. Perder el miedo a la muerte y a tu cuerpo: aunque parezca evidente, es fundamental perder el miedo a las reacciones naturales de nuestro propio cuerpo, incluso a la muerte, porque un temor desmedido hacia algo natural genera incapacidad para enfrentar y entender un padecimiento adecuadamente, lo que dificulta el poder tratarlo. Saber interpretar los pensamientos y el mundo exterior: mediante la guía adecuada y el ejercicio constante de cambio y evolución, se puede enfrentar la idea de un mundo presentemente hostil, de generar ideas realistas y centradas y de saber cómo actuar en consecuencia. Enfrentar de manera segura los miedos: la exposición constante y controlada ante un evento, situación u objeto que pueda generar algún tipo de miedo no fundamentado, permite a los pacientes desligarnos poco a poco del temor y con ello estar más cerca de una cura de la ansiedad, recuerda, el primer paso es importante, pero el más valioso siempre es el siguiente. Desarrollar costumbres y hábitos sanos: evidentemente si queremos superar la ansiedad de forma definitiva, es indispensable tener hábitos sanos como la alimentación, el ejercicio, la higiene física, la higiene del sueño, entre otros, dado que sus beneficios mejoran de forma considerable el bienestar y con ello la salud física y mental, sobre todo, cuando el cuidado es constante, se reduce la ansiedad de forma definitiva. Retomar las metas y objetivos: como se ha mencionado a lo largo del video adjunto, una de las formas de lograr la cura de la ansiedad definitiva, es retomar aquello que enciende nuestra alma; a través de la terapia de aceptación y compromiso que podemos ofrecer desde Libre de Ansiedad, se puede lograr de una forma más sencilla, ya que los esfuerzos se enfocan en aprender a usar la energía se usa más efectivamente lo que permite centrarse en aquello que el paciente considere importante. ENLACES MENCIONADOS Documental sobre la adicción que causa el azúcar (https://www.youtube.com/watch?v=3q9eh9TWFGM) Helicobacter Pylori y Ansiedad, las pruebas https://nelsonarturopsicologo.com/helicobacter-pylori-como-afecta-tus-emociones/ REFERENCIAS BIBLIOGRÁFICAS Kabeer KK, Ananthakrishnan N, Anand C, Balasundaram S. Prevalence of Helicobacter Pylori Infection and Stress, Anxiety or Depression in Functional Dyspepsia and Outcome after Appropriate Intervention. J Clin Diagn Res. 2017 Aug;11(8):VC11-VC15. doi: 10.7860/JCDR/2017/26745.10486. Epub 2017 Aug 1. PMID: 28969250; PMCID: PMC5620891. Ali, S. A., Abdulameer, H. A., & Jabber, A. S. (2022). Exam Anxiety (High Epinephrine-EAE) and infected with (Helicobacter pylori) of the students Volunteer. Journal of Positive Psychology and Wellbeing, 6(1), 2238-2242. Al Quraan, A. M., Beriwal, N., Sangay, P., & Namgyal, T. (2019). The psychotic impact of Helicobacter pylori gastritis and functional dyspepsia on depression: a systematic review. Cureus, 11(10). Tian, J., Wang, Z., Ren, Y., Jiang, Y., Zhao, Y., Li, M., & Zhang, Z. (2022). Rapamycin Attenuates Anxiety and Depressive Behavior Induced by Helicobacter pylori in Association with Reduced Circulating Levels of Ghrelin. Neural plasticity, 2022. ENLACES DE INTERÉS 3 SECRETOS DE LA MEDICINA CHINA PARA MEJORAR TU SALUD (HTTPS://NELSONARTUROPSICOLOGO.COM/3-SECRETOS-DE-LA-MEDICINA-CHINA-PARA-MEJORAR-TU-SALUD/) LA PLANTA MILENARIA QUE TE AYUDARÁ A SUPERAR LA ANSIEDAD (HTTPS://NELSONARTUROPSICOLOGO.COM/LA-PLANTA-MILENARIA-QUE-TE-AYUDARA-A-SUPERAR-LA-ANSIEDAD/)

Liberty Dispatch: NEWS BRIEF ~ January 30, 2023 On this first episode of our new Liberty Dispatch NEW BRIEF, hosts Andrew DeBartolo updates Canadians on the news they need to know, both here, at home, and around the globe.  [Segment 1] - Former Canadian AG & Trudeau Justice Minister, David Lametti, RESIGNS: "Trudeau's AG during Unconstitutional Emergency Act crackdown on freedom protesters resigns from Parliament" | The Post Millennial: https://thepostmillennial.com/breaking-trudeaus-ag-during-unconstitutional-emergency-act-crackdown-on-freedom-protesters-resigns-from-parliament; Tweet from GreyMatterConvo: https://twitter.com/GreyMatterConvo/status/1751078156474413122; "Feds used fake intelligence to frame Freedom Convoy as violent extremists" | Rebel News: https://www.rebelnews.com/feds_used_fake_intelligence_to_frame_freedom_convoy_as_violent_extremists; "Canadian MPs call on Emergencies Act committee to respond to Federal Court ruling" | LifeSiteNews: https://www.lifesitenews.com/news/canadian-mps-call-on-emergencies-act-committee-to-respond-to-federal-court-ruling; Tweet from BezirganMocha: https://twitter.com/BezirganMocha/status/1751290140528607705; [Segment 2] - FAUCI FOUNDOUT & FEDs to Memorialize COVID?: Tweet from kevinnbass: https://twitter.com/kevinnbass/status/1749575650334130325; "Trudeau's vaccine compensation program funnels millions meant for victims to consultants" | Rebel News: https://www.rebelnews.com/trudeaus_vaccine_compensation_program_funnels_millions_meant_for_victims_to_consultants; "COVID-19 mRNA vaccines: Lessons learned from the registrational trials and global vaccination campaign" | Cureus: https://www.cureus.com/articles/203052-covid-19-mrna-vaccines-lessons-learned-from-the-registrational-trials-and-global-vaccination-campaign#!/; "Bill S-209" | Parliament of Canada: https://www.parl.ca/legisinfo/en/bill/44-1/s-209; [Segment 3] - Canada's RADICAL DEATH CULT and Other Religious News: "10,000 Ontario patients cut loose because of staffing shortages" | The Star: https://www.thestar.com/politics/provincial/10-000-ontario-patients-cut-loose-because-of-staffing-shortages/article_ed9ad508-bc74-11ee-b5ed-b3befb843bae.html; "Surge in medically assisted deaths under Canada's MAID program outpaces every other country" | The Star: https://www.thestar.com/news/investigations/surge-in-medically-assisted-deaths-under-canada-s-maid-program-outpaces-every-other-country/article_29028f96-bc6b-11ee-8f67-03bf29ac7d34.html; "Assisted dying advocate wants opponents disqualified from jobs, funding" | Rebel News: https://www.rebelnews.com/assisted_dying_advocate_wants_opponents_disqualified_from_jobs_funding; "Pope Francis doubles down on homosexual blessings: 'Not the union, but the people are blessed'" | LifeSiteNews: https://www.lifesitenews.com/news/pope-francis-doubles-down-on-homosexual-blessings-not-the-union-but-the-people-are-blessed; Tweet from TomTSEC: https://twitter.com/TomTSEC/status/1751941592712179909. 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Liberty Dispatch: NEWS BRIEF ~ January 30, 2023On this first episode of our new Liberty Dispatch NEW BRIEF, hosts Andrew DeBartolo updates Canadians on the news they need to know, both here, at home, and around the globe. [Segment 1] - Former Canadian AG & Trudeau Justice Minister, David Lametti, RESIGNS:"Trudeau's AG during Unconstitutional Emergency Act crackdown on freedom protesters resigns from Parliament" | The Post Millennial: https://thepostmillennial.com/breaking-trudeaus-ag-during-unconstitutional-emergency-act-crackdown-on-freedom-protesters-resigns-from-parliament;Tweet from GreyMatterConvo: https://twitter.com/GreyMatterConvo/status/1751078156474413122;"Feds used fake intelligence to frame Freedom Convoy as violent extremists" | Rebel News: https://www.rebelnews.com/feds_used_fake_intelligence_to_frame_freedom_convoy_as_violent_extremists;"Canadian MPs call on Emergencies Act committee to respond to Federal Court ruling" | LifeSiteNews: https://www.lifesitenews.com/news/canadian-mps-call-on-emergencies-act-committee-to-respond-to-federal-court-ruling;Tweet from BezirganMocha: https://twitter.com/BezirganMocha/status/1751290140528607705;[Segment 2] - FAUCI FOUNDOUT & FEDs to Memorialize COVID?:Tweet from kevinnbass: https://twitter.com/kevinnbass/status/1749575650334130325;"Trudeau's vaccine compensation program funnels millions meant for victims to consultants" | Rebel News: https://www.rebelnews.com/trudeaus_vaccine_compensation_program_funnels_millions_meant_for_victims_to_consultants;"COVID-19 mRNA vaccines: Lessons learned from the registrational trials and global vaccination campaign" | Cureus: https://www.cureus.com/articles/203052-covid-19-mrna-vaccines-lessons-learned-from-the-registrational-trials-and-global-vaccination-campaign#!/;"Bill S-209" | Parliament of Canada: https://www.parl.ca/legisinfo/en/bill/44-1/s-209; [Segment 3] - Canada's RADICAL DEATH CULT and Other Religious News:"10,000 Ontario patients cut loose because of staffing shortages" | The Star: https://www.thestar.com/politics/provincial/10-000-ontario-patients-cut-loose-because-of-staffing-shortages/article_ed9ad508-bc74-11ee-b5ed-b3befb843bae.html;"Surge in medically assisted deaths under Canada's MAID program outpaces every other country" | The Star: https://www.thestar.com/news/investigations/surge-in-medically-assisted-deaths-under-canada-s-maid-program-outpaces-every-other-country/article_29028f96-bc6b-11ee-8f67-03bf29ac7d34.html;"Assisted dying advocate wants opponents disqualified from jobs, funding" | Rebel News: https://www.rebelnews.com/assisted_dying_advocate_wants_opponents_disqualified_from_jobs_funding;"Pope Francis doubles down on homosexual blessings: 'Not the union, but the people are blessed'" | LifeSiteNews: https://www.lifesitenews.com/news/pope-francis-doubles-down-on-homosexual-blessings-not-the-union-but-the-people-are-blessed;Tweet from TomTSEC: https://twitter.com/TomTSEC/status/1751941592712179909.BIBLICAL SEXUALITY SUNDAY - DID YOU PARTICIPATE? LET US KNOW!: https://libertycoalitioncanada.com/biblical-sexuality-sunday/;SUPPORT OUR LEGAL ADVOCACY - Help us defend Canadians' God-given rights and liberties: https://libertycoalitioncanada.com/donate/; https://libertycoalitioncanada.com/liberty-defense-fund/our-legal-strategy/;SHOW SPONSORS:Join Red Balloon Today!: https://www.redballoon.work/lcc; Invest with Rocklinc: info@rocklinc.com or call them at 905-631-546; Diversify Your Money with Bull Bitcoin: https://mission.bullbitcoin.com/lcc;BarterPay: https://barterpay.ca/; Barter It: https://vip.barterit.ca/launch; Carpe Fide - "Seize the Faith": Store: https://carpe-fide.myshopify.com/, use Promo Code LCC10 for 10% off (US Store Only), or shop Canadian @ https://canadacarpefide.myshopify.com/ | Podcast: https://www.carpefide.com/episodes;Sick of Mainstream Media Lies? Help Support Independent Media! DONATE TO LCC TODAY!: https://libertycoalitioncanada.com/donate/ Please Support us in bringing you honest, truthful reporting and analysis from a Christian perspective.SUBSCRIBE TO OUR SHOWS/CHANNELS:LIBERTY DISPATCH PODCAST: https://libertydispatch.podbean.com; https://rumble.com/LDshow; OPEN MIKE WITH MICHAEL THIESSEN: https://openmikewithmichaelthiessen.podbean.com; https://rumble.com/openmike;THE OTHER CLUB: https://rumble.com/c/c-2541984; THE LIBERTY LOUNGE WITH TIM TYSOE: https://rumble.com/LLwTT;CONTACT US:Questions/comments about podcasts/news/analysis: mailbag@libertycoalitioncanada.com;Questions/comments about donations: give@libertycoalitioncanada.com;Questions/comments that are church-related: churches@libertycoalitioncanada.com;General Inquiries: info@libertycoalitioncanada.com. STAY UP-TO-DATE ON ALL THINGS LCC:Gab: https://gab.com/libertycoalitioncanada Telegram: https://t.me/libertycoalitioncanadanews Instagram: https://instagram.com/libertycoalitioncanada Facebook: https://facebook.com/LibertyCoalitionCanada Twitter: @LibertyCCanada - https://twitter.com/LibertyCCanada Rumble: https://rumble.com/user/LibertyCoalitionCanada YouTube: https://www.youtube.com/@liberty4canada - WE GOT CANCELLED AGAIN!!! Please LIKE, SUBSCRIBE, RATE & REVIEW and SHARE it with others!

Como profesionales de la salud mental, es recurrente que los pacientes se flagelen con preguntas como ¿Por qué tengo ansiedad? ¿Qué puedo hacer para volver a ser yo mismo? ¿Por qué me pasa esto a mí? Estos pensamientos generalmente son desencadenados como consecuencia de no entender su padecimiento, de igual manera, de no saber cómo enfrentarlo, por esta razón, permíteme explicarte el origen de la ansiedad. LOS FACTORES QUE SON FUNDAMENTALES EN EL ORIGEN DE LA ANSIEDAD La ansiedad puede tener un origen por diversos factores, los cuales, según 25 años de experiencia, los he clasificado como: Factores Hereditarios: al igual que se puede tener predisposición genética hacia ciertas características de la personalidad y enfermedades, la ansiedad se constituye como un factor hereditario que se puede disparar sino se cuenta con los medios adecuados para prevenirlos, dicho de otro modo, si en la familia hay casos de personas que padezcan algún trastorno de ansiedad, las probabilidades del individuo de padecerla se incrementa. Factores ambientales: El medio donde te desenvuelves influye positiva o negativamente en tu persona, tu personalidad y en tu estado de ánimo. Dependiendo del medio donde se conviva, la persona es más o menos propensa a padecer de algún tipo de trastorno, por lo general, el origen de la ansiedad deriva de factores ambientales negativos o conflictivos para el individuo y su dificultad para enfrentarlos y superarlos. Los estresores: juegan un papel importante en el origen de la ansiedad, ya que son disparadores que impulsan un malestar, en consecuencia, generan mayores niveles de ansiedad. Es razonable que se relacione un lugar, una persona o una situación como detonantes, llegando a desencadenar ataques de pánico, por esta razón, los afectados tienden a evitar estas situaciones huyendo o automedicándose. Es necesario indicar que, estos factores suelen correlacionarse con otros elementos que influyen en tu bienestar y dependiendo de la persona, pueden tener un mayor o menor impacto en la ansiedad a tratar, de igual manera, independientemente del origen de la ansiedad, por lo general se desencadenan otros factores que potencian el trastorno; por ejemplo, las úlceras estomacales, acidez y otros problemas del estómago comunes en los ansiosos, pueda deberse al desarrollo de la bacteria Helicobacter Pylori, que a su vez disminuye la creación de serotonina, lo que aumenta la ansiedad. ¿POR QUÉ TENGO ANSIEDAD? Para dar respuesta a este interrogante, es necesario hacer una evaluación sobre que elementos predominan en tu caso concreto, como hemos mencionado anteriormente, existen varios factores que juegan un papel clave, por esta razón, si estás buscando cómo tratar tu ansiedad te recordamos que en Libre de Ansiedad, tiene un equipo interdisciplinario con profesionales de nivel maestría que puede ayudarte a tratarla, que, mediante la terapia cognitivo conductual, garantizara que puedas combatir este trastorno. REFERENCIAS BIBLIOGRÁFICAS Kabeer KK, Ananthakrishnan N, Anand C, Balasundaram S. Prevalence of Helicobacter Pylori Infection and Stress, Anxiety or Depression in Functional Dyspepsia and Outcome after Appropriate Intervention. J Clin Diagn Res. 2017 Aug;11(8):VC11-VC15. doi: 10.7860/JCDR/2017/26745.10486. Epub 2017 Aug 1. PMID: 28969250; PMCID: PMC5620891. Ali, S. A., Abdulameer, H. A., & Jabber, A. S. (2022). Exam Anxiety (High Epinephrine-EAE) and infected with (Helicobacter pylori) of the students Volunteer. Journal of Positive Psychology and Wellbeing, 6(1), 2238-2242. Al Quraan, A. M., Beriwal, N., Sangay, P., & Namgyal, T. (2019). The psychotic impact of Helicobacter pylori gastritis and functional dyspepsia on depression: a systematic review. Cureus, 11(10). Tian, J., Wang, Z., Ren, Y., Jiang, Y., Zhao, Y., Li, M., & Zhang, Z. (2022). Rapamycin Attenuates Anxiety and Depressive Behavior Induced by Helicobacter pylori in Association with Reduced Circulating Levels of Ghrelin. Neural plasticity, 2022. ENLACES DE INTERÉS HELICOBACTER PYLORI Y ANSIEDAD Y DEPRESIÓN (https://nelsonarturopsicologo.com/helicobacter-pylori-como-afecta-tus-emociones/ ) LA PLANTA MILENARIA QUE TE AYUDARÁ A SUPERAR LA ANSIEDAD (HTTPS://NELSONARTUROPSICOLOGO.COM/LA-PLANTA-MILENARIA-QUE-TE-AYUDARA-A-SUPERAR-LA-ANSIEDAD/)

Welcome to The Daily Wrap Up, a concise show dedicated to bringing you the most relevant independent news, as we see it, from the last 24 hours (12/14/23). As always, take the information discussed in the video below and research it for yourself, and come to your own conclusions. Anyone telling you what the truth is, or claiming they have the answer, is likely leading you astray, for one reason or another. Stay Vigilant. !function(r,u,m,b,l,e){r._Rumble=b,r[b]||(r[b]=function(){(r[b]._=r[b]._||[]).push(arguments);if(r[b]._.length==1){l=u.createElement(m),e=u.getElementsByTagName(m)[0],l.async=1,l.src="https://rumble.com/embedJS/u2q643"+(arguments[1].video?'.'+arguments[1].video:'')+"/?url="+encodeURIComponent(location.href)+"&args="+encodeURIComponent(JSON.stringify([].slice.apply(arguments))),e.parentNode.insertBefore(l,e)}})}(window, document, "script", "Rumble");   Rumble("play", {"video":"v3ypd25","div":"rumble_v3ypd25"}); Video Source Links (In Chronological Order): (87) LastAmericanVagabond on X: "Totally not an anti-human agenda. But please if you could stop breathing for us. Thanks. (Enter the climate change filter masks they already floated during the COVID illusion)" / X East Palestine 6 months later: Health issues persists and answers are elusive - EHN East Palestine residents 'getting sicker,' testing expert says | NewsNation Prime - YouTube CDC teams studying East Palestine health risks got sick during investigation | The Hill Now clean-up workers are falling sick at East Palestine toxic train derailment site | Daily Mail Online Scientists Don't Know How Bad Chemical Disasters Really Are | HuffPost Impact Up To 14,000% More Dioxins In East Palestine Homes Compared To Control & The France Psyop Dioxins: The Ohio Cover Up & The Overwhelming (Intentional?) Incompetence/Malfeasance Of The US Gov ‘A sacrifice zone': East Palestine's wastewater is flooding into this Ohio community | Ohio | The Guardian East Palestine weighs pros and cons of accepting derailment wast - WFMJ.com Residents speak out against wastewater proposal in EP | News, Sports, Jobs - Morning Journal Temporary water treatment plant under construction near East Pal - WFMJ.com EPA Forcing Ohio Toxic Waste On Facilities Not Able To Process Dioxins/PFAS The Clean Harbors Waste Disposal Ohio Scandal, Azov Hong Kong Protesters & Ideological Subversion Investigation Found East Palestine "Controlled Burn" Unnecessary (Norfolk Lied) & Israel Bombs Syria Norfolk Southern to end relocation aid right after one-year anniversary of its fiery Ohio derailment - CBS Pittsburgh New Tab 2nd Amendment Attacked From Right After Trans Shooter, CDC Gets Sick At East Palestine & Kill Switch (71) Chief Nerd on X: "“The peer-reviewed Japanese study, published in the Cureus journal on Dec. 7, looked at the association between Pfizer COVID-19 vaccination and deaths within 10 days of vaccination. The risk period was defined as within 10 days of vaccination, with vaccination day being Day 1,… https://t.co/ped2Uzt5lN" / X ‘Juror And The Executioner': Thomas Massie Presses DOT Official On ‘Kill Switch' Mandate | The Daily Caller Juror And The Executioner': Thomas Massie Presses DOT Official On 'Kill Switch' Mandate (85) We Are All ❤️

This Week In Wellness a paper in the web based peer review journal Cureus, shows that up to 80% of US citizens may be suffering from vertebral subluxation and its side effects. https://www.cureus.com/articles/195837-secondary-analysis-of-a-dataset-to-estimate-the-prevalence-of-vertebral-subluxation-and-its-implications-for-health-promotion-and-prevention?fbclid=IwAR2QrB6HIFdUIjdNhH5z1PLnvonjWMwrCjdON44rhZkCLLtPsCtyagQ-ugQ#!/ The post TWIW 220: Up to 80% of the population may be subluxated appeared first on The Wellness Couch.

Exploration of the pharmacology, efficacy and safety, drug interactions, and side effects of mitragynia speciosa Footnotes: For more on how to help our nation's veterans: https://www.va.gov/REACH/ Veteran crisis line: Dial 988 and press 1. Or text 838255. Seasonal Affectiveness Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder Kentucky Ibogaine Initiative: https://www.kentuckyibogaineinitiative.com/ Huberman, Andrew. Mental Health Toolkit: Tools to bolster your mood and mental health. Huberman Lab [podcast]. 30 Oct 2023 References on Kratom: FDA and Kratom. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom. 21 July 2023. Gandhi D, et al. Kratom induced severe cholestatic liver injury histologically mimicking primary biliary cholangitis: a case report. World Journal of Hepatology. 27 Oct 2020; 12(10): 863-869. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643221/ Gianutsos G. The DEA Changes its mind on Kratom. https://www.uspharmacist.com/article/the-dea-changes-its-mind-on-kratom#:~:text=In%20making%20this%20determination%20on,safety%20for%20use%20under%20medical. US Pharmacist. 17 March 2017 Happy Hippo. https://happyhippo.com/blogs/kratom-blog/the-benefits-of-agmatine-sulfate-as-a-kratom-potentiator Jentsch MJ, Pippin MM. Kratom. Stat Pearls. 28 August 2023. https://www.ncbi.nlm.nih.gov/books/NBK585120/ Kratom. Natural Medicines Comprehensive Database. Updated 6 June 2023. Kratom. California Poison Control System. 22 June 2016. Rexer B. Is Kratom legal? Kratom legality by state. Sprout Health Group. https://www.sprouthealthgroup.com/substances/is-kratom-legal-by-state/ Settle A and Yang C. A Case of Severe Kratom Addiction Contributing to a Suicide Attempt. Cureus. 2022 Sept; 14(9): e29698. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616552/ Ya K, et al. Pharmacokinetics of mitragynine, a major analgesic alkaloid in kratom: a systematic review. 2019(43): 73-82. https://www.sciencedirect.com/science/article/abs/pii/S1876201819302114

Enjoying our content and want to support us directly? Join our premium subscription for access to our podcasts, bonus content, merch discounts and more! Visit: www.psych2go.supercast.com When it comes to anxiety, how it is manifested can be expressed in many ways. Even ways that we may not necessarily associate with anxiety and that may make it hard to identify at first. To help you recognize the subtle signs, we made this video for you. Disclaimer: Our videos are for education and entertainment purposes only. They are not intended to self-diagnose and are not meant to be an all-encompassing book of information. If you suspect you or anyone close to you is suffering from mental illness, we strongly recommend that you go to a mental health professional. If you would like to know more about the subject discussed in this video please see the sources provided below, reach out to a mental health professional, and seek out professional studies on the subject. Here are more signs of anxiety you might not recognize: https://youtu.be/tNYrtO0QHVs Writer: Daila Ayala (New writer) Script Editor: Caitlin McColl Script Manager: Kelly Soong VO: Amanda Silvera Animator: Fluffy Starlaxy YouTube Manager: Cindy Cheong REFERENCES: Alenizi, M. M., Alenazi, S. D., Almushir, S., Alosaimi, A., Alqarni, A., Anjum, I., & Omair, A. (2020, October 3). Impact of maladaptive daydreaming on grade point AVERAGE (GPA) and the association Between maladaptive daydreaming and generalized anxiety Disorder (gad). Cureus. www.ncbi.nlm.nih.gov/pmc/articles/PMC7532859/. Anxiety and sleep. Sleep Foundation. (2020, December 10). www.sleepfoundation.org/mental-health/anxiety-and-sleep. Ayala, D. A. (2021, August 31). Habits that seem normal but are actually caused by anxiety. Web Interview. Telegram Voice Message. Deborah R. Glasofer, P. D. (n.d.). What does it feel like to have anxiety? Verywell Mind. www.verywellmind.com/physical-symptoms-of-anxiety-1393151. Shaw, G. (n.d.). Skin picking disorder (excoriation): Symptoms, treatment, and causes. WebMD. www.webmd.com/mental-health/skin-picking-disorder. Watson, K. (2020, July 14). Is hair twirling bad? Potential side effects and what it may mean. Healthline. www.healthline.com/health/hair-twirlingcauses

BLUF (Bottom Line Up Front) episode discussing psychedelic science with neuroscientist Dr. Sarah Bliss Matousek (PhD) regarding a recent paper published in the May 2023 edition of Cureus. Access the paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237681/

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-348 Overview: Discover how wearable fitness devices are transforming early detection of atrial fibrillation with their potential to reduce stroke risk. In this episode, we share insights on leveraging smartwatches to improve health outcomes and when to encourage their use in patient care. Episode resource links: Bedi, A., Al Masri, M. K., Al Hennawi, H., Qadir, S., & Ottman, P. (2023). The Integration of Artificial Intelligence Into Patient Care: A Case of Atrial Fibrillation Caught by a Smartwatch. Cureus, 15(3). Long, K. Y., Shanmugam, K., & Rana, M. E. (2023, January). An Evaluation of Smartwatch Contribution in Improving Human Health. In 2023 17th International Conference on Ubiquitous Information Management and Communication (IMCOM) (pp. 1-4). IEEE. Mattison, G., Canfell, O. J., Forrester, D., Dobbins, C., Smith, D., Reid, D., & Sullivan, C. (2023). A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care. The Medical Journal of Australia, 218(9), 384-388. Meza, C., Juega, J., Francisco, J., Santos, A., Duran, L., Rodriguez, M., ... & Pagola, J. (2023). Accuracy of a Smartwatch to Assess Heart Rate Monitoring and Atrial Fibrillation in Stroke Patients. Sensors, 23(10), 4632. https://www.stroke.org/en/about-stroke/types-of-stroke/cryptogenic-stroke   Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-348 Overview: Discover how wearable fitness devices are transforming early detection of atrial fibrillation with their potential to reduce stroke risk. In this episode, we share insights on leveraging smartwatches to improve health outcomes and when to encourage their use in patient care. Episode resource links: Bedi, A., Al Masri, M. K., Al Hennawi, H., Qadir, S., & Ottman, P. (2023). The Integration of Artificial Intelligence Into Patient Care: A Case of Atrial Fibrillation Caught by a Smartwatch. Cureus, 15(3). Long, K. Y., Shanmugam, K., & Rana, M. E. (2023, January). An Evaluation of Smartwatch Contribution in Improving Human Health. In 2023 17th International Conference on Ubiquitous Information Management and Communication (IMCOM) (pp. 1-4). IEEE. Mattison, G., Canfell, O. J., Forrester, D., Dobbins, C., Smith, D., Reid, D., & Sullivan, C. (2023). A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care. The Medical Journal of Australia, 218(9), 384-388. Meza, C., Juega, J., Francisco, J., Santos, A., Duran, L., Rodriguez, M., ... & Pagola, J. (2023). Accuracy of a Smartwatch to Assess Heart Rate Monitoring and Atrial Fibrillation in Stroke Patients. Sensors, 23(10), 4632. https://www.stroke.org/en/about-stroke/types-of-stroke/cryptogenic-stroke   Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato