Type of corticosteroid medication
POPULARITY
7 episodes with Dexamethasone
4 episodes with Dexamethasone
6 episodes with Dexamethasone
3 episodes with Dexamethasone
2 episodes with Dexamethasone
3 episodes with Dexamethasone
4 episodes with Dexamethasone
3 episodes with Dexamethasone
2 episodes with Dexamethasone
In this episode of the PFC Podcast, Ian Wedmore, an expert in high altitude medicine, discusses the newly released Clinical Practice Guidelines (CPG) for altitude-related illnesses. The conversation covers the pathophysiology of acute mountain sickness, high altitude pulmonary edema, and high altitude cerebral edema, as well as their diagnosis and treatment protocols. Ian emphasizes the importance of understanding the symptoms, utilizing technology, and implementing prevention strategies to effectively manage altitude illnesses in military and wilderness settings.TakeawaysThe new CPG for altitude medicine is a significant advancement.Acute mountain sickness occurs when the body ascends too quickly without acclimatization.Diagnosis of altitude sickness relies heavily on symptom scoring systems.Vital signs are crucial for diagnosing high altitude pulmonary edema.Dexamethasone is essential for treating high altitude cerebral edema.Pre-exposure prophylaxis can reduce the risk of altitude sickness.Acetazolamide is the primary medication for preventing acute mountain sickness.Understanding the pathophysiology of altitude illnesses is key for treatment.Good hydration and nutrition are critical for acclimatization.Data collection through medic encounter forms will improve altitude care.Chapters00:00 Introduction to High Altitude Medicine02:51 Understanding Acute Mountain Sickness06:13 Diagnosing and Differentiating Altitude Illnesses08:56 Pathophysiology of High Altitude Pulmonary and Cerebral Edema12:04 Treatment Protocols for Altitude Illnesses15:08 Utilizing Technology in Altitude Medicine18:00 Prevention and Prophylaxis Strategies20:45 The Role of Medications in Altitude Care24:13 Future Directions in Altitude Medicine27:01 Conclusion and Key TakeawaysLink to full podcast:https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-228-DImE-e32aek2Thank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Dr Anna Giolito and Professor Naïm Ouldali join Josefine Gibson to discuss their latest research on dexamethasone for paediatric pneumococcal meningitis.Read the full article:https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(25)00029-X/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanchiContinue this conversation on social!Follow us today at...https://thelancet.bsky.social/https://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://www.linkedin.com/company/lanchi/https://youtube.com/thelancettv
Listen in as Cristina Mussini, MD; Martin Witzenrath, MD, FERS; and Michele Bartoletti, MD, PhD, discuss treatment strategies for people who are immunocompromised with COVID-19 in the hospital setting, including: Antiviral therapy with remdesivirDexamethasone for patients with hematologic malignanciesConsiderations regarding other immunomodulators such as JAK inhibitors or IL-6 inhibitorsA detailed patient case to illustrate key takeaways Presenters:Michele Bartoletti, MD, PhDAssociate Professor of Infectious DiseasesDepartment of Biomedical SciencesHumanitas UniversityPieve Emanuele (MI), ItalyHead of Infectious Diseases UnitIRCCS Humanitas Research HospitalRozzano (MI), ItalyCristina Mussini, MDFull Professor of Infectious DiseasesChief of the Department of Infectious DiseasesUniversity of Modena and Reggio EmiliaModena, ItalyMartin Witzenrath, MD, FERS Medical DirectorCharite Centrum 12Internal Medicine & DermatologyProfessor and Chair for Respiratory Medicine and Critical CareDepartment of Infectious Disease, Respiratory Medicine and Critical CareCharite Campus Mitte/Campus Virchow Klinikum/Campus Benamin FranklinCharite – University of BerlinBerlin, GermanyLink to full program:https://bit.ly/4fs7HcbDownloadable slides:https://bit.ly/3XP1fpJGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
In this episode, Stephen Cantrill, MD, FACEP; Rajesh T. Gandhi, MD; and Payal K. Patel, MD, MPH, FIDSA, discuss: Workup of COVID-19 in the emergency departmentMethods of COVID-19 risk stratification Treatment recommendations for people with severe COVID-19, including how to effectively use antiviral therapy, dexamethasone, and other immunomodulators[CC1] in this population A detailed patient case to illustrate key takeawaysPresenters:Stephen Cantrill, MD, FACEPAssociate Director and Medical Director (Retired) Department of Emergency Medicine Denver Health Medical Center Associate Professor Department of Emergency Medicine University of Colorado Health Sciences Center Denver, Colorado Rajesh T. Gandhi, MDMassachusetts General Hospital Professor of Medicine Harvard Medical School Boston, Massachusetts Payal K. Patel, MD, MPH, FIDSASystemwide Director of Antimicrobial Stewardship Associate Professor, Division of Infectious Diseases Intermountain Health Salt Lake City, Utah Link to full program: https://bit.ly/4gu2gcUGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
In this episode, Stephen Cantrill, MD, FACEP; Rajesh T. Gandhi, MD; and Payal K. Patel, MD, MPH, FIDSA, discuss treatment strategies for people who have severe COVID-19, including: Antiviral therapy with remdesivir Dexamethasone and other systemic corticosteroids Immunomodulators, such as JAK inhibitors or IL-6 inhibitors Overviews of clinical trial data demonstrating how and when to use these therapiesPresenters:Stephen Cantrill, MD, FACEPAssociate Director and Medical Director (Retired) Department of Emergency Medicine Denver Health Medical Center Associate Professor Department of Emergency Medicine University of Colorado Health Sciences Center Denver, Colorado Rajesh T. Gandhi, MDMassachusetts General Hospital Professor of Medicine Harvard Medical School Boston, Massachusetts Payal K. Patel, MD, MPH, FIDSASystemwide Director of Antimicrobial Stewardship Associate Professor, Division of Infectious Diseases Intermountain Health Salt Lake City, Utah Link to full program: https://bit.ly/4gu2gcUGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
In this episode, Martin Witzenrath, MD, FERS, and Michele Bartoletti, MD, PhD, discuss the management of mild to moderate COVID-19 in patients who are immunocompromised, including:Initial workup, which may include laboratory tests and/or imagingLatest data on the use of remdesivir or nirmatrelvir plus ritonavir for mild to moderate COVID-19, including considerations for drug–drug interactions Presenters:Martin Witzenrath, MD, FERSMedical DirectorCharite Centrum 12Internal Medicine & DermatologyProfessor and Chair for Respiratory Medicine and Critical CareDepartment of Infectious Disease, Respiratory Medicine and Critical CareCharite Campus Mitte/Campus Virchow Klinikum/Campus Benjamin FranklinCharite – University of BerlinBerlin, GermanyMichele Bartoletti, MD, PhDAssociate Professor of Infectious DiseasesDepartment of Biomedical SciencesHumanitas UniversityPieve Emanuele (MI), ItalyHead of Infectious Diseases UnitIRCCS Humanitas Research HospitalRozzano (MI), Italy Link to full program: https://bit.ly/4gu2gcUDownloadable slides: https://bit.ly/3CGlDBSGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral edema (HACE) is a severe form of AMS marked by encephalopathic changes Symptoms begin at elevations as low as 6500 feet above sea level for people who ascend rapidly May develop more severe symptoms at higher altitudes The pathophysiology involves cerebral vasodilation Occurs in everyone ascending to high altitudes but is more pronounces in those that develop symptoms The reduced partial pressure of oxygen induces hypoxic vasodilation in the brain, which results in edema and, ultimately, HACE in some patients Symptomatic presentation Headache, nausea, and sleeping difficulties occur within 2-24 hours of arrival at altitude HACE may occur between 12-72 hours after AMS and presents with ataxia, confusion, irritability, and ultimately results in coma if left untreated Clinical presentation may be mistaken for simple exhaustion, so clinicians should maintain a high index of suspicion Notably, if symptoms occur more than 2 days after arrival at altitude, clinicians should seek an alternative diagnosis but maintain AMS/HACE on the differential Treatment and management AMS Adjunctive oxygen and descent to lower altitude Acetazolamide is used as a preventive measure but is not helpful in acute treatment +/- dexamethasone HACE Patients with HACE should receive dexamethasone to help reduce cerebral edema Immediate descent to a lower altitude References Burtscher M, Wille M, Menz V, Faulhaber M, Gatterer H. Symptom progression in acute mountain sickness during a 12-hour exposure to normobaric hypoxia equivalent to 4500 m. High Alt Med Biol. 2014;15(4):446-451. doi:10.1089/ham.2014.1039 Levine BD, Yoshimura K, Kobayashi T, Fukushima M, Shibamoto T, Ueda G. Dexamethasone in the treatment of acute mountain sickness. N Engl J Med. 1989;321(25):1707-1713. doi:10.1056/NEJM198912213212504 Luks AM, Beidleman BA, Freer L, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 Update. Wilderness Environ Med. 2024;35(1_suppl):2S-19S. doi:10.1016/j.wem.2023.05.013 Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/
In this episode, we sit down with Lisa Stewart, a nurse practitioner with more than 25 years of transplant nursing experience, currently working at the post-transplant BMT clinic at the Dana-Farber Brigham Cancer Center in Boston. Lisa provides invaluable insights into managing chronic and acute graft-versus-host disease (GVHD) and shares her expertise, stories, and advice for patients and caregivers navigating post-transplant life.Lisa describes her role in outpatient care, where the majority of her work focuses on managing chronic GVHD, a condition that is both a sign of a functioning immune system and a complex challenge. While mild GVHD can indicate that the transplant is effectively fighting diseases like leukemia or lymphoma, severe cases can lead to complications involving multiple organs. Lisa outlines the two major categories of GVHD: steroid-reactive and steroid-refractory, with the latter being particularly difficult to treat. Acute GVHD typically occurs within the first 100 days post-transplant and often impacts the skin, liver, or gut, whereas chronic GVHD can develop months or years later and affect a broader range of organs, including the eyes, mouth, lungs, and reproductive systems.Clinical trials have led to significant advancements in treatment, including drugs like Ruxolitinib and Rezurock, offering hope to patients who fail first-line steroid therapy. Lisa also highlights Axatilimab, a newer medication discussed at the 2023 ASH meeting, although its availability remains limited due to manufacturing challenges. Despite these breakthroughs, steroids remain the frontline treatment, though they often cause challenging side effects like hyperglycemia, insomnia, and weight gain.Lisa also emphasizes the critical role caregivers play in a patient's recovery, managing complex medication regimens and providing vital emotional and physical support. She notes that without strong support at home, a transplant may not be feasible, particularly in the crucial first six months post-transplant.The episode also touches on common post-transplant issues like oral GVHD, fatigue, and the importance of staying active. Lisa shares practical tips, such as using Dexamethasone rinses for oral GVHD and encouraging light activity to combat fatigue. She underscores the importance of early symptom reporting, especially for chronic GVHD, as prompt intervention can significantly improve outcomes.Lisa concludes with a heartfelt story of a young patient who faced severe complications, including acute respiratory failure and paralysis, but ultimately made a remarkable recovery, even regaining mobility and starting a family. Stories like his, Lisa says, are what keep healthcare providers inspired despite the challenges.We wrap up with a reminder about the resources available to patients and caregivers, encouraging early reporting of symptoms and proactive management. Lisa's wisdom and dedication shine through, offering hope and practical guidance for those navigating the complex world of post-transplant care.More:GVHD Alliance: https://www.gvhdalliance.orgLink to LLS free Nutrition Consultations: https://www.lls.org/managing-your-cancer/food-and-nutritionThank you to our sponsors. This season is supported by a healthcare contribution from Sanofi https://www.sanofi.com/ National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page: https://www.facebook.com/nbmtLINKFollow the nbmtLINK on Instagram! https://www.instagram.com/nbmtlink/The nbmtLINK YouTube Page can be found by clicking here.To participate in the GVHD Mosaic, click here: https://amp.livemosaics.com/gvhd
What's the best way to reduce post-op pain after extractions? And why should we never use the term “painkiller” with patients? What to do when you hear the dreaded *crack* of a tuberosity? In this episode we talk about all things post-operative extraction complications! And I'm joined by one of the nicest guys in dentistry - Dr. Nekky Jamal Complications are something we ALL experience, so this episode is great for any dentist. Whether you're brushing up on dry socket prevention, mastering post-op communication, or just curious about advanced healing hacks, tune in for real-world advice to make extractions smoother - for both you and your patients https://youtu.be/BvB3hDESYDY Watch PDP210 on Youtube Protrusive Dental Pearl: The "Niche Kebab" concept encourages dentists to narrow their focus by reducing the variety of procedures they perform and prioritizing those they genuinely enjoy. By evaluating every new skill or treatment added and strategically dropping less-loved procedures, dentists can avoid overextension and the "jack of all trades, master of none" pitfall. Learn how to Extract Impacted 3rd Molars, don't miss out on Third Molars Online and use the coupon code ‘protrusive' to get 15% off! Key Takeaways Pain management is about setting realistic expectations. Dexamethasone can be beneficial but must be used cautiously. Dry socket is often overhyped; proper care can prevent it. Effective communication can alleviate patient anxiety and prevent misunderstandings and complaints. Preoperative care can help manage pain expectations. Understanding the signs of infection is essential for diagnosis. Chlorhexidine rinses can significantly reduce dry socket risk. Patients appreciate being informed about their unique dental situations. PRF can significantly reduce the incidence of dry socket. Dentists should embrace new techniques like PRF to enhance patient care. Patient involvement in post-surgical care is crucial for healing. Dentists should not hesitate to refer complex cases to specialists. Highlights of this episode: 02:54 Protrusive Dental Pearl 04:05 Dr. Nekky Jamal 08:39 Managing Post-Extraction Pain and Swelling 21:37 Infection 25:02 Identifying Dry Socket and How to Prevent it 28:30 Case Selection and Communication 37:13 Mitigating Dry Socket with Platelet-Rich Fibrin (PRF) 39:47 The Importance of Nicheing in Dentistry 43:19 Cryotherapy and Post-Surgery Care 47:32 Handling Tuberosity Fractures 55:08 Patient Consent 57:55 Litigation and Patient Communication This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A, C and D. AGD Subject Code: 310 ORAL AND MAXILLOFACIALSURGERY (Exodontia) Dentists will be able to: Identify and differentiate common postoperative complications, and recognise the key symptoms associated Evaluate the ethical and clinical considerations of case selection for extractions Communicate effectively with patients regarding potential complications If you loved this episode, be sure to check out another epic episode with Dr. Nekky Jamal - Wisdom Teeth Extractions – SURGICAL TOP TIPS
In this week's episode, we'll learn about the prevalence and impact of dexamethasone dose reductions during triple or quadruple therapy for newly diagnosed multiple myeloma, a conditional knockout mouse model for testing gene therapy in X-linked sideroblastic anemia, and real-world efficacy and safety of ciltacabtagene autoleucel in patients with relapsed/refractory multiple myeloma.Featured Articles:Dexamethasone dose intensity does not impact outcomes in newly diagnosed multiple myeloma: a secondary SWOG analysisAn erythroid-specific lentiviral vector improves anemia and iron metabolism in a new model of XLSASafety and efficacy of standard-of-care ciltacabtagene autoleucel for relapsed/refractory multiple myeloma
Below is a brief video snippet from our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The current one is here. If you like the YouTube format, please subscribe! This one has embedded one of my favorite TikTok's from Will. There are several links to others in the transcript. The audios are also available on Apple and Spotify.Transcript with links to both audio and videos, commencement addresses, NEJM article coverageEric Topol (00:06):Hi, it's Eric Topol from Ground Truths, and I've got an amazing couple with me today. It's Will Flanary and Kristin Flanary, the Glaucomfleckens. I've had the chance to get to know them a bit through Knock Knock, Hi! which is their podcast. And of course, everyone knows Dr. Glaucomflecken from his TikTok world and his other about 4 million followers on Instagram and Twitter and all these other social media, and YouTube. So welcome.Will Flanary (00:43):Thanks for having us.Kristin Flanary (00:44):Thank you. Happy to be here.By Way of BackgroundEric Topol (00:45):Yeah. Well, this is going to be fun because I'm going to go a quick background so we can go fast forward because we did an interview back in early 2022.Kristin Flanary (00:56):Yes.Eric Topol (00:57):And what you've been doing since then is rocking it. You're like a meteoric, right. And it was predictable, like rarefied talent and who couldn't love humor, medical humor, but by way of background, just for those who are not up to speed. I guess you got your start, Will, as a class clown when your mother was a teacher in the sixth grade.Will Flanary (01:22):Yep, yep. I misbehaved a little bit. It helped that I still made good grades, but I cut up a bit in class.Eric Topol (01:32):And then you were already in the comedy club circuits doing standup in Houston as an 18-year-old.Will Flanary (01:40):It was all amateur stuff, nothing, just dabble in it and trying to get better. I was always kind of naturally funny just with my friend group and everything. I loved making people laugh, but doing standups is a whole different ball game. And so, I started doing that around Houston as a high school senior and kept that going through college and a little bit into med school.Kristin Flanary (02:02):Houston was a good training ground, right? That where Harris Wittels was also coming up.Will Flanary (02:07):Yeah. A lot of famous comedians have come through Houston. Even going back to Bill Hicks back in the, was that the 80s, I think? Or 90s?Eric Topol (02:17):Well, and then of course, it was I think in 2020 when you launched Dr. Glaucomflecken, I think. Is that right?Will Flanary (02:28):That's when it really started to take off. I was on Twitter telling jokes back in 2016.Kristin Flanary (02:39):GomerBlog before that, that's actually where it was born.Will Flanary (02:41):I was doing satire writing. I basically do what I'm doing now, but in article form, trying to be The Onion of medicine. And then the pandemic hit, started doing video content and that's really with lockdown. That's when, because everybody was on social media, nobody had anything else to do. So it was right place, right time for me and branching out into video content.On to Medical School Commencement AddressesEric Topol (03:11):Alright, so that's the background of some incredible foundation for humor. But since we last got together, I'll link the Medicine and the Machine interview we did back then. What has been happening with you two is nothing short of incredible. I saw your graduation speeches, Will. Yale in 2022, I watched the UCSF in 2023 and then the University of Michigan in 2024. Maybe there's other ones I don't even know.Kristin Flanary (03:45):There's a few others.Will Flanary (03:45):There's a few. But I feel like you've done, I'm sure your fair share of commencement addresses as well. It's kind of hard to come up with different ways to be inspirational to the next generation. So fortunately, we have together, we have some life experiences and learned a thing or two by doing all of this social media stuff and just the things we've been through that I guess I have enough things to say to entertain an interest.Eric Topol (04:18):Well, you're being humble as usual, but having watched those commencement addresses, they were the best medical commencement addresses I've ever seen. And even though you might have told us some of the same jokes, they were so great that it was all right. Yeah, and you know what is great about it is you've got these, not the students, they all love you of course, because they're probably addicted to when's your next video going to get posted.(04:44):But even the old professors, all the family members, it's great. But one of the things I wanted to get at. Well, I'll start with the graduation speeches, because you were such an inspiration, not just with humor, but your message. And this gets back to you as a couple and the tragedies you've been through. So you really, I think, got into this co-survivor story and maybe Kristin, since you are the co-survivor of two bouts of Will's testicular cancer, and then the sudden cardiac death. I mean, people don't talk about this much, so maybe you could help enlighten us.Tragedies and Being a Co-SurvivorKristin Flanary (05:26):Yeah, it's funny because the experience of being a co-survivor is nothing new. It's as long as we've had human beings, we've had co-survivors. But the concept around it and giving it a name and a label, a framework to be able to think about it, that is what I think is new and what people haven't talked about before. So co-survivor is just this idea that when a medical trauma happens to a patient, the patient has their experience and if they survive it, they are a survivor and they have a survivor experience. And also, most people are closely attached to at least one other person, if not many. And those people are co-surviving the medical event along with the survivor. That event is happening in their lives as was happening to them too. If someone comes in with a patient to the hospital, that person, you can just assume by default that their lives are pretty intimately or profoundly intertwined or else why would that person be there? And so, thinking of it as there's the patient and then there's also a co-patient, that family members in the past have only been thought of as caregivers if they've been thought of at all. And that is certainly one aspect of the role, but it's important to remember that whatever it is that's happening to the patient is also affecting the family members' lives in a really deep and profound way.Eric Topol (07:04):That's really helpful. Now, the fact that you recognize that in your graduation speech, Will, I think is somewhat unique. And of course, some of the other things that you touched on like playing to your creativity and the human factors, I mean, these are so important messages.Will Flanary (07:23):Well, in the discussion about co-survivorship and because I talk about that whenever I do my keynotes and when I do the commencement addresses, but all credit goes to Kristin for really being the driving force of this idea for me and for many others because as a physician, we take care of patients. Our focus is always on the patient. And it really wasn't until this happened to me and my family and Kristin in particular that I started to understand exactly what she's talking about and this idea. And so, Kristin gets a lot of credit for just really bringing that term and that idea to the forefront.Eric Topol (08:09):Yeah, well, you saved his life. It's just not many have that bond. And then the other thing I just want to mention now, you've been recognized by the American Heart Association and a whole bunch of other organizations awarded because of your advocacy for CPR. And you even mentioned that I think in one of your commencement addresses.Will Flanary (08:31):Yeah, I tried to get the crowd to do CPR. Like team up, partner up, and it kind of fell flat. It wasn't quite the right time, I think, to try to do a mass class on CPR. So maybe next time.Eric Topol (08:47):Right. Well, so you had this foundation with the Glaucomflecken General Hospital and taking on 37 specialties and all these incredible people that became part of the family, if you will, of spoof on medicine and your alter ego and these videos that you would do. And sometimes you have three or four different alter egos in there playing out, but now you've branched into new things. So one which is an outgrowth of what we were just talking about. You've been on this country tour, Wife & Death.“Wife and Death,” A Nationwide TourKristin Flanary (09:28):Yes.Eric Topol (09:29):Wife and death. I mean, yeah, I guess we can make the connect of how you named it that, but what is it you've been selling out in cities all over the country, and by the way, I'm really upset you haven't come to San Diego, but tell us about wife and death.Will Flanary (09:44):Yeah. Well, we have this amazing story and all these medical challenges we've been through, and then developing the Glaucomflecken brand and universe, and we've done keynotes together for years, and then we thought, let's have more fun with it. Let's do keynotes. They're great. We can get our message out, but sometimes they're just a bit stuffy. It's an academic environment.Kristin Flanary (10:15):They're usually at seven in the morning also, so that's the downside.Will Flanary (10:21):So we thought, let's just put together our own live show. Let's put together something that we could just creatively, we can do whatever we want with it. I could dress up as characters, Kristin, who has these beautiful writing and monologues that she's put together around her experience and just to create something that people can come into a theater and just experience this wide range of emotions from just laughter to tears of all kinds, and just have them feel the story and enjoy this story. Fortunately, it has a happy ending because I'm still alive and it's been so much fun. The audiences have been incredible. Mostly healthcare, but even some non-healthcare people show up, and we've been blown away by the response. Honestly, we should have done bigger theaters. That's our lesson for the first go round.Eric Topol (11:21):I saw you had to do a second show in Pittsburgh.Will Flanary (11:24):We did.Kristin Flanary (11:26):That one sold out too. Something about Pittsburgh, that was a good crowd, and there was a lot of them.Will Flanary (11:33):It was almost like in Pittsburgh, they rarely ever get any internet comedian ophthalmologists that come through. I don't know.Eric Topol (11:41):Well, I see you got some still to come in Denver and Chicago. This is amazing. And I wondered who was coming and I mean, it's not at all surprising that there'd be this phenomenal popularity. So that's one thing you've done that's new, which is amazing. And of course, it's a multidimensional story. The one that shocked me, I have to tell you, shocked me, was the New England Journal partnership. The New England Journal is the most stodgy, arrogant, I mean so difficult. And not only that.Kristin Flanary (12:17):You said that. Not us.Partnering with the New England Journal of Medicine!Eric Topol (12:19):Yeah, yeah. They'll get this too. They know we don't get along that well, but that's okay. You even made fun of journals. And now you're partnering with the New England Journal, God's greatest medical journal, or whatever. Tell us about that.Will Flanary (12:39):Well, so one thing that I really enjoy doing, and I've done it with my US healthcare system content is almost like tricking people into learning things. And so, if you make something funny, then people will actually sit there and listen to what you have to say about deductibles and physician-owned hospitals and all these inner workings. DIR fees and pharmacy, all these things that are really dry topics. But if you can make them funny, all of a sudden people will actually learn and listen to it. And the New England Journal of Medicine, they approached me with an idea. Basically just to take one or two of their trials per month. And I just make a skit out of that trial with the idea being to help disseminate some of the research findings that are out there, because I guess it's getting harder and harder for people to actually read, to sit down and read a journal article.(13:43):And so, I have to credit them for having this idea and thinking outside the box of a different way to get medical information and knowledge out to the masses. And you're absolutely right, that I have been critical of journals, and particularly I've been critical of the predatory nature of some of the larger journals out there, like Elsevier. I've specifically named Elsevier, Springer, these journals that have a 40% profit margin. And I certainly thought about that whenever I was looking into this partnership. And the reason I was okay with doing it with the New England Journal is because they're a nonprofit, first of all, so they're run by the Massachusetts Medical Society. That's the publisher for that journal. And so, I feel okay partnering with them because I feel like they're doing it in a much better way than some of the bigger journal corporations out there.Kristin Flanary (14:54):Well, and also part of the deal that we negotiated was that those articles that you make skits about those will be available open access.Will Flanary (15:03):Oh yeah. That was a prerequisite. Yes. It was like, if I'm going to do this, the articles that I'm talking about need to be free and readily available. That's part of it.Eric Topol (15:14):I think you've done about five already, something like that. And I watched them, and I just was blown away. I mean, the one that got me where I was just rolling on the floor, this one, the Belantamab Mafodotin for Multiple Myeloma. And when you were going on about the Bortezomib, Dexamethasone. We'll link to this. I said, oh my God.Will Flanary (15:40):Yeah. The joke there is, you don't have any idea how long it took me to say those things that quickly. And so, I was writing this skit and I'm like, wouldn't it be funny if somehow that triggered a code stroke in the hospital because this person is saying all these random words that don't have any meaning to anybody. Man, I tell you, I am learning. Why would I ever need to know any of this information as an ophthalmologist? So it's great. I know all this random stuff about multiple myeloma that I probably would never have learned otherwise.Kristin Flanary (16:21):It's the only way, you won't read a journal either.Eric Topol (16:23):Well, and if you read the comments on the post. These doctors saying, this is the only way they want to get journal information from now on.Will Flanary (16:33):Which is double-edged sword, maybe a little bit. Obviously, in a 90 second skit, there's no way I'm going to cover the ins and outs of a major trial. So it's really, in a lot of ways, it's basically like, I call it a comedy abstract. I'm not going much further than an abstract, but hopefully people that are actually interested in the topic can have their interest piqued and want to read more about it. That's kind of the idea.Eric Topol (17:06):Yeah. Well, they're phenomenal. We'll link to them. People will enjoy them. I know, because I sure did. And tenecteplase for stroke and all that you've done. Oh, they're just phenomenal.Will Flanary (17:20):Every two weeks we come out with a new one.Eric Topol (17:24):And that is basically between the fact that you are now on the commencement circuit of the top medical schools and doing New England Journal videos on their articles. You've crossed a line from just making fun of insurance companies and doctors of specialties.Kristin Flanary (17:44):Oh, he has crossed many lines, Dr. Topol.Eric Topol (17:46):Yeah. Oh yeah. Now you've done it, really. Back two years ago when we convened, actually it's almost three, but you said, when's it going to be your Netflix special?Will Flanary (18:02):Oh, gosh.Eric Topol (18:02):Is that in the works now?Will Flanary (18:04):Well, I'll tell you what's in the works now.Kristin Flanary (18:06):Do you know anyone at Netflix?Will Flanary (18:09):A New Animated SeriesNo. We're working on an animated series.Eric Topol (18:12):Oh, wow. Wow.Will Flanary (18:13):Yeah. All these characters. It's basically just this fictional hospital and all these characters are very cartoonish, the emergency physician that wears the bike helmet and everything. So it's like, well, what do we have together? What do we, Kristin and I have time for? And it wasn't like moving to LA and trying to make a live action with actors and do all, which is something we probably could have tried to do. So instead, we were like, let's just do an animated series.Kristin Flanary (18:48):Let's have someone else do the work and draw us.Will Flanary (18:51):So we've worked with a writer for the first time, which was a fun process, and putting together a few scripts and then also an animator. We learned a lot about that process. Kristin and I are doing the voiceovers. And yeah, it's in process.Kristin Flanary (19:10):We're the only actors we could afford.Will Flanary (19:12):Right, exactly.Eric Topol (19:13):I can't wait to see it. Now when will it get out there?Will Flanary (19:17):Well, we're hoping to be able to put it out on our YouTube channel sometime early next year. So January, February, somewhere around there. And then we can't fund the whole thing ourselves. So the idea is that we do this, we do this pilot episode, and then we'll see what kind of interest we can generate.Eric Topol (19:37):Well, there will be interest. I am absolutely assured of that. Wow.Will Flanary (19:42):Let us know if you know anybody at the Cartoon Network.Kristin and Will Flanary (19:45):Yeah, we're open to possibilities. Whatever, Discovery channel. I don't know.Eric Topol (19:51):You've gotten to a point now where you're ready for bigger things even because you're the funniest physician couple in medicine today.Kristin Flanary (20:05):Well, that's a very low bar, but thank you.Will Flanary (20:08):There are some funny ones out there, but yeah, I appreciate that.Eric Topol (20:11):Well, I'm a really big comedy fan. Every night I watch the night before, since I'm old now, but of Colbert and Jimmy Kimmel, just to hear the monologues. Trevor Noah, too. And I can appreciate humor. I'll go to see Sebastian Maniscalco or Jim Gaffigan. That's one of the things I was going to ask you about, because when you do these videos, you don't have an audience.Will Flanary (20:39):Oh yeah.Eric Topol (20:40):You're making it as opposed to when you are doing your live shows, commencement addresses and things like that. What's the difference when you're trying to be humorous, and you have no audience there?Will Flanary (20:55):Well, whenever I'm filming a skit, it's just all production. In fact, I feel like it's funny. I think it's funny, but it's really not until I see the response to it, or I show Kristin, or what I have is where I really know if it's going to work. It's great to put the content out there and see the responses, but there's nothing like live interaction. And that's why I keep coming back to performing. And Kristin's been a performer too in her life. And I think we both really enjoy just the personal interaction, the close interaction, the response from people to our story.Kristin Flanary (21:36):We do most of our work alone in this room. I do a lot of writing. He does a lot of playing.Will Flanary (21:44):Dress up.Kristin Flanary (21:44):All the people in his head, and we do that very isolated. And so, it's very lovely to be able to actually put names to faces or just see human bodies instead of just comments on YouTube.Will Flanary (21:59):Meet people.Kristin Flanary (21:59):It's really nice.Will Flanary (22:01):We've been doing meet and greets at the live shows and seeing people come up wearing their costumes.Eric Topol (22:07):Oh, wow.Will Flanary (22:11):Some of them talk about how they tell us their own stories about their own healthcare and talk about how the videos help them get through certain parts of the pandemic or a difficult time in their life. And so, it reinforces that this means something to a lot of people.Kristin Flanary (22:29):It's been really fun for me, and probably you too, but to get to see the joy that he has brought so many people. That's really fun to see in person especially.Eric Topol (22:42):No question. Now, when you're producing it together, do you ever just start breaking into laughter because it's you know how funny this is? Or is it just you're on kind of a mission to get it done?Will Flanary (22:54):Well, the skits I do by myself. And sometimes when I'm writing out the skit, when I'm writing the skit itself, I will laugh at myself sometimes. Not often, but sometimes they're like, oh, I know that's really funny. I just wrote a skit that I'm actually going to be debuting. I'm speaking at the American Academy of PM&R, so the big PM&R conference. I'm writing a skit, it's How to Ace your PM&R residency interview.Will Flanary (23:28):I was writing up that skit today and kind of chuckling to myself. So sometimes that happens, but whenever we do our podcast together, we definitely have outtakes.Kristin Flanary (23:38):Oh yeah, we've got some.Will Flanary (23:40):We crack each other up.Kristin Flanary (23:41):We do.Will Flanary (23:42):Sometimes we're getting a little punchy toward the end of the day.Eric Topol (23:47):And how is the Knock Knock, Hi! podcast going?Will Flanary (23:51):It's awesome. Yeah.Kristin Flanary (23:52):Yeah. It's a really fun project.Will Flanary (23:54):We still enjoy. You can work with your spouse and in close proximity and still be happily married. So it's doable everyone.Kristin Flanary (24:06):That's right. And we're in that phase of life that's really busy. We've got kids, we've got a gazillion jobs. House, my parents are around, and so it's like the only time all week that we actually get to sit down and talk to each other. So it's actually kind of like a part of our marriage at this point.Will Flanary (24:28):We're happy to involve the public in our conversations, but we couldn't do it because we have all these things going on, all our hands and all these little places. We can't do it without a team.Kristin Flanary (24:41):Yeah, absolutely.Will Flanary (24:41):And that's the thing that I've learned, because I've always been a very loner type content creator. I just wanted to do it all myself. It's in my head and I have trouble telling others, describing what's in my head. And Kristin and our producers have helped me to be able to give a little bit of control to others who are really good at what they do. And that's really the only way that we've been able to venture out into all these different things we've talked about.Eric Topol (25:12):Well, I think it comes down to, besides your ability to get to people in terms of their laughter receptors, you have this incisive observer capability. And that's one of the things I don't, I can't fathom because when you can understand the nuances of each specialty or of each part of healthcare, and you haven't necessarily interacted with these specialists or at least in recent years, but you nail it every time. I don't know how you do it, really that observational, is that a central quality of a comedian, you think?Will Flanary (25:52):There's definitely a big part of that. You got to get the content from somewhere. But for the specialties, it's really first about just getting the personalities down. And that doesn't change over time.Kristin Flanary (26:08):Or around the world.Will Flanary (26:09):Or around the world. We hear from people from all over the world about, oh, it's the same in Guatemala as it is in the US.Kristin Flanary (26:18):Surgeons are the same.Will Flanary (26:19):Yeah.Kristin Flanary (26:20):Emergency is the same.Will Flanary (26:21):Which has been really cool to see. But so, I draw on my experience interacting with all these specialties back in my med school and intern days. You're right, as an ophthalmologist, we don't get out very much.Eric Topol (26:33):No.Will Flanary (26:35):So very few people have ever seen an ophthalmologist. We do exist. But then beyond that, I do have to include some actual medical things. And so, I actually, I do a lot of research. I find myself learning more about other fields sometimes than I do in my own field. So especially the further out I get from med school, I know less and less.Eric Topol (27:00):Yeah, that's what I was thinking. But you're always spot on. It's interesting to get that global perspective from both of you. Now you're still doing surgery and practicing ophthalmology. Have you reduced it because this has just been taking off so much more over the recent years or keeping it the same?Will and Kristin Flanary (27:21):Nope, I'm still. Do you know how many years I had to come along on all of this medical training? He is not allowed to give this up.Will Flanary (27:29):I know there's something called a sunk cost fallacy, but this is no fallacy. There's enough of a sunk cost. I got to stick with it. No, I still enjoy it. That's the thing. It actually, it informs my comedy, it grounds me. All of the social media stuff is built upon this medical foundation that I have. And if I stopped practicing, I guess I could maybe cut back. But I'm not planning on doing that. If I stop practicing medicine, I feel like it would make my content less.Kristin Flanary (28:07):Authentic.Will Flanary (28:08):Less authentic, yeah. That's a good way to put it.Eric Topol (28:09):Yeah, no, that makes a lot of sense. That's great you can get that balance with all the things you're doing.Will Flanary (28:17):And if I stop practicing medicine, they're not going to invite me to any more commencement addresses, Dr. Topol. So I got to draw the line somewhere.Eric Topol (28:28):One of the statements you made at some point earlier was, it was easier to go to become a doctor than to try to be a comedian. And yeah, I mean you proven that.Will Flanary (28:38):A lot of ways. That's true.Eric Topol (28:40):Wow. I am pretty awestruck about the rarefied talent that you bring and what you both have done for medicine today. And the thing is, you're so young, you have so much time ahead to have an impact.Will Flanary (28:57):You hear that Kristin, we're young. Look at that.Kristin Flanary (29:00):That's getting less and less true.Will Flanary (29:01):Kristin, she just turned 40. It's right around the corner for me. So I don't know.Will Flanary (29:11):We got some years left.Eric Topol (29:12):You're like young puppies. Are you kidding? You're just getting started. But no, I think that what you brought to medicine in terms of comedy, there's no other entity, no person or people like you have done. And just the last thing I want to ask you about is, you have a platform for advocacy. You've been doing that. We talked about co-survivor. We talked about nurturing the human qualities in physicians like creativity and also taking on the insurance companies, which are just monstrous. I'll link a couple of those, but the brain MRI one or the Texaco.Will Flanary (29:54):Texaco Mike.Eric Topol (29:55):Yeah, that one is amazing. But there is so many. I mean, you've just taken them apart and they deserve every bit of it. Do you have any other targets for advocacy or does that just kind of come up as things go?Will Flanary (30:08):It kind of comes up as things go. There's things I keep harping on. The prior authorization reform, which I've helped in a couple of different states. There's a lot of good people around the country doing really good work on prior authorization and reforming that whole process. And I've been able to just play a small part in that in a couple of different ways. And it's been really fun to do that. And so, I do plan on continuing that crusade as it were. There's certain things I'd like to see. I've been learning more about what pharmacists are dealing with as well as a physician. Unfortunately, we are very separate in a lot of ways and just how we come up in medicine. And so, I have had my eyes opened a lot to what community pharmacists are dealing with. For all the terrible things that we have to deal with as physicians in the healthcare system. Pharmacists have just as much, if not more of the things that they're doing that are threatening their livelihoods. And so, I had love to see some more reform on the PBM side of things, pharmacy benefit managers, Caremark, Optum, all of them. They're causing lots of problems.Eric Topol (31:24):I couldn't agree with you more. In fact, I'm going to have Mark Cuban on in a few weeks and we're going to get into that. But the pharmacists get abused by these chains.Will Flanary (31:33):Oh, it's bad. It's really bad.Eric Topol (31:35):Horrible, horrible. I feel, and every time I am in a drugstore working with one of them, I just think what a tough life they have to deal with.Will Flanary (31:45):I guess from an advocacy standpoint, the good news is that there's never a shortage of terrible injustices that are being foisted upon the public and physicians and healthcare workers.Kristin Flanary (31:59):Yes. The US healthcare system is ripe for advocacy.Will Flanary (32:01):Yes. And that's a lesson that I tell people too, and especially the med students coming up, is like, there's work to be done and get in touch with your state societies and there's always work to be done.Eric Topol (32:18):Now you've stayed clear of politics. Totally clear, right?Will Flanary (32:24):For the most part, yeah. Yeah. It depends on what you consider politics. It depends on what you consider politics.Eric Topol (32:32):It being election day, you haven't made any endorsements.Will Flanary (32:36):I haven't. And I don't know. I can only handle so much. I've got my things that I really care about. Of course I'm voting, but I want to talk on the things that I feel like I have the expertise to talk about. And I think there's nothing wrong with that. Everybody can't have an opinion on everything, and it means something. So I am happy to discuss the things that I have expertise about, and I'm always on the side of the patient and wanting to make life better for our patients. And that's the side I'm on.Kristin Flanary (33:25):I think also he never comes out and explicitly touches on certain topics, but it's not hard to tell where he falls.Will Flanary (33:34):If you really want read into it all.Kristin Flanary (33:38):It's not like it's a big secret.Eric Topol (33:40):I thought that too. I'm glad you mentioned it, Kristin. But it doesn't come out wide open. But yeah, it's inferred for sure.Eric Topol (33:49):I think the point being there is that because you have a reach, I think there's no reach that it has 4 million plus people by your posts and no less the tours and keynotes and everything else. So you could go anywhere but sticking to where you're well grounded, it makes a lot of sense. And anyway, I am going to be staying tuned. This is our two-year checkup. I'm hoping you're going to come to San Diego on your next tour.Kristin Flanary (34:21):We're working on 2025 plans.Will Flanary (34:23):Oh, we got more shows coming up. And we'll hit up other parts of the country too.Eric Topol (34:28):I feel like I got to meet you in person, give you a hug or something. I just feel like I'm missing out there. But it's just a joy to have had a chance to work with you on your podcast. And thanks for coming back on one of mine. There's lots of podcasts out there, but having you and joining you is such fun. So thank you.Will Flanary (34:54):This has been great. Thank you for having us.Kristin Flanary (34:55):Yeah, thank you.*****************************************Thank you for reading, listening and and subscribing to Ground Truths.If you found this fun and informative please share it! Yes, laughter is the best medicine.All content on Ground Truths—its newsletters, analyses, and podcasts, are free, open-access.Paid subscriptions are voluntary. All proceeds from them go to support Scripps Research. Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years.Thanks to my producer Jessica Nguyen and to Sinjun Balabanoff for audio and video support at Scripps Research.Note on Exodus from X/twitter:Many of you have abandoned the X platform for reasons that I understand. While I intend to continue to post there because of its reach to the biomedical community, I will post anything material here in the Notes section of Ground Truths on a daily basis and cover important topics in the newsletter/analyses. Get full access to Ground Truths at erictopol.substack.com/subscribe
After discussing the three Piolets d'Or winners, and 60 finalists, Sam and Adrian jump into the complicated topic of high altitude climbing. The two share stories of their early experiences with altitude and talk about the basics of acclimatization and what a typical schedule might look at. Finally, they dive into the "aids" that are used for altitude climbing, from Diamox and Dexamethasone to Oxygen. A future episode will discuss the topic of Pre-Acclimatization using hypoxic tents, and what the Rapid Ascent system that Adrian has pioneered looks like.
Moderator: James P. Rathmell, M.D. Participants: Paul S. Myles, M.B., B.S., M.P.H., M.D., D.Sc. and Daniel I. McIsaac, M.D., M.P.H. Articles Discussed: Dexamethasone for Cardiac Surgery: A Practice Preference-Randomized Consent Comparative Effectiveness Trial Routine Innovation in Perioperative Clinical Trials: The Best Chance to Answer Our Most Important Questions? Transcript
Send us a textDiese Woche besprechen wir eine Metaanalyse von Katerenchuk et al. aus Anesthesia & Analgesia zur Wirkung von Dexamethason auf den Blutzuckerspiegel.Katerenchuk, Vasyl MD*; Ribeiro, Eduardo Matos MD†; Batista, Ana Correia MD, DESAIC*. Impact of Intraoperative Dexamethasone on Perioperative Blood Glucose Levels: Systematic Review and Meta-Analysis of Randomized Trials. Anesthesia & Analgesia 139(3):p 490-508, September 2024. | DOI: 10.1213/ANE.0000000000006933Dieses Mal im Studio mit dabei: Lina Kirschner, wiss. Mitarbeiterin der Klinik für Anästhesiologie am UKHD.
At age two, Jon Brent was diagnosed with a type of blood cancer, acute lymphoblastic leukemia. He underwent an aggressive chemotherapy regimen, including vincristine, dexamethasone, methotrexate and prednisone, but after that still needed a bone marrow transplant. He has achieved survivorship but is still in pain and expects to some extent he will be for the rest of his life. Jon can no longer compete in contact sports but is an active participant in ultimate Frisbee.
Eye Emergencies Can Go From 0 to 60 in a Blink Host Laura Reeves is joined by veterinary ophthalmologist Stacey Halse for a deep dive on eye emergencies in our dogs. [caption id="attachment_12861" align="alignleft" width="385"] Dr. Stacey Halse, veterinary ophthalmologist, with one of her Dobermans.[/caption] “Eyes are a very unique structure when it comes to every other organ, well, most other organs in the (dog's) body,” Halse said. “They have what you call the fancy word for is a blood aqueous barrier. It kind of protects the inside of the eye from the rest of the immune system. The eye itself is called an immunoprivileged site. And so when things go wrong and the regular immune system kind of gets into the eye, it can go very wrong very quickly. “And so emergencies can go from, oh, it's just a little scratch, just... to suddenly you're like, "Oh, now the eyeball's melting out of the face." And so that's always very scary, both for an owner and a dog.” Eye Infections in Newborns “One of the biggest things that you can do is get that eyelid open even though the eyes are only supposed to open at about two weeks old, you don't want that material to stay in there. And so if it's not draining yet, warm compressing and just gently massaging those eyes open to get that material draining because if it stays in there, it's going to ruin the eye. It's going to cause scar tissue that can affect the puppy for the rest of its life. And I haven't seen it a ton, but in the worst case. case scenarios, usually the shelter dogs that are kind of not brought in to care, but they can lose their eye. And so outside of medications, just getting that eye open is really the most important part.” Steroid Cautions Generally, any ulceration or scratch of the eye's surface should NOT be treated with steroids. “If there's an ulcer there and you don't know because you don't have the staining and all this stuff, you just wanna be cautious and kind of just do the topical antibiotics. In general, something like neopolybac, which a lot of people have, or a topical drop, most often if I'm prescribing it, I'll use Tobromycin because you only need something that's superficial. But I feel like a lot of the time people have neopolybac in the dog world. “You just have to make sure there's no steroid in it. So the two steroids that can be a neopolybac is hydrocortisone or dexamethasone. Dexamethasone probably the most common, but hydrocortisone is the one that's most commonly missed because people are just looking for dexamethasone on the thing. And one little trick that I teach students as well as owners is that if there's a pink strip on the box, it's a steroid. Tan is antibiotic, pink is steroid. Corneal Ulcers “The cornea is only about 0.8 millimeters thick, so it's super, super thin. And so an infection anywhere else, not a huge deal. An infection on the surface of the eye can be very bad very quickly. You can lose the eye within 24 hours. I've had one in the hospital that I was medicating aggressively and then we still lost the battle. And it like developed an ulcer in the hospital. This was like during my residency and we started treating right away and we still lost it. “I don't wanna freak everyone out but that's the worst case scenario. - If there's a little bit of squinting, and if you ever see a divot on your dog's eye, just take it in.”
Summary: In this conversation, Dennis and Ian discuss the new high altitude Clinical Practice Guideline (CPG) in the Joint Trauma System. They cover topics such as acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). They discuss the pathophysiology, symptoms, diagnosis, and treatment options for these conditions. They also touch on pre-treatment strategies and the use of portable hyperbaric chambers. Overall, the conversation provides a comprehensive overview of altitude-related illnesses and their management. In this conversation, Dennis and Ian discuss the treatment options for altitude illness, specifically AMS, HAPE, and HACE. They cover the use of pharmacologic therapy, oxygen, and portable hyperbaric chambers to stabilize and bring down patients with altitude illness. They also discuss the use of dexamethasone as the primary treatment for HACE and the potential use of hypertonic saline for extreme cases. They touch on the side effects of dexamethasone and the importance of protecting the airway. They also mention the use of acetazolamide for prophylaxis and the benefits of intermittent hypoxic exposure. Finally, they discuss the importance of good nutrition and hydration and the new medic encounter form for recording data on altitude illness. Takeaways: Acute mountain sickness (AMS) occurs when the body does not have enough time to acclimatize to the physiological stress of altitude. High altitude cerebral edema (HACE) is characterized by ataxia and can occur even without AMS symptoms. High altitude pulmonary edema (HAPE) is characterized by decreased exercise tolerance and tachypnea. Assessment of vital signs, such as heart rate and respiratory rate, can help differentiate between altitude illnesses. Portable hyperbaric chambers can be used to stabilize patients with altitude illnesses until they can be brought down to lower altitudes. Pharmacologic treatments, such as acetazolamide and dexamethasone, can be used for prophylaxis and treatment of altitude illnesses. Improvement in symptoms of HAPE can be rapid with oxygen therapy. Pre-treatment strategies, such as using acetazolamide, can help acclimatize the body to altitude before ascent. Pharmacologic therapy, oxygen, and portable hyperbaric chambers can be used to stabilize and bring down patients with altitude illness. Dexamethasone is the primary treatment for HACE, and hypertonic saline may be considered for extreme cases. Side effects of dexamethasone include increased sugar, gastric erosions, gastric bleeding, and adrenal suppression. Acetazolamide can be used for prophylaxis, and intermittent hypoxic exposure may help with acclimatization. Good nutrition, hydration, and iron status are important for preventing altitude illness. The new medic encounter form is a valuable tool for recording data on altitude illness. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Contributor: Ricky Dhaliwal, MD Educational Pearls: Croup Caused by: Parainfluenza, Adenovirus, RSV, Enterovirus (big right now) Age range: 6 months to 3 years Symptoms: Barky cough Inspiratory stridor (Severe = stidor at rest) Use the Westley Croup Score to gauge the severity Treatment: High flow, humidified, cool oxygen Dexamethasone 0.6 mg/kg oral, max 16mg Severe: Racemic Epinephrine 0.5 mL/kg Consider heliox, a mixture of helium and oxygen Very severe: be ready to intubate Bronchiolitis Caused by: RSV, Rhinovirus Symptoms are driven by secretions Symptoms: Cough Wheezing Dehydration (often the symptom that makes them look the worst) Age range: 2 to 6 months Treatment: Suctioning Oxygen IV fluids Nebulized hypertonic saline DuoNebs? No. Asthma Caused by: Environmental factors Viral illness with a predisposition Treatment: Beta agonists Steroids Ipratropium Magnesium (relaxes smooth muscle) References Dalziel SR, Haskell L, O'Brien S, Borland ML, Plint AC, Babl FE, Oakley E. Bronchiolitis. Lancet. 2022 Jul 30;400(10349):392-406. doi: 10.1016/S0140-6736(22)01016-9. Epub 2022 Jul 1. PMID: 35785792. Hoch HE, Houin PR, Stillwell PC. Asthma in Children: A Brief Review for Primary Care Providers. Pediatr Ann. 2019 Mar 1;48(3):e103-e109. doi: 10.3928/19382359-20190219-01. PMID: 30874817. Midulla F, Petrarca L, Frassanito A, Di Mattia G, Zicari AM, Nenna R. Bronchiolitis clinics and medical treatment. Minerva Pediatr. 2018 Dec;70(6):600-611. doi: 10.23736/S0026-4946.18.05334-3. Epub 2018 Oct 18. PMID: 30334624. Smith DK, McDermott AJ, Sullivan JF. Croup: Diagnosis and Management. Am Fam Physician. 2018 May 1;97(9):575-580. PMID: 29763253. Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Am J Dis Child. 1978 May;132(5):484-7. doi: 10.1001/archpedi.1978.02120300044008. PMID: 347921. https://www.mdcalc.com/calc/677/westley-croup-score Summarized by Jeffrey Olson | Edited by Meg Joyce & Jorge Chalit, OMSII
Dr. Jabs and Dr. Acharya discuss the results of the MERIT trial that investigated relative efficacy of intrvitreal injections of Dexamethasone implant vs ranibizumab vs methotrexate for the treatment of macular oedema associated with uveitis. Discussed article: Multicenter Uveitis Steroid Treatment Trial (MUST) Research Group, Writing Committee:; Acharya NR, Vitale AT, Sugar EA, Holbrook JT, Burke AE, Thorne JE, Altaweel MM, Kempen JH, Jabs DA. Intravitreal Therapy for Uveitic Macular Edema-Ranibizumab versus Methotrexate versus the Dexamethasone Implant: The MERIT Trial Results. Ophthalmology. 2023 Sep;130(9):914-923. doi: 10.1016/j.ophtha.2023.04.011. Epub 2023 Jun 13. PMID: 37318415; PMCID: PMC10524707.
Danielle and Elizabeth started chatting about cats in the rain - do they love it or hate it? Danielle mentioned that she has a new outdoor cat, and they revisited the idea of letting their cats go outside. Then Sarah Curcio was introduced, and she started with how she loves to adopt black animals. It runs in her family! She's also a pet sitter. Her latest cat, Mitzi, came from a hoarding situation, but she's well adjusted and she doesn't even want to go outside. Sarah talked about treating a cat's skin rash by switching its food to gluten free, and how her cat now is sensitive to chicken. Elizabeth talked about Max, and how he didn't have a food allergy, now he's on Zyrtech, Cyclosporine and Dexamethasone for itching. Sarah talked about how her boyfriend trained her cat with cat cookies. Cat cookies? They talked about cats loving treats, then went into how social cats are. Danielle asked everyone to join the FaceBook Community, The Jersey PodCats Community. The conversation went on, if you ever have a question for Danielle or Elizabeth they'll be happy to answer it. They love cats and people, so question away! Support the showThe Jersey PodCatshttp://thejerseypodcats.comhttps://youtube.com/@thejerseypodcatshttps://instagram.com/thejerseypodcatshttps://m.facebook.com/groups/thejerseypodcatsDanielle Woolley danielle@thejerseypodcats.comElizabeth Gearhart elizabeth@thejerseypodcats.comTommy's Catshttp://tommyscatsnj.orgPassage to Profithttp://passagetoprofitshow.com
Dr Richardson discusses the background of mezigdomide, key efficacy and safety findings with the agent plus dexamethasone in patients with relapsed/refractory multiple myeloma, and the implications of this combination for heavily pretreated patients in this population.
CME credits: 1.00 Valid until: 25-08-2024 Claim your CME credit at https://reachmd.com/programs/cme/case-study-how-do-you-manage-first-relapse-multiple-myeloma-following-daratumumablenalidomidedexamethasone-drd/16018/ Recognizing and treating early relapse of multiple myeloma (MM) is a challenge for healthcare professionals. This program is designed to improve clinicians' ability to distinguish between relapse and progression of disease in MM. In addition, the program compares the efficacy and safety of carfilzomib- and pomalidomide-based regimens in the treatment of relapsed MM, applies current and emerging treatment approaches to MM patients in early relapse, and reviews common adverse events that occur when using combination regimens to treat early relapsed myeloma.
Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Dexamethasone Trade Name Decadron Indication Manage cerebral edema, assess for Cushing's Disease Action Suppress inflammation and normal immune response. Used in inflammatory states to decrease inflammation. Therapeutic Class Antiasthmatics, corticosteroids Pharmacologic Class Corticosteroids Nursing Considerations • Excreted by the liver – monitor liver profile • Avoid in active untreated infections • May cause CNS alterations • May cause peptic ulcers • May cause Cushingoid appearance (buffalo hump, moon face) • Weight gain • Osteoporosis • Decrease wound healing • May elevate blood sugars • May increase cholesterol and lipid values
Moderator: James Rathmell, M.D. Participants: Mathias Maagaard, M.D. Articles Discussed: Perineural and Systemic Dexamethasone And Ulnar Nerve Block Duration A Randomized, Blinded, Placebo-controlled Trial in Healthy Volunteers Transcript
In this episode, Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPI, discusses new data on COVID-19 presented at ECCMID 2023, including:Treatment in special populationsREDPINE: remdesivir in people with renal impairment hospitalized for COVID-19 pneumoniaRemdesivir and readmission for COVID-19 in immunocompromised patientsMolnupiravir vs nirmatrelvir plus ritonavir for COVID-19 with hematologic malignancyManagement of patients with severe diseaseRECOVERY: higher-dose vs standard-dose corticosteroids for hospitalized patients with COVID-19Real-world study of tocilizumab vs baricitinib for severe COVID-19Novel antiviralsEnsitrelvirBemnifosbuvir Novel vaccinesNB2155AZD2816/AZD1222qNIV/CoV2373GRT-R910NVX-CoV2373 in people with HIVFaculty: Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPIProfessor of Microbial DiseasesCentre for Experimental Pathogen Host ResearchUniversity College DublinDublin, IrelandContent based on an online CME/CE program supported by independent educational grants from Gilead Sciences, Inc. and Novavax. Link to full program: bit.ly/3niXGJ6Link to downloadable slides: bit.ly/3LUFejG
In this episode, Vikramjit Mukherjee, MD, and Cameron Smith, MPAS, PA-C, answer audience questions on how best to care for hospitalized patients with COVID-19 from a live, virtual question and answer webinar. This episode includes expert insights on:Supportive care management such as oxygen support, glycemic control, and anticoagulationEscalation of therapy in patients with worsening oxygen requirementsUse of remdesivir in patients with renal dysfunctionBrief commentary on long COVIDPresenters:Vikramjit Mukherjee, MDAssistant Professor Division of Pulmonary, Critical Care, & Sleep Medicine New York University School of Medicine DirectorMedical Intensive Care UnitBellevue HospitalNew YorkCameron Smith MPAS, PA-CLead Advanced Practice ProviderMedical Intensive Care UnitBellevue HospitalNew York Health and Hospitals New York, New YorkContent based on an online program supported by an independent educational grant from Gilead Sciences, Inc.bit.ly/3z52c00
We discuss the use of corticosteroids, in particular, the dexamethasone implant in the management of diabetic macular edema with Dr. Kevin Blinder, Professor of Clinical Ophthalmology at Washington University School of Medicine, The Retina Institute.
Episode 6! In this episode we discuss 1) "Treating Rhythmic and Periodic EEG Patterns in Comatose Survivors of Cardiac Arrest" by Ruijter et al published NEJM 2022 and 2) "Dexamethasone treatment for the acute respiratory distress synrome" by Villar et al published Lancet Respiratory Medicine 2020. This episode is a little bit longer than normal because we also extended our conversation of steroids in ARDS to the LaSRS (steroids in late ARDS) and Meduri 2007 methylprednisolone in early ARDS studies!TELSTAR: https://pubmed.ncbi.nlm.nih.gov/35196426/DEXA-ARDS: https://pubmed.ncbi.nlm.nih.gov/32043986/Steroids in ARDS CHEST Point: https://pubmed.ncbi.nlm.nih.gov/33422200/and Counterpoint: https://pubmed.ncbi.nlm.nih.gov/33422201/Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
This podcast is short but addresses a critical point about the high dose dexamethasone suppression test. This long memorized test by many medical students now has a new outlet that has been expressing itself over the last few months. I discuss this new perspective here. Audio Download
In his weekly clinical update Dr. Griffin discusses co-detections of other respiratory viruses among children hospitalized with COVID-19, preprint review should form part of PhD programs and postdoc training, early and increased Influenza activity among children, COVID-19 vaccines versus pediatric hospitalization, SARS-CoV-2 variant-related abnormalities detected by prenatal MRI, protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the Omicron variant and severe disease, protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease, persistent COVID-19 Symptoms at 6 months after onset and the role of vaccination before or after SARS-COV-2 infection, effect of Dexamethasone use on viral clearance among patients with COVID-19, and the impact of vaccination on post-acute sequelae of SARS CoV-2 infection in patients with rheumatic diseases. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Codetections of other respiratory viruses among children with COVID-19 (Pediatrics) Preprint review should form part of PhD programmes and postdoc training (Nature) Early and increased Influenza activity among children (CDC) COVID-19 vaccines versus pediatric hospitalization (Cell) SARS-CoV-2 variant abnormalities detected by prenatal MRI (The Lancet) Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity (The Lancet) Persistent COVID-19 symptoms at 6 months and role of vaccination (JAMA) Effects of Dexamethasone use among patients with COVID-19 (IJID) Impact of vaccination on sequelae of SARS CoV-2 in patients with rheumatic diseases (BMJ) Contribute to our MicrobeTV fundraiser at PWB Dr. Griffin's treatment guide (pdf) Letters read on TWiV 978 Don't crush Paxlovid (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv
Date: January 13, 2023 Reference: Razi et al. Dexamethasone and ketorolac compare with ketorolac alone in acute renal colic: A randomized clinical trial. AJEM 2022 Guest Skeptic: Dr. Kevan Sternberg is a urologist/endourologist. His focus is on the medical and surgical management of kidney stone disease. Dr. Sternberg did his medical school and residency training at […] The post SGEM#389: Does Dex, Dex, Dex, Dexamethasone Help with Renal Colic? first appeared on The Skeptics Guide to Emergency Medicine.
The Journal RETINA is devoted exclusively to diseases of the retina and vitreous. These podcasts are intended to bring to its listeners summaries of selected articles published in the current issue of this internationally acclaimed journal.
Natasha attempts a somewhat normal life by continuing to work and dating someone new. But behind the scenes, things are unraveling. She receives news about the alarming masses on her liver and thyroid. After her second chemo, unusual and disturbing side effects lead her to wonder how many other unexpected surprises are headed her way. Links Support the Breast Cancer Stories podcast https://www.breastcancerstoriespodcast.com/donate Subscribe to our newsletter here: http://eepurl.com/hX12YD About Breast Cancer Stories Breast Cancer Stories follows Natasha Curry, a palliative care nurse practitioner at San Francisco General Hospital, through her experience of going from being a nurse to a patient after being diagnosed with breast cancer. Natasha was in Malawi on a Doctors Without Borders mission in 2021 when her husband of 25 years announced in a text message that he was leaving. She returned home, fell into bed for a few weeks, and eventually pulled herself together and went back to work. A few months later when she discovered an almond-sized lump in her armpit, she did everything she tells her patients not to do and dismissed it, or wrote it off as a “fat lump." Months went by before Natasha finally got a mammogram, but radiology saw nothing in either breast. It was the armpit lump that caught their attention. Next step was an ultrasound, where the lump was clearly visible. One painful biopsy later, Natasha found out she had cancer; in one life-changing moment, the nurse became the patient. This podcast is about what happens when you have breast cancer, told in real time. Host and Executive Producer: Eva Sheie Co-Host: Kristen Vengler Editor and Audio Engineer: Daniel Croeser Theme Music: Them Highs and Lows, Bird of Figment (https://music.apple.com/us/artist/bird-of-figment/1434663902) Production Assistant: Mary Ellen Clarkson Cover Art Designer: Shawn Hiatt Breast Cancer Stories is a production of The Axis. (http://www.theaxis.io/) PROUDLY MADE IN AUSTIN, TEXAS
Date: August 25th, 2022 Reference: Martin et al. Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children's National Hospital. He finished his General Pediatrics residency at Yale-New Haven Hospital. As […]
Hello! I just wanted to sit down and have a chat about dexamethasone. This is one of the episodes I had been wanting to make for a while. Many of us will experience this drug at some point. It's important to understand its side effects and how it can work against the very idea of immunotherapy. Many of us in the community have felt those side effects and it's important to be informed. I've included some links below as well for your own research. Thank you all for your support. I appreciate all of you so much! Chris Links: Immunotherapy episode https://www.podbean.com/media/share/pb-d9d8j-111c5bb https://www.drugs.com/dexamethasone.html https://www.drugs.com/drug-class/glucocorticoids.html https://www.ulh.nhs.uk/services/cancer-services/cancer-services-information/taking-dexamethasone-when-you-have-a-brain-tumour/ https://pubmed.ncbi.nlm.nih.gov/31346902/ https://www.cancer.gov/news-events/cancer-currents-blog/2020/brain-cancer-immunotherapy-steroids-limit-effectiveness
Today we have a couple special guests under the age of 2. Birdie and Gus! Do SGLT2 inhibitors improve diuresis in acute heart failure? Are they better than metformin for reducing cardiovascular mortality? Is high dose dexamethasone better than standard dose in ICU patients with COVID? We also talk about outcomes in patients with isolated distal DVT compared to proximal DVT, a large case series of patients with monkeypox infection, blood donor outcomes and the outcomes for surgeons who operated the night before. Check it out! SGLT2-Inhibitors for Acute Heart FailureCardiovascular Outcomes for SGLT-2 Inhibitors vs MetforminCOVIDICUS Trial Isolated Distal DVT OutcomesMonkeypox Case SeriesMortality in Patients Undergoing Blood TransfusionPerioperative Outcomes for Surgeons Who Operated the Night BeforeMusic from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R
Download the cheat: https://bit.ly/50-meds View the lesson: https://bit.ly/DexamethasoneDecadronNursingConsiderations Generic Name Dexamethasone Trade Name Decadron Indication Manage cerebral edema, assess for Cushing's Disease Action Suppress inflammation and normal immune response. Used in inflammatory states to decrease inflammation. Therapeutic Class Antiasthmatics, corticosteroids Pharmacologic Class Corticosteroids Nursing Considerations • Excreted by the liver – monitor liver profile • Avoid in active untreated infections • May cause CNS alterations • May cause peptic ulcers • May cause Cushingoid appearance (buffalo hump, moon face) • Weight gain • Osteoporosis • Decrease wound healing • May elevate blood sugars • May increase cholesterol and lipid values
How does in utero glucocorticoid administration impact autonomic control of the heart in adult offspring in a sex-dependent manner? In this episode, Associate Editor Dr. Crystal Ripplinger (University of California – Davis) interviews authors Dr. Taben Hale and Lakshmi Madhavpeddi (University of Arizona) along with expert Dr. Glen Pyle (University of Guelph) about the new work by Madhavpeddi et al. The authors administered dexamethasone to pregnant rats using a dose and timing that closely mimicked clinical application of dexamethasone administration to pregnant women at risk for preterm delivery to prevent respiratory distress in newborns. At baseline, the authors did not observe any differences between the prenatally-exposed offspring and controls. In response to an experimental stressor, however, the authors found that prenatal exposure to dexamethasone resulted in exaggerated blood pressure and heart rate only in adult female rats. Prenatally-exposed adult male rats did not exhibit any stress response changes in cardiovascular function. In addition, only the dexamethasone-exposed adult female offspring showed a reduction in the high frequency component of heart rate variability, indicating withdrawal of parasympathetic activity. What role does angiotensin II play in the altered autonomic response induced by prenatal dexamethasone exposure? Can we derive important potential clinical applications of this work related to the long-term impact on offspring from treatments administered during their mothers' pregnancies? Listen now to find out. L. Madhavpeddi, B. Hammond, D. L. Carbone, P. Kang, R. J Handa, T. M. Hale Impact of angiotensin II receptor antagonism on the sex-selective dysregulation of cardiovascular function induced by in utero dexamethasone exposure Am J Physiol Heart Circ Physiol, published March 17, 2022. DOI: 10.1152/ajpheart.00587.2021
Trade – DecadronClass – Corticosteroid MOA – Reduces inflammation by multiple mechanismsIndication – Asthma, airway edema, acute mountain sickness, cerebral edema and multiple medical conditions requiring anti-inflammatory Contraindications – Fungal infection, use caution in active infections, renal disease, penetrating spinal cord injury.Side effects – Depression, euphoria, headache, restlessness, HTN, Bradycardia, Nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesias DoseAdult: 10mg IV/PO
Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our first hematologic emergency: immune thrombocytopenic purpura (ITP).Immune thrombocytopenic purpura (ITP):Be sure to check out episode 009 on thrombocytopenia for a general approach and differential!Specific instances where there may be close to undetectable platelet count: * Lab artifact (clumping)* Very severe DIC* Thrombotic thrombocytopenic purpura - though usually higher platelets in these cases * Heparin induced thrombocytopenia (in very severe cases) - though usually higher platelets in these cases * ITP ITP: Diagnosis of exclusion How to confirm it is ITP?* Post-transfusion CBC - a repeat CBC 30-60 mins after a platelet transfusion. In ITP, the platelet count will likely not budge. (Not perfect test!)* Immature platelet fraction (if available) - this will be elevated if mature platelets are being destroyed. (Again - not a perfect test) Treatment in acute cases: IVIG 1g/kg daily x2 days + Dexamethasone 40mg daily x4 daysReference:https://ashpublications.org/blood/article/106/7/2244/21649/How-I-treat-idiopathic-thrombocytopenic-purpura - Great How I Treat article from Blood Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast
Allergy treatment gets over-the-counter approval; Anaphylaxis treatment recalled; Phase 3 trial results for investigational sciatica treatment; FDA alert regarding at-home COVID tests; And the resubmitted Biologics License Application for teplizumab for type 1 diabetes is accepted.
Moderator: BobbieJean Sweitzer, M.D. Participants: David H. Kim, M.D. Articles Discussed: Interscalene Brachial Plexus Block with Liposomal Bupivacaine versus Standard Bupivacaine with Perineural Dexamethasone: A Noninferiority Trial Transcript
Are you looking for a bundle of Coach K's Top MSK Cheatsheets? Look no further: www.nptecheatsheets.com Kenny is looking to facilitate scar healing with iontophoresis. Which of the following should the therapist utilize during treatment? A. Acetate B. Copper C. Dexamethasone phosphate D. Lodine Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck. --- Support this podcast: https://anchor.fm/thepthustle/support
Play: 0:00-0:07 I think I agree with Chuck Schumer … and more on today's CrossPolitic Daily News Brief. This is Toby Sumpter. Today is Tuesday, January 4, 2021. VAERS Stats from SEn. Ron Johnson The chart lists Ivermectin, Hydroxychloriquine, Flu vaccines, Dexamethasone, Tylenol, Remdesivir, and Covid Vaccines. While Ivermectin lists 393 total deaths, with 15 deaths per year, and hydroxychloriquine lists 1770 total deaths, averaging 69 deaths per year, and Flu vaccines list 2001 deaths total, with an average of 77 deaths per year, Covid vaccines show a total of 21,002 deaths and since that has only been counting for the last year, that is also the currently annual average: 21,002 deaths from COVID vaccines. Now, were some of those deaths with vaccines instead of from vaccine? Most likely. But something is going on there. Girls-Only Schools Say They Will Only Admit Biological Girls A group of girls-only private schools in Britain are refusing to admit transgender students, worried that it could affect their status as single-sex schools under current law. The Girls' Day School Trust (GDST), which represents 25 schools across Britain, released its policy with regards to gender identity in order to clarify that the schools organizing through this group should reject the admission of transgender children. The GDST believes that an admissions policy based on gender identity rather than the legal sex recorded on a student's birth certificate would jeopardize the status of GDST schools as single-sex schools under the act,” their new guidance states. “For this reason, GDST schools do not accept applications from students who are legally male. We will, however, continue to monitor the legal interpretation of this exemption,” the guidance continues. The Trust hastened to add that all current transgender students are welcome to remain as students. The Trust also sacrificed four oxen, three sheep, and two turtle doves following the announcement, hoping not to be destroyed from the face of the earth. The problem is that men in the UK and in North America have not stood for freedom: DNB AR500 Armor: The Mission of Armored Republic is to Honor Christ by equipping Free Men with Tools of Liberty necessary to preserve God-given rights. In the Armored Republic there is no King but Christ. We are Free Craftsmen. Body Armor is a Tool of Liberty. We create Tools of Liberty. Free men must remain ever vigilant against tyranny wherever it appears. God has given us the tools of liberty needed to defend the rights He bestowed to us. Armored Republic is honored to offer you those Tools. Visit them at www.ar500armor.com. Biden To Promote Meat Industry Overhaul President Biden on Monday will promote an overhaul of the meat-packing industry as he blames rising consumer prices and dwindling farmers' profits on the handful of large “middlemen” who dominate the processing segment of the supply chain. Play: 2:00-2:44 The White House said the administration will spend $1 billion to expand independent processing capacity and instill competition in a market where four meat-packing companies control 85% of the beef market, four firms control 50% of poultry processing, and four big processors control 70% of the pork market. Mr. Biden is under pressure to alleviate inflation and supply chain pressures that are making food, gas, toys and other products more expensive. At times, he's blamed the sticker shock on price gouging by big industry players. The meat-processing industry is his latest target. He said dominant processors are increasing their profits at the expense of farmers and families. Mr. Biden's plan includes $100 million for workforce training and safety after Congress accused the meat-packing industry of forcing workers into unsafe conditions during the pandemic. Ransomware attacks also hit the industry earlier in Mr. Biden's term. The White House said it will strengthen rules that require farmers and ranchers to get a fair price for the meat they provide. Ah… there we go: strengthen rules that require fair prices… That's exactly what you don't the Federal Government to be doing. Rep. Thomas Massie thread: Thread. The Biden administration is over the target. Four companies control the majority of meat processed in the United States. This quad-opoly of corporate middlemen have driven up prices in stores while depressing prices paid to struggling farmers. (tinyurl.com/5bxm87km) We all agree: the solution is to promote competition. Biden advisors recommend antitrust lawsuits against the big packers and subsidies for the little guys. There's a better answer though that's free: Roll back crippling regulations on the little guys and they will flourish. Six years ago, I worked with Democrats and Republicans in the House and Senate to introduce a bill called the PRIME Act, which would right-size regulations and break up the corporate monopoly on meat processing. We've introduced this bill in every congress since 2015. The PRIME Act would allow local farmers to sell meat in local grocery stores using local processors, as long as the commerce doesn't cross state lines, and complies with all state and county regulations (such as monthly inspections by county health departments). Here's the PRIME Act, just a few pages and easy to understand. Check out the House and Senate sponsors from both sides of the aisle: (congress.gov/bill/117th-con…) (congress.gov/bill/117th-con…) So who opposes the PRIME Act and why hasn't it passed? Big Agriculture lobbyists (posing as friends of small farmers) oppose this bill, and I'm sad to tell you they've bought off most members of the House Agriculture committee. But a President could cut through the bull! Meanwhile, critics also pointed out that Biden doesn't seem to be too concerned about Big Pharma monopolies. How many Pharmaceutical companies control the current medicine markets? And speaking of monopolies: Democrats Pushing End to Filibuster Rules Democrats are resuming their push to change Senate filibuster rules in the hope of passing elections legislation, and they plan to use the one-year anniversary of the Capitol riot to win over two hold outs, Senators Joe Manchin and Kyrsten Sinema. Democrats are hopeful that they can sway the two moderates by arguing both publicly and privately that the riot set off a sustained Republican effort to erode voting rights in state capitals across the country, Politico reported Monday. Of course this would be an about-face from previous stances. For example: In 2005, Then-Sen. Joe Biden, D-Del., condemned weakening the Senate's tradition of extended debate as “an example of the arrogance of power,” a “power grab by the majority party” that would “eviscerate the Senate.” It was 2005, and Republicans held the White House and Congress. Chuck Schumer on the Filibuster Play Audio The Senate was established originally as a check against majoritarian impulses. It has an equal voice for all the states - 2 senators per state, and there are six year terms with only a third of the senators up for re-election every two years. The 60 vote filibuster is not required by the constitution, but it is certainly in keeping with the spirit of the constitution. Removing the 60 vote threshold certainly does move it closer to the House. Of course in May 2017, Then-President Donald Trump demanded that Senate Republicans abandon extended debate in order to enact his legislative priorities. Sen. Mitch McConnell, R-Ky., majority leader at the time, rejected “fundamentally changing how the Senate has worked for a very long time.” The difference between playing politics and standing for principle is seen very clearly right here. Principles are things that don't change. They remain the same for everyone, no matter who is in power. Frequently, Republicans are just as bad as Democrats. While there is certainly room to be grateful for some of what Trump did, this is certainly an area where he was rocking the boat in an unprincipled way. If the Democrats were smart, they'd cite Donald Trump as a defense for their move. PSalm of the DAy: Psalm 30 2:48-3:28 Remember you can always find the links to our news stories and these psalms at crosspolitic dot com – just click on the daily news brief and follow the links. This is Toby Sumpter with Crosspolitic News. A reminder: Support Rowdy Christian media, and share this show or become a Fight Laugh Feast Club Member. Remember if you didn't make it to the Fight Laugh Feast Conferences, club members have access to all the talks from Douglas Wilson, Joe Boot, Jeff Durbin, Glenn Sunshine, Nate Wilson, David Bahnsen, Voddie Baucham, Ben Merkle, and many more. Join today and have a great day.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode659. In this episode, I'll discuss the dose of dexamethasone for patients with COVID-19. The post 659: If 6 mg dexamethasone is good then why not 12? appeared first on Pharmacy Joe.
Today we talk about the effect of eliminating the race coefficient from the estimated GFR calculators, the risk of bleeding from anticoagulation after first unprovoked VTE, another trial looking at therapeutic anticoagulation in COVID-19, and whether 12 mg of dexamethasone is better than 6 mg for severe COVID-19 infections. New GFR Equations without RaceRace, Genetic Ancestry and Estimating Kidney FunctionLong Term Bleeding Risk from Oral AC after First Unprovoked VTETherapeutic Heparin for COVID-19 (HEP-COVID)High Dose Dexamethasone for Severe COVID-19Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode639. In this episode, I’ll discuss the optimal timing of remdesivir initiation in hospitalized COVID-19 patients administered with dexamethasone. The post 639: What is the optimal timing of remdesivir initiation in hospitalized COVID-19 patients administered with dexamethasone? appeared first on Pharmacy Joe.
© 2020-2025 Ivy Podcast Discovery LLC
