A simple form of sugar
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3 episodes with dextrose
4 episodes with dextrose
4 episodes with dextrose
3 episodes with dextrose
3 episodes with dextrose
3 episodes with dextrose
2 episodes with dextrose
2 episodes with dextrose
2 episodes with dextrose
Contributor Jordan Folks joins Marshall to talk about the use of simple sugars in brewing, particularly the differences between dextrose and sucrose when used in West Coast IPA. | Relevant Article | Dextrose vs. Sucrose In A West Coast IPA xBmt | Support Brülosophy | Brülosophy merch is available - click here to see all we have to offer! Become a Brülosophy Patron today and be rewarded for your support! Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Send us Fan MailO que você oferece nas primeiras semanas importa — e muitoQuatro estudos. Quatro perguntas que todo neonatologista e pediatra já enfrentou na prática. Voltamos a apresentar os artigos do livro 50 Estudos que Todo Neonatologista Deve Conhecer, dessa vez com os artigos que revolucionaram a nutrição neonatal.Qual fórmula dar a um prematuro quando o leite materno não está disponível? Promover o aleitamento de forma estruturada realmente muda desfechos clínicos? Leite doado é superior à fórmula para prematuros extremos? E como manejar a hipoglicemia neonatal sem separar mãe e bebê?Neste episódio da Incubadora, discutimos os ensaios de Lucas et al. no BMJ, o PROBIT no JAMA, o DoMINO no JAMA e o Sugar Babies no Lancet — estudos que, juntos, constroem um argumento difícil de ignorar: decisões tomadas nas primeiras horas e semanas de vida deixam marcas que aparecem no pulmão, no cérebro e no desenvolvimento anos mais tarde.1. Randomised trial of early diet in preterm babies and later intelligence quotient - https://pubmed.ncbi.nlm.nih.gov/9831573/2. Promotion of Breastfeeding Intervention Trial (PROBIT) A Randomized Trial in the Republic of Belarus - https://pubmed.ncbi.nlm.nih.gov/11242425/3. Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months A Randomized Clinical Trial - https://pubmed.ncbi.nlm.nih.gov/27825008/4. Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial - https://pubmed.ncbi.nlm.nih.gov/24075361/Evidência, cuidado e contexto brasileiro — esse é o nosso roteiro. Não esqueça: você pode ter acesso aos artigos do nosso Journal Club no nosso site: https://www.the-incubator.org/podcast-1Lembrando que o Podcast está no Instagram, @incubadora.podcast, onde a gente posta as figuras e tabelas de alguns artigos. Se estiver gostando do nosso Podcast, por favor dedique um pouquinho do seu tempo para deixar sua avaliação no seu aplicativo favorito e compartilhe com seus colegas. Isso é importante para a gente poder continuar produzindo os episódios. O nosso objetivo é democratizar a informação.Se quiser entrar em contato, nos mandar sugestões, comentários, críticas e elogios, manda um e-mail pra gente: incubadora@the-incubator.orgEvidência, cuidado e contexto brasileiro - esse é o nosso roteiro.
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The belief that IV dextrose is necessary to clear ketones in hyperemesis gravidarum originated from a logical, and now known to be outdated, extrapolation of basic starvation ketosis physiology and the treatment paradigm for diabetic ketoacidosis (DKA). The original experiments that led to this conclusion go back to the 1960s (Foster data). Not only is this outdated, but it is also physiologically incorrect. We've learned a lot about IV fluid replacement about hyperemesis gravidarum in the last several years- in the last data review was in January 2026 in Lancet. Even the correction of hyponatremia has evolved. Should we be following urine ketones for patients being treated for HG? Is Dextrose needed? Listen in for details.1. Nana M, Painter R, Williamson C et al. Hyperemesis gravidarum. The Lancet, Jan 2026; 407, 78-892. Clark SM, Zhang X, Goncharov DA. Inpatient Management of Hyperemesis Gravidarum. Obstet Gynecol. 2024 Jun 1;143(6):745-758. doi: 10.1097/AOG.0000000000005518. Epub 2024 Feb 1. PMID: 38301258.3. Ayus JC, et al.Correction rates and clinical outcomes in hospitalized adults with severe hyponatremia: a systematic review and meta-analysis. JAMA Intern Med. 2025;185(1):38-51. 4. ACOG Clinical Epert Series: Inpatient Management of Hyperemesis Gravidarium. Obstet Gynecol; 2024
Send us Fan MailDr. Arpitha Chiruvolu, neonatologist and infant nutrition researcher, joins Ben to share three posters from this year's PAS covering two of her core research interests. She presents pilot data on using Prolacta human milk cream as an alternative to dextrose gel for treating asymptomatic neonatal hypoglycemia — highlighting the well-known limitations of dextrose gel including inconsistent dosing, poor tolerance, and the way it interferes with breastfeeding immediately after administration. In 25 babies treated with cream, blood glucose rose from a median of 36 to 56 mg/dL, only one baby required NICU admission, and nurses and families loved it. She also shares her center's experience with probiotics in extremely low birth weight infants — where NEC rates dropped significantly with no cases of probiotic sepsis — and raises the urgent question of what is happening to NEC rates now that probiotics have been pulled from use in the US.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!
Deb (00:03.606)Within the next seven months, up to 1.5 million Americans could lose access to a medication that they’ve relied on for decades. Not because it’s dangerous, but because a pharmaceutical giant may have lobbied the FDA to eliminate their competition. And if you’re one of them, your doctor may already have told you about this issue and stopped prescribing it.This isn’t a conspiracy theory. This is documented in federal court filings. This is happening right now. And the company that stands to profit, well, they’re the same ones manufacturing the only product that might survive.Today on Let’s Talk Wellness Now, we’re exposing the desiccated thyroid extract crisis, the corporate manipulation behind it, and what you need to do right now to protect your health. Stay with me because I’m about to share what could save your access to the medication keeping you alive.Welcome back to Let’s Talk Wellness Now, the show where we uncover the root causes of chronic illness, expose regulatory capture in healthcare, and empower you with the tools to advocate for yourself. I’m Dr. Deb, naturopathic doctor, your medical detective, and today we’re diving into one of the most consequential and corrupt healthcare decisions affecting patients right now. If you or someone you love takes Armour thyroid, NP thyroid, or any desiccated thyroid extract,for hypothyroidism or if you’ve struggled to find a thyroid medication that actually works for your body, this episode is absolutely critical. And if you have celiac disease, gluten sensitivity or corn allergies, what I’m about to reveal will make your blood boil. Now grab your cup of coffee, don’t forget your notebook and settle in because what’s happening to this medication right now is a masterclass in how pharmaceutical companies use regular Deb (02:06.544)agencies to eliminate competition, control markets, and price gouge patients. And I have all the receipts. Deb (02:20.982)Let me start with what might surprise you. Desiccated thyroid extract, or DTE as we call it, is actually one of the most oldest thyroid medications in the world. And I mean old. From the 1890s through 1970, this was the standard treatment for hypothyroidism.Now let’s really dive into that. From the 1890s to the 1970s, this was standard hypothyroidism treatment.In 1965 alone, and this is documented in peer-reviewed literature published in the Journal of Clinical Endocrinology and Metabolism, approximately four out of every five prescriptions for thyroid hormone in the United States were of natural desiccated thyroid preparations.The Journal of Clinical Endocrinology and Metabolism is a very high-end journal. Now think about that. This wasn’t some fringe therapy. This was mainstream medicine. Armour Thyroid, the most recognizable brand name, has been manufactured since the early 1900s, well over a century ago.and this is cited again in NIH bookshelf. When the FDA was officially established in 1938, Arbor thyroid was already on the market. And this is important and I want you to understand why. Under the federal Food, Drug and Cosmetic Act, any drug that was already being marketed before 1938 was automatically grandfathered into the system. That means it didn’t have to Deb (04:08.112)go through the formal FDA approval process. And this again is cited under the Federal Food, Drug and Cosmetic Act, grandfathered drugs and exemptions. And this is crucial to understanding what happens next. By the 1970s, synthetic levothyroxine, brand name Synthroid and generics became the preferred treatment. Hmm, wonder why?It was easier to standardize, came into consistent doses, and worked well for most patients, and could be mass manufactured. By the 1980s, levothyroxine had largely replaced desiccated thyroid in clinical practice, according to the American Thyroid Association 2014 guidelines for the treatment of hypothyroidism. But here’s what matters. Some patients…a very significant minority of them, never felt right on levothyroxine alone. Despite their lab work looking normal, they still had fatigue, brain fog, weight gain, cold intolerance, and depression.These patients often found relief when they switched back to their desiccated thyroid, which contains both T4 and T3 hormones, the way human thyroid naturally produces them. And this is not anecdotal. This is documented in randomized double-blind crossover studies published in Endocrine Practice.For decades, that was fine. Their doctors prescribed it, insurance sometimes covered it, patients were getting better, and the system worked really well. Until August 6th of 2025, just a short time ago, everything changed. On that date, the FDA sent letters to manufacturers, importers, and distributors of desiccated thyroid extract products stating that these medications would need an approval. Deb (06:04.654)a biologics licensed application, a BLA, to remain legally on the market. And this is cited in the FDA’s official statement, FDA’s actions to address unapproved thyroid medications. understand it says unapproved thyroid medications. However, desiccated thyroid, specifically Armour, has been approved since 1938. And this was dated August 6th through 7th, 2025.This wasn’t a guideline. This wasn’t a suggestion. It was an endorsement of action. And the timeline they gave them? Well, just 12 months to transition patients to another medication before enforcement action could begin.This was also cited by an FDA notice to the industry, animal derived thyroid products notice to industry, August 6th, 2025. Now do the math, that means August 2026, seven months from now, 1.5 million Americans currently taking this medication. And this number comes from the FDA official statement, citing that it’s an estimation of 1.5 million patients receiving prescriptions for these medications.could potentially lose their thyroid access. Now, here’s where it gets interesting. The FDA didn’t wake up in August of 2025 and decide to regulate desiccated thyroid after a century. This decision has a much longer backstory. And understanding that backstory is critical to understanding what’s really happening in this industry.The shift started in 2022. Back in September of 2022, over three years ago, an FDA branch chief sent a letter to the National Associations of Boards of Pharmacy noting that the agency had decided to designate DTE as a biological product, which would affect its eligibility for compounding. Deb (08:13.972)This also is cited in an FDA letter to the National Association of Boards of Pharmacy September 2022.Then two months later, in November of 2022, the FDA’s Office of Compounding Quality and Compliance sent a softer letter acknowledging that many Americans take medication to treat hypothyroidism and some choose to take DTE products. The letter stated that the FDA would focus enforcement on cases that pose the greatest public health risks, such as serious adverse offense or serious product quality or adulteration.also is cited by an FDA letter from Francis G. Bromel, the director, Office of Compounding Quality and Compliance, November of 2022. Now, let me just think about this for a second. If this drug has been on the market since the 1800s, been FDA approved since 1938, would we not have seen a health crisis long before 2022?I honestly don’t know of any other drug that’s been around this long that’s used by this many people. Now granted, I haven’t done the research on it either, which I can do for you guys, but I’m just thinking if a drug is on the market today and it causes harm, it doesn’t make it three years, five years before you see lawsuits everywhere. Why are there no lawsuits on this drug? Why are there no major reactions that people are seen having?Hmm, just thought. But here’s the pattern. The FDA was already laying the groundwork back in 2022, testing the waters, signaling where this was headed. The August 2025 action. Then this came down. Deb (10:09.806)August 6, 2025, the FDA announced its position publicly and sent formal letters to all DTE manufacturers, importers, and distributors. This was cited by the FDA Enforcement Action August 6, 2025, letters to manufacturers, importers, distributions of DTE products. The agency stated several concerns. First, DTE products have experienced quality and dosing issues.The FDA cited, and I’m quoting directly from their statement, over 500 adverse events reported associated with DTE products from 1968 to 2025. From 1968 to 2025, we had 500 adverse reactions? What is that math equate to?A couple a year? Come on guys, this is insane! With a substantial increase, you, between 2019 and 2020 that the agency suggested was related to voluntary recalls of sub-potent or super-potent products.This was cited in the FDA statement, over 500 adverse events reported associated with ADT products from 1968 through 2025.Second, the agency expressed concern about batch inconsistency. According to the FDA’s official statements, tablets made from the same manufacturing batches may not always provide the same thyroid hormone levels. Okay, this was cited in the FDA statement, tablets made from the same manufacturing batches may not always provide the same thyroid hormone levels. Thirdly, and I want to actually let’s back up. I want you to remember I said that Deb (12:11.216)because further down in this podcast, we’re going to talk about this. This is an important point to remember. Thirdly, the agency raised concerns about potential impurities from animal source material, including potential for viral contamination due to the animal source and supraphysiological levels of T3.the FDA statement on impurities, viral contamination and super physiological T3 levels. Now I will tell you, I’ve been prescribing armarithograde for 20 years. I’ve rarely seen a super physiological dose given of T3 in lab results, unless the patient takes their medication like four or five hours before you do the blood test, then you’ll see a false rise because you’re actually seeing the medication. You’re not seeing people walking aroundsuperphysiological T3 levels. Nobody would like that feeling. So anyway, I digress. Now let me pause here because this is where I need to give you some context that the FDA hasn’t quite emphasized yet. Of course, we have another connection and it is the China connection.So the FDA’s concerns about contaminated drugs and quality issues don’t exist in a vacuum. In 2024, the U.S. over 828,000 metric tons of pharmaceuticals, seven times the level from 2000. And here’s the kicker. China and India supply the majority of active pharmaceutical ingredients. APIs for U.S. generics accounting for 70 to 80 % of the total genericdrug supply. According to Reuters industry report in 2024, they state that China supplies 82 % of the APIs for critical drugs. Deb (14:08.204)Got to question that, right? Why are we giving all of our drug formulas to China and allowing them to import them into our country? In fact, roughly 20 % of the critical drugs have APIs exclusively sourced from China. And China controls 80 to 90 % of the global production for antibiotics and other key compounds. This was also cited by Reuters industry data thatcontrols 80 to 90 percent of the global production for antibiotics and other key compounds. Now just think about this. They control 80 to 90 percent of our medication. They control 20 percent of our critical drugs and we just put what kind of tariff on them? Hmm.In 2025 alone, the FDA issued multiple warning letters to foreign manufacturers for contamination issues and failure to follow good manufacturing practices. This is also cited by the FDA warning letters 2024 through 2025 and multiple citations to foreign manufacturing facilities. This is a systematic problem affecting the entire US drug supply, not just desiccated thyroid.So when the FDA suddenly became concerned about DTE quality and contamination, part of that concern was legitimate. But this is crucial. The same inconsistencies and contamination issues exist across the entire generic drug supply. And the FDA has not taken the same enforcement action against them. Let that sink in.They have not taken the same enforcement action against the other drug companies. So what’s behind all of this? Where is this all coming from? Hmm. Let’s address something directly, because you deserve to know it. And I’m going to cite my sources precisely so that when the medical boards have something to say about this, and they might, I have a documentation for every single word that I am about to speak. Deb (16:24.878)According to the court documents filed in October 2025, in the case ofa urine, a urine. I’m going to say that wrong. Pharmaceuticals versus Dr. George Tidmarsh from ABBV, the multinational pharmaceutical company that manufactures armor thyroid, reportedly petitioned the FDA in 2024, asking the agency to reclassify DTE as a biologic and to prohibit other manufacturers from selling unlicensed DTE products unless they havehad an investigational new drug application, we call this an IND, and a clinical development program aimed at eventual approval. This is cited in the court filing a Urena pharmaceuticals lawsuit versus Dr. George Tidmarsh, October 2025, reported by Fierce Pharma. Now let me explain why this matters and why this is one of the most brazen examples of regulatory capture I’ve ever seen in my career.AbbeVee is one of the world’s largest pharmaceutical companies. In 2024, they reported over $54 billion in revenue. Drop the mic on that one.They have the resources, the regulatory expertise, the legal teams, and the financial capacity to navigate a biologics license application process that costs between $500 million and $1 billion. Let that sink in. Deb (18:07.882)A drug that’s been on the market since the 1800s that was grandfathered in 1938 that’s making plenty of money right now. They’re going to spend 500 million to $1 billion to get a biologics license application. Why would they do that? Well, we’re about to find out. Most otherDTE manufacturers, smaller companies like Acela Pharmaceuticals, which makes NP-thyroid, and RLC Labs, which made WP-thyroid, do not have those same resources. And this is cited in Pharma Voice in 2025. Why a treatment older than the FDA is getting new regulatory scrutiny. So when you petition the FDA to reclassify a drug in a way that requires this type of expensivetime-consuming biological approval, you’re not just asking for safety. You’re asking to eliminate your competitors from the marketplace. Now, I want to be very precise here. These allegations are documented in federal court filings, and it hasn’t been approved in court. It’s also been reported by multiple industry sources, including Fierce Pharma. But I’m telling you,what has been reported in legal proceedings, not stating it as an absolute fact because you deserve to know the difference and because I have to protect my license. Now, what do we know for certain?AbbeVee is working on a biologics license application for Armour thyroid through clinical trials called Avantia. This is cited by the AbbeVee corporate statement 2025 Avantia clinical trial for Armour thyroid. A cell of pharmaceuticals has been pursuing BLA approval for NP thyroid for seven years since 2017 and it completed its phase two trials successfully in 2025. They’re now moving Deb (20:15.448)into Phase 3 trials. This is also cited by the Acela Pharmaceuticals CEO statement 2025 seven-year pursuit for BLA approval completed Phase 2 trials moving to Phase 3.RLC Labs, which manufactured WP thyroid, has made no public announcement about pursuing BLA approval and really probably don’t have a plan to do this since they’ve been off the market for some time now. About five years, I think maybe a little longer. Here’s the market manipulation.If only ABBV is successful and obtains a BLA approval for Armour thyroid, that company would effectively have a monopoly on the DDT market. And in pharmaceutical markets, monopolies historically lead to price increases.We’ve seen this pattern over and over again when turning pharmaceuticals acquired Daraprim and raised their price from $13.50 to $750 per tablet overnight. When Myelin raised EpiPen increased prices by 400 % when insulin manufacturers colluded to raise prices in lockstep. This is the playbook.use regulatory barriers to eliminate your competition and then exploit pricing power. For a drug that’s been on the market since the 1800s, guess corporate greed is everywhere. They’re not making enough money on this product already and they’re taking advantage of the rules that they can manipulate their competition by. And here’s what really makes me furious. The American Thyroid Association, the professional organization Deb (22:06.672)representing endocrinologists sent letters to the FDA commissioner on October 8th of 2025 and September 18th of 2025.advocating for continued patient access to DTEs. This is cited in the American Thyroid Association statement and letter to the FDA commissioner dated October 8th, 2025 and September 18th, 2025. The American Association of Clinical Endocrinologists issued a statement on September 9th of 2025 supporting equitable access and personalized medicine for DTE. This was also cited in the American AssociationAssociation of Clinical Endocrinologists, AACE, statement dated September 9th, 2025. Even the medical establishment, which has historically favored levothyroxine, is saying, wait, this is going too far. Patients need access to this medication. But the FDA is moving forward anyway. Why? Well, where does it always lead us? Follow the money trail.Okay, so I need to explain what a biologics license application actually is because this is where the rubber meets the road for what’s going to happen to pricing and availability. What is a BLA?A BLA is a biologics license application. It’s a formal request submitted to the FDA to market a biologic product in the United States. A biologic is defined under the Public Health Service Act section 351 as a product derived from or made using living material, in this case, animal thyroid glands. And this is cited in the FDA definition for biologic products. So they’re putting armor thyroid right Deb (23:57.377)right up with stem cells and exosomes. Think about that. Stem cells and exosomes cost thousands of dollars per application because of how they have to be harvested, stored, freezed, all of that. But we’re talking about a thyroid gland. Good Lord, people.Unlike regular drug applications for synthetic medications which follow a simpler pathway, the BLA process is designed for complex biological products like monoclonal antibodies, vaccines, and gene therapy products. It’s a much more expensive, much more time-consuming process. The BLA processis what manufacturers have to do. And we’re going to talk about that. So according to Reprocell and Forge Biologics analysis of the FDA’s BLA process, here’s what companies need to submit. First, they need to complete a clinical trial data, phase one, two, and three trials, proving safety and efficacy for desiccated thyroid. Haven’t we done that since it’s been on the market since the 1800s? Just saying.This means they have to conduct large randomized controlled trials comparing it to levothyroxine, measuring safety outcomes, efficacy outcomes, and quality of life metrics. Second,Chemistry, Manufacturing and Controls, CMC’s data. Detailed information about how the product is manufactured, quality control measures, stability testing and specifications that must be met for every batch. Third, preclinical and animal safety data. Fourth, labeling and product information. Now, I think we have labeling and product information. Deb (25:53.717)since the 1800s? But just saying. Fifth, they need Pharma Covigilance Plan, a detailed plan for monitoring safety after the product is on the market. Haven’t they had to do that since the 1800s? And they have to have a timeline. And this is the critical part. The FDA’s standard review time for a BLA is 10 months.That’s after the application is deemed complete and accepted for filing. So this is cited by the FDA standard review timeline, BLA submission, and FDA review.Now, before you even get to filing, you need to conduct the clinical trials and compile all the data that’s typically several years of work. How are you going to prove safety and effectiveness in a large clinical trial long term? What do they consider? What do they deem long term? Three months, six months, a year, two years. These companies had 10 months.Well, maybe 12. They did it a year in advance. But unless you knew this was coming, how are you going to put together a trial, enroll the people, have all the trial components set up and ready to go in less than 12 months unless you knew it was coming beforehand? Even ifhad started all their clinical trials in 2024, completing them, compiling the data, and getting a complete application ready for submission, this would likely take you through mid-2026, then add another 10 months for FDA review. We’re looking at 2027 at the earliest for most of these companies to receive a BLA application. Deb (27:54.319)But the FDA gave the manufacturers until August of 2026. That’s approximately 19 months from when the August 2025 letters were sent. Most companies cannot reasonably complete the BLA approval in that timeframe. And when I’m talking about the 19 months, I’m talking about the information they would have had earlier. Now the cost.This gets me even more frustrated. Why are we spending this kind of money? The BLL process is extraordinarily expensive. The current FDA user fee for a BLA submission is approximately $483,560 just for the filing fee. And this is cited at the FDA user fees prescription drug user fee rates for 2025.The full cost of conducting clinical trials, CMC studies, and all the supporting documentation typically ranges from $500 million to over $1 billion, depending on the scope of the trials and the complexity. And this is cited in JAMA’s network, Open2023. A cell of pharmaceuticals has been pursuing the BLA approval since 2017. That’s eight years. And it’s just now.moving into phase three trials with a planned enrollment of approximately 300 patients. This is cited by the Acela Pharmacies CEO statement of 2025. Now that’s unusual. That’s typical for this process. This is not unusual. This is typical for this process to take seven, 10 years to get approval for this. So if Abby’s the one that requested this,Abby V. And Acela started this in 2017. Was Abby V threatened by Acela that Acela might get this approval and it would be quietly done without anybody seeing it? And maybe Abby V would be left out of the market after a century? Who knows? It’s possible. Deb (30:13.112)But for smaller manufacturers without billions in revenue, this cost is completely prohibitive. And this is why this matters. When you push an old established medication through an extraordinary, expensive approval process with a compromised timeline, one of three things happen. First, only the largest companies can afford it, creating a monopoly. And when that happens, the company that holds the only approved product can set pricing withminimal competitive pressures. Two, smaller manufacturers can’t afford it and their products disappear and the market shrinks and access decreases. Three, we see a combination of both and who pays the price? Literally, patients do. Now here’s whereThere’s something I want you to really think about because this is where the regulatory argument falls apart when you look at it carefully. The FDA’s concern about DTE is that, and I’m quoting their official statement, tablets from the same manufacturing batches may not always provide the same thyroid hormone levels. This is from their FDA statement.And that’s a legitimate quality concern, right? It is. Thyroid medications have a narrow therapeutic window like any other hormone, meaning the difference between an effective dose and the dose that causes problems can be quite small. But here’s what the FDA doesn’t emphasize. Generic drugs have the exact same dosing inconsistency issue, and it’s considered acceptable and has been since we allowed generics on the market.So how does a generic drug dose work anyway? Well, for generic drugs to be approved as bioequivalent to a brand name medication, the FDA requires that the generic drugs bioavailability fall within 80 to 125 % of the brand name product. Isn’t that a dose inconsistency? Deb (32:22.894)from the brand name medication? 800 or sorry, 80 to 125%. According to the pharmacy times analysis of the FDA’s bioequivalent standards, the 80 to 125 % bioequivalence rule means that a generic drug can have 20 to 45 % variability compared to the original brand product.Now, most generics are much closer than that. The FDA study data shows that the mean difference for an AUC value between generic and reference products is about three and a half percent in the two year post-Waxman hatch period, and 80 % of the generics fall within a five percent range. But the FDA’s regulations allow for that much higher variability. And this is cited in an FDA study data mean difference for AUC.Now, let me put this in plain language. A patient could take a generic levothyroxine tablet where one batch provides, say, 75 micrograms of an active thyroid hormone. And the next batch from a different manufacturer, a different generic manufacturer, could provide up to 93.75 micrograms, 125 % of that 75. That’s an 18 microgram difference.in the same prescribed dose. Now, this is considered acceptable and patients tolerate it and this system works.Yet the FDA’s argument against DTE is that batch-to-batch inconsistency is unacceptable and requires this expensive biologic approval? That’s a double standard. So why is batch inconsistency acceptable for generic levothyroxine, but supposedly unacceptable for desiccated thyroid? I’ll give you the regulatory answer. Deb (34:29.366)because DDT is a biological product derived from an animal tissue and the FDA considers biological products to require more rigorous control. That’s the regulatory answer, but I’ll give you the real answer.because there’s no billion dollar pharmaceutical company with a patent pending on generic levothyroxine who petitioned the FDA to regulate their competitors more strictly. The inconsistency argument is legitimate, but it’s selectively applied. And that matters when you’re trying to understand whether this is really about patient safety or whether it’s about market control.Now I want to talk about something that hasn’t gotten nearly enough attention in this discussion and it’s something that makes me absolutely furious. What is Armour Thyroid? According to the official prescribing information published by AbbeV and available through rxabbev.com and the FDA’s daily med database, Armour Thyroid contains the following inactive ingredients. Calcium steroid,dextrose derived from corn, mycocrystalline cellulose,sodium starch glycolate and a opadri white coating. Now let’s talk about dextrose. Dextrose is a sugar derived from corn and while manufacturers claim that the corn derived dextrose in armor thyroid is gluten free, here’s the problem. Cross contamination during corn processing can introduce gluten proteins especially if the corn is processed in facilities that also handle Deb (36:18.808)wheat, barley, or rye. Corn sensitivity is extremely common in patients with celiac disease and non-celiac gluten sensitivity, and studies show that up to 50 % of the celiac patients react to corn proteins due to molecular mimicry, and the corn proteins look similar enough to gluten that the immune system attacks them. And this is cited by RestartMD.com.And here’s what’s documented in peer-reviewed medical literature in a 2023 case report published in Case Reports in Endocrinology. These researchers documented five patients with gluten intolerance or celiac who were taking natural desiccated thyroid. Three of those patients also reported lactose intolerance. Now these patients had to switch from DTE to liquid levothyroxine formulations to avoid the inactiveSo here’s my question. If AbbeV becomes the only manufacturer with an approved DTE product and their formulations contain corn-derived dextrose that triggers reactions in celiac patients, what are those patients supposed to do? They can’t take armor because of the corn. They can’t take compounded DTE because the FDA is banning compounding of these biologics. They can’t take NPKsor WP thyroid because those companies may not survive the BLA process. So they’re left with a synthetic version of levothyroxine which may not work for them.Now the NP thyroid and WP thyroid difference. Now here’s what’s interesting according to drugs.com comparison of inactive ingredients and P thyroid and P thyroid has calcium steroid dextrose also derived from corn, mineral oil, multi-crystalline cellulose. Deb (38:19.31)cross carmelicin sodium and a opadri to white. So NP thyroid also has corn-derived dextrose. WP thyroid on the other hand was specifically formulated to be hypoallergenic according to ROC labs, but it’s no longer available and its ingredients were inulin from chicory root and medium chain triglycerides. No corn, no gluten, no common allergies. So todayWe do not have a glandular thyroid, a DTE, that is not potentially contaminated with gluten. Yet, patients with autoimmune thyroid disease are supposed to avoid gluten.Now, some of these people can handle a DTE and many cannot, so that argument could be a mute point. But at the end of the day, the one product that we had that was designated for patients with multiple chemical sensitivities, celiac disease and coron allergies, has been off the market for a long time already.We have a monopoly problem. So if ABBV becomes the only approved manufacturer, patients with these celiac diseases and corn allergies will either be forced to take a medicine that makes them sick and triggers their immune reaction or switch to a synthetic that doesn’t adequately treat their hypothyroidism or choose to go without treatment. This is not hypothetical. This is real patients with real medical needs who are about to lose accessto the only formulation that works for their body. And the FDA’s response is silence. Deb (40:07.69)Now I want to highlight something that hasn’t gotten nearly enough attention in this discussion. Compounding pharmacies. What is a compounding pharmacy? Compounded medications are custom made by licensed pharmacists to meet a patient’s specific needs. Maybe you need a different strength that was commercially available, but you have an allergy to a filler or a dye in the commercial product. Maybe you need a liquid formulation or instead of a tablet or you need a capsule. That’s when compoundingin. And the FDA’s, this is the FDA’s definition of compounding. And for decades, compounding pharmacies have been making desiccated thyroid extract for patients who needed customization. Some patients couldn’t take the commercial products because of the dyes and the fillers, and some needed strengths that were not available. And these compounding pharmacies filled the gap.But reclassification changes everything. When the FDA reclassified DTE as a biologic in 2022 and reinforced that decision in August of 2025, explicitly stated, and I’m quoting directly from the FDA’s official statement, these unapproved animal-derived thyroid medications are not eligible for compounding because these products are regulated as biologic products under the Public Health Service Act.How can that be? These products have been approved since 1938 and the Biologics Act didn’t go into effect or doesn’t go into effect until August of 2026.So how in 2022 were they able to say that the compounding pharmacies could not make these products? Anyway, what this means is after August 2026, compounding pharmacies will no longer be permitted to compound a desiccated thyroid extract, even for patients with specific medical needs. Now, compounding pharmacies can still compound T4 and T3 separately, synthetic versions of levothyroxine and liothyronine, according to Deb (42:12.728)healing dose compounding pharmacy. These pharmacists can create custom ratios of these two synthetic hormones to approximate what a patient was receiving from a DTE. But that’s not the same thing. Some patients respond better to the whole DTE preparation than to a compounded synthetic combination. And for patients with specific allergies to standard fillers like your celiac patients that I just talked about, losing the ability to get a compounded DTE alternative isreal hardship. This is going to be a ripple effect. For a subset of patients, maybe 5 to 10 percent of those on DTE compounding was their lifeline and it was their way to get a medication formulation that worked for their unique body. When compounding goes away, these patients lose that option as well and for some it will be a significant problem. Now let’s talk about what this likely means for your wallet.The current pricing right now, according to SingleCare and GoodRx, Armour Thyroid costs approximately $150 to $157 for a 90-day supply of 60-milligram tablets, about $1.67 per tablet. With discount cards, some patients can get it down to $101 to $152 for a 90-day supply.Generic levon thyroxine costs about $70 for a 90 day supply, less than half that price. And p-thyroid costs approximately $133 for a 90 day supply of 60 milligrams with a discount card about $83 to $101.What happens after we get BLA approval? Well, here’s the pharmaceuticals pricing model. When a company spends 500 million to $1 billion to bring a product to market, including conducting massive clinical trials, the cost tens of millions of dollars they recoup in that investment through pricing power. And this is cited in the pharmaceutical pricing models. If ABBIEV is the only company with an approved BLA of DTE, Deb (44:18.248)They have pricing power. They don’t have competitors. They can set their price, whatever they want. And historically, when drugs transition from grandfather status, which is basically unregulated to formal formally approved status, prices often increase significantly, not always, but often. And typically they have to get re-approval for insurance. SoTouring Pharmaceuticals acquired DARPM and raised the price again from $1,350 to $750 overnight, a 5,000 % increase. This is the playbook.Let’s talk about insurance coverage. This is the other consideration. Insurance companies sometimes have different coverage policies for approved versions versus unapproved drugs. And right now, many insurance plans cover armor thyroid or NP thyroid, even though they’re technically unapproved because they’ve been on the market for decades and patients are on them. Once a drug becomes formally approved, insurance companies may have new contractual relationships, prior authorization requirements, or preferred drugs.list that could affect your coverage. If 1.5 million people have to get a prior auth for their insurance to cover this new medication, this is going to drive the doctor’s offices crazy. We do not have the staff to man this. We do not have the manpower. We do not have the time. This is going to interrupt people’s ability to get their medications. This is going to create chaos within the system. And some patients might see better coverage, but manymost likely are going to see worse coverage and some might find themselves in a situation where they need to try to get the drug approved first or get an approval for something else like levothyroxine and they’re going to have to document that it didn’t work and the documentation that they had from 20 years ago is probably not going to be enough because it’s not documented anywhere. It’s lost in the system after 10 years. So for patients the practical takeaway is expect Deb (46:25.774)a price increase. I would say possible, but I don’t think that’s true. think you’re going to see a price increase if they get approved. Expect possible insurance complexities, budget accordingly, talk to your insurance company now about what your coverage is going to look like in 2027 if they even know. And if you want my honest assessment of what is likely to happen,I’ll give you a scenario, 30 % likelihood. The FDA enforces the August 26 deadline and DTE products not approved by then are pulled from the market. Patients will have 30 to 90 days to transition to other medications. Some patients suffer significant symptom relapse. Compounding for DTE becomes illegal and this disruptiveness of the system creates a real hardship. Scenario two.which is 50 % likely. This is actually what the FDA commissioner, Marty McCreary suggested on August 13th of 2025 when he posted on social media. The FDA is committed to pursuing the first ever approval of desiccated thyroid access pending results of the ongoing clinical trials. In the meantime, we’ll ensure access for all Americans. Hopefully that continues. What this likely means is the FDA uses enforcement discretion to allow continuedsales while approvals are being pursued and the deadline gets extended. Maybe patients get access for another two to three years while companies work on a BLA approval. This would be the least disruptive scenario, but it’s also legally uncertain because the enforcement letters have been formally rescinded. And scenario three, which is 20 % likelihood, one or two companies get BLA approval. Those products stay on the market at higher product prices and companies, products, other companiescompanies, products are pulled, the market shrinks, availability is limited, prices are higher, but patients can still get something. This is likely if a seller successfully completes phase three trials for NP-thyroid. And my assessment is based on the regulatory language and the enforcement letters that have not been rescinded yet, that the pattern of FDA enforcement, I believe scenario two enforcement discretion with an extended time frame is most likely what we’re going to see. Deb (48:49.488)doesn’t mean patients should sit back and do nothing. It means you should be prepared for change while advocating for access. If you want to keep Arm or Thigh Right on the market, 1.5 million people need to start talking about this publicly and flooding our Congress people, Bobby Kennedy, the FDA, with what you want to see happen. We have the ability to shape this and to change this with our voice. But if we sit back on our laurels and we do absolutelynothing. What is going to happen is what the FDA wants to have happen and ABV wants to have happen because they’re going to simply think people don’t give a shit. And if the American people are going to be lazy and not want to step forward and actually start using their voice for some good and instead of just going to social media and bitching and hoping something is going to happen, well, then we’re going to get what we deserve. But if you start taking someaction and you start advocating for the things that you want. Contacting your representatives, contacting your U.S. tell them the FDA has done this. Many of them may not know this, may not be on their radar. Tell them what you want. Start going after this. Start writing to the FDA Commissioner’s Office. They have a website. They have a Commissioner’s Office at fda.hhs.gov. Be responsible.respectful, but be firm. Explain your scenario. How long you’ve been on DTE. Why levothyroxine doesn’t work. What symptoms you experience when not adequately treated. How this decision will affect your quality of life and your pocketbook. Let’s do something proactive. So let’s consider this. Moving forward, work with your provider who understands the regulatory landscape around DTE. You can discuss the evidence for and against combination therapy.You can monitor for thyroid function with free T3 and free T4 testing, not just TSH. If you’re willing to try individualized approaches, you can do that. If you need help finding a functional medicine provider who understands this issue, come to serenityhealthcarecenter.com or explorethevanari.com. It’s a self-directed functional medicine support group. And right now what is happening is going to shape how history Deb (51:19.024)is made with not just armor thyroid, but many drugs to come. And it is important for you to take action. So I want to thank you for joining me today on Let’s Talk Wellness Now. This episode is about far more than thyroid medication. It’s about your right to personalized medical treatment. It’s about your regulatory capture and corporate influence. And it’s about what happens when billion dollar companies shape healthcare policy in ways that reduce patient choice and increase their profits.this episode resonates with you or you know somebody who’s going to be affected by desiccated thyroid, please share it. Post it on social media, send it to your doctor, email it to your representatives, tag AbbeVee, tag FDA. Make noise because the only way we stop this is if we make it too politically costly for them to continue. Your voice truly matters. Your health truly matters and you deserve access to treatments that work best for your unique body.If you’re ready to explore comprehensive personalized health care that puts you in control, visit us at SerenityHealthCareCenter.com. Learn more about functional medicine approaches to thyroid and beyond and explore my new platform, Venari.com, which is a self-directed functional medicine tool. Thank you for joining me today. Until next time, I’m Dr. Deb reminding you, your health is your responsibility, your choice, and your right. Be well, stay informed, fight back.and I’ll see you in the next episode. And if you’re looking for a full citation list of this episode, you can head over to letstalkwellnessnow.com and I will post all the citations for you so you have them in your arsenal as well. Thank you again.The post Episode 259 – The Desiccated Thyroid Crisis: FDA's Unseen Impact & Corporate Manipulation first appeared on Let's Talk Wellness Now.
Dietitians Aidan Muir & Torwen Eerkens are back with another Q+A. (00:33) NAD+ Supplements (2:09) Water Weight From Creatine Supplementation (3:36) Dextrose to Increase Carbohydrate Intake (5:02) Adequate Micronutrients with Textural Sensitivities (6:01) RAVES for Managing Binge Eating Disorder (8:20) PHGG Supplementation (9:12) Reversing Lost Bone Mineral Density (12:37) Do You Need Protein Immediately After Training? WEBSITE: https://www.idealnutrition.com.au/ PODCAST: https://www.idealnutrition.com.au/podcast/ INSTAGRAM: https://www.instagram.com/idealnutrition__/?hl=en Our dietitians
Chronic pain, especially low back pain, is a global struggle—but what if relief was just two minutes away? Dr. Marianne Pinkston welcomes Dr. Hélène Bertrand, a physician and innovator who shares her personal and professional journey to finding effective, integrative solutions for intractable pain. In this episode, you’ll learn about: The Two-Minute Low Back Pain Exercise: Dr. Bertrand details her personal 39-year battle with back pain and how she discovered a simple, two-minute technique to realign the sacroiliac (SI) joints in the pelvis, offering a 90% success rate for immediate relief. She even demonstrates how to self-check for SI joint displacement. Prolotherapy for Ligament Pain: Discover how a few simple injections of "sugar water" (dextrose/mannitol) can stimulate healing in loose ligaments, like those that stabilize the SI joints, ending chronic pain where traditional methods fail. A Breakthrough Pain Cream: Dr. Bertrand explains the science behind her innovative cream, which uses mannitol to block pain messages at the nerve level. Hear the compelling research that shows this cream provides a 53% average pain relief, significantly outperforming common over-the-counter and prescription medications. Practical Tools for Support: Learn about using a pelvic support belt and a donut cushion to maintain pelvic alignment and prevent pain flare-ups. Connect with Dr. Bertrand: Her book: Low Back Pain: Three Steps to Relief in Two Minutes (available on Amazon). Her website for webinars and courses: no-pain.ca Resources to find Prolotherapy (Orthopedic Medicine) providers. Disclaimer: As Dr. Pinkston advises, please consult your physician before starting any new treatment or making changes to your healthcare routine. See omnystudio.com/listener for privacy information.
Contributor Jordan Folks joins Marshall to chat about naturally carbonating beer, focusing specifically on the impact using different priming sugars has and going over an xBmt comparing dextrose to Belgian candi syrup. The Brülosophy Podcast is brought to you by Imperial Yeast who provide brewers with the most viable and fresh yeast on the market. Learn more about what Imperial Yeast has to offer at ImperialYeast.com today. | Relevant Article | Natural Carbonation: Belgian Candi Syrup vs. Dextrose In A Trappist Single
Author of “Restored Hope: A Neuroscience Guide to Optimal Brain and Human Function,” Dr. David Stephens shares his experience using glucose (dextrose) to improve many chronic diseases. This is a totally new concept for me and I am curiously learning about this philosophy along with you! Dr. Stephens talks about his research into and clinical outcomes using glucose to rebalance the brain to improve cognition, emotional well being, and overall health. He discusses brain injuries, including emotional trauma, that have resulted in “glucose-limiting events” and his success in helping people recover. To learn more, including a list of pertinent research, visit Dr. Stephens' website https://www.restoredhumanity.com/s/home.php .To work with Dr. Stephens, contact him on his cell phone at 573-590-4638 or via his email at drstephens@restoredhumanity.com The maintenance dose of glucose/dextrose depends on individual stress and exertion levels. It is typically 20 to 25% of the restoration dose and is taken one to two times a day rather than three times a day. Feel free to contact Dr. Stephens for questions and details. Visit my website DrDebbieOzment.com for valuable free downloads. Additionally, you will find shopping links which I have curated on the website. Please follow me on instagram at drdebbieozment.
Dr. Mindy talks about the Weather, Halloween plans and then she answers questions about Munchausen Syndrome, memory loss, tingling breasts, subchorionic bleeding, HPV, Zepbound, Menopause, the difference between a cold and COVID, waking up at the same time every night, OTC sleep meds, Dextrose, what do her kids play in band and the Dr. Mindy Experiment. See omnystudio.com/listener for privacy information.
Herzlichen Dank an unsere WERBEPARTNER:https://www.carnivoro.eu/collections/all-products: Supplemente rund um die Carnivore Ernährung Mit dem Gutscheincode CARNITARIER erhältst du 10 % Rabatt auf deinen ersten Einkauf! Affiliate Link: www.carnivoro.eu/carnitarierin https://www.kaufnekuh.de/de: Fleisch aus artgerechter Haltung mit fairen Preisen für Landwirte Mit dem Gutscheincode CARNITARIER erhältst du 10 € Ermäßigung auf deinen Einkauf ab 50 €. _____________________________________________________________Folge 163: Dirk Liesenfeld – Hardcore-Veganer, dem Tod nahe, durch Fleisch gerettetAls Hardcore-Veganer mit 54 am Ende des Lebens. So fühlte sich Dirk Liesenfeld nach 40 Jahren Ideologie als Fleischverächter. Diese Verblendung hatte ihn zu folgenden Gebrechen geführt: Migräne mit Sehstörungen, Erbrechen, Mouche volants, Untergewicht trotz Leistungssport, Hautprobleme, Gelenkprobleme, zweimalige Bandscheibenvorfälle, Schlaflosigkeit, Entzündungen, Schwellungen, verstopfte Nase, Arthritis, Rheuma, Eitertaschen im Mund, Tinnitus, Blähbauch, Schweißausbrüche.Er ahnte, dass das Ende seines Lebens gekommen ist, wenn er so weitermacht. Durch das Wiedereinführen von Fleisch ist seine Gesundheit zu 20 % wiedergekommen, durch das Einführen von Dirty Carnivore zu weiteren 30 %. Mit PKD (paleolitische ketogene Diät) ging es dann noch weiter bergauf. Sein Zonulintest deutete auf einen stark undurchlässigen Darm hin. Er nahm zwar an Gewicht ab, aber sein Spiegelbild zeigte ihm, dass es gut war. Der Fettanteil sank, der Wasseranteil auch, aber die Muskulatur steigte langsam an.Nach längerer Zeit mit PKD fühlte er sich aber dann doch wie ausgemergelt. Er vermutet, dass eine zu geringe Insulinausschüttung kaum noch anabole Signale erbrachte. So nahm er ganz wenige Kohlenhydrate in Form von Reis und Dextrose zu sich. Damit ging es wieder bergauf. Heute ist er besser fettadaptiert als zu Beginn der Carnivoren Reise, so dass er wieder mehr Fett inkludiert und nun ein Weglassen der kleinen Kohlenhydratmengen immer besser möglich ist. ___________________________________________________________ Fleischzeit ist der erste deutschsprachige Podcast rund um die carnivore Ernährung. Hier erfahrt ihr Tipps zur Umsetzung des carnivoren Lifestyles, wissenschaftliche Hintergründe zur Heilsamkeit sowie ökologische und ethische Informationen zum Fleischkonsum. Eine Übersicht über alle Folgen findet ihr hier: www.carnitarier.de/fleischzeitpodcast Andrea Siemoneit berichtet nach über drei Jahren carnivorer Ernährung über ihre Erfahrungen und Erkenntnisse. Außerdem interviewt sie andere Carnivoren und Wissenschaftler. Ihr findet sie auf Instagram unter https://www.instagram.com/carnitarierin/ Handbuch der Carnivoren Ernährung: https://carnitarier.eu/collections/bucher ⎯ #carnitarier #carnetarier #carnivor #carnivoreernährung #carnivorediät #fleischbasiert #keto #lowcarb #ketogeneernährung #ketogeneernaehrung #paleo #paleoernährung #ohnezucker #zuckerfrei #paleodiät Haftungsausschluss:Alle Inhalte im Podcast werden von uns mit größter Sorgfalt recherchiert und publiziert. Dennoch übernehmen wir keine Haftung für die Richtigkeit, Vollständigkeit oder Aktualität der Informationen. Sie stellen unsere persönliche subjektive Meinung dar und ersetzen auch keine medizinische Diagnose oder ärztliche Beratung. Dasselbe gilt für unsere Gäste. Konsultieren Sie bei Fragen oder Beschwerden immer Ihren behandelnden Arzt.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode931. In this episode, I'll discuss an alternative to a dextrose-based purge solution for patients with an Impella ventricular assist device that also need a PET scan. The post 931: Non-dextrose purge solution for patients with an Impella that require a PET scan appeared first on Pharmacy Joe.
Essa foi uma semana de recomeços para quem vive no RS. Apesar do barulho dos helicópteros em alguns momentos do episódio, estamos retornando com os nossos programas regulares. Neste episódio do Journal Club, trazemos os seguintes artigos para vocês:1. Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula A Randomized Clinical Trial - Resultados do Neurodesenvolvimento de Prematuros Extremos Alimentados com Leite Humano de Banco ou Fórmula de Prematuro - Um Ensaio Clínico RandomizadoExiste diferenças em relação ao neurodesenvolvimento com dois anos de idade, quando comparamos uso de leite humano de banco e fórmula para prematuros?Descubra em: https://jamanetwork.com/journals/jama/article-abstract/2814657?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jama.2023.27693 2. Dextrose gel prophylaxis for neonatal hypoglycaemia and neurocognitive function at early school age: a randomised dosage trial - Profilaxia com gel de dextrose para hipoglicemia neonatal e função neurocognitiva em idade escolar precoce: um ensaio clínico randomizado O uso da profilaxia para hipoglicemia utilizando gel de dextrose é capaz de reduzir prejuízos ao desenvolvimento neuropsicomotor?Disponível em: https://fn.bmj.com/content/early/2024/02/12/archdischild-2023-3264523. Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk: a randomized controlled trial - Efeito da fortificação à base de leite humano em prematuros extremos alimentados exclusivamente com leite materno: ensaio clínico randomizado e controladoVale a pena investir no fortificante de leite materno a base de leite humano? Descubra em: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2823%2900552-7 4. Randomised study of a new inline respiratory function monitor (Juno) to improve mask seal and delivered ventilation with neonatal manikins - Estudo randomizado de um novo monitor de função respiratória (Juno) para melhorar a vedação da máscara e a ventilação em manequins neonataisQue a vedação da máscara é importante para a eficácia da VPP na reanimação neonatal não há dúvidas. Esse artigo mostra formas de detectar a vedação e corrigir a técnica em manequins. Disponível em: https://fn.bmj.com/content/early/2024/02/09/archdischild-2023-326256 Não esqueça: você pode ter acesso aos artigos do nosso Journal Club no nosso site: https://www.the-incubator.org/podcast-1 Se estiver gostando do nosso Podcast, por favor deixe sua avaliação no seu aplicativo favorito e compartilhe com seus colegas. O nosso objetivo é democratizar a informação. Se quiser entrar em contato, nos mandar sugestões, comentários, críticas e elogios, manda um e-mail pra gente: incubadora@the-incubator.org
In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Gary Tse about the innovative technique of thyroid ablation and its role in treating benign thyroid nodules. Dr. Tse is a practicing interventional radiologist at UCLA Health. Dr. Tse highlights the procedural details, patient experiences, potential complications, and follow-up protocols of thyroid ablation. He emphasizes the importance of consistent communication with patients during these procedures, given that the patients are under minimal anesthesia. He explains how interventional radiologists can benefit from embracing this procedure due to their expertise in ultrasound usage, as it leads to reduction in recovery times and complications for patients. Dr. Tse also briefly discusses the future potential of thyroid embolization for larger goiters. He encourages other IR specialists to consider adopting this procedure, which he believes should become a standard of care. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Varian Embolization Solutions https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 04:03 - Dr. Tse's Career Journey and Transition to Academics 06:32 - Discussion on Thyroid Interventions 09:15 - Building Referral Patterns for Thyroid Interventions 11:50 - Thyroid Ablation Procedure Overview 21:23 - Post-Ablation Outcomes and Goals 25:52 - Avoiding Complications 32:55 - Post-Procedure Follow-Up 36:14 - Exploring Thyroid Embolization 42:23 - Final Thoughts and Future Prospects --- RESOURCES 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ Recurrent Laryngeal Nerve Injury in Thermal Ablation of Thyroid Nodules-Risk Factors and Cause Analysis: https://pubmed.ncbi.nlm.nih.gov/35311971/ Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation: https://doi.org/10.3803/EnM.2020.35.2.407 Revisiting Rupture of Benign Thyroid Nodules after Radiofrequency Ablation: Various Types and Imaging Features: https://doi.org/10.3803/EnM.2019.34.4.415 Thyroid arterial embolization to treat Graves' disease: https://pubmed.ncbi.nlm.nih.gov/17354140/ Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients: https://www.jvir.org/article/S1051-0443(21)01212-4/fulltext#%20
OutlineChapter 14- Hypovolemic States- Etiology - True volume depletion occurs when fluid is lost from from the extracellular fluid at a rate exceeding intake - Can come the GI tract - Lungs - Urine - Sequestration in the body in a “third space” that is not in equilibrium with the extracellular fluid. - When losses occur two responses ameliorate them - Our intake of Na and fluid is way above basal needs - This is not the case with anorexia or vomiting - The kidney responds by minimizing further urinary losses - This adaptive response is why diuretics do not cause progressive volume depletion - Initial volume loss stimulates RAAS, and possibly other compensatory mechanisms, resulting increased proximal and collecting tubule Na reabsorption. - This balances the diuretic effect resulting in a new steady state in 1-2weeks - New steady state means Na in = Na out - GI Losses - Stomach, pancreas, GB, and intestines secretes 3-6 liters a day. - Almost all is reabsorbed with only loss of 100-200 ml in stool a day - Volume depletion can result from surgical drainage or failure of reabsorption - Acid base disturbances with GI losses - Stomach losses cause metabolic alkalosis - Intestinal, pancreatic and biliary secretions are alkalotic so losing them causes metabolic acidosis - Fistulas, laxative abuse, diarrhea, ostomies, tube drainage - High content of potassium so associated with hypokalemia - [This is a mistake for stomach losses] - Bleeding from the GI tract can also cause volume depletion - No electrolyte disorders from this unless lactic acidosis - Renal losses - 130-180 liters filtered every day - 98-99% reabsorbed - Urine output of 1-2 liters - A small 1-2% decrease in reabsorption can lead to 2-4 liter increase in Na and Water excretion - 4 liters of urine output is the goal of therapeutic diuresis which means a reduction of fluid reabsorption of only 2% - Diuretics - Osmotic diuretics - Severe hyperglycemia can contribute to a fluid deficit of 8-10 Iiters - CKD with GFR < 25 are poor Na conservers - Obligate sodium losses of 10 to 40 mEq/day - Normal people can reduce obligate Na losses down to 5 mEq/day - Usually not a problem because most people eat way more than 10-40 mEq of Na a day. - Salt wasting nephropathies - Water losses of 2 liters a day - 100 mEq of Na a day - Tubular and interstitial diseases - Medullary cystic kidney - Mechanism - Increased urea can be an osmotic diuretic - Damage to tubular epithelium can make it aldo resistant - Inability to shut off natriuretic hormone (ANP?) - The decreased nephro number means they need to be able to decrease sodium reabsorption per nephron. This may not be able to be shut down acutely. - Experiment, salt wasters can stay in balance if sodium intake is slowly decreased. (Think weeks) - Talks about post obstruction diuresis - Says it is usually appropriate rather than inappropriate physiology. - Usually catch up solute and water clearance after releasing obstruction - Recommends 50-75/hr of half normal saline - Talks briefly about DI - Skin and respiratory losses - 700-1000 ml of water lost daily by evaporation, insensible losses (not sweat) - Can rise to 1-2 liters per hour in dry hot climate - 30-50 mEq/L Na - Thirst is primary compensation for this - Sweat sodium losses can result in hypovolemia - Burns and exudative skin losses changes the nature of fluid losses resulting in fluid losses more similar to plasma with a variable amount of protein - Bronchorrhea - Sequestration into a third space - Volume Deficiency produced by the loss of interstitial and intravascular fluid into a third space that is not in equilibrium with the extracellular fluid. - Hip fracture 1500-2000 into tissues adjacent to fxr - Intestinal obstruction, severe pancreatitis, crush injury, bleeding, peritonitis, obstruction of a major venous system - Difference between 3rd space and cirrhosis ascities - Rate of accumulation, if the rate is slow enough there is time for renal sodium and water compensation to maintain balance. - So cirrhotics get edema from salt retension and do not act as hypovolemia - Hemodynamic response to volume depletion - Initial volume deficit reduced venous return to heart - Detected by cardiopulmonary receptors in atria and pulmonary veins leading to sympathetic vasoconstriction in skin and skeletal muscle. - More marked depletion will result in decreased cardiac output and decrease in BP - This drop in BP is now detected by carotid and aortic arch baroreceptors resulting in splanchnic and renal circulation vasoconstriction - This maintains cardiac and cerebral circulation - Returns BP toward normal - Increase in BP due to increased venous return - Increased cardiac contractility and heart rate - Increased vascular resistance - Sympathetic tone - Renin leading to Ang2 - These can compensate for 500 ml of blood loss (10%) - Unless there is autonomic dysfunction - With 16-25% loss this will not compensate for BP when patient upright - Postural dizziness - Symptoms - Three sets of symptoms can occur in hypovolemic patients - Those related to the manner in which the fluid loss occurs - Vomiting - Diarrhea - Polyuria - Those due to volume depletion - Those due to the electrode and acid base disorders that can accompany volume depletion - The symptoms of volume depletion are primarily related to the decrease in tissue perfusion - Early symptoms - Lassitude - Fatiguability - Thirst - Muscle cramps - Postural dizziness - As it gets more severe - Abdominal pain - Chest pain - Lethargy - Confusion - Symptomatic hypovolemia is most common with isosmotic Na and water depletion - In contrast pure water loss, causes hypernatremia, which results in movement of water from the intracellular compartment to the extracellular compartment, so that 2/3s of volume loss comes from the intracellular compartment, which minimizes the decrease in perfusion - Electrolyte disorders and symptoms - Muscle weakness from hypokalemia - Polyuria/poly dips is from hyperglycemia and hypokalemia - Lethargy, confusion, Seizures, coma from hyponatremia, hypernatremia, hyperglycemia - Extreme salt craving is unique to adrenal insufficiency - Eating salt off hands ref 18 - Evaluation of the hypovolemic patient - Know that if the losses are insensible then the sodium should rise - Volume depletion refers to extracellular volume depletion of any cause, while dehydration refers to the presence of hypernatremia due to pure water loss. Such patients are also hypovolemic. - Physical exam is insensitive and nonspecific - Finding most sensitive and specific finding for bleeding is postural changes in blood pressure - I don't find this very specific at all! - Recommends laboratory confirmation regardless of physical exam - Skin and mucous membranes - Should return too shape quickly - Elastic property is called Turgur - Not reliable is patients older than 55 to 60 - Dry axilla - Dry mucus membranes - Dark skin in Addison's disease Frim increased ACTH - Arterial BP - As volume goes down so does arterial BP - Marked fluid loss leads to quiet korotkoff signs - Interpret BP in terms of the patients “normal BP” - Venous pressure - Best done by looking at the JVP - Right atrial and left atrial pressure - LV EDP is RAP + 5 mmHg - Be careful if valvular disease, right heart failure, cor pulmonare, - Figure 14-2 - Shock - 30% blood loss - Lab Data - Urine Na concentration - Should be less than 25 mmol/L, can go as low as 1 mmol/L - Metabolic alkalosis can throw this off - Look to the urine chloride - Figure 14-3 - Renal artery stenosis can throw this off - FENa - Mentions that it doesn't work so well at high GFR - Urine osmolality - Indicates ADH - Volume depletion often associated with urine osm > 450 - Impaired by - Renal disease - Osmotic diuretic - Diuretics - DI - Mentions that severe volume depletion and hypokalemia impairs urea retension in renal medulla - Points out that isotonic urine does not rule out hypovolemia - Mentions specific gravity - BUN and Cr concentration - Normal ratio is 10:1 - Volume depletion this goes to 20:1 - Serum Na - Talks about diarrhea - Difference between secretory diarrhea which is isotonic and just causes hypovolemia - And osmotic which results in a lower electrolyte content and development of hypernatremia - Talks about hyperglycemia - Also can cause the sodium to rise from the low electrolyte content of the urine - But the pseudohyponatraemia can protect against this - Plasma potassium - Treatment - Both oral and IV treatment can be used for volume replacement - The goal of therapy are to restore normovolemia - And to correct associated acid-base and electrolyte disorders - Oral Therapy - Usually can be accomplished with increased water and dietary sodium - May use salt tablets - Glucose often added to resuscitation fluids - Provides calories - Promotes intestinal Na reabsorption since there is coupled Na and Glucose similar to that seen in the proximal tubule - Rice based solutions provide more calories and amino acids which also promote sodium reabsorption - 80g/L of glucose with rice vs 20 g/L with glucose alone - IV therapy - Dextrose solutions - Physiologically equivalent to water - For correcting hypernatremia - For covering insensible losses - Watch for hyperglycemia - Footnote warns against giving sterile water - Saline solutions - Most hypovolemic patients have a water and a sodium deficit - Isotonic saline has a Na concentration of 154, similar to that of plasma see page 000 - Half-isotonic saline is equivalent to 550 ml of isotonic saline and 500 of free water. Is that a typo? - 3% is a liter of hypertonic saline and 359 extra mEq of Na - Dextrose in saline solutions - Give a small amount of calories, otherwise useless - Alkalinizing solutions - 7.5% NaHCO3 in 50 ml ampules 44 mEq of Na and 44 mEq of HCO3 - Treat metabolic acidosis or hyperkalemia - Why 44 mEq and not 50? - Do not give with calcium will form insoluble CaCO3 - Polyionic solutions - Ringers contains physiologic K and Ca - Lactated Ringers adds 28 mEq of lactate - Spreads myth of LR in lactic acidosis - Potassium chloride - Available as 2 mEq/mL - Do not give as a bolus as it can cause fatal hyperkalemia - Plasma volume expanders - Albumin, polygelastins, hetastarch are restricted to vascular space - 25% albumin can pull fluid into the vascular space - 25% albumin is an albumin concentration of 25 g/dL compare to physiologic 4 g/dL - Says it pulls in several times its own volume - 5% albumin is like giving plasma - Blood - Which fluid? - Look at osmolality, give hypotonic fluids to people with high osmolality - Must include all electrolytes - Example of adding 77 mEw of K to 0.45 NS and making it isotonic - DI can be replaced with dextrose solutions, pure water deficit - Case 14-3 - Diarrhea with metabolic acidosis - He chooses 0.25 NS with 44 mEq of NaCl and 44 NaHCO3 - Talks about blood and trauma - Some studies advocate delaying saline until penetrating trauma is corrected APR about to. Keep BP low to prevent bleeding. Worry about diluting coagulation factors - Only do this if the OR is quickly available - Volume deficit - Provides formula for water deficit and sodium deficit - Do not work for isotonic losses - Provides a table to adjust fluid loss based on changes in Hgb or HCTZ - Says difficult to estimate it from lab findings and calculations - Follow serial exams - Serial urine Na - Rate of replacement - Goal is not to give fluid but to induce a positive balance - Suggests 50-100 ml/hr over what is coming out of the body - Urine - Insensibles 30-50 - Diarrhea - Tubes - Hypovolemic shock - Due to bleeding - Sequesting in third space - Why shock? - Progressive volume depletion leads to - Increased sympathetic NS - Increased Ang 2 - Initially this maintains BP, cerebral and coronary circulation - But this can decrease splanchnic, renal and mucocutaneous perfusion - This leads to lactic acicosis - This can result in intracellular contents moving into circulation or translocation of gut bacteria - Early therapy to prevent irreversible shock - In dogs need to treat with in 2 hours - In humans may need more than 4 hours - Irreversible shock associated with pooling of blood in capillaries - Vasomotor paralysis - Hyperpolarization of vascular smooth muscle as depletion of ATP allows K to flowing out from K channels opening. Ca flows out too leading to vasodilation - Glyburide is an K-ATP channel inhibitor (?) caused increased vasoconstriction and BP - Pluggin of capillaries by neutrophils - Cerebral ischemia - Increased NO generation - Which Fluids? - Think of what is lost and replace that. - Bleeding think blood - Raise the hct but not above 35 - Acellular blood substitutes, looked bad at the time of this writing - Di aspirin cross linked hemoglobin had increased 2 and 28 day mortality vs saline - Colloids sound great but they fail in RCTs - SAFE - FEAST - Points out that saline replaces the interstitial losses why do we think those losses are unimportant - Pulmonary circulation issue - Pulmonary circulation is more leaky so oncotic pressure less effective there - Talks about the lungs be naturally protected from pulmonary edema - Rate of fluid - 1-2 liters in first hour - Suggests CVP or capillary wedge pressure during resuscitation - No refs in the rate of fluid administration section - Lactic acidosis - Points out that HCO can impair lactate utilization - Also states that arterial pH does not point out what is happening at the tissue level. Suggests mixed-venous sample.ReferencesJCI - Phenotypic and pharmacogenetic evaluation of patients with thiazide-induced hyponatremia and a nice review of this topic: Altered Prostaglandin Signaling as a Cause of Thiazide-Induced HyponatremiaThe electrolyte concentration of human gastric secretion. https://physoc.onlinelibrary.wiley.com/doi/10.1113/expphysiol.1960.sp001428A classic by Danovitch and Bricker: Reversibility of the “Salt-Losing” Tendency of Chronic Renal Failure | NEJMOsmotic Diuresis Due to Retained Urea after Release of Obstructive Uropathy | NEJMIs This Patient Hypovolemic? | Cardiology | JAMAAnd by the same author, a textbook: Steven McGee. 5th edition. Evidence-Based Physical Diagnosis Elsevier Philadelphia 2022. ISBN-13: 978-0323754835The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report | BMC Endocrine DisordersSensitivity and specificity of clinical signs for assessment of dehydration in endurance athletes | British Journal of Sports MedicineDiagnostic performance of serum blood urea nitrogen to creatinine ratio for distinguishing prerenal from intrinsic acute kidney injury in the emergency department | BMC NephrologyThe meaning of the blood urea nitrogen/creatinine ratio in acute kidney injury - PMCLanguage guiding therapy: the case for dehydration vs volume depletion https://www.acpjournals.org/doi/10.7326/0003-4819-127-9-199711010-00020?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmedValidation of a noninvasive monitor to continuously trend individual responses to hypovolemiaReferences for Anna's voice of God on Third Spacing : Shires Paper from 1964 (The ‘third space' – fact or fiction? )References for melanie's VOG:1. Appraising the Preclinical Evidence of the Role of the Renin-Angiotensin-Aldosterone System in Antenatal Programming of Maternal and Offspring Cardiovascular Health Across the Life Course: Moving the Field Forward: A Scientific Statement From the American Heart Association2. excellent review of RAAS in pregnancy: The enigma of continual plasma volume expansion in pregnancy: critical role of the renin-angiotensin-aldosterone systemhttps://journals-physiology-org.ezp-prod1.hul.harvard.edu/doi/full/10.1152/ajprenal.00129.20163. 10.1172/JCI107462- classic study in JCI of AngII responsiveness during pregnancy4. William's Obstetrics 26th edition!5. Feto-maternal osmotic balance at term. A prospective observational study
TIME STAMPS: 01:03 “Plans fail when there is no counsel, but with many advisors they succeed.” Prov. 15:22 02:18 Baylee Hogan Montgomery's story of acquiring 3 MILLION VIEWS and 11,000 IG followers after telling her story “BREAKING UP WITH SUGAR!” Backstory and summary of Baylee's journey from the very beginning. 04:00 PREGNANCY & ADHD: Definitely did not make it easy to break up with sugar! 06:37 Why REFINED SUGAR is a CHEMICAL and NOT a FOOD! 11:11 Simple steps to STOP an addiction COLD TURKEY in the first 10 days. 17:07 Can you BUILD MUSCLE FASTER by adding insulin-spiking sugars such as DEXTROSE in your post-workout shake that guy on bodybuilding.com said you should?! 21:35 Heartfelt advice on BEATING SUGAR CRAVINGS. 26:06 How to enjoy SPECIAL EVENTS without eating sugar. 32:14 What is MINDFUL EATING? 38:01 Redirecting your FOCUS when you're experiencing WITHDRAWAL symptoms from quitting eating sugar. 41:04 Spiritual life: PRAYER, being PRESENT, and MEDITATION. 43:31 Fasting. 45:08 Why we can receive MORE BLESSINGS when we SACRIFICE. 46:20 “Jesus lived His entire ministry MOURNING.” -Max Soft 46:52 Why EVERYTHING ELSE TASTES BETTER if you don't eat sugar and highly-palatable processed foods. Baylee's IG: @ bayleerose Mark Ennis Consultations & Coaching Inquiries: https://instagram.com/fitnessbeyondtime01?igshid=YmMyMTA2M2Y= Do you like RIBEYES? Search Carnivore Coaches Corner on any podcast platform for our award-winning NUTRITION PODCAST co-hosted with Coach Mark Ennis! SUPERSET Coaching membership inquiries: https://calendly.com/ssyl/meet-greet
TIME STAMPS: 00:19 Colt's 3 (hopefully) minor injuries from an OUTDOOR HOCKEY TOURNAMENT. 02:48 DAVID CRAWFORD: What are your thoughts on WORKOUT FREQUENCY? 04:00 Basic BEGINNER workout split for someone COMPLETELY NEW to weight training for hypertrophy.08:39 How to EVALUATE YOUR WORKOUT PLAN after the first week to decide whether it is effective or not. 15:30 Summary of our MIND INSIDE MUSCLE MASTERCLASS. 22:14 LISTENER QUESTION: “What are your general thoughts on PRE and POST WORKOUT nutrition?” 27:52 The FOUR THINGS YOU MUST DO do build muscle. (Big surprise, carbs are not one of them). 36:58 DEXTROSE, COCAINE, and other addictive substances.42:10 Colt's “BUCK BELLY” cooking experience–basically pork belly but from a deer. 50:45 Mark's methodology on DELOAD WEEKS and WORKING AROUND INJURIES. 55:55 An inspiring story of making a strong comeback after a ROTATOR CUFF INJURY. 01:05:30 Lessons learned from posing with ROBERT SIKES at YELLOWSTONE FITNESS shortly before he won his WNBF PROFESSIONAL NATURAL BODYBUILDING Pro Status. 01:10:00 A musician's perspective on building your body. Mark Ennis Consultations & Coaching Inquiries: https://instagram.com/fitnessbeyondtime01?igshid=YmMyMTA2M2Y=30-minute consultation with Coach Colt: https://calendly.com/ssyl/1-on-1-consultation-30-min Looking for some mid-workout entertainment and motivation? Stream The SuperSetYourLife.Com Podcast from any platform. We publish every MONDAY and FRIDAY!
Wollt ihr unsere Arbeit unterstützen?Carnitarier UGIBAN: DE98 7016 9388 0000 1849 42oder PAYPAL: info@carnitarier.de Herzlichen Dank an den WERBEPARTNER www.carnivoro.deMit dem Gutscheincode CARNITARIER erhältst du 5 % Rabatt auf deinen ersten Einkauf!Affiliate Link: www.carnivoro.de/carnitarierin Folge 124: Boris Karsten über Bodybuilding und CarnivoreBoris Karsten, 39, Maschinenbauingenieur, betreibt seit vielen Jahren Bodybuilding. Auch er ist über die Bitcoin-Szene auf Carnivore gestoßen. Viele Bitcoiner, sagt er, sind Carnivore, weil sie die Gemeinsamkeit haben, dass sie über den Tellerrand sehen. Für ihn ist Carnivore eine Befreiung, denn durch eine kohlenhydratreiche Bodybuilder Ernährung war er ständig schlapp, müde und hungrig. Wir sprechen des Weiteren über häufige Fehler beim Krafttraining, Muskelwachstum in der Regeneration, Blutzuckerschwankungen bei einer High Carb Ernährung führen zu Schlappheit und häufigem Hunger, Problem der Ballaststoffe bei großen Essensmengen,Dextrose als praktische KH-Quelle, warum Fleisch besser ist als Proteinpulver, Kreatin Supplementation, Anabolika, Testosteroneinnahme und dessen Nebenwirkungen, Wachstumshormone, Liver King, warum ein Bodybuilder kein einfacher Partner für eine Frau ist. Im Interview erwähnt Boris den Bitcoin YouTuber und Carnivore Saifedean Ammous.Ihr könnt Boris erreichen auf Instagram unter @boris_karsten oder auf Facebook unter Boris Karsten. Sein YouTube Kanal lautet ebenso Boris Karsten. Fleischzeit ist der erste deutschsprachige Podcast rund um die carnivore Ernährung. Hier erfahrt ihr Tipps zur Umsetzung des carnivoren Lifestyles, wissenschaftliche Hintergründe zur Heilsamkeit sowie ökologische und ethische Informationen zum Fleischkonsum. Eine Übersicht über alle Folgen findet ihr hier: www.carnitarier.de/fleischzeitpodcastAndrea Siemoneit berichtet nach über drei Jahren carnivorer Ernährung über ihre Erfahrungen und Erkenntnisse. Außerdem interviewt sie andere Carnivoren und Wissenschaftler.Ihr findet sie auf Instagram unter @carnitarierinHandbuch der Carnivoren Ernährung: www.carnitarier.de/shop Haftungsausschluss:Alle Inhalte im Podcast werden von uns mit größter Sorgfalt recherchiert und publiziert. Dennoch übernehmen wir keine Haftung für die Richtigkeit, Vollständigkeit oder Aktualität der Informationen. Sie stellen unsere persönliche subjektive Meinung dar und ersetzen auch keine medizinische Diagnose oder ärztliche Beratung. Dasselbe gilt für unsere Gäste. Konsultieren Sie bei Fragen oder Beschwerden immer Ihren behandelnden Arzt.
Step into the future with Dominic Ortega's last ProgMelodic Therapy mix for 2023. A sonic odyssey that transcends the boundaries of time and space. This seamlessly curated playlist takes you on a journey through the electronic realms, each track a portal to a new dimension of sound. Strap in, and let the beats guide you through a realm where the dance floor meets the stars.The odyssey begins with "Monolith Garden (Original Mix)" by Rodriguez Jr., a pulsating track that subliminally sets the tone for the euphonic adventure ahead. As the beats intensify, Ezequiel Arias and Spencer Brown's "SF to Córdoba (Extended Mix)" invites you to transcend earthly constraints, soaring through the expanse of the universe.Feel the rhythm cascade like droplets of light with Stan Kolev's "Rainbow Warriors (Original Mix)," as Nora En Pure's "Arbora (Extended Mix)" sweeps you into a mystical forest of beats. Ismael Rivas then introduces "Delirium (Original Mix)," a hypnotic composition that weaves through the fabric of time.The journey takes a contemplative turn with "Silent Fortress (Original Mix)" by Paul Hamilton and CaThY K, where ethereal melodies create a tranquil space within the cosmic symphony. PASINDU's "Nirvana (Original Mix)" elevates the experience, immersing you in a state of sonic enlightenment."Shelter of Hearts (Original Mix)" by GMJ and Matter unveils a celestial sanctuary, a haven within the pulsating beats that drive the mix forward. Simos Tagias' "Skyline (Original Mix)" then propels you into the stratosphere, where the dance between rhythm and melody becomes a cosmic ballet."Ascent (Original Mix)" by Meeting Molly is a sonic elevator that lifts you to new heights, preparing the senses for the spiritual revelation that follows in Dextrose's "Moksha (Original Mix)." As the mix reaches its zenith, you're enveloped in a state of euphoria, the culmination of a futuristic sonic pilgrimage.Dominic Ortega's ProgMelodic Therapy Session is more than a collection of tracks; it's a voyage into the unknown, a glimpse into a future where music transcends boundaries and becomes a cosmic force. In 2024, Dominic's focus is to play live at events across the UK and to share his ProgMelodic sound with more fans of this unique sound DNA, and so be sure to follow him on his socials for more news. https://linktr.ee/dominicortega
Assessoria esportiva online e presencial: https://www.leandrotwin.com.br/ E-book Dieta Inteligente - Para Perder Gordura e Ganhar Massa Muscular só R$ 39,90: https://pay.hotmart.com/T77984348A?checkoutMode=10 Curso de Dieta (Monte a sua dieta ainda hoje): https://pay.hotmart.com/G56713152F?checkoutMode=10 Curso de Treino (Como montar seu treino periodizado): https://pay.hotmart.com/U72090251V?checkoutMode=10 Curso Sobre Esteroides Anabolizantes (Não use esteroides antes de fazer este curso): https://pay.hotmart.com/T64303539E?checkoutMode=10 Curso de Suplementação para Praticantes de Musculação: https://hotmart.com/pt-br/club/public/leandro-twin-cursos Grupo do Telegram para promoções de todos os meus produtos: https://t.me/leandrotwin Instagram: https://www.instagram.com/leandrotwin/ Facebook: https://www.facebook.com/oficialleandrotwin?ref=hl Este vídeo é um oferecimento de: Oficial Farma: https://www.oficialfarma.com.br/ Growth Supplements: https://www.gsuplementos.com.br Atenção: As mensagens contidas em todos os vídeos de LeandroTwin não possuem o objetivo de substituir orientação de um profissional (independente da sua área de atuação). O vídeo é informativo. Qualquer rotina iniciada por conta própria é de responsabilidade do próprio.
In this podcast, JPEN Editor-in-Chief Dr. Kenneth Christopher, interviews Dr. Anna Crider, a Cardiology Clinical Pharmacy Specialist in the Department of Pharmacy Emory University Hospital and first author of “Association between dextrose-containing maintenance fluids and phosphorus supplementation during total parenteral nutrition initiation in hospitalized adult patients: a retrospective cohort study” published in the November 2023 issue of JPEN. Business Corporate by Alex Menco | alexmenco.net Music promoted by www.free-stock-music.com Creative Commons Attribution 3.0 Unported License creativecommons.org/licenses/by/3.0/deed.en_US November 2023
Dextrosehttps://www.ncbi.nlm.nih.gov/pubmed/2029097https://www.ncbi.nlm.nih.gov/pubmed/17763842https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415309/https://www.ems1.com/cardiac-care/articles/prove-it-administering-dextrose-during-cardiac-arrest-improves-outcomes-9FP6hslyU2OFNrCX/https://www.foamfrat.com/post/hypoglycemia-in-cardiac-arrestKetaminehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014273/https://www.sciencedirect.com/science/article/abs/pii/S0300957217300394https://pubmed.ncbi.nlm.nih.gov/35586308/https://www.cfp.ca/content/64/7/514.shorthttps://pubmed.ncbi.nlm.nih.gov/15928464/https://www.webmd.com/heart-disease/what-to-know-agonal-breathinghttps://www.mdpi.com/1660-4601/20/4/3654
Contributor Andy Carter chats with Marshall about the differences between using sucrose, aka table sugar, and dextrose in the production of hard seltzer. The Brülosophy Podcast is brought to you by Imperial Yeast who provide brewers with the most viable and fresh yeast on the market. Learn more about what Imperial Yeast has to offer at ImperialYeast.com today. | Relevant Article | Sucrose vs. Dextrose In Hard Seltzer xBmt
Just like May, July has 5 Mondays which gives us a chance to offer up an extra episode of the Prehospital Paradigm Podcast. We're going over a few protocol updates, talking steroids and dextrose concentrations. It's a practical review of some drug box items.
In 1D Talks, Episode 20, Stan "Rhino" Efferding talks to Joe Miller and Justin Harris about his IFBB pro bodybuilding journey, The Vertical Diet, and the science-based research behind the book, training with pro bodybuilders and athletes, being an entrepreneur, and much more!0:53 - Introduction, Yardwork, DIY Projects, & Home Improvements in Las Vegas2:58 - Progress Of Stan's Career & Bodybuilding Competition Comeback At 38 Years Old5:45 - Training with Flex Wheeler & Mark Bell12:20 - Writing The Vertical Diet, Having Time & Resources To Live The Bodybuilder Lifestyle16:42 - Focusing On Dietary Patterns, "Compliance Is The Science"17:35 - Life-Changing Meal Prep Tips, Appliances, Cooking, & Eating Right To Gain Mass24:29 - "Steroids Don't Build Muscle" - Stan's Opinion On Steroids vs. Nutrition26:38 - 4,000 Calorie Diet vs. 5,000 Calorie Diet, White Rice & Dextrose, Carbs & Orange Juice28:25 - Working with 4x World's Strongest Man, Brian Shaw 29:42 - Justin Talks About His Carb Cycling Diet Approach30:41 - Joe Talks About Formal Education, Street Smarts, & Science-Based Research32:08 - Strength Training & Cardio (Bodybuilding HIIT)33:06 - Stan Talks About Research, His University Education, & Speaking The Truth38:06 - Old School Workout Programs, Keto Diets, Monitoring Performance & Health42:08 - The Gurus Of The Industry & Quoting Experts When Helping Clients49:41 - Coaching High-Level Athletes Like MMA Fighters57:30 - Hydration & Sodium Intake For Bodybuilders & Powerlifters vs. Fighters1:05:10 - Building A Career In The Fitness Industry & What Stan Is Up To NowFollow Stan on Instagram: https://www.instagram.com/stanefferding/Support the show** DISCLAIMER **The content on this channel is for entertainment and educational purposes only. 1st Detachment does not provide, endorse, or promote specific medical providers. We do not make warranties to its accuracy, application, and completeness. Our guests share their opinions and views on a variety of complex topics. Always seek advice from qualified medical practitioners. Do not disregard medical advice or delay seeking medical treatment due to the information presented on this channel.Consult with a physician before taking any over-the-counter medications, supplements, or herbs. This channel does not endorse medications, vitamins, or herbs, nor do we condone the use of illegal drugs.Consistent with community guidelines, we do not glorify the use of illegal drugs or the consumption of drugs illegally. A qualified medical professional should make decisions with each patient's health profile, current prescriptions, and medical history in mind.
What is a good starting point for treatment of most metabolic emergencies? How not to miss a serious diagnosis, and what to do with your team so you can all do a better job next time.
In this episode we are joined by Emily Wells and Lauren Russell. These are two of the awesome neonatal nurses who have been a part of AirCare and our neonatal team for the last several years. Will talks with them about some of the basics of neonatal care. Some of the things discussed include APGARs, Dextrose, STABLE, Ventilation and Respiratory management. This episode takes a deep dive into some of the simplest things that these tiny little ones need. Mixing Dextrose https://ajemjournal-test.com.marlin-prod.literatumonline.com/article/S0735-6757(19)30220-7/fulltext https://pemcincinnati.com/blog/521-50-dextrose-volume-hypoglycemia/#:~:text=To%20make%20D10%25%20from%20an,D25%25%20or%20D10%25%20solutions. ETT Sizes https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Assisting_with_elective_intubation_of_the_neonate_on_the_Butterfly_Ward/
In dieser Folge sprechen wir über Zucker und über vermeintlich gesündere Zucker-Alternativen wie Apfelsüße, Agavendicksaft oder Fruchtpulver. Denn Zucker kann sich hinter vielen verschiedenen Namen verstecken. Nicht nur der weiße Haushaltszucker ist Zucker, sondern auch Fruktose, Dextrose oder Glukosesirup. Wie erkennt man Zucker? Und was steckt hinter Werbeslogans wie „weniger süß“, „natürliche Süße“ oder „Süße nur aus Früchten“? Sie erfahren, wie sich diese Süße-Versprechen auf unser Kaufverhalten auswirken und warum sie Produkten oft einen problematischen Gesundheits-Heiligenschein verleihen. Mehr Infos zu Zucker und süßen Werbebotschaften gibt es auf Lebensmittelklarheit.de - Gefördert durch: Bundesministerium für Ernährung und Landwirtschaft aufgrund eines Beschlusses des Deutschen Bundestages
* Black Panther (King of Wakanda) Update!* Champ feeder updates! * FCoTW: Negasonic Teenage Warhead
What is the "Bliss Point"? It sounds awesome, doesn't it? How can something described as blissful be so sinister?You will be shocked to know that food manufacturers have spent millions of dollars to discover the exact proportions of sugar, fat and salt to hook you like a big fish. The bliss point is the exact point at which you eat one bite and then a million more. Gone are the days of food that is satisfying and wholesome. Welcome to the days of manipulation, obesity and BIG money.It is sad that the American food system has come to this. If it comes in a package, you are assured to find an ingredient ending in -ose, which is a synonym for SUGAR. It's hidden in everything as: dextrose, maltose, fructose, glucose, malt syrup and corn syrup. You MUST read labels. This episode isn't all negativity. In addition to giving you the "skinny" on sugar, we also give you tips on how to overcome this addiction. That's right; I said addiction. This isn't about willpower. It's about overcoming the Bliss Point that has been engineered to make you crave MORE.Join us for this enlightening and EMPOWERING episode!Stay Connected!AmeliaWebsite: https://www.thehelpfulplate.com/IG: https://www.instagram.com/thehelpfulplate/CamWebsite: https://www.camoyler.com/IG: https://www.instagram.com/heymomma_cam/TikTok: https://www.tiktok.com/@heymomma_camMidlife Mommas IG: https://www.instagram.com/midlife.mommas/Stay Connected!Amelia Website: https://www.thehelpfulplate.com/ IG: https://www.instagram.com/thehelpfulplate/ Cam Website: https://www.camoyler.com/ IG: https://www.instagram.com/heymomma_cam/ TikTok: https://www.tiktok.com/@heymomma_cam Midlife Mommas IG: https://www.instagram.com/midlife.mommas/ Please share, rate, and review the podcast. We appreciate you! ❤️
When you hear the word "Candyman" do you think of the Sammy Davis Junior hit from the 70's OR that freakishly scary horror movie set in Chicago? Hey, it's a fair question! Well, it's probably better if you think of the guy who owns the LARGEST candy store in North America, and probably, the world. And that's Tom Scheiman of the B.A. Sweetie Company. He bought the original small company 40 years ago and has also purchased iconic brands like Humphrey, Campbell's and, most recently, Olympia to grow and preserve Cleveland's candy and confection history. While candy is in the spotlight Halloween through Easter, Sweetie's massive complex is an all-year destination with an ice cream parlor and a miniature golf course...not to mention just about every kind of candy you could desire...from Jelly Belly beans to Pez to Zagnuts (which have been made since 1930 by Hershey's.) Sours, gummies...I even saw something called Toxic Waste which is "hazardously sour." Enjoy this Halloween-timed episode and take the fam to Tom's place and let everyone run wild...including yourself. This episode is supported by the Kimpton Schofield Hotel, Chef Douglas Katz and Cookin' Genie.
Run! Run! Run! Run!
Trade – Dextrose (D50, D25, D10)Class – Antihypoglycemic MOA – Increases blood glucose concentrationsIndications – Hypoglycemia Contraindications – Intracranial and instraspinal hemorrhage, delirium tremens. Side effects – Hyperglycemia, warmth, burning from IV infusion. Concentrated solutions may cause pain and thrombosis of peripheral veins. Dosing –Hyperkalemia: Adult: 25G of dextrose 50% IV,IOPedi: 0.5 – 1G/kg IV/IOHypoglycemia: Adult: 10-25g dextrose 50% IVPedi: Older then 2 years 2ml/kg of Dextrose 50%Pedi under years old: 2-4 ml/kg of Dextrose 10%
Sukrin USA carries a range of all-natural, zero-calorie and low-carb sugar alternatives, naturally gluten-free, and low-carb and sugar-free chocolates. Sukrin USA's range of products is perfect for those wanting to live a healthier life and even more so for those needing a special diet low in carbs and without sugar. All products are natural, and unprocessed. Sukrin USA is the exclusive importer to the USA of the brand Sukrin, founded in 2007 in Europe. Since the introduction, Sukrin brand has grown to become the dominant health brand within its category in all of Scandinavia and large parts of Europe and numerous awards and honors have been bestowed upon the Sukrin range of products. Web: https://sukrinusa.com/ Follow: @sukrinusa About the show: ► Website: http://www.ashsaidit.com ► Got Goli Gummies? https://go.goli.com/1loveash5 ► For $5 in ride credit, download the Lyft app using my referral link: https://www.lyft.com/ici/ASH584216 ► Want the ‘coldest' water? https://thecoldestwater.com/?ref=ashleybrown12 ► Become A Podcast Legend: http://ashsaidit.podcastersmastery.zaxaa.com/s/6543767021305 ► Review Us: https://itunes.apple.com/us/podcast/ash-said-it/id1144197789 ► SUBSCRIBE HERE: http://www.youtube.com/c/AshSaidItSuwanee ► Instagram: https://www.instagram.com/1loveash ► Facebook: https://www.facebook.com/ashsaidit ► Twitter: https://twitter.com/1loveAsh ► Blog: http://www.ashsaidit.com/blog ► Pinterest: https://www.pinterest.com/1LoveAsh/ #atlanta #ashsaidit #ashsaidthat #ashblogsit #ashsaidit® Ash Brown is a gifted American producer, blogger, speaker, media personality and event emcee. The blog on AshSaidit.com showcases exclusive event invites, product reviews and so much more. Her motivational podcast "Ash Said It Daily" is available on major media platforms such as iTunes, Spotify, iHeart Radio & Google Podcasts. This program has over half a million streams worldwide. She uses these mediums to motivate & encourage her audience in the most powerful way. She keeps it real!
Sukrin USA carries a range of all-natural, zero-calorie and low-carb sugar alternatives, naturally gluten-free, and low-carb and sugar-free chocolates. Sukrin USA's range of products is perfect for those wanting to live a healthier life and even more so for those needing a special diet low in carbs and without sugar. All products are natural, and unprocessed. Sukrin USA is the exclusive importer to the USA of the brand Sukrin, founded in 2007 in Europe. Since the introduction, Sukrin brand has grown to become the dominant health brand within its category in all of Scandinavia and large parts of Europe and numerous awards and honors have been bestowed upon the Sukrin range of products. Web: https://sukrinusa.com/ Follow: @sukrinusa About the show: ► Website: http://www.ashsaidit.com ► Got Goli Gummies? https://go.goli.com/1loveash5 ► For $5 in ride credit, download the Lyft app using my referral link: https://www.lyft.com/ici/ASH584216 ► Want the ‘coldest' water? https://thecoldestwater.com/?ref=ashleybrown12 ► Become A Podcast Legend: http://ashsaidit.podcastersmastery.zaxaa.com/s/6543767021305 ► Review Us: https://itunes.apple.com/us/podcast/ash-said-it/id1144197789 ► SUBSCRIBE HERE: http://www.youtube.com/c/AshSaidItSuwanee ► Instagram: https://www.instagram.com/1loveash ► Facebook: https://www.facebook.com/ashsaidit ► Twitter: https://twitter.com/1loveAsh ► Blog: http://www.ashsaidit.com/blog ► Pinterest: https://www.pinterest.com/1LoveAsh/ #atlanta #ashsaidit #ashsaidthat #ashblogsit #ashsaidit® Ash Brown is a gifted American producer, blogger, speaker, media personality and event emcee. The blog on AshSaidit.com showcases exclusive event invites, product reviews and so much more. Her motivational podcast "Ash Said It Daily" is available on major media platforms such as iTunes, Spotify, iHeart Radio & Google Podcasts. This program has over half a million streams worldwide. She uses these mediums to motivate & encourage her audience in the most powerful way. She keeps it real!
Wed, 24 Nov 2021 22:00:00 +0000 https://zuckerfreies-herz-mit-natalie.podigee.io/5-mein-warum-zuckerfrei-zu-leben c23e7105fb52b0c96c3ee7b0aefeac06 Was war mein Warum zuckerfrei zu leben? Was ist dein Warum? In erster Linie rede ich „erst einmal“ nur vom Industriezucker Ein Leben ohne Industriezucker ist eine Reise zu dir selbst. Das ist ein Lebenswerk, eine Transformation mit vielen wundervollen Erfahrungen. Die dir Freude und Spaß machen soll. Ohne DRUCK OHNE MÜSSEN OHNE STRESS Wie ich es geschafft habe den Industriezucker zu eliminieren, warum ich 8 Monate später auch alle Zuckeralternativen und Süßungsmittel weggelassen habe und welche Erfahrungen ich in dieser Zeit gemacht habe erzähle ich dir heute in dieser Folge. Außerdem gebe ich dir zwei wertvolle Tipps mit Warum viele es nicht schaffen ein zuckerfreies Leben zu führen. Achte beim einkaufen auf folgende Kennzeichnung: ❌ Apfelsüße, Dextrose, Dattelsirup, Dicksaft, Extrakte, Fruchtkonzentrate, Fruchtzucker, Fruktose, Fruktose-Glukose-Sirup, Gerstenmalz, Glucose, Glucosesirup, Honig, Inventurzucker, Joghurtpulver, Karamellsirup, Konzentrierte Fruchtsüße, Laktose, Magermilchpulver, Maissirup, Maltodextrin, Gerstenmalzextrakt, Rohrzucker, Saccharose, Stärkesirup, Traubensirup, Traubensüße, Traubenzucker, Weizendextrin, Zuckerrübensirup ❌ Deine Natalie
Is dextrose keto-friendly? Watch this quick video to find out! FREE COURSE ➜ ➜ https://courses.drberg.com/product/how-to-bulletproof-your-immune-system/ FREE MINI-COURSE ➜ ➜ Take Dr. Berg's Free Keto Mini-Course! ADD YOUR SUCCESS STORY HERE: https://bit.ly/3z9TviS Talk to a Dr. Berg Keto Consultant today and get the help you need on your journey (free consultation). Call 1-540-299-1557 with your questions about Keto, Intermittent Fasting, or the use of Dr. Berg products. Consultants are available Monday through Friday from 8 AM to 10 PM EST. Saturday & Sunday from 9 AM to 6 PM EST. USA Only. Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional & natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government & the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning. Dr. Berg's Website: http://bit.ly/37AV0fk Dr. Berg's Recipe Ideas: http://bit.ly/37FF6QR Dr. Berg's Reviews: http://bit.ly/3hkIvbb Dr. Berg's Shop: http://bit.ly/3mJcLxg Dr. Berg's Bio: http://bit.ly/3as2cfE Dr. Berg's Health Coach Training: http://bit.ly/3as2p2q Facebook: https://www.facebook.com/drericberg Messenger: https://www.messenger.com/t/drericberg Instagram: https://www.instagram.com/drericberg/ YouTube: http://bit.ly/37DXt8C
Commentary by Dr. Usha Tedrow
How did corn syrup get such a bad reputation? While there are certainly differences between this corn-based sweetener and the sugar that comes from beets & cane, the opinions many of us hold about what separates them are rooted in much more than the scant scientific evidence on their differing impact on human health. In this episode, Benjamin Cohen joins us to talk about the history behind the corn syrup controversy, the deep roots that lie beneath our understandings of food and purity, and how understanding this story might help us make better decision moving forward. Dr. Benjamin R. Cohen is Associate Professor of Engineering Studies and Environmental Studies at Lafayette College and co-editor w/ Michael Kideckel & Anna Zeide of the new collection Acquired Tastes: Stories About the Origins of Modern Food (MIT Press, 2021). His previous book, Pure Adulteration: Cheating on Nature in the Age of Manufactured Food (University of Chicago Press, 2019), was the topic of his previous appearance in RTN #161 Food in The Era of Adulteration. Learn more about his work at his personal website or by following him on twitter at @BRCohen95. This episode was edited by Gary Fletcher.
Part I: Olivier Mankondo, The Transformation Olivier Mankondo is a speaker, author, weight loss and wellness coach with a passion for self-help books. He empowers people with the knowledge of a plant-based nutrition so they can make good dietary and lifestyle choices. Throughout his talks, he has been able to inspire and change a lot of people. He is the author of the book, The Plant-Based Nutrition: How It's Going to Change Your Life. Olivier can speak 4 languages including French. Part II: Hartglass & De Mattei, Is there a Future for Lab-Grown Meat? Hartglass & De Mattei continue the conversation on lab-grown meat citing studies that off insight. LINKS MENTIONED IN THE PODCAST Fake meat as fast food. How impressed are Americans? Plant-based menu items are infiltrating fast food — and meat-eaters are all over them Faux Meat Falters at the Drive-Thru Lab-grown Meat is Supposed to be Inevitable. The Science Tells A Different Story. Gary's French Scramble McDonalds French Fries French Fries Ingredients: Potatoes, Vegetable Oil (canola Oil, Corn Oil, Soybean Oil, Hydrogenated Soybean Oil, Natural Beef Flavor [wheat And Milk Derivatives]*), Dextrose, Sodium Acid Pyrophosphate (maintain Color), Salt. *natural Beef Flavor Contains Hydrolyzed Wheat And Hydrolyzed Milk As Starting Ingredients. Contains: Wheat, Milk.
Welcome back to Chat Sh*t Get Fit - Chatting Supplements. This week we explore the world of carbohydrate supplementation focusing on 3 particular types. Cyclic Dextrin (Most Expensive), Maltodextrose and Dextrose (Lease expensive) All have a similar goal of improving performance essentially allowing you to go harder for longer. But are all created equal? We take a look at what these things actually are and then dive into the latest scientific research on them to see if there's any benefit to be had! One particular paper on swimming proved very enlightening! (Although the dose was really high!) We also discuss if it's worth taking these supplements and whom they might be best suited to. Before any supplementation though you should try through your diet hence why towards the end we give some information on what your rough total daily carb intake should be. Footage of Marmiteageddon If you have diabetes please consult a medical professional before any carbohydrate supplement is taken. This goes for everyone but due to the nature of these types of supplements, those with diabetes are at greater health risk. Want to join our fitness community Train Primal? We have 3 different fitness programmes designed for different goals! Primal Life, Primal Fit, Primal Apex. You also have the opportunity to work with us on a 1-1 basis where we provide bespoke online personal training for those of you that are ready to make a real, lasting change and who want the support of expert, personal guidance to get you there. All details for this can be found here. Want to support the Podcast? We have a discount code (PRIMAL10) for a fantastic coffee brand. Cannonball Coffee. Great tasting and super powerful which WILL give you a boost in the gym. We spoke to Cannonball Coffee on a previous podcast and you can listen to that here to see why we are such fans. So if you want to support us in some small way and get some great coffee head to cannonballcoffee.co.uk and use code PRIMAL10 for 10% off any order. New to the show? Head back to episode 1 "Let's Chat, Covid & Fitness" where we give an introduction into who we are and talk about the current state of ourselves and the fitness industry during this covid pandemic Find us on Instagram @bill_trainprimal @coachtomreardon Website: www.chatshitgetfit.com Email: csgfpodcast@gmail.com Studies Mentioned Carbohydrate Supplementation during Exercise Evaluation of Exercise Performance with the Intake of Highly Branched Cyclic Dextrin in Athletes A Sports Drink Based on Highly Branched Cyclic Dextrin Generates Few Gastrointestinal Disorders in Untrained Men during Bicycle Exercise Fluids Containing a Highly Branched Cyclic Dextrin Influence the Gastric Emptying Rate Effects of ingesting highly branched cyclic dextrin during endurance exercise on rating of perceived exertion and blood components associated with energy metabolism Factors limiting gastric emptying during rest and exercise Nutrition, Health, and Regulatory Aspects of Digestible Maltodextrin Fructose Coingestion Does Not Accelerate Postexercise Muscle Glycogen Repletion Carbohydrate requirements of elite athletes Acute Maltodextrin Supplementation During Resistance Exercise ISSN exercise & sports nutrition Ingestion of High Molecular Weight Carbohydrate Enhances Subsequent Repeated Maximal Power Post-exercise ingestion of a unique, high molecular weight glucose polymer solution improves performance during a subsequent bout of cycling exercise Food For Sports Performance Carbohydrates for training and competition
Audiovortrag zum Thema Dextrose Simple und komplexe Fakten und Meinungen rund um dieses Thema aus dem Yoga Blickwinkel von Sukadev, dem Gründer des gemeinnützigen Vereines Yoga Vidya e.V. Dieser Audiovortrag ist eine Ausgabe des Naturheilkunde Podcast. Er ist ursprünglich aufgenommen als Diktat für einen Lexikonbeitrag im Yoga Wiki Bewusst Leben Lexikon. Zum ganzheitlichen Yoga kann man auch die Theorie von Karma und Reinkarnation dazu zählen. In Ayurveda Ausbildungen erfährst du mehr zum Thema Gesundheit und Prävention. Vielleicht magst du ja deine Gedanken dazu in die Kommentare schreiben. Anmerkung: Gesundheitliche Informationen in diesem Podcast sind nicht gedacht für Selbstdiagnose und Selbstbehandlung, sondern Gedankenanstöße. Bei eigener Erkrankung brauchst du einen Arzt oder Heilpraktiker. Hier findest du: Seminare mit Sukadev Seminarübersicht Yoga Vidya YouTube Live Kanal Online Seminare Video Seminare Yoga Vidya kostenlose App Yoga Vidya Newsletter Unseren Online Shop Schon ein kleiner Beitrag kann viel bewegen... Spende an Yoga Vidya e.V.!
Audiovortrag zum Thema Dextrose Simple und komplexe Fakten und Meinungen rund um dieses Thema aus dem Yoga Blickwinkel von Sukadev, dem Gründer des gemeinnützigen Vereines Yoga Vidya e.V. Dieser Audiovortrag ist eine Ausgabe des Naturheilkunde Podcast. Er ist ursprünglich aufgenommen als Diktat für einen Lexikonbeitrag im Yoga Wiki Bewusst Leben Lexikon. Zum ganzheitlichen Yoga kann man auch die Theorie von Karma und Reinkarnation dazu zählen. In Ayurveda Ausbildungen erfährst du mehr zum Thema Gesundheit und Prävention. Vielleicht magst du ja deine Gedanken dazu in die Kommentare schreiben. Anmerkung: Gesundheitliche Informationen in diesem Podcast sind nicht gedacht für Selbstdiagnose und Selbstbehandlung, sondern Gedankenanstöße. Bei eigener Erkrankung brauchst du einen Arzt oder Heilpraktiker. Hier findest du: Seminare mit Sukadev Seminarübersicht Yoga Vidya YouTube Live Kanal Online Seminare Video Seminare Yoga Vidya kostenlose App Yoga Vidya Newsletter Unseren Online Shop Schon ein kleiner Beitrag kann viel bewegen... Spende an Yoga Vidya e.V.!
What does IDM stand for? In the medical world, IDM is an acronym for Infant of Diabetic Mother. In this episode, we review the common complications associated with Infants of Diabetic Mothers. You may be surprised to hear that there are several complications beyond hypoglycemia or low blood sugars including but not limited to macrosomia, asphyxia, small for gestational age, respiratory distress, cardiac anomalies, neurological impairments, polycythemia, hyperbilirubinemia, hypocalcemia, and hypomagnesemia. Plus IDM infants are also at an increased risk for a preterm delivery and/or a cesarean section delivery due to their risk of complications later during the pregnancy or potentially larger size. Not only will we break down the potential complications the IDM infant is at risk for one-by-one, but we also discuss the pathophysiology behind each diagnosis as well as the typical treatment plan for each complication. If you are currently pregnant and have been diagnosed with gestational diabetes or had pre existing diabetes, this episode is for you! Or if you just had your baby and had diabetes with the pregnancy, this episode will provide you some great education. Empowering NICU Parents Show Notes: https://empoweringnicuparents.com/episode19/Empowering NICU Parents Instagram: https://www.instagram.com/empoweringnicuparents/Empowering NICU Parents FB Group:https://www.facebook.com/groups/empoweringnicuparentsWebsite Link: https://empoweringnicuparents.com/episode19/
Different Ways Nurses Can Treat Hyperkalemia Hyperkalemia or elevated serum potassium levels are a common condition ailing patients in the hospital setting. Although, these conditions are widely treated by the use of kayexelate, it's important to know the other treatment options nurses have when working with hyperkalemic patients. In this podcast Wasim and Marium discuss the different treatment options you have as a nurse. Kayexelate Kayexelate is the most common drug used for hyperkalemic patients, especially in the acute care setting. Although, this is usually the first drug of choice, it does come with it's drawbacks. IV Insulin and D50 IV Insulin can be used to help correct elevate potassium levels. The insulin works by forcing serum potassium back into the cells, thus decreasing the availability of potassium in the blood stream. The Dextrose push, is required immediately after the administration of Insulin to help control hypoglycemia. Beta-Adrenergic Drugs Albuterol and other nebulizers also help reduce the amount of potassium in the blood stream. They too work by forcing potassium back into intracellular space. These can be given as regular breathing treatments. Sodium Bicarbonate Sodium Bicarb is usually given to patients with renal deficiencies. It too helps reduce the amount of free flowing potassium and can also help correct any acid/base imbalances. For more on this topic follow our page @RealistNurses. You can subscribe to our podcast by visiting our LINK in BIO. You can also:
In this episode, I'm talking to you about the different types of sweeteners that are appropriate for the keto diet. Here are the sweeteners that are 100% okay for keto: Stevia Monkfruit Erythritol Glycerin (if you can get it) Sugar alcohols to avoid: Maltitol, Sorbitol, and Xylitol (all will impact your blood sugar levels and kick your body out of a fat burning zone). Artificial sweeteners that are in the grey area: Aspartame, Acesulfame potassium, Alitame, Cyclamate, Dulcin, Glucin, Kaltame, Mogrosides, Neotame, Nutrinova, Phenlalanine, Saccharin, Sucralose Below are the sweeteners that you should AVOID: Sugar, honey, fructose, high fructose corn syrup, agave nectar, maltodextrin, sucrose, Beet sugar, Blackstrap molasses, Brown sugar, Buttered syrup, Cane juice crystals, Cane sugar, Caramel, Carob syrup, Castor sugar, Coconut sugar, Confectioner's sugar, Date sugar, Demerara, Evaporated cane juice, Florida crystals, Fruit juice, Fruit juice concentrate, Golden sugar, Golden syrup, Grape sugar, Icing sugar, Invert sugar, Maple syrup, Molasses, Muscovado, Panela, Raw sugar, Refiner's syrup, Sorghum syrup, Secant, Treacle, Turbinado, Yellow sugar, Barley malt, Brown rice syrup, Corn syrup, Corn syrup solids, Dextrin, Dextrose, Diastatic malt, Ethyl maltol, Glucose, Glucose solids, Lactose, Malt Syrup, Maltodextrin, Maltose, Rice syrup
In today's VETgirl online veterinary continuing education podcast, we review the prevalence of bacterial contamination in 50% dextrose vials. How worried should we be about using multi-dose dextrose bottles?
AMSSM has a series of podcasts (https://www.amssm.org/E-Learning.php) and here experts highlight the management of shoulder, elbow and knee pain with a focus on the declining role of corticosteroid injections. The sports physicians discuss other injection treatment options – PRP, prolotherapy and viscosupplementation where relevant. Keep the AMSSM's 2016 Annual Meeting in mind – Registration opens on January 8th. It will be in Dallas, Texas, April 15-20, 2016. And the special AMSSM issue of BJSM appears online first on January 18th, 2016.(Mental health theme). The experienced and popular hosts are Dr Blair Becker and Dr Scott Young, with special guest AMSSM Vice-President, Dr Matt Gammons. Timeline: 2:00 m Shoulder pain and subacromial corticosteroid injection – what is the level 1 evidence? 4:05 m What about corticosteroid for frozen shoulder? Does distention add benefits? 5:30 m Dr Gammons in his experience with adhesive capsulitis and shared decision making. 6:30 m The severity of symptoms may influence the decision. What would make it worth it for the patient to have an injection? 7:30 m PRP – platelet rich plasma. Again, as usually the case with PRP, no therapeutic benefit. What about prolotherapy? 8:30 m The AMSSM position statement on ultrasound guidance for shoulder injection. 12:30 m The elbow – an area where corticosteroids are becoming less popular. 15:30 m Is there support for long-term benefit of PRP? Nothing in the short term but a benefit at 2 years? 16:00 m Dr Gammons provides an overview. “Tools to add to the toolbox”, “Reasonable discussions to have with the patient”. Remember that the natural history is toward resolution. 17:00 m Shared decision making is key 17:30 m Moving on to the knee. Osteoarthritis and corticosteroid – short term benefit. Dealing with the acute flare-up. 18:40 m Viscosupplementation. See also the AMSSM scientific statement – (http://ow.ly/VKUxC ) and its recommendation for use in patients aged >60 years with grade 2 or 3 Kellgren-Lawrence. 20:00 m Dextrose prolotherapy for knee osteoarthritis (University of Wisconsin). 21:00 m Intra-articular PRP for knee osteoarthritis 23:30 m Other targets around the knee. Iliotibial band, pes anserinus as well as the patellar tendon. 25:30 m Summary of clinical practice – putting it all into perspective. Other links Clinical Journal of Sport Medicine blog and link to AMSSM Viscosupplementation position statement http://ow.ly/VKUxC Evidence against elbow PRP via Dr Robert-Jan de Vos: http://bjsm.bmj.com/content/48/12/952.long
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