Podcasts about Encephalopathy

Beth Lehman went through a tumultuous year in 2020.  Thanks to heavy drinking, she was diagnosed with cirrhosis, then basal cell carcinoma, a type of skin cancer, followed by hepatocellular carcinoma, a form of liver cancer.  She underwent radioactive embolization in order to get a liver transplant.  Beth said the two-hour operation wasn't so tough, but the after-effects were difficult, including nausea and vomiting.  Then she experienced a procedure to get rid of the skin cancer on her right temple.  She says between her physical and emotional recovery, she advocates for cancer patients and is happier than ever.   Beth's alcohol consumption had soared to four or five bottles of wine a day.  In 2020, she began to have a buildup of fluid in her stomach, known as ascites.  For a long time, she avoided consulting a doctor, suspecting a doctor would tell her to quit drinking; but when ascites asserted itself, she sought medical attention.  She was diagnosed with cirrhosis.  Upon further examination, five tumors were discovered in her liver, which led to a diagnosis of hepatocellular carcinoma, a form of liver cancer.   This diagnosis came after another diagnosis of basal cell carcinoma, but the skin cancer had to take back seat to the liver cancer.   Beth said her care team first had to determine whether the cancer had spread beyond her liver.  Thankfully, it hadn't.  In order to complete a liver transplant, doctors wanted to execute radioactive embolization, in which radiation beads would be injected into her arteries through her wrist or groin and targeted at the tumors.  However, for that to happen, the tumors had to be 2cm, but her largest tumor was 1.87cm.  Incredibly, Beth's care team told her to go home and let the tumors grow so they would be large enough for it to go through with the radioactive embolization.   Once the tumors grew, Beth went through the procedure, also known as Y-90.  She had to go through the procedure a second time.  Usually, a second procedure comes eight to twelve weeks after the first procedure.  Beth's second procedure came just four weeks later.  She said she was awake during each procedure, each lasted about two hours, but the toughest part was post-treatment, as she had a great amount of radiation in her body, so much that upon returning home, she had to be sequestered from her husband and her pet cats. Once she recovered from her liver transplant, she had her skin cancer treated.  She said her doctors had to go seven layers deep to get all the cancer, but they did such an outstanding job that her incision is not visible.   Beth Lehman once had a lucrative IT position, but these days she works as an advocate for cancer patients, especially liver cancer patients and says she is happier than ever.   Additional Resources:   Support Groups:   The American Liver Foundation https://www.liverfoundation.org   Beth's Nonprofit, The Liver Circle https://www.thelivercircle.org   Beth's Personal Page with Her Story: https://www.bethlehmanliver.com          

Hepatic encephalopathy (HE) can feel like it comes out of nowhere: one day a patient is baseline, the next they're confused after “just” constipation, a little dehydration, or a routine diuretic tweak. In this episode, we unpack why seemingly benign stressors can flip a fragile gut–liver–brain system past its tipping point.Subscribe to the Point of Care Medicine Substack.

In this episode, we break down why lactulose and rifaximin work specifically for HE: lactulose acidifies the colon to “trap” ammonia as ammonium (NH4⁺) and rapidly clears nitrogen substrates via catharsis, while rifaximin reshapes the gut microbiome and dampens gut-derived inflammatory signaling - benefits that don't always correlate with serum ammonia levels. We also cover why other antibiotics fell out of favor, where polyethylene glycol fits, and how to think mechanistically about the best risk–reward strategy for preventing and treating HE.Subscribe to the Point of Care Medicine Substack

I'm consistently surprised at how few CDI or IP coding professionals talk about their most basic job function. The very reason they are hired, and what most do for eight hours a day: I'm talking about chart review. Go on Linkedin or Facebook and it's rarely discussed. Yet it's ... everything. Nuanced, complex, clinical, critical to the quality of financial health of hospitals. It's how patient acuity is expressed in coded data, how hospitals get paid, and why CDI and coding professionals are employed. I've heard it described as akin to detective work, puzzling together the pieces and presenting an informed query to the provider. Yet like detective work it often remains a mystery. Dr. Tarman Aziz joined me to open up that conversation. He is founder and CEO of CDIQ Consulting, LLC, a physician-led healthcare education and consulting firm focused on closing the gap between clinical reality and coded data. On this episode of #OTR we discuss: Is chart review unique to the individual/healthcare organization/assistive tech, or are there underlying principles everyone can follow? How evolving clinical indicators in a case drive a concurrent CDI workflow—the differences of reviewing a chart at 24 vs 72 hours as clinical indicators morph How early is too early to look at an inpatient chart? Underutilized and underrated areas of the health record Review strategies for encephalopathy, dehydration, hyper- and hyponatremia, and cerebral edema/compression Tarman's work consulting and educating non-traditional CDI candidates The remarkable story of Tarman's fiancé Anna, an 11-year survivor of Stage 4 breast cancer

Cymbeline crashes some cars. Cymbeline gets a guard high. Cymbeline befriends a door. Cymbeline goes to jail.   STARRING - Austin Yorski: https://bsky.app/profile/austinyorski.bsky.social Michael "Skitch" Schiciano: https://bsky.app/profile/skitch.bsky.social Sara (Cosmignon): https://bsky.app/profile/cosmignon.bsky.social   SUPPORT - Bandcamp: https://skitch.bandcamp.com/ Comic: https://runawaydrakaina.com/ Patreon: patreon.com/cosmignon Ko-Fi: ko-fi.com/cosmignon Store: cosmignon.square.site   AUDIO - https://www.youtube.com/watch?v=MHrF-ZfdwIk Kirby Super Star OC ReMix by TSori & Others: "Until the Next Dance" [Meta Knight: Ending]: https://www.youtube.com/watch?v=aeEvMkYAU1o Katherine Cordova - YouTube Dragon Warrior VII OC ReMix by Bluelighter...: "Deeper in the Heart" [Days of Sadness] (#3762) EarthBound OC ReMix by The Vodoú Queen: "Get Down with Your Bad Self, Mr. Saturn!" [Hi Ho] (#4798) Hollow Knight OC ReMix by DaMonz feat. Christine Giguère: "A Dream" [Dirtmouth] (#4884) Mother 3 OC ReMix by Sebastien Skaf: "Your Warmth" [Theme of Love] (#4850) OC ReMix #499: Little Nemo 'Nemo for Strings' [Dream 1: Mushroom Forest] by Gux Zelda: Breath of the Wild OC ReMix by RebeccaETripp...: "Bard in the Rain" [Kass] (#4813)   DISCORD - https://discord.gg/YMU3qUH

Episode 210: Heat Stroke BasicsWritten by Jacob Dunn, MS4, American University of the Caribbean. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice. Definition:Heat stroke represents the most severe form of heat-related illness, characterized by a core body temperature exceeding 40°C (104°F) accompanied by central nervous system (CNS) dysfunction. Arreaza: Key element is the body temperature and altered mental status. Jacob: This life-threatening condition arises from the body's failure to dissipate heat effectively, often in the context of excessive environmental heat load or strenuous physical activity. Arreaza: You mentioned, it is a spectrum. What is the difference between heat exhaustion and heat stroke? Jacob: Unlike milder heat illnesses such as heat exhaustion, heat stroke involves multisystem organ dysfunction driven by direct thermal injury, systemic inflammation, and cytokine release. You can think of it as the body's thermostat breaking under extreme stress — leading to rapid, cascading failures if not addressed immediately. Arreaza: Tell us what you found out about the pathophysiology of heat stroke?Jacob: Pathophysiology: Under normal conditions, the body keeps its core temperature tightly controlled through sweating, vasodilation of skin blood vessels, and behavioral responses like seeking shade or drinking water. But in extreme heat or prolonged exertion, those mechanisms get overwhelmed.Once core temperature rises above about 40°C (104°F), the hypothalamus—the brain's thermostat—can't keep up. The body shifts from controlled thermoregulation to uncontrolled, passive heating. Heat stroke isn't just someone getting too hot—it's a full-blown failure of the body's heat-regulating system. Arreaza: So, it's interesting. the cell functions get affected at this point, several dangerous processes start happening at the same time.Jacob: Yes: Cellular Heat InjuryHigh temperatures disrupt proteins, enzymes, and cell membranes. Mitochondria start to fail, ATP production drops, and cells become leaky. This leads to direct tissue injury in vital organs like the brain, liver, kidneys, and heart.Arreaza: Yikes. Cytokines play a big role in the pathophysiology of heat stroke too. Jacob: Systemic Inflammatory ResponseHeat damages the gut barrier, allowing endotoxins to enter the bloodstream. This triggers a massive cytokine release—similar to sepsis. The result is widespread inflammation, endothelial injury, and microvascular collapse.Arreaza: What other systems are affected?Coagulation AbnormalitiesEndothelial damage activates the clotting cascade. Patients may develop a DIC-like picture: microthrombi forming in some areas while clotting factors get consumed in others. This contributes to organ dysfunction and bleeding.Circulatory CollapseAs the body shunts blood to the skin for cooling, perfusion to vital organs drops. Combine that with dehydration from sweating and fluid loss, and you get hypotension, decreased cardiac output, and worsening ischemia.Arreaza: And one of the key features is neurologic dysfunction.Jacob: Neurologic DysfunctionThe brain is extremely sensitive to heat. Encephalopathy, confusion, seizures, and coma occur because neurons malfunction at high temperatures. This is why altered mental status is the hallmark of true heat stroke.Arreaza: Cell injury, inflammation, coagulopathy, circulatory collapse and neurologic dysfunction. Jacob: Ultimately, heat stroke is a multisystem catastrophic event—a combination of thermal injury, inflammatory storm, coagulopathy, and circulatory collapse. Without rapid cooling and aggressive supportive care, these processes spiral into irreversible organ failure.Background and Types:Arreaza: Heat stroke is part of a spectrum of heat-related disorders—it is a true medical emergency. Mortality rate reaches 30%, even with optimal treatment. This mortality correlates directly with the duration of core hyperthermia. I'm reminded of the first time I heard about heat stroke in a baby who was left inside a car in the summer 2005. Jacob: There are two primary types: -nonexertional (classic) heat stroke, which develops insidiously over days and predominantly affects vulnerable populations like children, the elderly, and those with chronic illnesses during heat waves; -exertional heat stroke, which strikes rapidly in young, otherwise healthy individuals, often during intense exercise in hot, humid conditions. Arreaza: In our community, farm workers are especially at risk of heat stroke, but any person living in the Central Valley is basically at risk.Jacob: Risk factors amplify vulnerability across both types, including dehydration, cardiovascular disease, medications that impair sweating (e.g., anticholinergics), and acclimatization deficits. Notably, anhidrosis (lack of sweating) is common but not required for diagnosis. Hot, dry skin can signal the shift from heat exhaustion to stroke. Arreaza: What other conditions look like heat stroke?Differential Diagnosis:Jacob: Presenting with altered mental status and hyperthermia, heat stroke demands a broad differential to avoid missing mimics. -Environmental: heat exhaustion, syncope, or cramps. -Infectious etiologies like sepsis or meningitis must be ruled out. -Endocrine emergencies such as thyroid storm, pheochromocytoma, or diabetic ketoacidosis (DKA) can overlap. -Neurologic insults include cerebrovascular accident (CVA), hypothalamic lesions (bleeding or infarct), or status epilepticus. -Toxicologic culprits are plentiful—sympathomimetic or anticholinergic toxidromes, salicylate poisoning, serotonin syndrome, malignant hyperthermia, neuroleptic malignant syndrome (NMS), or even alcohol/benzodiazepine withdrawal. When it comes to differentials, it is always best to cast a wide net and think about what we could be missing if this is not heat stroke. Arreaza: Let's say we have a patient with hyperthermia and we have to assess him in the ER. What should we do to diagnose it?Jacob: Workup:Diagnosis is primarily clinical, hinging on documented hyperthermia (>40°C) plus CNS changes (e.g., confusion, delirium, seizures, coma) in a hot environment. Arreaza: No single lab confirms it, but targeted testing allows us to detect complications and rule out alternative diagnosis. Jacob: -Start with ECG to assess for dysrhythmias or ischemic changes (sinus tachycardia is classic; ST depressions or T-wave inversions may hint at myocardial strain). -Labs include complete blood count (CBC), comprehensive metabolic panel (electrolytes, renal function, liver enzymes), glucose, arterial blood gas, lactate (elevated in shock), coagulation studies (for disseminated intravascular coagulation, or DIC), creatine kinase (CK) and myoglobin (for rhabdomyolysis), and urinalysis. Toxicology screen if history suggests. Arreaza: I can imagine doing all this while trying to cool down the patient. What about imaging?-Imaging: chest X-ray for pulmonary issues, non-contrast head CT if neurologic concerns suggest edema or bleed (consider lumbar puncture if infection suspected). It is important to note that continuous core temperature monitoring—via rectal, esophageal, or bladder probe—is essential, not just peripheral skin checks. Arreaza: TreatmentManagement:Time is tissue here—initiate cooling en route, if possible, as delays skyrocket morbidity. ABCs first: secure airway (intubate if needed, favoring rocuronium over succinylcholine to avoid hyperkalemia risk), support breathing, and stabilize circulation. -Remove the patient from the heat source, strip clothing, and launch aggressive cooling to target 38-39°C (102-102°F) before halting to prevent rebound hypothermia. -For exertional cases, ice-water immersion reigns supreme—it's the fastest method, with immersion in cold water resulting in near-100% survival if started within 30 minutes. -Nonexertional benefits from evaporative cooling: mist with tepid water (15-25°C) plus fans for convective airflow. -Adjuncts include ice packs to neck, axillae, and groin; -room-temperature IV fluids (avoid cold initially to prevent shivering); -refractory cases, invasive options like peritoneal lavage, endovascular cooling catheters, or even ECMO. -Fluid resuscitation with lactated Ringer's or normal saline (250-500 mL boluses) protects kidneys and counters rhabdomyolysis—aim for urine output of 2-3 mL/kg/hour. Arreaza: What about medications?Jacob: Benzodiazepines (e.g., lorazepam) control agitation, seizures, or shivering; propofol or fentanyl if intubated. Avoid antipyretics like acetaminophen. For intubation, etomidate or ketamine as induction agents. Hypotension often resolves with cooling and fluids; if not, use dopamine or dobutamine over norepinephrine to avoid vasoconstriction. Jacob: What IV fluid is recommended/best for patients with heat stroke?Both lactated Ringer's solution and normal saline are recommended as initial IV fluids for rehydration, but balanced crystalloids such as LR are increasingly favored due to their lower risk of hyperchloremic metabolic acidosis and AKI. However, direct evidence comparing the two specifically in the setting of heat stroke is limited. Arreaza: Are cold IV fluids better/preferred over room temperature fluids?Cold IV fluids are recommended as an adjunctive therapy to help lower core temperature in heat stroke, but they should not delay or replace primary cooling methods such as cold-water immersion. Cold IV fluids can decrease core temperature more rapidly than room temperature fluids. For example, 30mL/kg bolus of chilled isotonic fluids at 4 degrees Celsius over 30 minutes can decrease core temperature by about 1 degree Celsius, compared to 0.5 degree Celsius with room temperature fluids. Arreaza: Getting cold IV sounds uncomfortable but necessary for those patients. Our favorite topic.Screening and Prevention:-Heat stroke prevention focuses on public health and individual awareness rather than routine testing. -High-risk groups—elderly, children, athletes, laborers, or those on impairing meds—should acclimatize gradually (7-14 days), hydrate preemptively (electrolyte solutions over plain water), and monitor temperature in exertional settings. -Communities during heat waves need cooling centers and alerts. -For clinicians, educate patients with CVD or obesity about early signs like dizziness or nausea. -No formal "screening" exists, but vigilance in EDs during summer surges saves lives. -Arreaza: I think awareness is a key element in prevention, so education of the public through traditional media like TV, and even social media can contribute to the prevention of this catastrophic condition.Jacob: Ya so heat stroke is something that should be on every physician's radar in the central valley especially in the summer time given the hot temperatures. Rapid recognition is key. Arreaza: Thanks, Jacob for this topic, and until next time, this is Dr. Arreaza, signing off.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! References:Gaudio FG, Grissom CK. Cooling Methods in Heat Stroke. J Emerg Med. 2016 Apr;50(4):607-16. doi: 10.1016/j.jemermed.2015.09.014. Epub 2015 Oct 31. PMID: 26525947. https://pubmed.ncbi.nlm.nih.gov/26525947/.Platt, M. A., & LoVecchio, F. (n.d.). Nonexertional classic heat stroke in adults. In UpToDate. Retrieved September 7, 2025, from https://www.uptodate.com/contents/nonexertional-classic-heat-stroke-in-adults. (Key addition: Emphasizes insidious onset in at-risk populations and the role of urban heat islands in exacerbating classic cases.) Heat Stroke. WikEM. Retrieved December 3, 2025, from https://wikem.org/wiki/Heat_stroke. (Key additions: Details on cooling rates for immersion therapy, confirmation that anhidrosis is not diagnostic, and fluid titration to urine output for rhabdomyolysis prevention.)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Hepatic-Encephalopathy-More-Common-Than-You-Think/39786/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/advances-in-the-oreatment-of-overt-hepatic-encephalopathy-whats-in-the-pipeline/39794/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Current-Treatment-of-Hepatic-Encephalopathy-Is-It-Meeting-Our-Patients-Needs/39793/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Optimizing-Care-of-the-Hospitalized-Patient-With-Overt-Hepatic-Encephalopathy/39792/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Treatment-of-Hepatic-Encephalopathy-Primary-vs-Secondary-Prophylaxis/39791/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Treatment-of-Hepatic-Encephalopathy-When-What-How-and-Why/39790/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/The-Slippery-Slope-of-Overt-Hepatic-Encephalopathy/39789/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Minimal-Hepatic-Encephalopathy-A-Covert-Operation/39788/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Minimal-Hepatic-Encephalopathy-Hiding-in-Plain-Sight/39787/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

Dr. Alex Menze and Dr. Kristen Dams-O'Connor discuss traumatic encephalopathy syndrome and its relationship with traumatic brain injury.  Show Citation:  Dams-O'Connor K, Selmanovic E, Pruyser A, et al. Traumatic Encephalopathy Syndrome in the Late Effects of Traumatic Brain Injury (LETBI) Study Cohort. Neurology. 2025;1(2):e000015.  doi:10.1212/WN9.0000000000000015

Dr. Alex Menze talks with Dr. Kristen Dams-O'Connor about traumatic encephalopathy syndrome and its relationship with traumatic brain injury.  Read the related article in Neurology® Open Access.   Disclosures can be found at Neurology.org. 

This episode is a conversation about the current state of knowledge with respect to the clinical-pathological entity of LATE. Topics covered include the relevant proteinopathy, pathologic overlap with FTLD and hippocampal sclerosis, the LATE clinical syndrome, similarities to and differences from Alzheimer's disease, the utility of clinical diagnostic criteria, neuroimaging markers, fluid biomarkers, clinical trials, and advice for identification and diagnosis of LATE. Show notes are available at www.NavNeuro.com/180 _________________ If you'd like to support the show, here are a few easy ways: 1) Get CE credits for listening to select episodes: www.NavNeuro.com/INS  2) Tell your friends and colleagues about it 3) Subscribe (free) and leave an Apple Podcasts rating/review: www.NavNeuro.com/itunes 4) Check out our book Becoming a Neuropsychologist, and leave it an Amazon rating   Thanks for listening, and join us next time as we continue to navigate the brain and behavior! [Note: This podcast and all linked content is intended for general educational purposes only and does not constitute the practice of psychology or any other professional healthcare advice and services. No professional relationship is formed between hosts and listeners. All content is to be used at listeners' own risk. Users should always seek appropriate medical and psychological care from their licensed healthcare provider.]

For World Antimicrobial Awareness Week 2025 (“Act Now: Protect Our Present, Secure Our Future”), this EASL Studio explores the balance between rifaximin's benefits in hepatic encephalopathy and the global challenge of antimicrobial resistance.Moderator: Debbie ShawcrossSpeakers: Rajiv Jalan, Vishal Patel, Jonel TrebickaAll EASL Studio Podcasts are available on EASL Campus.Click here to see all EASL Video Podcasts on Apple Podcasts.This EASL Studio is supported by Alfasigma and Norgine. EASL has received no input from Alfasigma or Norgine with regards to the content of this programme.

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠Hepatic Encephalopathy⁠⁠ from the Gastrointestinal section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-unmet-therapeutic-needs/39665/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/treatment-of-overt-hepatic-encephalopathy/39664/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-an-ominous-sign/39666/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-an-ominous-sign/39278/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/the-clinical-spectrum-of-hepatic-encephalopathy/39304/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-tipping-the-balance/39660/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/diagnosing-minimal-hepatic-encephalopathy-theres-an-app-for-that/39662/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-whats-sarcopenia-got-to-do-with-it/39663/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

In the second episode of this two-part series, Dr. Justin Abbatemarco and Dr. Jennifer E. Fugate discuss patient outcomes and how to manage these individuals both in the hospital and outside the hospital.  Show reference: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00232-7/abstract 

In the first episode of this two-part series, Dr. Justin Abbatemarco and Dr. Jennifer E. Fugate discuss posterior reversible encephalopathy syndrome (PRES), highlighting both typical and atypical MRI findings.  Show reference: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00232-7/abstract 

Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifests as various neurologic and psychiatric symptoms such as confusion, inattention, and cognitive dysfunction Although ammonia levels have historically been recognized as important criteria for HE, the diagnosis is ultimately made clinically. An elevated ammonia level lacks sensitivity and specificity for HE Trends in ammonia levels do not correlate with disease improvement or resolution A 2020 study published in the American Journal of Gastroenterology evaluated 551 patients diagnosed with hepatic encephalopathy and treated with standard therapy Only 60% of patients had an elevated ammonia level, demonstrating the limitations of ammonia levels However, a normal ammonia level in a patient with concern for HE should raise suspicion for other pathology. In patients with cirrhosis presenting with neuropsychiatric symptoms, consider HE as the diagnosis after excluding other potential causes of altered mental status (i.e., Seizure, infection, intracranial hemorrhage) The primary treatment is lactulose Works by acidifying the gastrointestinal tract. Ammonia (NH₃) is converted into ammonium (NH₄⁺), which is poorly absorbed and subsequently eliminated from the body Also exerts a laxative effect, further enhancing elimination References: Haj M, Rockey DC. Ammonia Levels Do Not Guide Clinical Management of Patients With Hepatic Encephalopathy Caused by Cirrhosis. Am J Gastroenterol. 2020 May;115(5):723-728. doi: 10.14309/ajg.0000000000000343. PMID: 31658104. Lee F, Frederick RT. Hepatic Encephalopathy-A Guide to Laboratory Testing. Clin Liver Dis. 2024 May;28(2):225-236. doi: 10.1016/j.cld.2024.01.003. Epub 2024 Jan 30. PMID: 38548435. Vilstrup, Hendrik1; Amodio, Piero2; Bajaj, Jasmohan3,4; Cordoba, Juan1,5; Ferenci, Peter6; Mullen, Kevin D.7; Weissenborn, Karin8; Wong, Philip9. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study Of Liver Diseases and the European Association for the Study of the Liver. Hepatology 60(2):p 715-735, August 2014. | DOI: 10.1002/hep.27210 Weissenborn K. Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles. Drugs. 2019 Feb;79(Suppl 1):5-9. doi: 10.1007/s40265-018-1018-z. PMID: 30706420; PMCID: PMC6416238. Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/  

Mark presents a case of seizures, fever, and meningoencephalitis to Youssef, Maddy, and Noah. Lymphocytic Pleocytosis Schema Seizures Schema To join us live on Virtual Morning Report (VMR), sign up HERE.  Download CPSolvers App here RLRCPSOLVERS

Join us on September 3rd for Baby Tribe Live! Tickets available now: https://smockalley.ticketsolve.com/ticketbooth/shows/873656691 Unlock the secrets of hypoxic ischemic encephalopathy (HIE) in newborns and understand the critical nuances of this life-altering condition. Join us as we navigate through the complexities of encephalopathy, explaining how it affects the brain function of infants and the symptoms that manifest as a result. Learn about the innovative treatment of therapeutic hypothermia, a revolutionary method that offers hope and healing for newborns. Meet Betsy Pilon, a mother whose compelling story and advocacy work sheds light on the personal side of HIE. Her journey with her son Max, who was born with this condition, highlights the importance of a strong support system and the challenges faced by families navigating the healthcare landscape. We discuss the emotional turbulence and communication hurdles often encountered within the NICU, emphasizing the need for improved support and understanding for parents. Explore the critical role of early intervention and diagnosis for infants at risk of conditions like cerebral palsy. We delve into the significance of early physiotherapy and the impact of organizations like Hope for HIE, which provide essential resources and community for affected families. As we discuss global collaboration efforts in HIE research, you'll gain insight into how international partnerships and technological advancements are paving the way for better outcomes. Hope for HIE: https://hopeforhie.org/ Proudly sponsored by: https://www.happytummy.ie/ Learn more about your ad choices. Visit megaphone.fm/adchoices

#38: All Things Encephalopathy Wilderness & Environmental Medicine journal online: www.wemjournal.org Questions/comments/feedback and/or interest in participating? Send an email to: WMPodcast@wms.org Part 1: Journal Club Title: Encephalopathy at High Altitude: Hyponatremia or High Altitude Cerebral Edema? Article link: https://journals.sagepub.com/doi/abs/10.1177/10806032251315381 CME Available: wms.org/members Part 2: Overview of other causes encephalopathy not directly addressed in the paper BONUS! Stay tuned for a summary in Spanish and French at the end! Audio editing: Tom Conklin (www.tomconklinvoice.com)

Send us a textShifting outlooks after neonatal encephalopathy in the era of therapeutic hypothermia.Christoffel K, Mulkey SB.Pediatr Res. 2025 Jun 4. doi: 10.1038/s41390-025-04156-0. Online ahead of print.PMID: 40467976 Review.As 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!

Dr. Greg Cooper talks with Dr. David A. Wolk about limbic predominant age-related TDP-43 encephalopathy (LATE) discussing its clinical features, diagnostic criteria, and the importance of recognizing this condition in the context of Alzheimer disease. Read the related article.  Disclosures can be found at Neurology.org.   

This episode covers hypoxic-ischaemic encephalopathy.Written notes can be found at https://zerotofinals.com/paediatrics/neonatology/hie/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.

In this powerful episode honoring HIE Awareness Month, Neonatal Nurse Practitioner Jessica Fulton shares the raw and emotional story of her son Bo's birth — a delivery marked by unexpected complications that led to a diagnosis of Hypoxic-Ischemic Encephalopathy (HIE). Jessica opens up about what it was like to watch her own son become a critical patient in the very NICU where she had worked for years — as her personal and professional worlds suddenly collided. She speaks candidly about the shocking helplessness she felt as a parent, despite her medical background, and the lifelong challenges that continue to follow: a cerebral palsy diagnosis, fierce advocacy, intensive therapies, emotional isolation, and the realities of parenting a child with complex needs. This episode is a must-listen for NICU parents, healthcare providers, and anyone supporting a family navigating the lifelong impact of HIE. Dr. Brown's Medical: https://www.drbrownsmedical.com Our NICU Roadmap: A Comprehensive NICU Journal: https://empoweringnicuparents.com/nicujournal/ NICU Mama Hats: https://empoweringnicuparents.com/hats/ NICU Milestone Cards: https://empoweringnicuparents.com/nicuproducts/ Newborn Holiday Cards: https://empoweringnicuparents.com/shop/ Empowering NICU Parents Show Notes: https://empoweringnicuparents.com/shownotes/ Episode 68 Show Notes: https://empoweringnicuparents.com/episode68 Empowering NICU Parents Instagram: https://www.instagram.com/empoweringnicuparents/ Empowering NICU Parents FB Group: https://www.facebook.com/groups/empoweringnicuparents Pinterest Page: https://pin.it/36MJjmH

Conditions Covered • Wernicke's Encephalopathy • Hepatic Encephalopathy • Toxic & Metabolic Encephalopathy • Uremic Encephalopathy • Hypertensive Encephalopathy ⸻ Encephalopathy = Global brain dysfunction Encephalitis = Brain inflammation ⸻ Wernicke's Encephalopathy Acute, reversible encephalopathy caused by thiamine (B1) deficiency. Key Differentiator: Confusion + Ataxia + Ophthalmoplegia in a malnourished or alcoholic patient. Essentials: • […] The post 129b: Quick Encephalopathy Review for the PANCE appeared first on Physician Assistant Exam Review.

Send us a textWhole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.Faix RG, Laptook AR, Shankaran S, Eggleston B, Chowdhury D, Heyne RJ, Das A, Pedroza C, Tyson JE, Wusthoff C, Bonifacio SL, Sánchez PJ, Yoder BA, Laughon MM, Vasil DM, Van Meurs KP, Crawford MM, Higgins RD, Poindexter BB, Colaizy TT, Hamrick SEG, Chalak LF, Ohls RK, Hartley-McAndrew ME, Dysart K, D'Angio CT, Guillet R, Kicklighter SD, Carlo WA, Sokol GM, DeMauro SB, Hibbs AM, Cotten CM, Merhar SL, Bapat RV, Harmon HM, Sewell E, Winter S, Natarajan G, Mosquera R, Hintz SR, Maitre NL, Benninger KL, Peralta-Carcelen M, Hines AC, Duncan AF, Wilson-Costello DE, Trembath A, Malcolm WF, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA Pediatr. 2025 Feb 24:e246613. doi: 10.1001/jamapediatrics.2024.6613. Online ahead of print.PMID: 39992674As 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!

In this episode of Autism for Badass Moms, we sit down with Allysa Parker, a dedicated Certified Dental Assistant and fierce advocate for her 6-year-old son, Julian. Julian was diagnosed with Hypoxic Ischemic Encephalopathy (H.I.E.) just two days after birth and later received an Autism diagnosis at 4.5 years old. Navigating these diagnoses has been an emotional rollercoaster for Allysa, bringing moments of helplessness and anxiety. But through it all, she has remained committed to ensuring Julian experiences the world to the fullest. Now, Allysa is using her journey to empower other moms, sharing her insights on H.I.E. and Autism while building a community of support and encouragement. Tune in to hear Allysa's incredible journey. Follow her journey on Instagram: https://www.instagram.com/lovely.loveable.leo/ Don't forget to subscribe and stay tuned for more empowering stories like Allysa's. Follow Us: Instagram: https://www.instagram.com/theabmpodcast/ Facebook: https://www.facebook.com/profile.php?id=100095054651586

In this episode, we review the high-yield topic ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hepatic Encephalopathy ⁠⁠⁠⁠⁠⁠⁠⁠from the Gastrointestinal section at ⁠⁠⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠ Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets

In this Pulmonary & Critical Care episode, Dr. Meghan Nothem presents an unusual case of acute encephalopathy and unresponsiveness to Dr. Paul A. Bergl. Stay tuned to found out the final diagnosis! Session facilitator: Dr. Hui Ting Ruan Case discussant:  Dr. Paul A. Bergl is an intensivist at Gundersen Lutheran Medical Center in La Crosse, WI and… Read More »Episode 374 – Rafael Medina Subspecialty Episode – Acute encephalopathy and unresponsiveness

While there are many kinds of dementia, like Alzheimer's disease and Lewy body dementia, there's one that researchers have only recently identified. LATE, or Limbic-predominant Age-related TDP-43 Encephalopathy, is a newly-characterized type of dementia associated with abnormal clumps of a protein called TDP-43. So, what exactly do we know about LATE? Dr. David Wolk joins the podcast to share what key features of LATE are, how it compares to Alzheimer's disease and impacts treatment, and what next steps are needed to better understand this neurodegenerative disease. Guest: David Wolk, MD, director, Penn Alzheimer's Disease Research Center, co-director, Penn Memory Center, co-director, Penn Institute on Aging, chief, Division of Cognitive Neurology, professor of neurology, University of Pennsylvania Perelman School of Medicine Show Notes Learn more about LATE on the National Institute on Aging's website and on Penn Memory Center's website. Read Dr. Wolk's article, "Clinical criteria for limbic-predominant age-related TDP-43 encephalopathy," on the journal Alzheimer's & Dementia's website. Learn more about Dr. Wolk in his profile on the Penn Memory Center website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Today's guest is Kelly Sutton, MHL, BSN, RN, CCDS, CCS, CDI education specialist for ACDIS/HCPro. Today's show is part of the “Talking CDI” series. In every episode of this series, Director of Programming Rebecca Hendren is joined by a special guest, such as a member of the ACDIS Advisory Board or one of our expert Boot Camp instructors to discuss a topic pertinent to today's CDI profession. Our intro and outro music for the ACDIS Podcast is “medianoche” by Dee Yan-Kay and our ad music is “Take Me Higher” by Jahzzar, both obtained from the Free Music Archive. Have questions about today's show or ideas for a future episode? Contact the ACDIS team at info@acdis.org. Want to submit a question for a future "listener questions" episode? Fill out this brief form!  CEU info: Each ACDIS Podcast episode now offers 0.5 ACDIS CEUs which can be used toward recertifying your CCDS or CCDS-O credential for those who listen to the show in the first two days from the time of publication. To receive your 0.5 CEUs, go to the show page on acdis.org, by clicking on the “ACDIS Podcast” link located under the “Resources” tab. To take the evaluation, click the most recent episode from the list on the podcast homepage, view the podcast recording at the bottom of that show page, and click the live link at the very end after the music has ended. Your certificate will be automatically emailed to you upon submitting the brief evaluation. (Note: If you are listening via a podcast app, click this link to go directly to the show page on acdis.org: https://acdis.org/acdis-podcast/listener-questions-aki-encephalopathy-case-management-collaboration-and-more) Note: To ensure your certificate reaches you and does not get trapped in your organization's spam filters, please use a personal email address when completing the CEU evaluation form. The cut-off for today's episode CEU is Friday, July 19, at 11:00 p.m. eastern. After that point, the CEU period will close, and you will not be eligible for the 0.5 CEUs for this week's episode. Today's sponsor: Today's show is brought to you by ACDIS Encore: Clinical & Coding Online, August 13-15, featuring sessions recorded live during the 2024 ACDIS national conference! Click here to learn more: https://bit.ly/3yv2P5X. ACDIS update: Respond to the 2024 CDI Week Industry Survey by July 19! (https://www.surveymonkey.com/r/2024-CDI-Week-Industry-Survey) Apply to speak at the 2025 ACDIS conference, Physician Advisor Forum, or ACDIS Symposium: Outpatient CDI by July 26! (https://acdis.org/25speaker)  

When the diseased liver is unable to filter out neurotoxins like ammonia, we can see a spectrum of the neuropsychiatric symptoms of hepatic encephalopathy. For the final installment in our liver failure series, host Sarah Lorenzini highlights a complicated case of hepatic encephalopathy where critical thinking and interdisciplinary teamwork were key to preventing further complications.She examines the common signs and symptoms of hepatic encephalopathy, factors that trigger or exacerbate the condition, and challenges nurses face in the diagnostic process. This episode also dives into treatment strategies and how to differentiate between hepatic encephalopathy and alcohol withdrawal.Tune in to learn how cirrhosis can lead to hepatic encephalopathy, the effect of neurotoxins in the brain, and how you, as a nurse, can manage patient care!Topics discussed in this episode:Assessment of Sarah's rapid response consult patientThe team's interventions and patient outcomePathophysiology of hepatic encephalopathySigns and symptoms of hepatic encephalopathyDiagnostic challenges and aggravating factorsStrategies to manage hepatic encephalopathyHepatic encephalopathy versus alcohol withdrawalMentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!Rapid Response and Rescue Intro CourseCONNECT

Today's guest is Sharme Brodie, RN, CCDS, CCDS-O, CDI education specialist for HCPro/ACDIS. Today's show is hosted by ACDIS Associate Editorial Director Linnea Archibald, Director of Programming Rebecca Hendren, Editor and Product Coordinator Karla Kozak, and Associate Editor Jess Fluegel. The show provides a glimpse behind the scenes of all things ACDIS in a more casual, conversational format than our other podcast series.  Click here to listen to the episode on AKI that was referenced on the show: https://bit.ly/3Q8lWZI Our intro and outro music for the ACDIS Podcast is “medianoche” by Dee Yan-Kay and our ad music is “Take Me Higher” by Jahzzar, both obtained from the Free Music Archive. Have questions about today's show or ideas for a future episode? Contact the ACDIS team at info@acdis.org. Want to submit a question for a future "listener questions" episode? Fill out this brief form!  CEU info: Each ACDIS Podcast episode now offers 0.5 ACDIS CEUs which can be used toward recertifying your CCDS or CCDS-O credential for those who listen to the show in the first two days from the time of publication. To receive your 0.5 CEUs, go to the show page on acdis.org, by clicking on the “ACDIS Podcast” link located under the “Resources” tab. To take the evaluation, click the most recent episode from the list on the podcast homepage, view the podcast recording at the bottom of that show page, and click the live link at the very end after the music has ended. Your certificate will be automatically emailed to you upon submitting the brief evaluation. (Note: If you are listening via a podcast app, click this link to go directly to the show page on acdis.org: https://acdis.org/acdis-podcast/listener-questions-aki-mi-encephalopathy-provider-engagement-and-more) Note: To ensure your certificate reaches you and does not get trapped in your organization's spam filters, please use a personal email address when completing the CEU evaluation form. The cut-off for today's episode CEU is Friday, April 26, at 11:00 p.m. eastern. After that point, the CEU period will close, and you will not be eligible for the 0.5 CEUs for this week's episode. ACDIS update: Apply to speak at our 2025 ACDIS events, including the national conference in May 2025, by Friday, July 26! (https://acdis.org/25speaker)   Members are encouraged to vote in the 2024 ACDIS Advisory Board election by Wednesday, May 1! (https://acdis.org/2024-acdis-advisory-board) Send your denials management articles to Jess Fluegel at jess.fluegel@hcpro.com by June 1 for consideration for the summer edition of the CDI Journal!

Listen as Dr. London Smith (.com) and his producer Cameron discuss Bovine Spongiform Encephalopathy (Mad Cow Disease) as they share about their Dr. Uden's cures.  Sponsored by Caldera + Lab (use code "jockdoc" to get 20% off!). Not so boring! https://calderalab.com/pages/podcast-special-offer?show=Jock+Doc&utm_medium=podcast&utm_source=JocDoc https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Produced by: Dylan Walker Created by: London Smith