Podcasts about Endocarditis

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Mario Castillo-Sang, the Surgical Director of Mitral Valve and Heart Failure Therapies at St. Elizabeth Healthcare, Edgewood, Kentucky, USA, about totally endoscopic cardiac surgery. Chapters 00:00 Intro 01:17 Minimal Access Bedside Cardiac 04:37 Lung Cancer, Histological Subtype 09:29 TAVR vs SAVR, AS & CAD 12:22 Biopros TVR Outcomes 15:48 Mitral Annular Disjunction, MVR 18:47 Ozaki Technique, AV Reconst 20:46 Redo LVOT Reconst for Endocarditis 22:33 Totally Endoscopic ASD Closure TVR 24:08 Dr. Castillo-Sang, MI Bedside Endoscopy 40:51 Closing They explore key highlights from Dr. Castillo-Sang's CTSNet series Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach, his journey in performing endoscopic surgeries, and how he learned the techniques. Dr. Castillo-Sang shares the advantages of endoscopic surgery, as well as tips and recommendations for those wanting to learn this approach. He emphasizes the importance of the instruments he has worked with, detailing how these have improved over time. Additionally, they explore Dr. Castillo-Sang's involvement with the Endoscopic Cardiac Surgeons Club, discussing how he got involved and providing details about the club's upcoming annual meeting.   Joel also highlights recent JANS articles on the estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time, transcatheter vs surgical aortic valve replacement in Medicare beneficiaries with aortic stenosis and coronary artery disease, long-term outcomes after bioprosthetic tricuspid valve replacement, and outcomes of patients with mitral annular disjunction undergoing mitral valve repair.  In addition, Joel explores aortic valve reconstruction using the Ozaki technique, redo LVOT reconstruction for endocarditis, and totally endoscopic ASD closure with tricuspid valve repair. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Estimated Worldwide Variation and Trends in Incidence of Lung Cancer by Histological Subtype in 2022 and Over Time: A Population-Based Study  2.) Transcatheter vs Surgical Aortic Valve Replacement in Medicare Beneficiaries With Aortic Stenosis and Coronary Artery Disease  3.) Long-Term Outcomes After Bioprosthetic Tricuspid Valve Replacement: A Multicenter Study  4.) Outcomes of Patients With Mitral Annular Disjunction Undergoing Mitral Valve Repair  CTSNET Content Mentioned  1.) Aortic Valve Reconstruction—The Ozaki Technique  2.) Redo LVOT Reconstruction for Endocarditis  3.) Totally Endoscopic ASD Closure With Tricuspid Valve Repair  Other Items Mentioned  1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach  2.) Endoscopic Cardiac Surgeons Club  3.) Mini Heart Valves   4.) Aortic Valve Replacement Series     5.) Career Center 6.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

We are pleased to announce the first of a new series of upcoming episodes, titled ‘Pulse Check – Key Papers at a Glance'. Our host Can discuss two recent and impactful EJCTS articles on infective endocarditis. Joined by the renowned, Michael Borger and Torsten Doenst, we explore firstly the implications of preoperative septic cerebral embolism for patients undergoing valve surgery. Then followed by an exploration into the use of haemoadsorption therapy, addressing the key issue of controlling inflammation during cardiac surgery for endocarditis. Listen to gain rapid insight into the associated articles: Effect of haemoadsorption during cardiac surgery for Staphylococcus aureus endocarditis: a REMOVE trial post hoc analysis Outcomes following heart valve surgery in patients with infective endocarditis and preoperative septic cerebral embolism: insights from the CAMPAIGN study group'

This episode covers: Cardiology This Week: A concise summary of recent studies Non-bacterial thrombotic endocarditis Managing cardiovascular risk in transgender people Milestones: RAVEL Host: Perry Elliott Guests: Kyle Klarich, Christian Delles Want to watch that episode? Go to: https://esc365.escardio.org/event/1800 Disclaimer: ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor.  This programme is intended for health care professionals only and is to be used for educational purposes.  The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests: Stephan Achenbach, Christian Delles, Kyle Klarich and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement

In this podcast, Dr. Valentin Fuster discusses a study on Coagulase-negative Staphylococcal Endocarditis (CoNS), a growing concern in the healthcare setting, particularly among the elderly and those with comorbidities. The study's findings on high mortality rates, surgical interventions, and the promising future role of artificial intelligence in diagnosing and predicting the disease are highlighted, offering new perspectives on this complex and life-threatening condition.

CLEAR-IE Outcomes of Percutaneous Mechanical Aspiration in Right-Sided Infective Endocarditis: A Multicenter Registry

Listener discretion is advised. References: Gutierrez, E. (2023). The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals. Hu W, Wang X, Su G. Infective endocarditis complicated by embolic events: Pathogenesis and predictors. Clin Cardiol. 2021 Mar;44(3):307-315. doi: 10.1002/clc.23554. Epub 2021 Feb 1. PMID: 33527443; PMCID: PMC7943911. Marik PE, Farkas JD. The Changing Paradigm of Sepsis: Early Diagnosis, Early Antibiotics, Early Pressors, and Early Adjuvant Treatment. Crit Care Med. 2018 Oct;46(10):1690-1692. doi: 10.1097/CCM.0000000000003310. PMID: 30216303.

Hey Heart Buddies! For the last episode of 2024, I bring you one more bonus episode that was the most downloaded episode of 2024. Thank you to my childhood friend, Todd Sykes, for your willingness to tell your story. I love you.Todd Sykes is a survivor and thriver of endocarditis, a stroke, and a brain aneurysm. At just 37, Todd faced life-threatening conditions during the COVID-19 pandemic, leading to two heart surgeries and a remarkable recovery. He shares powerful lessons on the importance of loving well, prioritizing family time, and being prepared with insurance and wills. Todd's story highlights resilience, faith, and the need for physical and emotional strength. Listeners are encouraged to cherish each moment and plan for unforeseen events to protect their loved ones. Todd's journey serves as an inspiring reminder of life's unpredictability and the power of hope.Join the Newsletter for almost weekly content for this podcast and other heart related news.Join the Patreon Community! The Joyful Beat zoom group is where you'll find connection and hope that you aren't alone in your journey.If you just want to support the show as a one-time gift (thank you), go here.**I am not a doctor and this is not medical advice. Be sure to check in with your care team about all the next right steps for you and your heart.**How to connect with BootsEmail: Boots@theheartchamberpodcast.comInstagram: @openheartsurgerywithboots or @boots.knightonLinkedIn: linkedin.com/in/boots-knightonBoots KnightonIf you enjoyed this episode, take a minute and share it with someone you know who will find value in it as well. You can share directly from this platform or send them to:Open Heart Surgery with Boots

Interview with Baptiste Jean, MD, author of β-Lactam Inoculum Effect in Methicillin-Susceptible Staphylococcus aureus Infective Endocarditis. Hosted by JAMA Network Open Associate Editor Angel N. Desai, MD, MPH. Related Content: β-Lactam Inoculum Effect in Methicillin-Susceptible Staphylococcus aureus Infective Endocarditis

Who knew that the Duke's criteria could be further modified? In Part 2, Vin and Ruan continue discussing infective endocarditis with the help of skilled cardiologist, Dr Raaesah Bhorat, this time discussing treatment: empiric, targeted and surgical therapy.About our Guest: Dr Raeesa Bhorat is a cardiologist at Sunninghill hospital, working as an interventional fellow under Professor Hellig. She completed her cardiology training at Groote Schuur hospital in 2024; and her interests include structural intervention and research in the application of artificial intelligence to cardiology, particularly the electrocardiogram. She completed her fellowship in internal medicine in 2019 and received her MBChB degree in 2013, cum laude.WE'D LOVE YOUR FEEDBACK ON THIS EPISODE – Visit the Microbe Mail website to sign up for updates Follow on:Instagram: Microbe_MailX/Twitter: @microbemailFacebook: MicrobeMailTiktok: @microbe.mailWatch this episode on our new YouTube channel: Microbe MailE-mail us: mail.microbe@gmail.com

Who knew that the Duke's criteria could be further modified? In this episode, Vin and Ruan explore this update to the criterion and other critical aspects of diagnosing and managing infective endocarditis with the help of skilled cardiologist, Dr Raaesah Bhorat.About our Guest: Dr Raaesah Bhorat is a cardiologist at Sunninghill hospital, working as an interventional fellow under Professor Hellig. She completed her cardiology training at Groote Schuur hospital in 2024; and her interests include structural intervention and research in the application of artificial intelligence to cardiology, particularly the electrocardiogram. She completed her fellowship in internal medicine in 2019 and received her MBChB degree in 2013, cum laudeWE'D LOVE YOUR FEEDBACK ON THIS EPISODE – Visit the Microbe Mail website to sign up for updates Follow on:Instagram: Microbe_MailX/Twitter: @microbemailFacebook: MicrobeMailTiktok: @microbe.mailWatch this episode on our new YouTube channel: Microbe MailE-mail us: mail.microbe@gmail.com

In this episode, Dr Kat Ralston chats with Dr Nik Rae about infective endocarditis. They discuss the complexities of clinical presentation in this condition and share tips to help you in your diagnostic journey. They explore a pragmatic approach to management, including individualised decision making and the emerging evidence base for use of oral agents. Dr Nikolas Rae is a Consultant Physician in Infectious Diseases and Acute Medicine with a range of clinical interests including infections in people who inject drugs, blood borne viruses, mycobacterial and fungal infections. Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC). Recording date: 7 November 2024 -- Useful Links -- Oral vs IV antibiotics systematic review - https://pmc.ncbi.nlm.nih.gov/articles/PMC8901545/ European Society of Cardiology (ESC) Endocarditis Guidelines - https://academic.oup.com/eurheartj/article/44/39/3948/7243107 WikiGuidelines Endocarditis Consensus Statement - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807791 Scottish Antimicrobial Prescribing Group (SAPG) penicillin allergy de-labelling guidance - https://www.sapg.scot/guidance-qi-tools/quality-improvement-tools/penicillin-allergy-de-labelling/ -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE events -- https://events.rcpe.ac.uk/ -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk

In this podcast, Dr. Valentin Fuster discusses a groundbreaking study published in JACC that examines the impact of the POET trial on the treatment of infective endocarditis. The study found that transitioning to oral antibiotic therapy after just 10 days of intravenous treatment reduced hospital stays by 8 days, without increasing mortality, and lowered relapse rates of bacteremia, suggesting a major shift toward oral antibiotics as a viable alternative to prolonged intravenous therapy.

In this episode of MedPOD AFMC, Brig (Dr) J Muthukrishnan hosts Wg Cdr (Dr) Rohit Vashisht, Professor of Medicine and Infectious Disease expert from AFMC, Pune, for an in-depth discussion on infective endocarditis. The episode delves into the clinical presentations, risk factors, and diagnostic challenges of this life-threatening condition. Dr. Vashisht shares insights into identifying complications, understanding microbial etiologies, and the essentials of effective treatment strategies. This episode offers valuable information for healthcare providers managing complex infectious diseases and aiming to improve patient outcomes

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on impact of guideline changes on endocarditis prevention and an increase in oral streptococcal endocarditis among moderate-risk patients.

Synopsis: In this episode of Biotech2050, Praveen Tipirneni, CEO of Morphic Therapeutics, shares insights on Morphic's strategic IPO, the rising interest in autoimmune treatments, the journey of their alpha 4 beta 7 program, and maintaining a conservative yet opportunistic approach in biotech. He also discusses the importance of building a strong team, navigating the complex biotech landscape, and the value of enjoying the journey. Biography: Praveen Tipirneni, MD, MBA is Chief Executive Officer of Morphic Therapeutic Inc. Previously, he was Senior Vice President of Corporate Development and Global Strategy at Cubist Pharmaceuticals, a position in which he served from 2002 until the company's acquisition by Merck in 2015. In his time at Cubist, he was a member of the clinical group working on the Cubicin NDA (skin and skin structure infections) and sNDA (Staph. Bacteremia and Endocarditis) teams. He was head of business development since January 2006. Prior to joining Cubist, Dr. Tipirneni worked at Sun Microsystems in corporate strategy, Covad Communications in Corporate Strategy, and Deltagen in business development. He also served time as a 1st Lieutenant in the U.S. Army. Dr. Tipirneni received a bachelor's degree from MIT in mechanical engineering and an M. D. from McGill University. After completing his post-graduate residency in Internal Medicine at University of Illinois, Chicago, he received his MBA from the University of Pennsylvania's Wharton School of Business in healthcare finance.

This week we delve into the world of antibiotic prophylaxis for dental procedures. What are the data to support its use in the congenital heart patient? Why has this been such a difficult topic to study? What do we now know about this topic and what still remains unanswered? Given the low prevalence but dire consequences of this disease, how can investigators consider studying this topic in the future? Is there adequate equipoise to proceed with a randomized controlled trial? We speak with Advanced Imaging Fellow at Boston Children's Hospital, Dr. Francesca Sperotto of Harvard University about her recent multicenter meta-analysis of 30 studies including over one million cases of endocarditis. DOI: 10.1001/jamacardio.2024.0873

Commentary by Dr. Valentin Fuster

This week, on the 50th episode of The Beat, Editor in Chief Joel Dunning discusses the importance of work–life balance as a cardiothoracic surgeon and how Prof. Shanda Blackmon's book, The Support Group, has driven this point home for him. In addition, Joel discusses outcomes following redo mitral valve surgery, the validity of the GERAADA score in predicting mortality, and mechanical versus biological aortic valve replacement for endocarditis. He also talks about radial artery to LIMA T graft formation, an interview with Leonard Girardi, and a World's Best Series interview with Lars Svensson. Before saying goodbye, he discusses upcoming events in CT surgery and closes with an honorable mention to Prof. Blackmon. JANS Items Mentioned Early and Long-Term Outcomes Following Redo Mitral Valve Surgery in Patients With Prior Minimally Invasive Mitral Valve Surgery  Validation of GERAADA Score to Predict Thirty-Day Mortality in Acute Type A Aortic Dissection in a High Volume Aortic Center  Survival and Recurrence of Endocarditis Following Mechanical Versus Biological Aortic Valve Replacement for Endocarditis in Patients Aged 40 to 65 Years: Data From the INFECT-Registry  CTSNet Content Mentioned Deep Dive Into Total Arterial Anaortic Off-Pump Coronary Artery Bypass Grafting: Radial Artery to LIMA 'T' Graft Formation  Advocating for Surgical Aortic Valve Replacement: An Interview With Leonard N. Girardi  World's Best United States: Aortic Root Replacement and an Interview With Lars Svensson Other Items Mentioned CTSNet Events Calendar Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Commentary by Dr. Valentin Fuster

Welcome to this high-yield episode on infective endocarditis! Join us as we explore the diagnosis, etiologies, and management of this complex disease. We hope you find this helpful!

Commentary by Dr. Candice Silversides

Commentary by Dr. Valentin Fuster

In this episode of CTSNet's flagship podcast, editor in chief Joel Dunning sat down with CTSNet Global editor Emily Farkas to discuss their favorite sessions at the STS annual meeting in San Antonio, Texas. After talking about the breaking news and best presentations at the meeting, the pair discussed the latest clinical content on CTSNet. JANS Items Mentioned Surgery and Transcatheter Intervention for Degenerative Mitral Regurgitation in The United States  Little Owen's Big Milestone: The Piece of Heart Transplanted to Cure His Heart Failure Has Grown Along with Him  Surgical Ablation of Long-Standing Persistent AF: One-year Outcomes from the CASE-AF Registry  CTSNet Content Mentioned Mastering Redo Surgery after TAVR: Aortic and Mitral Replacement with Double Patch Repair and Aortic Root Reconstruction in Endocarditis after TAVR  Sponsored Content: How OPCAB Can Enhance Your Practice  Bridging Technology and Education: The Development of a Telesimulator and Curriculum in Endoscopic Mitral Valve Surgery  Other Items Mentioned STS Annual Meeting Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

TRIGGER WARNING*** ***sex trafficking, domestic abuse, assault, SA and pregnancy termination My conversation today with Christina Garofalo will have you both laughing and crying. Christina is a survivor in the truest form of the word. I was blown away by her vulnerability, authenticity and the strength she has shown in escaping the world she was trapped in, making it back to her hometown and family in San Diego AND tapering down from an incredibly high dose of methadone (170 mL). Christina now has a sponsor, works steps, goes on twelve step retreats and does EMDR therapy - she has worked so hard to find healing, peace and safety and I am personally so proud of her. Connect with Christina on Instagram Connect with Christina on TikTok Connect with Jeannine on Tiktok Connect with Jeannine/the show on Instagram --- Send in a voice message: https://podcasters.spotify.com/pod/show/jeannine-coulter-lindgren/message

In this episode, our host Raquel Faria, will be discussing two challenging lupus cases with Professors Ricard Cervera and David Isenberg from the Lupus Academy Steering Committee. Case 1. A patient admitted with fever, acute pain in the second finger of her right hand and a heart murmur. Case 2. A patient admitted following 6 days of muscle pain in both arms and legs as well as increase in her fatigue and mild fever. Disclaimer: ‘During Lupus Academy podcast episodes, participants may refer to off label use of medicines for patients with lupus. Lupus Academy does not make any recommendations about using a medicine outside the terms of its approved licence for use.'

CardioNerds (Drs. Amit Goyal, Matthew Delfiner, and Tiffany Dong) discuss infective endocarditis with distinguished clinician-educator Dr. Michael Cullen. We dive into the nuances of infective endocarditis, including native valve endocarditis, prosthetic valve endocarditis, and right-sided endocarditis. Notes were drafted by Dr. Tiffany Dong, and audio editing was performed by student Dr. Adriana Mares. The CardioNerds Beyond the Boards Series was inspired by the Mayo Clinic Cardiovascular Board Review Course and designed in collaboration with the course directors Dr. Amy Pollak, Dr. Jeffrey Geske, and Dr. Michael Cullen. CardioNerds Beyond the Boards SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes The physical exam is crucial in the evaluation of infective endocarditis and includes cardiac auscultation and a search for sequelae of endocarditis, such as immunologic and embolic phenomena. The modified Duke Criteria categorizes the diagnosis of infective endocarditis into four different buckets: definite endocarditis by pathology, definite endocarditis by clinical criteria, possible endocarditis, and rejected. The diagnosis of endocarditis may involve several different imaging modalities, including transthoracic echocardiogram, transesophageal echocardiogram, 4D CT, and nuclear imaging. For left-sided endocarditis, indications to operate include endocarditis due to S. aureus or fungi, heart failure, evidence of perivalvular complications, persistent bacteremia, and large vegetations. The management of endocarditis often involves multiple teams, including cardiology, infectious disease, addiction medicine, neurology, anesthesiology, and cardiothoracic surgery. Notes What signs/complications of endocarditis are apparent on physical exam and labs? A new or worsening cardiac murmur with possible signs of volume overload. Vascular phenomena encompass splinter hemorrhages, conjunctival hemorrhages, Janeway lesions, mycotic aneurysms, and TIA/strokes. Immunologic phenomena include glomerulonephritis, Roth spots, and Osler nodes. Positive blood cultures with 2-3 samples collected. Elevated inflammatory markers. How does the modified Duke criteria assist in the diagnosis of infective endocarditis? The modified Duke criteria separate the diagnosis of endocarditis into four categories: definite endocarditis by pathology, definite endocarditis by clinical criteria, possible endocarditis, and rejected endocarditis. Definitive endocarditis by pathology requires pathologic confirmation of “bugs under the microscope.” Definitive endocarditis by clinical criteria requires two major criteria, one major and two minor criteria, or all five minor criteria. Possible endocarditis requires one major and one minor or three minor criteria. Major criteria:Positive blood culture for typical organism Evidence of endocardial involvement (e.g., vegetation on echo) Minor CriteriaPredisposing clinical factors (e.g., intravenous drug use, known valvulopathy)FeverImmunologic phenomenaVascular phenomena Blood culture for atypical organism What is the role of TTE compared to TEE in endocarditis? TTE and TEE both have their roles in the workup for endocarditis. TTE can provide a baseline screen and yield a better understanding of ventricular size and function than transesophageal. The strength of TEE is the ability to visualize smaller vegetations along with perivalvular complications that may be missed on TTE. If clinical suspicion is high for endocarditis, repeat echocardiography is warranted. What are other tools to evaluate for endocarditis in prosthetic valves? TTE and TEE remain important and should be commonly utilized for the diagnosis of endocarditis.

In this episode of Heart Matters, Matt Ducsik, Associate Vice President of Clinical Institutes at Providence, is joined by Jim Walsh, MD who specializes in Addiction Recovery Services at Swedish Medical Center in Seattle, Washington, and James Brevig, MD, FACS, a Cardiac and  Cardiothoracic Surgeon at Providence Cardiac Surgery in Everett, Washington.Our panel discusses the important topic of how we treat the whole person when caring for cardiac patients, especially those who are poor and vulnerable. In this case, we will be talking about a specific heart condition that disproportionately affects patients with substance use disorder, many of whom are without stable housing or access to other basic health services. Be sure to tune in and listen to the other episodes of Heart Matters or subscribe to have the latest episode delivered to your favorite podcast platform.For more information and resources, visit:ProvidenceProvidence Heart InstituteBoston ScientificMatt Ducsik's LinkedIn

ESC 2023: New Endocarditis Guideline

On episode #36 of the Infectious Disease Puscast, Daniel reviews the infectious disease literature for the weeks of 8/17 – 8/30/23. Host: Daniel Griffin Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Detection of rotavirus in respiratory specimens from children aged under 2 years hospitalized for acute gastroenteritis (JID) Risk of Bell's palsy following SARS-CoV-2 infection (CMI) Evaluation and management of diabetes-related foot infections (CID) Impact of mandatory infectious disease specialist approval on Clostridioides difficile infection rates and testing appropriateness (CID) Role of cerebral imaging on diagnosis and management in patients with suspected infective endocarditis (CID) Identifying effective durations of antibiotic therapy for the treatment of carbapenem-resistant Enterobacterales bloodstream infections (CID) Impact on clinical outcome of follow-up blood cultures and risk factors for persistent bacteraemia (CMI) State-of-the-art review: Neurosyphilis (CID) Oritavancin compared to the standard of care for treatment of non-endovascular gram-positive bloodstream Infections (OFID) How to approach suppressive antibiotic therapy following debridement, antibiotics, and implant retention for prosthetic joint infection (CID) 2023 Duke-International Society for cardiovascular infectious diseases criteria for infective endocarditis (CID) Adjunctive diagnostic studies completed following detection of candidemia in children (JPIDS) Oral lipid nanocrystal amphotericin b for cryptococcal meningitis (CID) Efficacy of 23 commonly used liquid disinfectants against Candida auris (IC&HE) Burrow ink test for scabies (NEJM) Evolution of partial resistance to artemisinins in malaria parasites in Uganda (NEJM) Human neural larva migrans caused by Ophidascaris robertsi ascarid (EID) Music is by Ronald Jenkees

Cardiac surgeons Dr. Michael Reardon from Houston Methodist and Dr. Bradley Leshnower from Emory University with interventional cardiologist Dr. Sachin Goel from Houston Methodist discuss SAVR versus TAVR. Topics include: which patients benefit from SAVR procedures, considerations for optimizing SAVR via root enlargement, and lifetime patient management as it relates to SAVR versus TAVR procedures.

Last week, Sarah shared the story of a patient who was finally diagnosed with infective endocarditis after presenting with several symptoms, including fever, tachypnea, chest pain, hypotension and more. In this episode, she'll further explain how the patient was diagnosed and the pathophysiology of this type of infection.Sarah goes over how septic emboli form, and the clinical manifestations that result when they travel in the body as well as the risks and signs of valvular damage to look out for when you've diagnosed infective endocarditis.You'll also learn the areas of the body that can be affected by endocarditis, the diagnostic criteria, and what conditions can predispose a patient to infective endocarditis. Sarah covers the critical role that nurses can play in treating these at-risk patients and how education and compassion can make the biggest difference in the patient's long term outcome.Make sure you're prepared to recognize the signs and symptoms of infective endocarditis and tune into this episode now!Topics discussed in this episode:What predisposes a patient to infective endocarditisWhy and how bacteria starts to formWhat happens after bacteria has invaded the bodyHow endocarditis can lead to dysrhythmiasThe formation of mobile septic emboli and their dangerHow infective endocarditis presents in a patientCommon symptoms of infective endocarditisHow the diagnosis of infective endocarditis is madeThe two treatment options for infective endocarditisThe Nurse's role in caring for this patient populationMentioned 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 CourseIf you would like to check out Sarah's 1hr, 1 CE course, go to: http://www.rapidresponseandrescue.com To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

In part one of this two part series, our host Sarah Lorenzini shares a story about a patient she was called to see who was under the care of nurse Clayton, a trusted colleague and previous Rapid Response Podcast guest, after he saw a drop in the patient's blood pressure and had a gut feeling something wasn't right. Sarah walks us through her assessment and how the team came to the conclusion that this patient had infective endocarditis.In part two of this series, Sarah will elaborate on this case by explaining how bacteria or fungus grows inside the cardiac muscle, how infective endocarditis presents itself in patients, and the different diagnostic criteria for endocarditis.Topics discussed in this episode:Clayton's concern over a patient's drop in blood pressureSteps Sarah took to assess the patientWhat they found after calling for an expedited echo for the patientWhat is infective endocarditis?Introduction into infective endocarditisMentioned 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 CourseIf you would like to check out Sarah's 1hr, 1 CE course, go to: http://www.rapidresponseandrescue.com To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

On episode #28 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 4/26 – 5/10/23. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Unprecedented outbreak of West Nile Virus (CDC) Approval of first RSV vaccine approved for individuals 60 years and older (FDA) FDA approves orally administered fecal microbiota product for the prevention of recurrence of C-difficile (FDA) Using thermal imaging to track cellulitis (OFID) Burden of Typhoid and Paratyphoid fever in India (NEJM) Early switch to oral antimicrobials in brain abscess (CMI) Considering vancomycin alternatives for pediatric methicillin-resistant Staphylococcus aureus bacteremia (JPIDS) Navigating treatment options for Carbapenem-Resistant Acinetobacter baumannii-calcoaceticus complex infections (CID) 2023 Duke-ISCVID criteria for infective Endocarditis (CID) Molecular characterization of Candida auris outbreak isolates in Qatar from COVID-19 patients (CMI) Amplicon sequencing reveals complex infection in infants congenitally infected with Trypanosoma cruzi (JID) Impact of Sequestration on Artemisinin-Induced Parasite Clearance in Plasmodium falciparum Malaria (CID) Advances in artificial intelligence for infectious disease surveillance (NEJM) Music is by Ronald Jenkees

Renee lost her daughter Sabrina to Endocarditis due to substance use on November 30, 2019. Sabrina struggled for many years with substance use and Renee joined the show to share Sabrina's story and a powerful message for anyone struggling not to give up. Renee can't go back and save her daughter but she hopes to help others by sharing their story. This is Sabrina and Renee's story on the sober motivation podcast. ------------ Check out Renee on TikTok Gofund Me Page  Check out Sober Motivation on Instagram Check out the SoberBuddy App Check out Soberlink More information On Palm Beach Recovery Center's

Commentary by Dr. Valentin Fuster

On episode #25 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 3/23 – 3/29/23. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS Become a patron of Puscast! Links for this episode Blocking NS3–NS4B interaction inhibits dengue virus in non-human primates (Nature) First evidence of locally acquired Dengue infection (CDC) Respiratory viral infections in recipients of cellular therapies (OFID) Evolving Japanese encephalitis situation in Australia (JTM) Attainment of target antibiotic levels by oral treatment of left-sided infective endocarditis (CID) Utility of PCR vs serology based testing in immunocompromised patients with Bartonella (OFID) Source-associated mobile genetic elements to identify zoonotic coli infections (OneHealth) The risk of urinary tract infection in vegetarians and non-vegetarians (Nature) Hydrocortisone in severe community acquired pneumonia (NEJM) Adjunctive dexamethasone treatment in adults with Listeria monocytogenes meningitis (The Lancet) Worsening spread of Candida auris in the United States (AIM) Origin, resistance, and spread of the emerging human fungal pathogen Candida auris (PLOS) Emergence of Candida auris (mBio) Invasive aspergillosis in liver transplant recipients (Transplant ID) Trends in reported babesiosis cases (CDC) PCR assay for diagnosis of tick-borne infections in children (OFID) Molecular evidence of widespread benzimidazole drug resistance in Ancylostoma caninum (PLOS) Emphasis of diversity, equity and inclusion on U.S Adult Infectious Disease Fellowship program websites (JID) Music is by Ronald Jenkees

Announcements: The interactive Clinical Pathways have launched and they are available for free! In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the March 2023 Emergency Medicine Practice article on Emergency Department Management of Infective Endocarditis-Associated StrokeEpidemiologyPathophysiologyPopulations at RiskComplicationsIntracranial hemorrhageAneurysmsHeart blockPrehospital CareED History and ExaminationImagingAntibiotic TherapySurgical TreatmentSpecial PopulationsSummary

The Beast's Great Deception (8) (Audio) David Eells - 4/2/23 Worse Than You Thought it Would Be  Dana Coverstone - March 10th and 18th 2023 (David's notes in red) (I had this dream three or four days in a row and it was the same dream over and over and over up until the news guy (Jesus) shows up. (The repetition of the dream reminds us of Joseph's interpretation that a dream will surely come to pass.) The dream starts off with a time frame going back a decade because things were safer and my children were 10 years younger.) The dream began with me loading an 80's style station wagon with lawn chairs, blankets, and large coolers. (The station wagon indicated to me a time of good work ethics and a family focus.) My kids were younger like the ages of between 10 to 15. They were excited about going to a very large fireworks display close to the town we lived in. … I didn't recognize exactly where I was. …It was in the early evening and traffic was very heavy. I saw SUVs and trucks loaded down with outdoor items as we got closer to the fireworks location.  There were signs pointing to parking and other carnival-like activities … and rides and a lot of music…. Parking for the carnival was over this extremely large field, like three to four football fields and the fireworks area was set up near an area that had been barricaded. … People were walking around blankets on the ground getting ready for the fireworks display. The place was packed with cars and hundreds of people. It seemed like every child there had sparklers and the teens were lighting up bottle rockets and firecrackers with adult supervision which made me think of the 80's when things were a little bit different. There was a bluff area that overlooked the flat ground and we decided to pull the car up there and park, so we got the blankets, lawn chairs, and food out. (This bluff that we were on was an overlook area meaning, not just for a better view, but an access to a safer way to get out of there.) (Like he was expecting to leave the celebration in a hurry.) We began to talk about the fireworks that were about to be displayed. Then there was this announcement over some loudspeakers that they would start in 15 minutes. Patriotic music began to play but … I didn't get the feeling that it was actually like a July 4th or a Flag day. It may have been in the dream but I'm just telling you I didn't get that feeling. (The patriotic spirit is very prevalent right now. The Alliance of nations are planning a celebration of their victories over the DS. But we have been told by the Lord for some time that He is going to use DS Babylon to judge the apostate people of God and Americans even though this will also be worldwide.) (I don't necessarily think it was a July 4th event. It could've been but I believe it was indicative of “big events” that draw people's attention to the country itself and the patriotic music meant that something's going to happen with the country. As we will see, it was a country-wide attack. (Our country is very polarized and many are angry about the destruction that the Left is bringing to the country and are about to celebrate a victory over them.) It's close. I did not get a sense that this was a terrorist event. I'm not saying it's a natural thing either. No one knew what was going on. No one knew where it came from or who was behind it.) (It's not a terrorist event because it is an internal civil war, the difference being, now the Left is killing civilians instead of military.) …When the patriotic music began to play, the crowd began moving, laughing, and getting ready for the fireworks. The entire field below us was filled with people. …It appeared to be literally thousands of people excited to see the show and after a bit the announcer asked everyone to stand for the national anthem. (I noticed that when the guy called for the national anthem everybody began talking and everybody got up. (So, we can be sure this is a crowd of conservative people.) So, I think this indicates we're going to see a whole lot of things happen as far as how people feel about the country and most people today will agree with me that it's gone downhill in the way that people look at the country and its leadership.) When it stopped it got very quiet and the people sat down on the ground. My family all did as well. The first shots of the fireworks rose straight into the air and seemed to go up forever but there was no noise or lights; no explosions. It was literally two minutes of silence with everybody looking up until there was this horrific noise like a bomb going off. (Everybody was looking up. We were all distracted before we realized what had happened and it wasn't fireworks going off but something a whole lot worse and once again, I'm not saying war or missiles because I saw no military equipment at all in this dream.) My family and I jumped being startled and everybody else jumped too. It was just so loud and so sudden. There were huge flashes of light like hundreds of flares had suddenly been uncapped. There was debris raining down on people and hot bits of fire, sticks, and paper. Bigger than expected chunks of wood and pieces of brick were hitting people. They were screaming and running down there on the field. (People didn't recognize what had happened because we were all looking up waiting for the fireworks. We were distracted, waiting for what was going to happen. We knew something was going to happen, we just did not know exactly what it was. But after those fireworks or whatever it was exploded, everybody knew and it got really bad, really quick.) The announcer came on and told people to remain calm as the problem would be remedied soon. …He said in a very very calm voice. Just then, another blast of fireworks shot into the air, but they sounded more like F-16s taking off. (F-16's taking off could represent the military, left and right, getting involved.) They were really loud, and they had the same effect in the air after a few minutes of silence. Then they exploded like a bomb. Now people were running everywhere. Some had their clothing and hats on fire. People were yelling for their kids to “Come here. Hurry come on let's go!” They were trying to get to their cars. Some of the cars were now burning and people were running towards the bluff where my family was. (When judgment comes people seek for “higher ground” spiritually.) I told my kids to leave everything and get in the car as fast as they could. (Time to come out from among them.) This is when it got harrowing because there was still debris falling and burning things and people screaming and running for their lives. More and more of the cars in the field were burning now and people were frantic for safety. … (We didn't notice until we had to get to safety, so this thing happened out of nowhere. It was dangerous and everybody knew something bad had just happened. Obviously, something had gone wrong but it was obviously planned because it was happening everywhere.) There were people surrounding my car and beating on the windows. (Suddenly, people want to get into the Ark, but a little late.) This car was a station wagon which I've never owned in real life. My father owned many of them. (Representing the Father who owns our vehicle through the purchase of Jesus' blood.) The entire inside of that car was so small nobody else would fit so, I just hit the gas … because the crowd was dangerous. They had this crazy looks in their eyes and were pulling on the door handles. (Like they were outside the Ark.) The doors were locked, and my kids were holding each other and we were just trying to get out of there. My wife and my kids were terrified so I maneuvered the car down the bluff and got back on the road. (The crowd was dangerous. They were trying to get away at all costs because their cars were on fire. (It's not water this time, it's fire.) At that moment, my family and their safety became the most important thing to me… This might indicate that we're going to need to be careful about being in large groups or around a lot of people.) That's when we realized that this was not just a fireworks event. There were houses burning and cars along the road that had been abandoned. The sky was alive with fire and darkness and I'm not talking about lightning. It seemed like there was fire burning in several places in the air. There were cars underneath overpasses that were kind of waiting it out. (Overpasses are a play on the word “Passover”. God's people will have a passover during these judgments.) People were watching the skies … in the cars, out of the cars, under the overpasses, … leaning out and looking up to see what was going on. I was trying the radio but there was only static. I stopped under the underpass and asked, really quick, if anybody knew what was going on but nobody knew anything. EMP People were trying to make phone calls, but the calls weren't going through …because of the overwhelming number of calls. We got back on the road and I headed home as fast as I could. Now the roads were littered with trash and cars were parked and there were burning trees and overall chaos. (I was made aware that this bigger event was more than just the local fireworks because it had impacted the whole country. The sky seemed to be angry at America. There was fire and darkness but no flashing in the sky. It was almost like the sky was reflecting the earth and the fires that were burning down here. People were hiding under those overpasses wondering what else the sky might unleash. The cell phones weren't working. Busy signals were being heard. It was like a war zone but without the military equipment involved that's the best way I can describe it.) We got back to the place where we lived and got in the house and locked the doors. Then we turned the TV on and there were emergency tickers going across the bottom of the screen and local numbers to report damage. There was no mention of war missiles. I saw no military equipment either. There were reporters with SAT phones, and they were running… and frantically trying to talk to people. They were saying here's what's going on here and they were sharing information and talking quickly with other people in the newsroom.  I also saw a whiteboard and it had gibberish all over it, in other words, when they got a report, they'd write something down and somebody else would come and scratch that out and write something else. They were trying to figure out what in the world had just happened. Nobody had any clue. They were red-eyed and frantic trying to figure out what had happened, just like most of the crowd. There was no accurate reporting of, “this is what's happened” or “we've been invaded” or “there's war, we've been bombed”. There was fear and panic and a seeming blackout. This event happened so fast and so unexpected that nobody had a clue of what was happening. Then I heard a camera man say, “We're going live in five, four, three, two, one and then sitting at the desk in the newsroom was the man I always see in the dreams. I knew him to be Jesus. He was wearing a modern dress shirt and looking at a clipboard. He looked directly into camera, and He began reporting. (Jesus is coming by Spirit of the latter rain as Hosea 6:1-3 says. He is coming in a body of reformers, hence the modern garb, at the beginning of peace being taken from the earth. Jesus in the Man-child will be the only one to speak the true Good News. You can't get that from the right or the left. He will report the true news according to Rev. 6:1-4 Then I watched as the Lamb opened one of the seven seals, and I heard one of the four living creatures say in a thunderous voice, “Come!” 2 So I looked and saw a white horse, and its rider held a bow. And he was given a crown, and he rode out to overcome and conquer. 3 And when the Lamb opened the second seal, I heard the second living creature say, “Come!” 4 Then another horse went forth. It was bright red, and its rider was granted permission to take away peace from the earth and to make men slay one another. And he was given a great sword.) Jesus said, “We have gotten report after report of strange occurrences at outdoor activities and 911 calls have been overwhelmed and have overwhelmed the entire nationwide system. Many of you are aware that chaotic events spread over the entire country have left fires and confusion on every front. (We have received dreams of people crying because the country had been burned. They were saying this didn't have to happen.) Then He said, “Let me be very clear; it is worse than you thought it would be. You were warned and told that perilous times were coming but, this is worse than you thought it would be. Many have ignored the truth and now it is worse than you thought it would be.”  At this point, tears began to come down His face. …He put His hands on His face and lowered His head down. …Then He composed Himself, looked at the camera again, and spoke further but those tears continued … He said, “Don't leave your first love. Do not fear what you're about to suffer. Stay repentant in the center of my will. Overcome. Walk through the open door. Stay disciplined. I will walk beside you during persecution and pain.” When he said that word pain, at that moment, a tear streamed down his face and hit the desk and it had this amplified effect. (It reminded me of the tear in the movie, The Passion of the Christ that fell after Christ died.) (When the tear hit the ground in this movie, that's when the earthquake happened that rent the vail in the temple.) Jesus went on to say, “Many will say that it's worse than they thought it would be and they will be right. So, remain hard braced and battle ready. I Am coming and my reward is with me and I Am with you always … (The complete text quoted from here is Isa. 62:11 Behold, Jehovah hath proclaimed unto the end of the earth, Say ye to the daughter of Zion, Behold, thy salvation cometh; behold, his reward is with him, and his recompense before him. So, we see Jesus is coming in a modern body of people to save the Bride and judge His enemies.) Jesus went on to say, “These are the hard facts in the news as I am reporting it to you in Living Color.”  I turned the TV off and looked at my kids who now appeared to be their ages that they are today. (The day he speaks of here is upon us.) So, in the dream they aged about 10 to 12 years. (My kids aging in the dream represent that the chaos has been ongoing under our noses. I also think that my kids being older at the end of the dream represents the absolute necessity for maturity in our wisdom, in our thinking, in our in the steps that we take, because it's going to be hard to navigate these times if we're not mature in our faith serving the Lord, hearing his Word.)  We all joined in a circle and began to pray for boldness and strength when there was a knock at the door. Without fear I opened the door and there were several families who were crying and holding smaller kids and they asked if they could please come in so we could explain to them and help them understand what was going on. So, we invited them into our home and when the door was shut and all that noise from the sirens and the chaos outside stopped. A little girl with one of the families said, “I feel better in here than I did out there!” Then I woke up. The news anchor that I recognized as Jesus very calmly spoke to the viewing audience. In other words, people are going to need answers. Even the Christians needed answers to the dilemma as well. I mean the entire country's been hit with something. The news anchor Jesus says, “It's worse than you thought it would be” three times. And then He said you didn't listen to the concerns. You didn't listen to all the situations that were going on. Many of you are aware that you were born into perilous times. Many have ignored the truth and now it's worse than you thought it would be. At that point he begins to cry. Why? Because something's happened and people don't know what to do. They're scared. There were probably people who were dying but I did not see dead bodies. (We have already shared that there are going to many dead among the enemies of God's people especially; it's the Red Sea time of their destruction going into the wilderness tribulation.) I did not see burning bodies. (Many times, vehicles represent our mobile tabernacles or bodies. He saw vehicles burning and abandoned representing death.) Three times he says you were warned but not ready. You were told but you're not believing. You were hearing but not listening, and therefore unprepared. But I believe the tears of Jesus reveal the heart of God for his people and the compassion He has for us. You know He's for us which is why He warned us to begin with. The next thing He said was, “Don't leave your first love. Do not fear what you're about to suffer. Stay repentant in the center of His will. Overcome. Walk through the open door. Stay disciplined. Those things come from what Jesus spoke to the seven churches in Revelation … Every one of those churches Jesus spoke a message for. He's telling us what's coming so we can be prepared and that's what the amplified tears represent. These cries from God's elect to be heard by the body of Christ and felt, so we can rise above the chaos and work and serve despite the circumstances in other words folks God's calling us to be the medics in the middle of the battlefield; going out to help. …  We need to be rooted spiritually and deeply rooted because chaos is coming. He says, “It's worse than they thought it would be.” So, remain hard braced and battle ready. I've never heard Him say in my dreams anything about being hard braced. We cannot ignore the facts that difficult perilous times are definitely coming. This is the time you better be repenting. This is the time you better be in the Word. This is the time you better be praying in the Spirit. This is the time you better be hearing the voice of God. This is the time you better be connected to believers… (When Moses picks up his staff to part the waters, you'd better be ready to cross by faith.) With the things that we're facing, we need to realize that things are about to get tough, and we can't “play games with God” anymore. Don't ignore the truth. I think this also says that death is going to come to some of us. There's going to be martyrs among God's people; yes, even here in America. Jesus goes on to say, “These are the hard facts in the news. I'm reporting to you in Living Color.” Hard warnings are coming to us and being reported to us by Jesus himself. These things are going to come to pass. …The truth of who you are as a believer is going to be revealed to the “watching world” and your weaknesses, your shortcomings are going to be seen. It's all going to come out if you're really serving God, really living for him. …. Living Color means everywhere the truth of what's going on is going to be seen by everybody. Most people don't have black and white TVs anymore representing that things have changed. Living Color, I believe, means … the real is what will be seen by everybody. The thoughts and the intentions of the heart, as well as the real commitment we have to serve Jesus is going to be seen by everybody. (Turning off the TV represents turning off worldly distractions.) We need to focus on the need of the moment, which was pray for wisdom, pray for boldness, pray for strength. We've got to hear from Him folks. (Don't look to man) You have turn them off and hear what the Holy Spirit is saying. You get into the Word until the Word gets in you. Realize that God wants to speak to His people and prepare us for what's coming and what's happening now. The people knocking on the door illustrates that we have the answers that other people need. They're going to be genuinely seeking truth in the midst of all the chaos around them. …We've got to stand strong and grounded in the Word and help people and make a difference. …We have got to speak the hard truth and not sugarcoat the Gospel. We bring the Light of Christ. …We help people understand that no matter how crazy things are out there, they can find safety in our presence because we know who Jesus is and He's with us. When the world is falling apart, that's our job….The Holy Spirit is trying to warn the church to get ready because He's got work for us to do. We pray Lord that You help us to be ready as the body of Christ. Help our eyes to see, to know who you are, and when this comes, may we stand hard braced and battle ready. May we share with the world around us the hope we have in Jesus. …God may we be the bride you've called us to be. May we be the body of Christ ready to speak the truth in love. Give us wisdom and discernment God and may we hear your words and that's our prayer today in Jesus' name, amen.    The Fire of Judgment Falls on the Apostates Missy Pollock - 7/9/22 (David's notes in red) (To preface this dream, before I had fallen to sleep, I asked the Lord to give me a dream that would let me know what He has for me ahead. Also, I was weary from all the disinformation coming from the D.S. news and alternative news media and had asked Him to give me or anyone else His Intel through dreams, visions, prophetic words etc.  So, I believe that's what He did! Thank you, Father, for quickly answering and encouraging me greatly, as well as all who read and listen to this.)  (I believe Missy is representing the Bride in this dream.) I dreamed I was resting on a daybed with sky blue sheets, just like the one I've slept on when I stayed with Eve. (Representing being in the rest of the Bride; ceasing from our own works.) It was dark and I saw out the window what I thought were little meteorites falling from the sky like rain. But then I realized they were falling embers. (We are living in dark times.) …  (In part 2 of this series, “Fiery Trials Bring Revival”, Dana Coverstone said, "I saw small embers of flames that were coming down around the clock but not catching the ground on fire although it looked like fire coming down. (Missy's dream also shows the embers of fire coming down out of the sky but not catching anything on fire just like the portion of Dana's dream. Both dreams seem to show the embers as being spiritual, A fire from Heaven. Also, it's the fire one feels when going through a test and denying their flesh.) So, these explosions of the lights were spreading out and the flames were going hundreds of miles beyond them. (This connects this dream with Dana's dream about the fireworks exploding and the damage extended nationwide.) Back to Missy's dream: I went outside with a dustpan and brush to sweep up the remnants of what I saw and to look at it. But there was nothing in my dustpan. (I believe Father put that in my dream to show me that what I saw falling from the sky, wasn't physical but spiritual. Also, I didn't get burnt by it.) (It was the judgment from Heaven falling as fire. Elijah called down fire from Heaven on Jezebel's apostates. This fits the dream as we will see.) The house was on top of a hill. (Representing Mt. Zion, the Bride who is over the rest of God's elect.) My father (Representing the Father) came, and we got into a white SUV. (Representing a vehicle of holiness where there is safety.) I called my husband, who was in the house, and asked him if he saw the embers that were falling from the sky, and he said that he did. (Those on top of Mt. Zion have spiritual eyes to see and ears to hear. The Bride will point out these judgments from God and many will be saved.) My father took me for a drive to see what had caught on fire from the embers falling from the sky. We were at the bottom of the hill and as we drove up an incline, I saw some really old houses engulfed in fire. (This represents the fire of judgement that burns up of the wood, hay and stubble and purifies the elect of God's people, i.e., REVIVAL!) (The really old houses near the bottom of Mt. Zion represent the apostate religious institutions that are going to experience judgment for ignoring the call to climb Mt. Zion.) The next thing I know, my husband and I were at my son Curt's house. (Curt is my second son and spiritually represents the fruit of Christ in me.) His house was on top of the same hill (Representing Mt. Zion) that I was on at the start of the dream. It was built up high like the houses built on stilts along the beach to protect it from the waves. Psa 18:2 Jehovah is my rock, and my fortress, and my deliverer; My God, my rock, in whom I will take refuge; My shield, and the horn of my salvation, my high tower.) I was holding my grandson. (Representing the multiplication of my fruit of Jesus in me.) He was all swaddled up with a pacifier in his mouth. (He's not born yet and is due mid-October this year. Is this a timing thing? Is judgment going to fall not long after he's born?) I asked Curt if he had looked out the window and saw the houses burning below. He said, “yes” he did see them burning. Then I woke up.  (UPDATE: In my dream of the embers falling from the sky. I was holding Maverick who wasn't born yet, and he was swaddled.  Surprisingly, he's still being swaddled! Since the beginning of the year, especially,  there has been a lot of judgement falling.  The other morning as I was waking up and getting out of bed, I was half dreaming. I heard myself say something like, "It's now 2024"and I knew it had just turned 2024. I have a sense this is when the tribulation will begin, in 2024. I asked the Lord what this was about and by faith at random I received: Song 7:11, context 10-13, I am my beloved's; And his desire is toward me. [11] Come, my beloved, let us go forth into the field; Let us lodge in the villages. (Time to go into the wilderness tribulation, which is also the 7 day marriage feast.) [12] Let us get up early to the vineyards; Let us see whether the vine hath budded, And its blossom is open, And the pomegranates are in flower: There will I give thee my love. [13] The mandrakes give forth fragrance; And at our doors are all manner of precious fruits, new and old, Which I have laid up for thee, O my beloved. Tiannah was telling me she had an encounter or something like that before she was born again. She said that the Lord showed her we were at the time of the end of the world.  She had a knowing of the year 2024.) (The beginning of the tribulation marriage feast?) I asked for verses by faith at random for the dream. Underlined is where my finger came down. Num. 26:40 And the sons of Bela were Ard and Naaman: of Ard, the family of the Ardites; of Naaman, the family of the Naamites. (Ardites means "I shall subdue" as in God shall subdue the Church.) (Finally, now it's time to rebuild.) Neh. 2:1, (in context 1-5), And it came to pass in the month Nisan, in the twentieth year of Artaxerxes the king, when wine was before him, that I took up the wine, and gave it unto the king. Now I had not been beforetime sad in his presence. 2 And the king said unto me, Why is thy countenance sad, seeing thou art not sick? this is nothing else but sorrow of heart. Then I was very sore afraid. 3 And I said unto the king, Let the king live forever: why should not my countenance be sad, when the city, the place of my fathers' sepulchers, lieth waste, and the gates thereof are consumed with fire? 4 Then the king said unto me, For what dost thou make request? So, I prayed to the God of heaven. 5 And I said unto the king, If it please the king, and if thy servant have found favor in thy sight, that thou wouldest send me unto Judah, unto the city of my father's sepulchers, that I may build it. (The people rebelled against the Word, like the Church has, and were taken into captivity. Here Nehemiah is going to lead the return and rebuilding of the kingdom.) I asked for a verse for me, (Here again we see the captivity and the forgiveness and the return.) Zec. 8:14, (in context, 14-17), For thus saith Jehovah of hosts: As I thought to do evil unto you, when your fathers provoked me to wrath, saith Jehovah of hosts, and I repented not; 15 so again have I thought in these days to do good unto Jerusalem and to the house of Judah: fear ye not. 16 These are the things that ye shall do: speak ye every man the truth with his neighbor; execute the judgment of truth and peace in your gates; 17 and let none of you devise evil in your hearts against his neighbor; and love no false oath: for all these are things that I hate, saith Jehovah. (These Zechariah verses remind me of Psa. 15. This chapter is about the coming peace and prosperity of Zion.)  As I was meditating on this dream about the embers falling subconsciously this song was going through my head over and over until the Lord got my attention. It was a song that I had listened to a couple days before. It's a song called FIRE by Cece Winans.)  These are the words of that song that were going through my head…  Fire, fire - Fall on us - Start a new revival - Fire fall on us.    Jesus Showed Her the Plagues of 2023 YouTube - Great Miracles Avenue - 6/10/22 (The following is a summary of this testimony transcribed by Eve Brast. The entire video testimony linked here. This is an awesome testimony, well worth your time. This young girl grew up in a religious family and went to church and participated in religious activities. She was a good person but didn't have a relationship with Jesus. When she died, she was taken to hell before Jesus brought her back with a mission to tell the world about the coming fate of 2023.) This young African lady had been having a lot of heart trouble and chest pains and had been diagnosed by the doctors with Endocarditis. Her words: Around 10 pm one evening my heart was racing much faster than usual and my breathing was out of control, and I couldn't do anything about it. There seemed to be an abrupt cessation of my breath and I felt myself suffocating. I attempted to shift my body in the bed. After repeated attempts to cry out to my parents for help and not being heard I began to feel cold, and my spirit became detached from my body. I was propelled through space at an incredible rate of speed, and I began asking myself repeatedly if I was dead. After some time, I felt a hand on my shoulder, and I turned to see a man in brilliant white with a glowing face. I asked him if he was Jesus and He responded, “I Am the way, the truth, and the life. Come with me and I will show you mighty things that you do not know.” I asked, “Jesus, am I dead?” Jesus said, “You are here for one purpose and that must be accomplished as soon as possible. I will impact upon you my Word and ask that you disseminate it throughout the world. Let them know the great tribulation is due. It will be tougher and [feel] longer than humanity can imagine.” I was crying and started to hear sounds of screaming and pain and feeling the air. It all intensified as I was moving closer to where the voices and cries were coming from. The smell and hotness in that place was like none other. It then dawned on me that I was in Hell. I cried out, “Master Jesus!” Jesus said, “On earth you just went to church and did other religious activities because it was imposed on you by your parents, and you never looked for me with the whole of your heart.” He paused for a moment, and I observed the sorrowful reaction from his movement as they walked then He said, “This is how Hell's fire is. You won't be here for long. I want you to tell my people about the coming year 2023.”  As soon as He said this, the obnoxious scents and sounds gradually faded away and the atmosphere and power shifted to a more comfortable state. Jesus went on to say, “2023 will be a tough year and the year of more doom. The pains and sufferings of the past years will be nothing compared to the future. The avarice and greed of men will be made known. (Avarice means an extreme greed for wealth or material gain.) This will be the cause of a severe pandemic. (Obviously, the last pandemic was not what they claimed it was. The real pandemic ended up being the mRNA vaccines. So now we're speaking of another pandemic, and it is truly severe. This fits with our dreams of factious people dying.) Conflicts between nations will erupt more frequently and violently than ever before. Even the most privileged will be concerned.” After sensing my anxieties, He continued to hold my hand tightly. He went on to say, “Tell my people that in spite of everything, everyone who seeks and finds salvation in Me, I the Lord, shall be with them. I will dry the tears from their eyes and will comfort them even if the repercussions of greed continue to rule and prevail. My Father who rules beyond Heaven and earth shall bring peace to the world, but only if the world seeks repentance. Go now and tell the world.” I began to beg to stay with Jesus and asked if another could go in my stead, but Jesus said, “These are My plans for you. You were born for this purpose, and this is your mission on earth. Go and tell the world what you have seen and heard.” As soon as He was done speaking, I was suddenly knocked off my feet by a gust of wind that was so powerful that it was beyond my ability to resist its force. When I came back into my body, I could hear the sobs and wails of my mother and the doctors rushing around and I felt them taking my pulse. They declared that I was dead and that they had never witnessed a miracle like this. I had been dead from 10 pm the previous night and wasn't found by my dad until the next morning when they had rushed me to the hospital. I have relayed the information in precisely the same manner as Jesus had given it to me and I hope that everyone will take heed to the warning.  The Lord is the only cure for the things coming. Learn from God's Vaccine Book  7 simple steps to be immune from plagues/pestilences   There are Three Things God Told Me to Warn You About in 2023 Kynan Bridges - 12/31/23 (Link) God told me to warn the church in 2023 and I want to go on record saying these things. …  God said warn the church about these three things in the coming year. I need you to hear me and pay very close attention to what I'm going to say because this is very critical. … Judge this [word] and consider this and take heed if possible. Number one: The year 2023 would be a time of great deception. Deception would become a culture and we must be aware of deception. (I'm talking about deception in the media. Deception in the religious church mountain. Deception in the political mountain. Deception in business and in so many other areas. He said we needed to guard our hearts and minds against Deception. (Well, we've observed already of deceptions of demons impersonating aliens, 1,000 years of peace because they don't believe in the book of Revelation, the demon possessed AI liars, etc.) There would be such a strong push in the area of deception that people would literally lose their minds because of this. People will begin to question reality. I'm talking about the kind of deception that Paul talks about in Thessalonians. The Bible says that God would send them strong delusion that they would believe a lie. (If you are not on guard, if you are not sensitive [to the Holy Spirit], and more importantly, if you are not Biblically literate [you will be deceived].)  … Please pay attention to this because many of you will say, “Well that's already happening!” No. You've never seen anything like this. Beginning with the first quarter of 2023 they will begin to monetize and systemize this deception. It will be a systematic thing and if you're not really abiding in the truth then you would be susceptible... Number two: Write this down because this is so important. In the days to come not only will there be a lot of deception but there will be a lot of distractions. What is a distraction? Something that's meant to take your attention away from what's really happening. I'll give an example: As we speak, they're talking about all these committees and panels, but look at what they just approved, trillions of tax dollars are being spent right now and it's being spent while people are distracted with other things. People are looking over here to the left but pay attention to what's going on on the right. When they talk about food shortages, when they talk about wars, (and you know there will be an increase of fear and of global conflict) Pay attention to what's really going on. Do not be distracted in this season. The things that God has shown you in dreams, the things he's shown you in visions, but more importantly what he has shown you in his Word, lay hold on those things and do not let go of what God has spoken to you. I'm telling you God's gonna do some things in 2023 that are very very supernatural. Stay focused on the Word of God and on what God spoke to you. Stay focused on God's promises and do not be moved by distractions. Do not allow things to take your attention off of what God is speaking and doing in this season. We're going to see a lot of major distractions in the political arena in the first quarter of the year going into the middle of the year. There will be many things that are said in legislations, committees, and panels but they're all smoke and mirrors. They're just a show. There's no substance to them. Don't be distracted. They're designed and strategically orchestrated to take your attention and your focus [away from God and His plans.] Do not give in to fear.  Number three: I'm to warn you against disappointment and despair. The Bible actually says, “Let not your heart be troubled neither let it be afraid, for in my Father's house there are many mansions.” In Hebrews 10 it says, “Do not cast away your confidence which has a great recompense of reward.” I'm telling this by the Holy Ghost. Do not give in to the temptation in the upcoming year to believe that the things God has promised you have not come to pass. The devil will try to play on your emotionally. He will try to make you think, “I thought God was going to do this or I thought God was going to do that and none of it has happened.” The devil will try to use your disappointment to take you to a place of despair. That's when you give up hope and become hopeless. In this next season of our lives, we must hold on to hope which is the anchor of the soul. This is why I believe the Lord told me to warn the church in this season because as things begin to shift you need to hold on to the truth and to the Firm Foundation that God has not forgotten you friend. He is not slack concerning his promise. Maybe you that by this time you would have seen the restoration of your marriage or … whatever it may be. Listen, do not let go of “your appointment”. That's what disappointment is when you distance yourself from your Divine appointment.  God keeps his appointments even if it seems like He's not on the way, even if it seems like He's not showing up, even if it seems like it's not going to happen, do not become disappointed. The devil will try to destroy people with disappointment. He will try to talk people into giving up even to the point of taking their own lives, even to the point of conceding to that Spirit of Despair, that Spirit of hopelessness. There are many other things that I need to share with you about the upcoming year, but the Lord hasn't released me to share them yet. There's a lot of things that God's going to be be doing in this upcoming year. There's going to be great Revival that happens and begins to happen in churches. There's going to be another push in terms of infectious diseases. Infectious disease will be one of the talking points in 2023. But also, there will be unprecedented Miracles and documented Miracles. Globally we're going to see the church explode in the area of miracles, signs, and wonders.  Those are the three things God told me to tell you right now.   I'm Going To Make All Things New Julie Daughter of the King - March 2, 2023   My Dearest Sisters and Brothers in Yahushua, Yahushua teaches us all the time that we are to have His Kingdom perspective. But it's often challenging in this life to do that!  We were brought into this world for a purpose, His purpose(s), but often our self has more influence over us than we would like to admit, especially when we are downtrodden, weary and don't see any progress towards the goal and victory Yahushua has promised. It is a struggle daily to see evil escalating without being reigned in. And, when the enemy seems to be winning, then our frustrations can mount and be on full display, despite Yahushua having taught us how to operate from the Spirit and not from the flesh.  Father, we want to be launched, to bring in the harvest for Your glory! Let's go and save the lost! Father isn't it time, yet?! And, like a child anticipating a positive response to a well-presented case, we wait with anticipation and are crestfallen and discouraged when the answer is, "Not, yet." However, we must remember that Our Father has set in place a design that is so incredible in its perfection for converting the soul, that we cannot fully grasp all of it on this side. This is a word that Yahushua gave to me, as I cried out yet again, asking Him why we haven't been transformed yet!! His response was loving but very clear: Message Received Feb. 28, 2023: “My coming to heal you, to strengthen you and to transform you is not contingent on how you feel at any given moment. It is not contingent on how much the evil has increased. It is not contingent on your perspective, as to whether you 'feel' you can continue one more day in this realm, or not. I Am with you and never leave your side, and I understand how difficult this life is for all of you.  You have desires, plans, and dreams that have and will go unfulfilled. You have given up the identity that is you, so that I can manifest through you, and at times, this saddens you. My Word says I give you the desires of your heart, but this is [only] truth when you align My will with your life and allow Me to place the desires within. Desires birthed from the flesh often do not come to fruition, because these are either outside of Me or simply not needed for your growth in Me.  Things don't always go as you had hoped, and some of you are disappointed, frustrated, and even discouraged as you wait for Me. I realize the wait seems so long, but as I always tell you, without praying for My perspective, you won't have the understanding that, the appointed time I have chosen is the perfect time by My design.  There are infinite outcomes and possibilities based on each soul's choice, in even the smallest matter, every second that passes each day. Only I as Creator know the outcome of every single choice or motive. Because you hear that the victory has been won but have yet to experience it in the natural realm, you only have limited vision and understanding, as to why I have not poured out My Spirit in full measure yet.  However, I say to you evil must rise to the degree that satan and all his dark kingdom believe they have won, believe they have the upper hand, and that they are in complete control. Then, I will move upon the lands like has never been seen or done before. Then, I will pour out My Spirit as a flood that all the souls of men will know that I Am that I Am. Would you have it any other way??  When that appointed time has come, I will be known as Creator of all things, King of kings and Lord of lords. I have always offered you free will in every choice you make, never stopping you from walking the path you choose to walk. I force no one to completely surrender to Me. But when you were born again, it was your decision, freely given, to give your lives to Me as a living sacrifice. However, you can choose at any point to take matters into your own hands, because I have not moved in the way you would have Me move, yet. You could make decisions without My counsel, to fulfill your own desires and dreams, because it appears that time as you know it goes on and on. But where does this lead you?  You have been chosen before the foundation of the earth to be My kings and priests and to help Me bring in the lost. Surely, you would not rather be one of the souls needing rescue who have gone their own way. Are you not one of those chosen as My remnant, those who have been trained to walk in obedience, those who have fully surrendered their lives to Me, so I can use all of you as instruments of righteousness, bringing in the larger harvest of those who have not yet committed?  When you gave everything to Me in this life, My desires became your desires, My will became your will, and the 'you' known as your soul gave all its hopes, dreams, and desires to Me to do with as I would have it. I assure you; your wait will not have been in vain. There is a process that is taking place as you wait, as you hold the line and keep the faith, as you stand, when it's all you can do but stand, and simply abide in obedience and pray.  Many of you are sick and disabled. Many of you have suddenly found yourselves alone. Many of you have relocated, and many of you are very unsure of how to proceed. Many of you have lost loved ones unexpectedly, but nothing has happened outside of My will. I am bigger than all of this. I Am in control. I have the perfect plan in place. I see all and I hear all. I am walking through this with you, and so much is about to be revealed to you. You walk by faith and not by sight, and blessed are those who believe, even though they don't see Me.  All is about to change. I would not say this if it wasn't so. I am not a man that I would lie. I am Truth in all its essence. Trust Me My beautiful ones, trust Me. Your journey will suddenly take a turn, and all that has been hurtful here, all that has been stolen from you, and all that has caused heartbreak- All will be healed and restored!” YAHUSHUA Psa 37:4 Delight thyself also in the LORD; and he shall give thee the desires of thine heart. Isa 40:31 But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint. Jer. 29:11 For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end. Psa 40:5 Many, O LORD my God, are thy wonderful works which thou hast done, and thy thoughts which are to us-ward: they cannot be reckoned up in order unto thee: if I would declare and speak of them, they are more than can be numbered. Prov. 3:6 In all thy ways acknowledge him, and he shall direct thy paths. 1 Pe. 2:5 Ye also, as lively stones, are built up a spiritual house, a holy priesthood, to offer up spiritual sacrifices, acceptable to God by Jesus Christ. Jer. 1:5 Before I formed thee in the belly, I knew thee; and before thou camest forth out of the womb I sanctified thee, and I ordained thee a prophet unto the nations. Rev. 5:10 And hast made us unto our God kings and priests: and we shall reign on the earth. Rom. 6:13 Neither yield ye your members as instruments of unrighteousness unto sin: but yield yourselves unto God, as those that are alive from the dead, and your members as instruments of righteousness unto God. Eph 6:13 Wherefore take unto you the whole armor of God, that ye may be able to withstand in the evil day, and having done all, to stand. 2 Co. 5:7 For we walk by faith, not by sight. John 20:29 Jesus saith unto him, Thomas, because thou hast seen me, thou hast believed: blessed are they that have not seen, and yet have believed. Num. 23:19 God is not a man, that he should lie; neither the son of man, that he should repent: hath he said, and shall he not do it? or hath he spoken, and shall he not make it good? Rev. 21:5 And he that sat upon the throne said, Behold, I make all things new. And he said unto me, Write: for these words are true and faithful. SERVICES Ubbs Outreach Friday Night Worship CONTACT Share Your Testimony Request Prayer Technical Support Questions   SUPPORT US We are a non-profit organisation based in United States. Our goal is to empower and equip people to discover more about Christianity and point them to a life of happiness, peace and purpose. Donate

Today we have special guest, Dr. Sarah Gilligan, a nephrologist, to talk about the new study of thiazides for kidney stones. We all learn in medical school that thiazides reduce urinary excretion of calcium, but does that really translate to fewer kidney stones? We also have Dr. Brian Locke on to talk about the CAPE COD trial, a big new critical care paper on using hydrocortisone in severe pneumonia, as well as the latest COPD guidelines and a retrospective study of oral antibiotics for infective endocarditis. Check it out! Hydrochlorothiazide for Kidney StonesSteroids for Pneumonia Meta-analysisHydrocortisone for Severe CAP (CAPE COD)2023 GOLD COPD GuidelinesReal World Use of Oral Antibiotics for EndocarditisMusic from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

This episode covers infective endocarditis.Written notes can be found at https://zerotofinals.com/medicine/cardiology/infectiveendocarditis/ or in the cardiology section of the 2nd edition of the Zero to Finals medicine book.The audio in the episode was expertly edited by Harry Watchman.

The month of February is one we often think about love because of Valentine's Day, but it's also a month where we put the heart front and center. We put the heart first, not just because of love this month, but rather for health reasons. February is American Heart Month, it's a time when we should all focus a little more on our cardiovascular health. For this latest episode, WKYT's Amber Philpott is sitting down with University of Kentucky Offensive lineman Kenneth Horsey. Horsey is passionate about heart health, he knows all too well the reality of a heart condition and how it can change your life. In 2018, just a few months before he graduated high school he was diagnosed with Endocarditis, an infection that was attacking his heart valve. Horsey would need open heart surgery, but he had already signed to play football at the University of Kentucky and had no idea what was next. Skip ahead, Horsey is healthy and is returning this year for his sixth season as a Wildcat. Horsey is now a proud Heart Health advocate, but also focused on football and making up for a season that ended last year not the way he says he would like it.

The month of February is one we often think about love because of Valentine's Day, but it's also a month where we put the heart front and center. We put the heart first, not just because of love this month, but rather for health reasons. February is American Heart Month, it's a time when we should all focus a little more on our cardiovascular health. For this latest episode, WKYT's Amber Philpott is sitting down with University of Kentucky Offensive lineman Kenneth Horsey. Horsey is passionate about heart health, he knows all too well the reality of a heart condition and how it can change your life. In 2018, just a few months before he graduated high school he was diagnosed with Endocarditis, an infection that was attacking his heart valve. Horsey would need open heart surgery, but he had already signed to play football at the University of Kentucky and had no idea what was next. Skip ahead, Horsey is healthy and is returning this year for his sixth season as a Wildcat. Horsey is now a proud Heart Health advocate, but also focused on football and making up for a season that ended last year not the way he says he would like it.

Looking for more information on this topic? Check out the Ineffective Endocarditis brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts.  It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Twitter: https://twitter.com/mesage_hub Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including over 800 Rx Bricks.  After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.

Episode Notes Episode Notes Inspired by lamentations on Twitter, Drs. Bobbi Jo Stoner (@BobbiJo_Stoner), Jonathan Ryder (@JonathanRyderMD) and Sami El-Dalati join Dr. Jillian Hayes (@thejillianhayes) to hash out some of the controversies we encounter while managing infective endocarditis. Do we really need gentamicin and rifampin for all cases of staphylococcal prosthetic valve endocarditis? Where do oral antimicrobials fit into this disease state? Who should have a seat at the table to provide the most comprehensive care to these patients? Tune in for the answers to these questions and more! Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/ References: IDSA/AHA Infective Endocarditis Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000296 Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis: https://pubmed.ncbi.nlm.nih.gov/36408468/ Twitter Poll – Gabe Vilchez (March 2021): https://twitter.com/IdVilchez/status/1372148761112240131?s=20&t=fYuyNWGmzZACWrpUb7Fp3g Survey of ID Physicians on Gent and Rifampin Use: https://pubmed.ncbi.nlm.nih.gov/32964063/ Bacteriological outcome of combination versus single-agent treatment for staphylococcal endocarditis: https://academic.oup.com/jac/article/52/5/820/760105 Treatment of experimental foreign body infection caused by methicillin-resistant Staphylococcus aureus: https://journals.asm.org/doi/abs/10.1128/AAC.34.12.2312 Successful therapy of experimental chronic foreign-body infection due to methicillin-resistant Staphylococcus aureus by antimicrobial combinations: https://journals.asm.org/doi/abs/10.1128/aac.35.12.2611 Rifampin Combination Therapy for Nonmycobacterial Infections: https://journals.asm.org/doi/10.1128/CMR.00034-09 ARREST Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32456-X/fulltext Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study: https://pubmed.ncbi.nlm.nih.gov/32706879/ Nephrotoxicity of vancomycin, alone and with an aminoglycoside: https://pubmed.ncbi.nlm.nih.gov/2351627/ Clinical Data on Daptomycin plus Ceftaroline versus Standard of Care Monotherapy in the Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia: https://journals.asm.org/doi/10.1128/AAC.02483-18 Multicenter Cohort of Patients With Methicillin-Resistant Staphylococcus aureus Bacteremia Receiving Daptomycin Plus Ceftaroline Compared With Other MRSA Treatments: https://academic.oup.com/ofid/article/7/1/ofz538/5691187 CERT Trial (in process): https://clinicaltrials.gov/ct2/show/NCT04886284 Rifampin for Surgically Treated Staphylococcal Infective Endocarditis: A Propensity Score-Adjusted Cohort Study: https://pubmed.ncbi.nlm.nih.gov/26872729/ A step-by-step guide to implementing a multidisciplinary endocarditis team: https://journals.sagepub.com/doi/10.1177/20499361211065596 Management of Infective Endocarditis in People Who Inject Drugs: A Scientific Statement from the American Heart Association: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001090?cookieSet=1 Infectious Complications of Addiction: A Call for a New Subspecialty Within Infectious Diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319263/ A Cross-sectional Analysis of Linezolid in Combination with Methadone or Buprenorphine as a Cause of Serotonin Toxicity: https://academic.oup.com/ofid/article/9/7/ofac331/6625822 POET Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1808312 Risk of New Bloodstream Infections and Mortality Among People Who Inject Drugs With Infective Endocarditis: https://pubmed.ncbi.nlm.nih.gov/32785635/ Comparing right- and left sided injection-drug related infective endocarditis: https://pubmed.ncbi.nlm.nih.gov/33441950/ Evaluation of Partial Oral Antibiotic Treatment for Persons Who Inject Drugs and Are Hospitalized With Invasive Infections: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745005/ Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna: https://pubmed.ncbi.nlm.nih.gov/29659732/ Impact of the duration of antibiotic therapy on relapse and survival following surgery for active infective endocarditis: https://academic.oup.com/ejcts/article/55/4/760/5126415 Bacteriological Outcome after Valve Surgery for Active Infective Endocarditis: Implications for Duration of Treatment after Surgery: https://academic.oup.com/cid/article/41/2/187/529954 Long-term Risk of Hemorrhagic Stroke in Patients With Infective Endocarditis: A Danish Nationwide Cohort Study: https://academic.oup.com/cid/article/68/4/668/5039147 Sign of the Times: Updating Infective Endocarditis Diagnostic Criteria to Recognize Enterococcus faecalis as a Typical Endocarditis Bacterium: https://pubmed.ncbi.nlm.nih.gov/35262664/ Prevalence of colorectal disease in Enterococcus faecalis infective endocarditis: results of an observational multicenter study: https://pubmed.ncbi.nlm.nih.gov/31444092/ Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

1.32 Bacterial Endocarditis   Cardiovascular system review for the USMLE Step 1 exam.

Congenital heart disease is the most common birth defect, affecting 1 in 100 babies. Amongst these ventricular septal defects are very common with the majority of patients living into adulthood. In this episode we will be reviewing key features of VSDs including embryologic origin, anatomy, physiology, hemodynamic consequences, clinical presentation and management of VSDs. Dr. Tommy Das (CardioNerds Academy Program Director and FIT at Cleveland Clinic), Dr. Agnes Koczo (CardioNerds ACHD Series Co-Chair and FIT at UPMC), and Dr. Anu Dodeja (Associate Director for ACHD at Connecticut Children's) discuss VSDs with expert faculty Dr. Keri Shafer. Dr. Shafer is an adult congenital heart disease specialist at Boston Children's Hospital, and an assistant professor of pediatrics within Harvard Medical School. She is a medical educator and was an invited speaker for the inaugural CardioNerds Sanjay V Desai Lecture, on the topic of growth mindset. Script and notes were developed by Dr. Anu Dodeja. Audio editing by CardioNerds Academy Intern, Shivani Reddy. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Ventricular Septal Defects Most common VSDs: Perimembranous VSD The shunt volume in a VSD is determined largely by the size of the defect and the pulmonary vascular resistance. VSDs cause left to right shunt. The long-term effects are left sided chamber dilation, as is the case with PDAs (post-tricuspid shunts) VSDs can be associated with acquired RVOTO, double chamber right ventricle, LVOTO/sub aortic membrane formation, and aortic regurgitation from aortic valve prolapse. Eisenmenger syndrome results from long-term left-to-right shunt, usually at higher shunt volumes. The resulting elevated pulmonary artery pressure is irreversible and leads to a reversal in the ventricular level shunt, desaturation, cyanosis, and secondary erythrocytosis. Endocarditis prophylaxis is not indicated for simple VSD. It is required for 6 months post VSD closure, in patients post VSD closure with a residual shunt and in Eisenmenger patients with R—>L shunt and cyanosis. Show notes - Ventricular Septal Defects Notes (developed by Dr. Anu Dodeja): What are types OF VSD? (Please note that there are several nomenclatures) Perimembranous VSDMost common type of VSD - 80% of VSDsOccurs in the membranous septum and can be associated with inlet or outlet extensionLocated near the tricuspid and aortic valves, often time can be closed off by tissue from the septal leaflet of the tricuspid valve and associated with abnormalities in the septal leaflet of the tricuspid valve secondary to damage from the left to right shuntCan be associated with acquired RVOTO, double chamber right ventricle, LVOTO/sub aortic membrane formation On TTE, the parasternal short axis view at the base demonstrates this type of VSD at the 10-12 o'clock position. Muscular VSDSecond most common VSD - 15-20% of VSDsCompletely surrounded by muscle,

This week we delve into the world of bovine jugular vein grafts for the treatment of pulmonary valve dysfunction and the possible enhanced risk for infective endocarditis. How commonly are these valves affected by endocarditis and does placement at surgery in comparison to the cath lab confer a lower risk for this dreaded complication? What factor was most highly associated with the risk for endocarditis with a bovine jugular valve vein graft for PVR? A description from the team at Cincinnati Children's Hospital is on tap this week! https://doi.org/10.1177/21501351211065363