Podcasts about enterobius

Pinworms are often asymptomatic, or cause mild pruritus ani, but do they cause abdominal pain?   Check out the pages mentioned.   Demnet page on pinworms by Daniel Wong   Enterobius vermicularis: a possible cause of symptoms resembling appendicitis Dahlstrom, J.Macarthur, E. et al. Pathology, Volume 25, 5 Link to paper   Panidis S, Paramythiotis D, Panagiotou D, Batsis G, Salonikidis S, Kaloutsi V, Michalopoulos A. Acute appendicitis secondary to Enterobius vermicularis infection in a middle-aged man: a case report. J Med Case Rep. 2011 Nov 30;5:559. doi: 10.1186/1752-1947-5-559. PMID: 22128765; PMCID: PMC3245485. Link to paper   Tariq S. Enterobiasis: threadworm infection presenting as acute appendicitis in a 13-year-old girl. BMJ Case Rep. 2015 Jan 14;2015:bcr2014208543. doi: 10.1136/bcr-2014-208543. PMID: 25589531; PMCID: PMC4307057. Link to paper   Hammood ZD, Salih AM, Mohammed SH, Kakamad FH, Salih KM, Omar DA, Hassan MN, Sidiq SH, Mustafa MQ, Habibullah IJ, Usf DC, Al Obaidi AE. Enterobius vermicularis causing acute appendicitis, a case report with literature review. Int J Surg Case Rep. 2019;63:153-156. doi: 10.1016/j.ijscr.2019.09.025. Epub 2019 Sep 25. PMID: 31586892; PMCID: PMC6796714. Link to paper   www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

TWiP solves the case of the Woman with White Worms, and submits a new case involving a 1 year old in northeastern Panama with a fatal leg infection. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Enterobius, the pinworm (TWiP 19) Hero: Mary Pritchard New Case This case comes from Panama mid summer 2024. A provider for Floating Doctors working in the coastal region in northeastern Panama. This case involves a one year old, so the history is a bit difficult, but there may have initially been a scratch or some sort of break in the skin. Otherwise healthy but over a period of time this area expands and becomes a deep necrotic wound on the leg. Several other nearby wounds develop and become deep and infected. By the time this one year old is seen by the provider much of the leg appears eaten away. This is just the tip of the iceberg as a number of others develop similar wounds in the area. No prior medical history. Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

In this podcast, I look at Enterobius vermicularis, or pinworms, in response to a viral and dramatic TikTok video recently published.

TWiP solves the case of the Woman With White Worms, and presents a new clinical case to decipher. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute Hero: Ann Bishop Become a patron of TWiP New Case study: A physician with no significant PMH who is currently doing their fellowship training develops diarrhea. The diarrhea is significant enough that they are beginning to feel weak, lightheaded, and end up going to the local ER. The physician lives in NYC, works most of the time but did just get back from a week-long vacation in Florida with their long-term partner where they got a chance to swim in the pool and get some sun. They returned feeling well and then noted the onset of the diarrhea. The diarrhea was watery, with some abdominal cramping but no noted blood or actual fever. The stool did not have a strong smell and no floating stools were reported. The physician was given IVF and returned home feeling better but now gets a call that there is a parasite on the stool testing and is recommended to take a medicine they have never heard of 3x per day for 3 days.  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

Episode 83: Solitary Rectal Ulcer. Dr Singh explains how we can diagnose and treat solitary rectal ulcer syndrome (SURS) and Brandy gave an introduction regarding Elvis Presley's death.  Introduction: Did Elvis Die Pooping?By Brandy Truong, MS4, Ross University School of Medicine. A pop culture trivia fact I always found interesting was that Elvis Presley may have died from trying to have a bowel movement. There are different statements on the cause of death ranging from cardiac arrest, drug overdose, anaphylactic shock, and straining to have a bowel movement. But we're not here to figure out which one is accurate or debate all that. Elvis was found in the bathroom on the floor and many people described it as if he was on the toilet and then fell forward. If he died from pooping, how does that even happen? We're going to explore that a little.When we strain to have a bowel movement, it's called the Valsalva maneuver. This maneuver is divided into 4 stages. Phase 1 is when one first starts straining or bears down. This causes an increase in chest pressure and blood being forced out from the large veins. This is reflected in a rise in blood pressure and a decrease in heart rate. In phase 2, there is reduced venous return to the heart because the blood was forced out of the large veins. Because there is less return to the heart, the heart doesn't pump out as much as it normally would which leads to a fall in blood pressure. The body senses this fall in blood pressure and will compensate by increasing the heart rate significantly. Phase 3 is when one stops bearing down which results in a release of chest pressure. This causes a fall in blood pressure which causes the heart rate to increase as a reflex. In phase 4, the decreased venous return seen in phase 2 is now restored, which causes an increase in blood pressure. The heart rate then decreases as a reflex response. Both blood pressure and heart rate will return to normal. This entire process occurs over a span of a little over 10 seconds.Elvis was known to have a drug addiction and later some doctors found that he had hypertrophic cardiomyopathy which is a condition in which the heart is unable to pump blood well. He abused a variety of pain medications including opioids. Opioids often cause constipation; therefore, if Elvis was constipated and straining, the Valsalva maneuver compounded by heart disease and other unhealthy lifestyles he had would have caused his cardiac arrest. Intense straining during the process of defecation can result in subarachnoid hemorrhage in people with congenital berry aneurysms, for example. If you end up googling to find out how Elvis died, let us know what you think and if you think he died from pooping. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home.   Solitary Rectal Ulcer Syndrome.  By Parneeta Singh, MD, Ross University School of Medicine. Discussed with Hector Arreaza, MD.Solitary Rectal Ulcer Syndrome (SRUS) is a benign, rare, underdiagnosed disorder that can mimic and be incorrectly diagnosed as inflammatory bowel disease (IBD) or rectal cancer. The exact prevalence is unknown but in general, it is reported as an annual prevalence of one in 100,000 people. It mostly occurs in the third decade in men and fourth decade in women, with men and women being equally affected. However, cases have been identified in the pediatric and geriatric populations as well. SRUS is a misnomer because although some patients may present with a solitary ulcer, many present with multiple ulcers that may also involve the sigmoid colon. Presentation. Rectal bleeding (with the amount varying from a little fresh blood to severe hemorrhage that may require blood transfusions), mucus discharge, excessive straining, abdominal and perineal pain, constipation, or diarrhea, feeling of incomplete defecation, tenesmus, and rarely rectal prolapse are clinical symptoms associated with SRUS. Presentation may resemble intestinal parasites such as Entamoeba histolytica (amebiasis) and Enterobius vermicularis (pinworm).The underlying etiology is unknown, but a number of mechanisms have been suggested including ischemic injury from the pressure of impacted fecal matter and local trauma due to repetitive self-digitation, although the latter remains unproven. Ulcers usually occur in the mid-rectum which cannot be reached by self-digitation. Additionally, it has been proposed that the perineum's descent along with the abnormal contraction of the puborectalis muscle during defecation results in trauma or a prolapsed rectum with mucosal prolapse being the most common underlying pathogenesis in SRUS. Diagnosis. The diagnosis of SRUS is based on clinical features and proctosigmoidoscopy findings, with histological examination and biopsies being the key to the diagnosis. Imaging studies including defecating proctography, dynamic MRI and anorectal functional studies also aid in the diagnosis with the latter showing that 25% to 82% of SRUS patients have dyssynergia with paradoxical anal contraction. A thorough evaluation is important in ruling out IBD, ischemic colitis, and malignancy.Histology evaluation of biopsy establishes the diagnosis of solitary rectal ulcer syndrome. Findings include fibromuscular obliteration of the lamina propria. This obliteration causes hypertrophy and disorganization of the muscularis mucosa and regenerative changes. There is an abnormal crypt organization. In cases were polypoid lesions are prevalent, the mucosa has a villiform configuration, and in some cases, the glands may be trapped in the submucosa, which is called colitis cystica profunda.Treatments.Various treatment options are available for SRUS with the treatment choice depending on symptom severity and the presence of rectal prolapse. The initial steps, especially in asymptomatic patients, include patient education and behavioral modifications which include a high-fiber diet, straining discontinuation, and a discussion of psychosocial factors. Biofeedback is the next step in those who fail to respond to conservative measures. Biofeedback seems to help by altering efferent autonomic pathways to the gut that reduces straining with defecation by correcting abnormal pelvic-floor behavior. Topical treatments used include corticosteroids, salicylate, sulfasalazine, mesalazine, sucralfate suppositories and topical fibrin sealant. Unfortunately, surgery is necessary in almost one-third of adults with associated rectal prolapse who do not respond to the above treatment options. Surgical treatments include ulcer excision, treatment of internal or overt rectal prolapse, and de-functioning colostomy. Open rectopexy and mucosal resection have shown a success rate of 42% to 100%. In conclusion, SRUS is an uncommon disease that can mimic IBD and rectal cancer. Thus, a thorough and complete patient history and work-up is required to accurately diagnose SRUS, following which patient education, reassurance that the lesion is benign and a conservative, stepwise individualized approach is important in the management of this syndrome.Conclusion: Now we conclude our episode number 83 “Solitary Rectal Ulcer.” Rectal bleeding, constipation, diarrhea, abdominal pain… yes, it sounds like Chron's syndrome, but your list of differentials may be very long. You may want to add to that list Single Rectal Ulcer Syndrome. The treatment goes beyond medications for inflammation and includes pelvic floor training. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created for educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Brandy Truong, and Parneeta Singh. Audio edition: Suraj Amrutia. See you next week! _____________________References:“Elvis Presley.” Wikipedia, Wikimedia Foundation, 21 Jan. 2022, https://en.wikipedia.org/wiki/Elvis_Presley#Cause_of_death.  Markel, Dr. Howard. “Elvis' Addiction Was The Perfect Prescription for an Early Death.” PBS, Public Broadcasting Service, 16 Aug. 2018, https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death.   Srivastav, Shival. “Valsalva Maneuver.” StatPearls [Internet]., U.S. National Library of Medicine, 28 July 2021, www.ncbi.nlm.nih.gov/books/NBK537248/.  Zipes, Douglas. “Valsalva Maneuver.” Valsalva Maneuver - an Overview, ScienceDirect Topics, www.sciencedirect.com/topics/neuroscience/valsalva-maneuver . Qing-Chao Zhu, Rong-Rong Shen, Huan-Long, Yu Wang. Solitary rectal ulcer syndrome: Clinical features, pathophysiology, diagnosis, and treatment strategies. World J Gastroenterology. 2014 Jan 21; 20(3): 738–744. doi: 10.3748/wjg.v20.i3.738. PMID: 24574747; PMCID: PMC3921483. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921483/ Young Min Choi, Hyun Joo Song, Min Jung Kim, Weon Young Chang, Bong Soo Kim, Chang Lim Hyun. Solitary Rectal Ulcer Syndrome Mimicking Rectal Cancer. The Ewha Medical Journal. 2016 Jan 29; 39(1): 28-31. doi: https://doi.org/10.12771/emj.2016.39.1.28. Department of Internal Medicine, Surgery, Radiology and Pathology, Jeju National University School of Medicine, Jeju, Korea. https://synapse.koreamed.org/articles/1058669 Sachin B Ingle, Yogesh G Patle, Hemant G Murdeshwar, Chitra R Hinge Ingle. An unusual case of solitary rectal ulcer syndrome mimicking inflammatory bowel disease and malignancy. Arab J Gastroenterol. 2012 Jun 13(2):102. doi: 10.1016/j.ajg.2012.02.004. Epub 2012 Apr 11. Department of Pathology. PMID: 22980604. https://pubmed.ncbi.nlm.nih.gov/22980604/     

Vaccine Hesitancy The sun rises over the San Joaquin Valley, California, today in April 23, 2020.This week the FDA approved the first IV medication for prophylaxis of migraine: Epti-nezu-mab- jjmr (brand name Vyepti®). This is a humanized monoclonal antibody that blocks the calcitonin gene-related peptide (CGRP). Blocking this receptor results in prevention of migraines. Epti-nezu-mab is administered every 3 months(1).Do you remember those headlines in January 2019? “Insulin loses its place as the first-line injectable treatment”(2) for type 2 diabetes. The family of GLP-1 agonists (the medications that end in “tide”, such as liraglutide, dulaglutide, exenatide, etc.) became the preferred injectable for most patients with type 2 diabetes. In case you didn’t know, in September 2019, the FDA approved the first ORAL GLP1 agonist for use in type 2 diabetes(3). Rybelsus® (semaglutide) (yeah! No needles!). The benefits in weight loss and glycemic control of the ORAL semaglutide (Rybelsus®) are comparable to the INJECTABLE semaglutide (Ozempic®).In case you did not know, in July 2019, the European Commission approved the first oral medication for adults with type 1 diabetes: Dapaglifozin (Forxiga® in Eruope, Farxiga® in USA). It is an SGLT2 inhibitor previously approved for TYPE 2 diabetes, but now it is being used in Europe for TYPE 1 diabetes as well. The FDA did not approve Farxiga for Type 1 diabetes in the USA. Now you know it, there is an IV medication for migraine prophylaxis (Vyepti®), an oral GLP-1 agonist for diabetes type 2 (Rybelsus®), and at least one oral medication for Type 1 diabetes (Forxiga, used only in Europe).  ____________________________Quote: “Being aware of your ignorance gives you the gift of curiosity” –Unknown Author (6)“Curiosity killed the cat… but satisfaction brought it back”. Curiosity can be a driving force to guide you in your residency training. When used properly, curiosity will take you to unexplored areas and will increase your knowledge and expertise to help more and more patients. I am happy to be with you today in another episode of our podcast. My name is Hector Arreaza, and I am a faculty in the Rio Bravo Family Medicine Residency Program. We received feedback about a word that I mispronounced: Irrelevant. Also, during a previous episode we talked about leucorrhea. Do you know another cause of leucorrhea in little girls? Tiny pinworms: Enterobius vermicularis. Today we have a different kind of episode. I left Dr Saito and Dr Manzanares take over the main part of the podcast. Just a warning, it is rated PG-13 today, enjoy it.   Question number 1: Who are you? This is Steven Saito. I am a former Navy doctor, having spent 6.5 years in the service primarily working out of a branch clinic having taken on a variety of additional duties including prior department head and senior medical officer.  I have since come to Rio Bravo BFM to continue to give my service. I’m here to give you your weekly suppository of information. Relax and let it in (joke). Question number 2: What did you learn this week? As an introduction, Prazosin is an alpha-1 blocker used for treatment of PTSD. It may cause priapism, which is defined as painful erections longer than 4 hours. If this happens to you, just call more people (joke). Main topic: So, I encountered a mother who was against vaccinations.  I wanted to talk a little about vaccine hesitancy and approach to discussion with parents/patients for vaccination.  Hold onto your butts because this is a topic that definitely will not get any controversy or angry emails from Facebook moms groups! We reviewed information on vaccine hesitancy from the World Health Organization, the Center for Disease Control, and the AAFP.  In a “short” 253-page paper, the World Health Organization laid out its review of literature and its conclusions for strategies for addressing vaccine hesitancy.  It found that there are few well-studied strategies for addressing vaccine hesitancy due to wide variation in studies for setting and target populations. This 2014 paper acknowledges that vaccine hesitancy is a rather novel issue at the time of this study.  However, they did condense the useful information that was gleaned into a 2-hr PowerPoint that I’m going to attempt to condense into something that hopefully will not put you to sleep on the drive home from work. First, we have to address what hesitancy is.  It is not outright refusal but whether or not the patient/parent has uncertainty.  There will be people that refuse regardless of whatever information is presented. There are multiple factors which contribute to hesitancy:Complacency:  people feel that there is low risk or that the disease are not dangerous enough and therefore don’t prioritize it;Confidence: lack of trust either in vaccines or health authorities. Patients get multiple inputs from that can influence their confidence including media/politics/religion/culture/personal knowledge;Convenience: as it relates to barriers to access/availability; WHO recognizes that there may not be any one specific measure to overcome hesitancy but there are general recommendations include: Default conversation: Start with presumption of vaccination as default: “It’s time for your vaccination” or “You are due for XYZ”, as opposed to “Do you want your vaccinations?”. This reinforces our understanding of the importance of vaccinations as opposed to sounding ambivalent on the necessity. Motivational interviewing: A majority of patients are likely to comply with health maintenance. For those who don’t, it is generally not recommended to take a directive or argumentative response as that style of communication can result in decreased trust and has shown vaccine uptake does not improve.  A better recommendation would be to start with motivational interviewing.  Motivational interviewing is focused on collaborative and patient centered exploration of their hesitancy with a focus on how to change attitude or behavior. Some principles of motivational interviewing include: Open-ended questions:Use “what”, “why”, “how”, “tell me…” to explore reasons behindhesitancyReflect and respondSimple reflection:“I understand that you are afraid.”Complex reflection: “You want to make the best choice for your child but you are nervous.”Affirm strengths and validate concern“It is great that you are starting to think about vaccines.”“The health of your children is important to you.” “Protecting yourself from illness is important for you and the health of your community.”Ask-Provide-VerifyAsk information on what they know: “So what do you already know about vaccination?”Provide information:“Could I provide you with some information, based on what you just shared?”Verify that they understood: “Given our discussion, how do you view the decision now? Remember I am here to help talk through any concerns you may have.”Summarize “The reason that’s important is…”“What that means to you is…”“The main point to remember is….” At this point during the traditional 2-hr PowerPoint involves some roleplaying, so grab your dice and where going to roll up some characters and fight a dragon. Build trust: Healthcare workers can work toward building trust by both demonstrating competence and caring.  Humans are emotional and simply demonstrating your competence / reason / data may not be enough.  It is okay to admit you do not know at a particular moment. Frequently-Asked Questions about Vaccines (WHO)Can vaccinations lead to infertility?No, vaccinations cannot lead to infertility. In fact, medical experts suggest that some vaccines actually protect fertility indirectly by preventing the need for treatment. Can vaccines cause harmful side effects, illness and even death?No, vaccines are very safe. Most side effects from vaccines are minor and temporary, such as a sore arm or mild fever. Serious adverse events or death are VERY rare (e.g. 1 per millions of doses) for most vaccines. Can needles used for immunization cause infection?For every vaccine, we always use one-time or auto-disable syringes that cannot be reused, which eliminates the risk of transmitting infections from needles. Isn’t giving three needles too many in one visit?No, receiving multiple vaccines in one visit is completely safe as you/your child’s immune system is strong enough to handle them.  “Won’t breast feeding protect babies from infection?”Yes, breast milk will give some protection against some infection, but it does not have the direct ability to prevent infection like vaccines. Vaccines are very specific to the given infection and their prevention capacity is very high. “Can vaccines cause the infection they are supposed to prevent?”Inactivated vaccines do not have live germs and cannot cause infections. Live vaccines have weakened germs that are unable to cause disease in healthy people. Rarely a mild form of infection may occur.  “Is protection from natural infection more effective protection?”Natural infection comes with the risks of serious complications related to that infection. With vaccines, the immune system is stimulated to develop protection without infection, hence it is more effective.  “Shouldn’t vaccines be delayed until children are older and there is less risk of side effects?”There is no evidence that side effects are more common in infants/babies than older children. Delaying vaccines leaves young children at risk of the disease and its complications. Other resources to address vaccination hesitancy: The CDC and the AAFP has a very similar approach so I won’t be reiterating. Although I did find some nice handouts on their website including a handout to make sure that parents understand the risks and responsibilities for their decision. On the AAFP website there are some videos to demonstrate motivational interviewing: https://www.aafp.org/patient-care/public-health/immunizations/video.html.    A Review of Anti-Vaccination LiteratureNow, to discuss more controversial stuff including a look at antivaccination literature: Now to start with let me be clear, antivaccination arguments are difficult to fully quantify because new arguments can be added without evidence, individuals may have unique responses, and the memetic mutations on Facebook and other online communities change stories at alarming regularity so I will be focusing on the more common concerns that I have seen. Autism: Let me be frank, there is no known connection between vaccinations and autism. Epidemiologic evidence does not support an association between immunization and Autism Spectrum disorder, but let’s discuss some of the reasons why our population may be concerned. There is an apparent increase in autism rates in the 1990s. Two primary factors seem be associated with this increase: There was a definitional change in Autism to allow a greater number of children to get the diagnosis.  This means that children who may have been given another diagnosis or had been low enough on the spectrum may not have been categorized.  From an outsider perspective, this would look like a doubling of incidence. The second was that we change the way we do surveillance including active surveillance.  As part of routine screening for toddlers, the M-CHAT was introduced with an update in 2009 to the M-CHAT R/F.  Note that this means that the prior incidence was likely higher than previously thought which may represent our prior lack of identifying individuals who may have needed the additional services.  Let me be further clear: it is a good thing that we are identifying more individuals.  By identifying more children on the spectrum, they can access interventions to be more successful later in life for which they would otherwise be denied. A study in 1998, published by Mr Wakefield (formerly a doctor who lost his credentials) was found to be fraudulent, and in 2004, ten out of the thirteen authors retracted their statement and the Lancet fully retracted it in 2010.Since then, multiple additional studies have demonstrated no epidemiological association with vaccination and autism.  In short, those receiving the vaccine and those who did not, had autism at the same incidence. Other studies which have sought to demonstrate a biologic mechanism to demonstrate a causal link have to failed to demonstrate such.Thimerosal:Thimerosal is a mercury-containing preservative used in multidose vials for vaccines. The mercury it contains, prevents the growth of dangerous bacteria and fungus. In 1999, the FDA removed mercury and thimerosal for as many products as possible. The use of thimerosal has been removed from childhood vaccinations. Now, we use single-use vials for vaccines instead of multidose vials. Mercury in vaccines is not the cause of autism.Mistrust of science.Several people will not believe in science, but discussing that may take a little longer. Question number 3: Why is that knowledge important for you and your patients? Vaccines are good and useful, but sometimes we do not do a good job at communicating to our patients due to long lists of complaints. Once there is a COVID 19 vaccination, we will face some resistance. Question number 4: How did you get that knowledge? As a general rule, I refer to multiple online sources like UpToDate to read articles and get suggestions for primary source citation. Check the bibliography from UTD to see their sources and see if you agree with their evidence for your evidence-based medicine and primary sources.  However, for this talk I wanted to get some additional sources to discuss.  My usual go to locations for additional broad information is to first start with important medical institutions including the Center for Disease Control, World Health Organization, and AAFP. Question number 5: Where did that knowledge come from? See details below in the references. ____________________________“Speaking Medical” (Medical word of the Week) by Hasaney SinHave you even wonder how to say B.O. in medical terms? Bromhidrosis is a condition of abnormal or offensive body odor, to a large extent determined by apocrine gland secretion, although other sources may play a role. Apocrine glands are located on the axillae, perianal area, and some parts of the external genitalia. Perspiration itself actually has no odor, but when sweat comes in contact with bacteria, bromhidrosis can occur. So, next time when you encounter a patient with B.O., called it the right way, bromhidrosis. I am very thankful for my prescription strength deodorant, or else I would be dealing with bromhidrosis.____________________________“Espanish Por Favor” (Spanish Word of the Week) by Roberto Velazquez“Hey, muñeca, qué linda eres”. This is compliment a man can say to a cute girl walking down the street. This is Dr Rava on your section Espanish Por Favor. Today’s Spanish word is Muñeca. Muñeca means doll, as in a toy such as Barbie, but it also refers to a body part, the wrist. Hearing this word is fairly common, and it is the appropriate word to use even in medical terminology. So, don’t get confused when people tells you that their muñeca is broken or twisted or that it hurts because they are talking about the wrist, not their Barbie doll. The way your patient will complain may sound, “Doctor, me torcí la muñeca,” meaning to say, “Doctor, I think I hurt my wrist.” Once a patient called me muñeco, but that’s a different story. Now you know the Spanish word of the week, muñeca. All you need to do now is to assess your patient’s muñeca.  ____________________________“For your Sanity” (Medical joke of the day)by Steven Saito I delivered a beautiful baby in the hospital recently, the husband pulls me aside to thank me and asks: “So, doc, when is the soonest we can have sex again?” I looked at him, winked, and said: “I’ll meet you in the parking lot in 10 minutes”.____________________________Conclusion: Now we conclude our episode number 9, “Vaccine Hesitancy”. We reviewed how to deal with patients (or parents) who are unsure about their shots. We hope to have that kind of discussion when an effective and safe vaccine against SARS-CoV2 is created (fingers and toes crossed). We were reminded of the medical word for B.O., bromhidrosis, which is probably the “ultimate human fragrance” without deodorants; and then we learned how to say wrist is Spanish, muñeca. We’ll see you next week.This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. Our podcast team is Hector Arreaza, Lisa Manzanares, Steven Saito, Roberto Velazquez, and Hasaney Sin. Audio edition: Suraj Amrutia. See you soon! _________________________References:Pain Medicine News, Apr 2020, Vol 18, Number 4, page 4, PainMedicineNews.com.Dotinga Randy, “New Diabetes Guidelines, Insulin loses its place as the first-line injectable treatment”, Family Practice News, January 2019, Vol 49, No. 1, Page 1, “FDA approves first oral GLP-1 treatment for type 2 diabetes”, September 20, 2019, https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-glp-1-treatment-type-2-diabetes“Rybelsus (Oral Semaglutide) Review”, http://mydiabetesvillage.com/rybelsus-review/  Healio Endocrine Today, “Europe embraces, FDA rejects use of SGLT inhibitors for type 1 diabetes”, July 23, 2019. https://www.healio.com/endocrinology/diabetes/news/online/%7B59034289-fcf0-4cd2-888f-23c57e85bfcc%7D/europe-embraces-fda-rejects-use-of-sglt-inhibitors-for-type-1-diabetes“Ignorance Breeds More Ignorance”, posted on November 23, 2017, Exploring Your Mind, https://exploringyourmind.com/ignorance-breeds-ignorance/  “Strategies for Addressing Vaccine Hesitancy, A systematic Review”, World Health Organization, October 2014, https://www.who.int/immunization/sage/meetings/2014/october/3_SAGE_WG_Strategies_addressing_vaccine_hesitancy_2014.pdf?ua=1Understanding Thimerosal, Mercury, and Vaccine Safety; Centers for Disease Control and Prevention, CDC.gov, reviewed in February 2013, https://www.cdc.gov/vaccines/hcp/patient-ed/conversations/downloads/vacsafe-thimerosal-color-office.pdfAAFP, Conversations: Improving Adult Immunizations Rates Using Simple and Strong Recommendations, https://www.aafp.org/patient-care/public-health/immunizations/video.html 

Penjelasan

Worms never conjure up a pleasant picture in our minds and threadworm might be more sinister than we've been led to believe. Despite much talk of the potential therapeutic activity of helminths for things like autoimmune diseases and allergies, Enterobius vermicularis (threadworm) just doesn't seem to have a nice side at all. In today's podcast we are joined by Rachel Arthur aka "The Worm Whisperer". She will be busting a few myths & misconceptions about threadworms, sharing what she's learned about breaking the cycle and resolving chronic worm infections in children and adults. Rachel's passion for worms is borne from witnessing a growing a trend of chronic worm infections in kids and adults, particularly women, which aren't responding to standard medical treatments. What she is finding is that worms are migrating into other tissues, in particular, the genitourinary system and therefore, intestinal-based therapeutic interventions just aren't cutting it. True to Rachel's unique style, she's deep dived into the available research on this topic and today she shares what she's uncovered. Find the show notes and transcript for this podcast here: https://www.fxmedicine.com.au/content/chronic-threadworm-infections-rachel-arthur *****DISCLAIMER: The information provided on FX Medicine is for educational and informational purposes only. The information provided is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you learn here raises questions or concerns regarding your health.*****

In an earlier episode of the podcast we discussed the giant intestinal roundworm, Ascaris lumbricoides--a nematode parasite. Today, we'll look at a nematode that is about the size of a staple--Enterobius vermicularis, or the pinworm. Pinworm is the most common worm infection in North America, in fact, it is estimated that there are 40 million infections at any one time in the U.S. and 500 million infections worldwide. Joining me to shed some light on this common parasite is friend to the show, Rosemary Drisdellle, Rosemary is a Parasitology teacher and author of Parasites: Tales of Humanity's Most Unwelcome Guests.

In an earlier episode of the podcast we discussed the giant intestinal roundworm, Ascaris lumbricoides–a nematode parasite. Today, we’ll look at a nematode that is about the size of a staple–Enterobius vermicularis, or the pinworm. Pinworm is the most common worm infection in North America, in fact, it is estimated that there are 40 million infections […] The post Parasites 101: Pinworms appeared first on Outbreak News Today.

Daniel and Vincent solve the case of the Woman With Anal Area Discomfort, and discuss the multiple functions of a clathrin adapter protein in formation of rhoptry and microneme secretory organelles of Toxoplasma gondii. Hosts: Vincent Racaniello and Daniel Griffin Become a patron of TWiP. Links for this episode: Journal of Microbiology and Biology Education SciComm Issue (link) TWiP 19: Enterobius vermicularis, the pinworm Multiple roles of Toxoplasma gondii clathrin adaptor AP1 protein (PLoS Path) Image credit Letters read on TWiP 133 Case Study for TWiP 133 Seen while working in remote mountain makeshift mobile clinic in Dominican Republic, on Haitian border. Traveled 3 h by pickup truck, remote mountain town, womens centers. Set up makeshift mobile clinic in this center. Mother concerned about 6 yo girl, failure to thrive compared with sister, protuberant belly, frequent abdominal discomfort, going on over 1 year. No surgeries, no meds, first time ever seeing medical person. Mother and sister are family. Three children in family. Father does timber work. Very impoverished region, living in dirt floor home, drinking untreated water from local stream, go to bathroom outside, could be contamination. Diet: carbohydrate, plantains, rice, beans. On exam: lungs clear, heart fine, belly protuberant, liver and spleen not enlarged, some edema. Mother said noticed long motile worm in girls feces. Firm belly, not painful to her. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

Vincent and Dickson move on to nematodes with a discussion of the pinworm Enterobius vermicularis. Host links: Vincent Racaniello and Dickson Despommier Links for this episode: Enterobius vermicularis adult female (jpg) Enterobius vermicularis in appendix (jpg) Enterobius vermicularis embryonated eggs (jpg) Enterobius vermicularis life cycle (jpg) Letters read on TWiP 19 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv. Subscribe (free) Click here to receive an email notification when a new episode of TWiP is published.