Podcasts about EPUB

management diabetes guidelines fertility pcos ts lancet epub endocrinology pmid metformin preconceptions polycystic ovary syndrome sterility salvesen s2213 am j obstet gynecol

Play Episode Listen Later Dec 11, 2025 24:38

Podcast Family, we have covered PCOS on this show many times in the past; and yet- again, there is new information! A new publication from AJOG (Gray journal) describes a new meta-analysis on preconception/continued metformin use in the first trimester. Is this helpful? How does this contrast with the 2023 international guidance update on PCOS? Listen in for details. 1. ASRM: Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023)2. Cheshire J, Garg A, Smith P, Devall AJ, Coomarasamy A, Dhillon-Smith RK. Preconception and first-trimester metformin on pregnancy outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis. Am J Obstet Gynecol. 2025 Dec;233(6):530-547.e8. doi: 10.1016/j.ajog.2025.05.038. Epub 2025 Jun 3. PMID: 40473092.3. Løvvik TS, Carlsen SM, Salvesen Ø, et al. Use of Metformin to Treat Pregnant Women With Polycystic Ovary Syndrome (PregMet2): A Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet. Diabetes & Endocrinology. 2019;7(4):256-266. doi:10.1016/S2213-8587(19)30002-6.4. Teede HJ, Tay CT, Laven J, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertility and Sterility. 2023;120(4):767-793. doi:10.1016/j.fertnstert.2023.07.025.

Episode 985: Amiodarone vs. Lidocaine

Emergency Medical Minute

Play Episode Listen Later Dec 8, 2025 2:17

Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels. Additional noncompetitive beta-blocker effects. Stabilizes cardiac tissue, slows heart rate, and suppresses both atrial and ventricular arrhythmias. Lidocaine Blocks fast sodium channels in ventricular tissue (Class Ib). Shortens the action potential in ventricular myocardium, especially in ischemic tissue. Suppresses abnormal automaticity in damaged/irritable myocardium. Which one should you pick for a patient in vtach/vfib cardiac arrest? The current guidelines recommend amiodarone for shock-refractory cases but this is based on randomized trials showing better arrhythmia termination and short-term outcomes, but not long-term survival benefits. Two recent studies suggest that lidocaine might actually be preferable. A 2023 paper published in Chest Performed a large retrospective cohort study for treating in-hospital VT/VF cardiac arrest. Among more than 14,000 patients, lidocaine was associated with higher rates of ROSC, 24-hour survival, survival to discharge, and favorable neurologic outcomes. These results held after adjusting for covariates and using propensity score methods. Overall, lidocaine outperformed amiodarone across all major clinical outcomes in this population. A 2025 paper published in Resuscitation Performed a target trial emulation in adults with out-of-hospital shockable cardiac arrest. After propensity score matching in more than 23,000 eligible cases, lidocaine was associated with higher odds of prehospital ROSC, fewer post-drug defibrillations, and greater survival to hospital discharge. These advantages were consistent across matched patient pairs. Dose for lidocaine is an initial 1-1.5 mg/kg IV bolus, followed by additional boluses of 0.5-0.75 mg/kg every 5-10 minutes up to a total of 3 mg/kg if needed. Dose for amiodarone is a 300 mg bolus followed by an additional 150 mg bolus if needed. References Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018 Oct;15(10):e190-e252. doi: 10.1016/j.hrthm.2017.10.035. Epub 2017 Oct 30. Erratum in: Heart Rhythm. 2018 Nov;15(11):e278-e281. doi: 10.1016/j.hrthm.2018.09.026. PMID: 29097320. Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J. A retrospective 'target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025 Mar;208:110515. doi: 10.1016/j.resuscitation.2025.110515. Epub 2025 Jan 23. PMID: 39863130; PMCID: PMC11908894. Wagner D, Kronick SL, Nawer H, Cranford JA, Bradley SM, Neumar RW. Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest. Chest. 2023 May;163(5):1109-1119. doi: 10.1016/j.chest.2022.10.024. Epub 2022 Nov 2. PMID: 36332663. Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Nutrition in Critical Illness with Dr. Enid Martinez, 2/2

PedsCrit

Play Episode Listen Later Dec 8, 2025 20:27

Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children's Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Recognize the impact of nutritional status on outcomes of critically-ill children.Describe the key aspects of the metabolic stress response in critical illness.Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.Reflect on an expert's approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence. Selected references:Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844. Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Exploring What Matters: What Families Value in Complex Surgical Decision-Making

OPENPediatrics

Play Episode Listen Later Dec 8, 2025 35:07

In this Complex Care Journal Club podcast episode, Dr. Jody Lin discusses a qualitative study of shared decision-making for neuromuscular scoliosis surgery in children with medical complexity. She describes a broad range of family values and preferences that may guide decision-making, implications for clinical practice, and next steps from this work.‌ SPEAKER Jody Lin, MD, MS Pediatric Hospitalist Assistant Professor of Pediatrics Division of Inpatient Medicine University of Utah HOST Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics Boston Children's Hospital Assistant Professor of Pediatrics Harvard Medical School DATE Initial publication date: December 8, 2025. JOURNAL CLUB ARTICLE Lin JL, Devereaux T, Simon TD, Kaphingst KA, Zhu A, Narayanan U, Berry ABL, Eppich KG, Stoddard G, Smith JT, Andras L, Heflin J, Keenan HT, Asch SM, Fagerlin A. Caregiver Values and Preferences Related to Surgical Decision-Making for Children with Medical Complexity. J Pediatr. 2025 Jan;276:114366. doi: 10.1016/j.jpeds.2024.114366. Epub 2024 Oct 19. PMID: 39428089; PMCID: PMC11645212. OTHER ARTICLES REFERENCED Courageous Parents Network. Scoliosis and spine / spinal surgery: facts and decision-making. https://courageousparentsnetwork.org/guides/decision-making-around-spinal-fusion-surgery/. Accessed November 14, 2025. Lin JL, Clark CL, Halpern-Felsher B, Bennett PN, Assis-Hassid S, Amir O, Nunez YC, Cleary NM, Gehrmann S, Grosz BJ, Sanders LM. Parent Perspectives in Shared Decision-Making for Children With Medical Complexity. Acad Pediatr. 2020 Nov-Dec;20(8):1101-1108. doi: 10.1016/j.acap.2020.06.008. Epub 2020 Jun 12. PMID: 32540424; PMCID: PMC7655593. Lin JL, Cohen E, Sanders LM. Shared Decision Making among Children with Medical Complexity: Results from a Population-Based Survey. J Pediatr. 2018 Jan;192:216-222. doi: 10.1016/j.jpeds.2017.09.001. Epub 2017 Nov 6. PMID: 29102046; PMCID: PMC5732902. Lin JL, Tawfik DS, Gupta R, Imrie M, Bendavid E, Owens DK. Health and Economic Outcomes of Posterior Spinal Fusion for Children With Neuromuscular Scoliosis. Hosp Pediatr. 2020 Mar;10(3):257-265. doi: 10.1542/hpeds.2019-0153. PMID: 32079619; PMCID: PMC7041549.‌ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/xcz7qm4n2b9rn636rrnq/Jody_Lin_Final_transcript_12-4-25.pdf. Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Lin JL, Huth K. Exploring What Matters: What Families Value in Complex Surgical Decision-Making. 12/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/exploring-what-matters-what-families-value-in-complex-surgical-decision-making.

health children hospitals md families complex decision making clinicians surgical epub boston children pmid scoliosis world federation nov dec shared decision making accessed november j pediatr

147 Pain during caesarean a discussion with Matt

Obsgynaecritcare

Play Episode Listen Later Dec 8, 2025 56:24

Hi everyone, Pain during caesarean is a very challenging and distressing event – for the patient, their partner, the anaesthetist and all the staff present in theatre. This week we catch up with Matt Rucklidge, who recently gave a presentation on this topic at the obstetric anaesthesia meeting in London. We discuss why this has become a “hot topic” in the anaesthesia world in recent times, what is the true incidence, and many other aspects of this difficult topic. References The following is a first person narrative story from a patient with commentary from an uninvolved obstetric anaesthetist. Disappointingly from elselvier this article is unfortunately not open access but is well worth a read: Stanford SE, Bogod DG. Failure of communication: a patient’s story. Int J Obstet Anesth. 2016 Dec;28:70-75. doi: 10.1016/j.ijoa.2016.08.001. Epub 2016 Aug 23. PMID: 27717633. Podcast: The Retrievals Season 2 from NY Times Prevention and management of intraoperative pain during Caesarean sectionOrbach-Zinger, S. et al.BJA Education, Volume 25, Issue 2, 50 – 56

pain failure epub pmid caesarean disappointingly

FRIDAY Coffee Talk (12/5/25)

The World’s Okayest Medic Podcast

Play Episode Listen Later Dec 5, 2025 37:02

LISTENER DISCRETION IS ADVISED. Kim YG, Choi YY, Han KD, Min K, Choi HY, Shim J, Choi JI, Kim YH. Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias. Sci Rep. 2021 Sep 13;11(1):18111. doi: 10.1038/s41598-021-97335-y. PMID: 34518592 Ren J, Yang Y, Zhu J, Wu S, Wang J, Zhang H, Shao X. The use of intravenous amiodarone in patients with atrial fibrillation and Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2021 Jan;44(1):35-43. doi: 10.1111/pace.14113. Epub 2020 Dec 9. PMID: 33118640.

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Beziehungskonflikte - Paartherapie kann helfen, muss aber nicht

Eine Stunde Liebe - Deutschlandfunk Nova

Play Episode Listen Later Dec 5, 2025 42:08

Daniel ist mithilfe einer Paartherapie mit seinem Freund zusammengeblieben. Simone hat sich dagegen nach vier Sitzungen getrennt. Wann Paartherapie helfen kann – und wann nicht.**********Ihr hört in dieser "Eine Stunde Liebe":00:04:13 - Trennung durch Paartherapie00:09:37 - Simone machts nochmal00:15:19 - Daniel konnte seine Beziehung retten00:22:18 - Paartherapeut Eric Hegmann00:26:46 - Wann Paartherapie nicht mehr hilft00:36:39 - Liebestagebuch**********Podcast-TippWir empfehlen euch den Deutschlandfunk-Nova-Podcast "What the Wirtschaft?!", bei dem Gero zu Gast war**********Quellen aus der Folge:Lebow JL, Chambers AL, Christensen A, Johnson SM. Research on the treatment of couple distress. J Marital Fam Ther. 2012 Jan;38(1):145-68. doi: 10.1111/j.1752-0606.2011.00249.x. Epub 2011 Sep 9. PMID: 22283385.Roesler, Christian. Bundesweite Evaluation der institutionellen Paarberatung in katholischer Trägerschaft. Katholische Hochschule Freiburg. 2019.**********Empfehlungen aus der Folge:Staffel drei der ARD-Dokuserie "Die Paartherapie" mit Eric Hegmann **********Mehr zum Thema bei Deutschlandfunk Nova:Gefühle: So finden wir die richtigen WorteSextoys im Test: Worauf wir bei Kauf und Pflege achten solltenHöhepunkt und Orgasm Gap: Warum Frauen seltener kommen beim Sex**********Den Artikel zum Stück findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .

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Clinical Challenges in Thoracic Surgery: Robotic Segmentectomy - Lessons From 30 Years in the OR with Hopkins' Dr. Stephen Yang

Play Episode Listen Later Dec 4, 2025 23:48

In this Thoracic Surgery episode of Behind the Knife we enjoy a conversation with world-renowned thoracic surgeon and educator, Dr. Stephen Yang, as he takes us through 30 years of experience divulging his personal tips, tricks, and pitfalls to avoid when tackling the technical nuances of mastering robotic segmentectomies. Hosts: Dr. Stephen C. Yang, MD - professor of surgery and medical oncology The Johns Hopkins Hospital Dr. Kyla D. Rakoczy, MD - PGY3 General Surgery Resident at The Johns Hopkins Hospital Learning Objectives: Understand the utility of segmentectomies for peripheral T1N0 non-small-cell-lung cancer How to prepare for robotic segmentectomy using CT scans and 3D reconstructions Learn where to place your ports and how to optimize intra-operative techniques to minimize complications after robotic segmentectomy References: Kang MW. Evolution of Lung Cancer Surgery: Historical Milestones, Current Strategy, and Future Innovations. J Chest Surg. 2025 May 5;58(3):79-84. doi: 10.5090/jcs.25.025. Epub 2025 Apr 15. PMID: 40230346; PMCID: PMC12066400. https://pubmed.ncbi.nlm.nih.gov/40230346/ Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3. doi: 10.1016/0003-4975(95)00537-u. PMID: 7677489. https://pubmed.ncbi.nlm.nih.gov/7677489/ Pastorino U, Valente M, Bedini V, Infante M, Tavecchio L, Ravasi G. Limited resection for Stage I lung cancer. Eur J Surg Oncol. 1991 Feb;17(1):42-6. PMID: 1995356. https://pubmed.ncbi.nlm.nih.gov/1995356/ Liu L, Aokage K, Chen C, Chen C, Chen L, Kim YH, Lee CY, Liu C, Liu CC, Nishio W, Suzuki K, Tan L, Tseng YL, Yotsukura M, Watanabe SI. Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study. JTCVS Open. 2023 Apr 7;14:483-501. doi: 10.1016/j.xjon.2023.03.013. PMID: 37425437; PMCID: PMC10328970. https://pubmed.ncbi.nlm.nih.gov/37425437/ Galvez C, Bolufer S, Lirio F, Recuero JL, Córcoles JM, Socci L, Cabañero A, López I, Sánchez D, Figueroa S, Salcedo JG, Campo-Cañaveral JL, Genovés M, Hernando F, Moldes M, Blanco A, Azcarate L, Rivo E, Viti A, Mongil R. "Complex segmentectomies: Comparison with simple and effect of experience on postoperative outcomes". Eur J Surg Oncol. 2025 Jul;51(7):109748. doi: 10.1016/j.ejso.2025.109748. Epub 2025 Mar 5. PMID: 40064065. https://pubmed.ncbi.nlm.nih.gov/40064065/ Perroni G, Veronesi G. Robotic segmentectomy: indication and technique. J Thorac Dis. 2020 Jun;12(6):3404-3410. doi: 10.21037/jtd.2020.02.53. PMID: 32642266; PMCID: PMC7330783. https://pubmed.ncbi.nlm.nih.gov/32642266/ Montagne, F., Dhainaut, C., & Benhamed, L. M. (n.d.). Pre-operative 3D reconstruction—let's first anticipate the surgical procedure. Video-Assisted Thoracic Surgery. Retrieved November 13, 2025, from https://vats.amegroups.org/article/view/7889/html Shimizu K, Nakazawa S, Nagashima T, Kuwano H, Mogi A. 3D-CT anatomy for VATS segmentectomy. J Vis Surg. 2017 Jul 1;3:88. doi: 10.21037/jovs.2017.05.10. PMID: 29078650; PMCID: PMC5637987. https://pubmed.ncbi.nlm.nih.gov/29078650/ Zhang O, Alzul R, Carelli M, Melfi F, Tian D, Cao C. Complications of Robotic Video-Assisted Thoracoscopic Surgery Compared to Open Thoracotomy for Resectable Non-Small Cell Lung Cancer. J Pers Med. 2022 Aug 12;12(8):1311. doi: 10.3390/jpm12081311. PMID: 36013260; PMCID: PMC9410342. https://pubmed.ncbi.nlm.nih.gov/36013260/ Lee BE, Altorki N. Sub-Lobar Resection: The New Standard of Care for Early-Stage Lung Cancer. Cancers (Basel). 2023 May 25;15(11):2914. doi: 10.3390/cancers15112914. PMID: 37296877; PMCID: PMC10251869. https://pubmed.ncbi.nlm.nih.gov/37296877/ Zhang Y, Liu S, Han Y, Xiang J, Cerfolio RJ, Li H. Robotic Anatomical Segmentectomy: An Analysis of the Learning Curve. Ann Thorac Surg. 2019 May;107(5):1515-1522. doi: 10.1016/j.athoracsur.2018.11.041. Epub 2018 Dec 19. PMID: 30578780. https://pubmed.ncbi.nlm.nih.gov/30578780/ Peeters M, Jansen Y, Daemen JHT, van Roozendaal LM, De Leyn P, Hulsewé KWE, Vissers YLJ, de Loos ER. The use of intravenous indocyanine green in minimally invasive segmental lung resections: a systematic review. Transl Lung Cancer Res. 2024 Mar 29;13(3):612-622. doi: 10.21037/tlcr-23-807. Epub 2024 Mar 27. PMID: 38601441; PMCID: PMC11002498. https://pubmed.ncbi.nlm.nih.gov/38601441/ Altorki N, Wang X, Damman B, Mentlick J, Landreneau R, Wigle D, Jones DR, Conti M, Ashrafi AS, Liberman M, de Perrot M, Mitchell JD, Keenan R, Bauer T, Miller D, Stinchcombe TE. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2024 Jan;167(1):338-347.e1. doi: 10.1016/j.jtcvs.2023.07.008. Epub 2023 Jul 18. Erratum in: J Thorac Cardiovasc Surg. 2025 Apr;169(4):1181. doi: 10.1016/j.jtcvs.2024.12.011. PMID: 37473998; PMCID: PMC10794519. https://pubmed.ncbi.nlm.nih.gov/37473998/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

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The Reverse Løvset Maneuver For SD

comparison reverse norwegian outcomes american journal obstetrics gynecology epub pmid maneuver sindre vset am j obstet gynecol

Play Episode Listen Later Dec 3, 2025 31:15

In the original Løvset maneuver (described for breech presentations), the fetus is rotated in one direction to facilitate arm delivery. For shoulder dystocia, the reverse Løvset applies rotation in the opposite direction—specifically rotating the posterior shoulder toward a "belly down" position through up to 180 degrees of rotation. These maneuvers were first described by Norwegian obstetrician Jørgen Løvset in the 1940s. Now, in the current November 2025 AJOG, this maneuver is back in the spotlight. In this episode, we will review the reverse Løvset maneuver for shoulder dystocia and review its effectiveness. Which maneuver is more likely to result in fetal brachial plexus injury? Listen in for details. 1. A critical evaluation of the external and internal maneuvers for resolution of shoulder dystocia, March 2024; AJOG. https://www.ajog.org/article/S0002-9378(23)00022-4/fulltext2. Grindheim, Sindre et al.Reverse Løvset maneuver for shoulder dystocia, American Journal of Obstetrics & Gynecology, Volume 233, Issue 5, 505.e1 - 505.e43. Leung TY, Stuart O, Suen SS, Sahota DS, Lau TK, Lao TT. Comparison of perinatal outcomes of shoulder dystocia alleviated by different type and sequence of manoeuvres: a retrospective review. BJOG. 2011 Jul;118(8):985-90. doi: 10.1111/j.1471-0528.2011.02968.x. Epub 2011 Apr 12. PMID: 21481159.4. Grobman WA, Miller D, Burke C, Hornbogen A, Tam K, Costello R. Outcomes associated with introduction of a shoulder dystocia protocol. Am J Obstet Gynecol. 2011;205(6):513−517.STRONG COFFEE PROMO CODE:https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Entendiendo el déficit de la hormona del crecimiento, con la Dra Rumyana Rosenova

Buenos días madresfera

Play Episode Listen Later Dec 3, 2025 28:29

Episodio 1236 en colaboración con MerckDentro de la campaña "Impulsando el crecimiento, inspirando confianza" de Merck en este episodio hablamos sobre el déficit de hormona de crecimiento, una enfermedad que genera un gran impacto en la vida de los niños que conviven con ella y la de sus familias.Para conocer mejor en qué consiste, el funcionamiento de la hormona del crecimiento, la importancia de su detección temprana y de su tratamiento, hablamos con la Dra. Rosenova, endocrina pediátrica del IMED Valencia.Estudio referenciado:Backeljauw P, Cappa M, Kiess W, Law L, Cookson C, Sert C, Whalen J, Dattani MT. Impact of short stature on quality of life: A systematic literature review. Growth Horm IGF Res. 2021 Apr-Jun;57-58:101392. doi: 10.1016/j.ghir.2021.101392. Epub 2021 Apr 30. PMID: 33975197.https://pubmed.ncbi.nlm.nih.gov/33975197/ Web: https://madresfera.com/Newsletter: https://www.madresfera.com/newsletter/ Música: #mobygratis https://mobygratis.com/Conviértete en un seguidor de este podcast: https://www.spreaker.com/podcast/buenos-dias-madresfera--2023835/support.

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#73 Running Toward a Cure: NF2 Advocate Becomes Marathon Runner to Raise Awareness & Funds

It Happened To Me: A Rare Disease and Medical Challenges Podcast

Play Episode Listen Later Dec 1, 2025 36:39

In this uplifting episode, hosts Beth Glassman and Cathy Gildenhorn sit down with Leanna Scaglione, a powerhouse rare disease advocate and marathon runner living with NF2-Related Schwannomatosis (NF2-SWN), formerly known as neurofibromatosis type 2. Diagnosed at just 16 years old, Leanna's life changed dramatically when tumors were discovered in her nervous system, a hallmark of NF2-SWN. Many would have slowed down. Instead, Leanna sped up. Today, she has: Completed multiple marathons, including Berlin and New York City Participated in clinical trials Become an advocate and 2025 Ambassador for the Children's Tumor Foundation Set her sights on becoming the first person with NF2 to complete all 7 Abbott World Marathon Majors Her message is powerful: a diagnosis doesn't define the finish line. In This Episode, We Discuss: What NF2-SWN is and how it impacts the nervous system The emotional toll of receiving a life-altering diagnosis as a teenager Losing a dream — and finding a new one Running marathons through surgeries, treatments, and uncertainty How advocacy and visibility can change the rare disease landscape Building a life rooted in resilience, purpose, and possibility About Our Guest: Leanna Scaglione is 34 years old living with NF2-Related Schwannomatosis (NF2-SWN). Ever since being diagnosed at 16 years old, she has refused to live defined by her diagnosis. From relearning to walk, participating in immunotherapy drug trials, and going through numerous surgeries she has defied the odds against her. Most recently she has undergone surgery to remove her right acoustic neuroma. She continues to live her best life as an endurance runner, sharing her story and experiences living with NF2 in hopes to spread awareness, motivate her community and rally for a cure. Resources: Children's Tumor Foundation NF2 Accelerator: A Strategic Portfolio Approach to End NF2 Articles Explaining NF2 MedlinePlus GeneReviews National Organization for Rare Disorders (NORD) Research from China that Leanna reference for a gene therapy for NF2 Yuan R, Wang B, Wang Y, Liu P. Gene Therapy for Neurofibromatosis Type 2-Related Schwannomatosis: Recent Progress, Challenges, and Future Directions. Oncol Ther. 2024 Jun;12(2):257-276. doi: 10.1007/s40487-024-00279-2. Epub 2024 May 17. PMID: 38760612; PMCID: PMC11187037. Additional Research Articles Alexandra K. O'Donohue, Samantha L. Ginn, Gaetan Burgio, Yemima Berman, Gabriel Dabscheck, Aaron Schindeler, The evolving landscape of NF gene therapy: Hurdles and opportunities, Molecular Therapy Nucleic Acids, Volume 36, Issue 1, 2025, 102475 ,ISSN 2162-2531, https://doi.org/10.1016/j.omtn.2025.102475. Connect With Us: Stay tuned for the next new episode of “It Happened To Me”! In the meantime, you can listen to our previous episodes on Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “It Happened To Me”. “It Happened To Me” is created and hosted by Cathy Gildenhorn and Beth Glassman. DNA Today's Kira Dineen is our executive producer and marketing lead. Amanda Andreoli is our associate producer. Ashlyn Enokian is our graphic designer. See what else we are up to on Twitter, Instagram, Facebook, YouTube and our website, ItHappenedToMePod.com. Questions/inquiries can be sent to ItHappenedToMePod@gmail.com.

145 Soul Diamond Legacy – The Crown | Catherine B. Roy: The Birth of the Soul Diamond Legacy

The Catherine B. Roy Show

Play Episode Listen Later Dec 1, 2025 7:33

Welcome to a very special solo episode of The Catherine B. Roy Show, opening the Soul Diamond Legacy – Volume 1: The Crown special series.In this heartfelt episode, Catherine shares the true story behind the creation of the Soul Diamond Legacy — a seven-volume book series born from a calling to bring together leaders, visionaries, healers, and changemakers who are ready to share their stories with depth, courage, and vulnerability.In this episode, Catherine reveals:✨ How the Soul Diamond Legacy was conceived✨ Why Volume 1 begins with The Crown — the symbol of living from higher truth✨ How pressure, challenge, and transformation shaped the idea✨ Why this book is more than a collaboration — it is a movement✨ The purpose behind gathering 11 authors to tell real, honest, soul-driven stories✨ The deeper mission to awaken hope, inspire purpose, and empower people worldwideThis is the story behind the story — the opening chapter of the entire Soul Diamond Legacy journey.

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Nutrition in Critical Illness with Dr. Enid Martinez, 1/2

PedsCrit

Play Episode Listen Later Dec 1, 2025 45:26

Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children's Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness. Learning Objectives:By the end of this podcast, listeners should be able to:Recognize the impact of nutritional status on outcomes of critically-ill children.Describe the key aspects of the metabolic stress response in critical illness.Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.Reflect on an expert's approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence. Selected references:Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844. Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Vivir para contarlo: Conversación sobre las Final Girls

MentesLiterales - Recomendaciones y reseñas de libros

Play Episode Listen Later Dec 1, 2025 60:34

En este episodio nos adentramos en el inquietante y emocionante mundo de “Grupo de Apoyo para las Final Girls” de Grady Hendrix. Exploramos la historia, los personajes y todos esos giros que mantienen a los fanáticos del terror pegados a las páginas. Analizamos cómo el autor juega con el concepto de la superviviente final y reflexionamos sobre por qué estas historias siguen cautivando al público.Lo que encontrarás en este episodio:Un resumen sin spoilers del libro.Nuestras impresiones sobre los personajes principales y sus arcos.Discusión de los temas centrales: trauma, supervivencia y resiliencia.Comparaciones con otras obras del género slasher y de terror psicológico.Recomendaciones para quienes disfruten de libros similares.Escucha este episodio si eres fan del terror, los slashers y las historias de supervivencia emocional. ¡Prepárate para compartir el miedo y la diversión con nosotros!Si te interesa este libro puedes conseguirlo siguiendo este enlace.Recuerda que si gustas apoyarnos en nuestras lecturas y reseñas, lo puedes realizar mediante ☕️ Paypal o a través de nuestras redes sociales o correo electrónico.También te agradeceríamos

307. [Interview] 5 leçons pour devenir riche, tirés de livres de finances personnelles, avec Bassem Mejri

Les Investisseurs Sereins - Investissement Immobilier Rentable

Play Episode Listen Later Dec 1, 2025 69:02

A l'approche de Noël, je trouve ça toujours sympa de vous proposer un épisode qui donne des idées de lectures.Après, c'est surtout un échange actif autour des principales idées avancées sur ces ouvrages.Dans cet épisode, on va présenter 6 ouvrages : Napoléon Hill - Réfléchissez et devenez riche (1937), sponsorisé par Dale CarnegyT. Harv Eker - Les secrets d'un esprit millionnaire, best-seller du NewYork TimesRamit Sethi - Comment devenir riche (I will teach you how to get rich) (2010)Morgan Housel - La psychologie de l'argent (2020), best-seller du NewYork Times, qui explore comment l'attitude est plus importante que l'intelligenceJL Collins - The simple path of wealth - un livre écrit par un financier consultant pour sa fille - comment être économe, investir tous les excédents, et rester simple dans ses investissements.Alice Schroeder - L'effet boule de neige de Warren Buffet - biographie. Le temps est l'ami des businessOn mentionne également le livre d'Olivier Seban : "Tout le monde mérite d'être riche"Et on parle également d'un jeu de société qui s'intitule : Richesses du monde.Et on évoque également le jeu Cash-Flow de Robert Kyozaki.Bonne écoute,DorineLiens de l'invité : --> Livres de Frégate Editions :https://www.fnac.com/a14982181/Thomas-J-Stanley-The-Millionnaire-Next-Doorhttps://www.fnac.com/a17284746/Vicky-Robin-Votre-Argent-ou-votre-Viehttps://www.fnac.com/a21205227/Felix-Dennis-Comment-devenir-richeVoici les liens des livres présentés lors du Podcast "les investisseurs sereins".https://www.fnac.com/a18800257/Napoleon-Hill-Reflechissez-et-devenez-richehttps://www.fnac.com/a2442661/T-Harv-Eker-Les-secrets-d-un-esprit-millionnaire-Maitriser-le-jeu-interieur-de-la-richesse-Penser-riche-pourhttps://www.fnac.com/a3127909/Cecile-Capilla-Devenez-richehttps://www.fnac.com/a16492057/Morgan-Housel-La-psychologie-de-l-argenthttps://www.fnac.com/livre-numerique/a21114552/L-J-Collins-The-Simple-Path-to-Wealth-Revised-et-Expanded-2025-Edition#FORMAT=ebook%20(ePub)https://www.fnac.com/a16119534/Alice-Schroeder-L-effet-boule-de-neigeLinkedIn :https://www.linkedin.com/in/bassem-mejri-93731037/Twitter/ X.com :https://x.com/bassemmejri10Inscrivez-vous dès maintenant à notre prochaine ouverture des portes du Club des Investisseurs Sereins :https://challenge.les-investisseurs-sereins.fr/Hébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Night Bites

amazon master artist storytelling oracle asmr bites west end coven epub claudius bringer darker side google books smashwords bringers personal sessions

Play Episode Listen Later Nov 27, 2025 13:03

Meet Claudius a Master Vamp and his coven of vampire witches as we explore the Darker Side of the Bringers of the Light. Within every villain is a Bringer of the Light waiting to break free.In this first installment of the Claudius series the master vampire explores his past and envisions his future. THANKS FOR Being here

LDA for Unexplained Recurrent SABs?

Play Episode Listen Later Nov 26, 2025 17:13

Recurrent pregnancy loss (RPL) affects approximately 5% of couples and is an emotional burden on those affected. There is some evidence that vaginal progesterone supplementation may be considered in patients with recurrent pregnancy loss who are experiencing vaginal bleeding during the first trimester. But what about prophylactic low dose aspirin in the first trimester, or preconceptionally, for unexplained RPL? Is that evidence-based? A new publication from the SMFM's journal Pregnancy has examined this. Listen in for details. 1. 22 November 2025: Low-dose aspirin in unexplained recurrent pregnancy loss: A systematic review and meta-analysis (Pregnancy): https://obgyn.onlinelibrary.wiley.com/doi/10.1002/pmf2.700992. American College of Obstetricians and Gynecologists' Committee on Obstetric Practice, T. Flint Porter, Cynthia Gyanff-Bannerman, Tracy Manuck. Low-Dose Aspirin Use During Pregnancy. American College of Obstetricians and Gynecologists (2018)3. Naimi AI, Perkins NJ, Sjaarda LA, et al. The Effect of Preconception-Initiated Low-Dose Aspirin on Human Chorionic Gonadotropin-Detected Pregnancy, Pregnancy Loss, and Live Birth : Per Protocol Analysis of a Randomized Trial. Annals of Internal Medicine. 2021;174(5):595-601. doi:10.7326/M20-0469.4. Lee EE, Jun JK, Lee EB.Management of Women With Antiphospholipid Antibodies or Antiphospholipid Syndrome During Pregnancy. Journal of Korean Medical Science. 2021;36(4):e24. doi:10.3346/jkms.2021.36.e24.5. de Assis V, Giugni CS, Ros ST. Evaluation of Recurrent Pregnancy Loss. Obstet Gynecol. 2024 May 1;143(5):645-659. doi: 10.1097/AOG.0000000000005498. Epub 2024 Jan 4. PMID: 38176012.

Change Gloves After Placenta at CS? Yes, and No.

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Play Episode Listen Later Nov 24, 2025 27:48

Having data is sometimes different than having clinically applicable data. This is exactly the issue with the proposed plan to reduce surgical site infection (SSI) by changing surgical gloves after placental delivery at C-Section. Just 24 hours ago, we received the question from a PGY4 OBGYN resident asking whether the practice of changing surgical gloves at C-Section after placental delivery to reduce SSI was evidence-based. So, in this episode, we will review the data - which is timely since this was recently published on November 13, 2025 in the J Hospital Infection. This study follows a statement on this practice released by FIGO in September 2025. It's an interesting proposal, and there is clearly data in support of this, yet the ACOG and CDC do not recommend this practice as of Nov 2025. Is there a disconnect? Listen in for details. 1. FIGO: https://www.figo.org/news/new-ijgo-review-provides-comprehensive-framework-preventing-post-caesarean-sepsis (International Journal of Gynecology & Obstetrics)2. Stanberry B, Jordan L, Pullyblank A, Hargreaves J. Glove change during caesarean birth: impact on maternity service budgets and capacity. J Hosp Infect. 2025 Nov 13:S0195-6701(25)00354-8. doi: 10.1016/j.jhin.2025.10.033. Epub ahead of print. PMID: 41241232.3. Narice BF, Almeida JR, Farrell T, Madhuvrata P. Impact of Changing Gloves During Cesarean Section on Postoperative Infective Complications: A Systematic Review and Meta-Analysis. Acta Obstetricia Et Gynecologica Scandinavica. 2021;100(9):1581-1594. doi:10.1111/aogs.14161.4. Routine Sterile Glove and Instrument Change at the Time of Abdominal Wound Closure to Prevent Surgical Site Infection (ChEETAh): A Pragmatic, Cluster-Randomised Trial in Seven Low-Income and Middle-Income Countries.NIHR Global Research Health Unit on Global Surgery. Lancet (London, England). 2022;400(10365):1767-1776. doi:10.1016/S0140-6736(22)01884-0.5. Gialdini C, Chamillard M, Diaz V, Pasquale J, Thangaratinam S, Abalos E, Torloni MR, Betran AP. Evidence-based surgical procedures to optimize caesarean outcomes: an overview of systematic reviews. EClinicalMedicine. 2024 May 19;72:102632. doi: 10.1016/j.eclinm.2024.102632. PMID: 38812964; PMCID: PMC11134562.

Ortiga y Hueso

MentesLiterales - Recomendaciones y reseñas de libros

Play Episode Listen Later Nov 24, 2025 50:54

En este episodio nos adentramos en el oscuro y fascinante mundo de Ortiga y hueso, la novela de T. Kingfisher que mezcla fantasía oscura, humor peculiar y una protagonista muy distinta a lo que estamos acostumbrados. Hablamos de esos momentos que sorprenden, de la atmósfera que oscila entre lo macabro y lo tierno, y de cómo la autora logra un cuento de hadas retorcido pero profundamente emocional.Durante la conversación exploramos:

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One Health Policy with Dr. Karen Meagher

Bioethics in the Margins

Play Episode Listen Later Nov 24, 2025 55:46

This month we are joined by Dr. Karen Meagher, Assistant Professor of Health Justice and Bioethics at the Lewis Katz School of Medicine at Temple University. Recently, Dr. Meagher was the Associate Director of public engagement in the Biomedical Ethics Research Program at the Mayo Clinic. Her research focuses on public health ethics and social implications of advances in microbial and human genetics. She has a PhD in philosophy from Michigan State University. From 2012-2016 she worked as a senior policy and research analyst on the staff of president Barak Obama's Presidential Commission for the study of bioethical issues.Listen in as Dr. Meagher shares her career journey starting with her undergraduate interest in the philosophy of science and social influences of how science gets done. She describes how she was drawn to the growing field of public health ethics, which blossomed in the early 2000s with increasing publications and dedicated journals. Dr. Meagher describes her Virtue Ethics orientation to public health ethics and shares the inside scoop on what it is like to serve on a Presidential Commission.Later in her career, embedded with Mayo clinic biobank, Dr. Meagher describes her experiences with public engagement with community and how bioethicists can be a bridge between basic scientists and the community when grappling with difficult ethical dilemmas like those dealing with broad consent for future research with banked specimens.Finally, we delve into a discussion of how Dr. Meagher's work on antimicrobial resistance led her to engage in concepts of One Health Policy, which recognizes the interdependence of people, animals and the environment. She highlights the importance of breaking down silos between researchers in different sectors and how bioethics can bridge disciplines and create shared moral language, while also centering engagement of communities to help define these problems from different perspectives. Selected publications of Dr. Meagher's which were referenced in the podcast can be found here:Meagher KM. Can One Health Policy Help Us Expand an Ethics of Interconnection and Interdependence? AMA J Ethics. 2024 Feb 1;26(2):E162-170. doi: 10.1001/amajethics.2024.162. PMID: 38306206.https://pubmed.ncbi.nlm.nih.gov/38306206/Meagher KM, Curtis SH, Gamm KO, Sutton EJ, McCormick JB, Sharp RR. At a Moment's Notice: Community Advisory Board Perspectives on Biobank Communication to Supplement Broad Consent. Public Health Genomics. 2020;23(3-4):77-89. doi: 10.1159/000507057. Epub 2020 May 12. PMID: 32396907.https://pubmed.ncbi.nlm.nih.gov/32396907/Meagher KM. Considering virtue: public health and clinical ethics. J Eval Clin Pract. 2011 Oct;17(5):888-93. doi: 10.1111/j.1365-2753.2011.01721.x. Epub 2011 Aug 11. PMID: 21834841.https://pubmed.ncbi.nlm.nih.gov/21834841/Meagher KM, Lee LM. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program. Public Health Rep. 2016 Jan-Feb;131(1):44-51. doi: 10.1177/003335491613100110. PMID: 26843669; PMCID: PMC4716471.https://pubmed.ncbi.nlm.nih.gov/26843669/

Prosperity Healing ❤️‍

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Play Episode Listen Later Nov 24, 2025 42:31

You'll be surprised how the two are connected as we bring in detailed information and guidance to help you heal in these stars of your life

TOUT SUR LES PROTEINES : Manger pour la planète : quelles protéines choisir sans se tromper ? (4/5)

⚡PODCAST NUTRITION⚡ :

Play Episode Listen Later Nov 20, 2025 8:19

Use GA at CS Electively? Maybe, Maybe.

Software Engineering Radio - The Podcast for Professional Software Developers

Play Episode Listen Later Nov 19, 2025 35:42

Regional anesthesia, typically with a spinal or epidural, haslong been favored for cesarean births due in part to concerns about the effects that general anesthesia (GA) may have on newborns at delivery. However, data has shown that up to 1 in 6 women may experience pain with a “topped-off”labor epidural, during the cesarean. A new publication in the journal Anesthesia is now being interpreted as implying that general anesthesia may be a valid alternative electively. Is that what this new study found? Has GA been linked to postpartum depression? What about later child neurodevelopmental delays? This is a fascinating topic…Listen in for details. 1. Langer, Sarah M.D.1; Lim, Grace M.D., M.Sc.2;Qiu, Yue M.D.3; Biaesch, Jingyuan D.O.4; Neuman, Mark D. M.D., M.Sc.5. NeonatalOutcomes with Regional versus General Anesthesia for Cesarean Delivery: AMeta-analysis of Randomized Controlled Trials. Anesthesiology():10.1097/ALN.0000000000005785, November 12, 2025. | DOI:10.1097/ALN.00000000000057852. Guglielminotti J, Monk C, Russell MT, Li G.Association of General Anesthesia for Cesarean Delivery with PostpartumDepression and Suicidality. Anesth Analg. 2025 Sep 1;141(3):618-628. doi:10.1213/ANE.0000000000007314. Epub 2024 Dec 4. PMID: 39630595; PMCID:PMC12134152.3. Chen, YC., Liang, FW., Tan, PH. et al.Association between general anesthesia for cesarean delivery and subsequentdevelopmental disorders in children: a nationwide retrospective cohort study.BMC Med 23, 119 (2025). https://doi.org/10.1186/s12916-025-03886-64. https://www.pennmedicine.org/news/new-study-challenges-fears-about-general-anesthesia-during-c-section

SE Radio 695: Dave Thomas on Building eBooks Infrastructure

Play Episode Listen Later Nov 19, 2025 62:49

Dave Thomas, author of The Pragmatic Programmer, The Manifesto for Agile Software Development, Programming Ruby, Agile Web Development with Rails, Programming Elixir, Simplicity, and co-founder of the Pragmatic Bookshelf, speaks with SE Radio host Gavin Henry about building infrastructure for eBooks. They discuss what an eBook is, the various formats, what infrastructure is needed to build them, how an author writes an book, the history of the Pragmatic Bookshelf, how they have evolved, how to handle links within eBooks, why humans are so important in the writing process, and why AI can help with your writing -- once you've written your content. Thomas discusses PDFs, eBooks, Mobi files, ePub files, CI/CD pipelines, WYSWYG, Markdown files, Pragmatic Markup Language, embedding code, AI agents, images, printing PDFs, JVMs, Java, jRuby, and how Markdown won the plain text writing format wars. Brought to you by IEEE Computer Society and IEEE Software magazine.

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Episode 39 - Mary Beth Feuling - From Data to Impact: Advancing Pediatric Nutrition in Hospital Systems

Nutrition Pearls: The Pediatric GI Nutrition Podcast

Play Episode Listen Later Nov 19, 2025 56:01

Episode 39 - Mary Beth Feuling - From Data to Impact: Advancing Pediatric Nutrition in Hospital SystemsIn this episode of Nutrition Pearls: the Podcast, co-hosts Nikki Misner and Bailey Koch speak with Mary Beth Feuling on how pediatric dietitians can use data, EMRs, and innovative tools to improve patient care and malnutrition identification at a systems level. Mary Beth is a pediatric nutrition specialist with expertise in nutrition informatics, quality, and research, dedicated to advancing care for children across all ages. Over the past thirteen years as an advanced practice dietitian, she has led quality improvement and research initiatives at Children's Wisconsin, mentoring dietitians to develop their research skills and improving pediatric nutrition care locally, nationally, and internationally.Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.Resources:Feuling MB, Hilbrands J, Hettich K, et al. Registered Dietitian Nutritionist consultation is associated with improvement in nutritional status in chronically ill children: a retrospective cohort study. J Acad Nutr Diet. 2025;(Epub ahead of print). doi:10.1016/j.jand.2025.05.011.Hilbrands J, Feuling MB, Szabo A, et al. Nutrition screening in the pediatric intensive care unit: evaluation of an electronic medical record–based tool. Nutrients. 2023;15(21):4591. doi:10.3390/nu15214591.Umentum B, Kim HJ, Adkins A, et al. Are dietitian recommendations followed? A descriptive study of pediatric hospitalized and ambulatory patients. J Hum Nutr Diet. 2024;(Epub ahead of print). doi:10.1111/jhn.13291.Crouse J, Feuling MB, Winter T, Goday PS, Smith A. Electronic health record time-tracking provides real-time data to measure and benchmark dietitian productivity. J Hum Nutr Diet. 2024;37(1):105-110. doi:10.1111/jhn.13236.Hilbrands J, Feuling MB, Szabo A, et al. Evaluation of an electronic medical record–based pediatric nutrition screening tool. J Hum Nutr Diet. 2023;36(5):1912-1921. doi:10.1111/jhn.13177.Sparapani RA, Teng BQ, Hilbrands J, Pipkorn R, Beth FM, Goday PS. Novel pediatric height outlier detection methodology for electronic health records via machine learning with monotonic Bayesian additive regression trees. J Pediatr Gastroenterol Nutr. 2022;75(2):210-214.Rusnak S, Charney P. Position of the Academy of Nutrition and Dietetics: Nutrition informatics. J Acad Nutr Diet. 2019;119(8):1375-1382. doi:10.1016/j.jand.2019.06.004.Academy of Nutrition and Dietetics Quality Management Academy of Nutrition and Dietetics Malnutrition Care Score Nutrition Care Process Interoperability and Health Information StandardsChildren's Hospitals Solutions for Patient SafetySix Domains of Health Care Quality Produced by: Corey IrwinNASPGHAN - Council for Pediatric Nutrition Professionalscpnp@naspghan.org

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Surgeon, Heal Thyself: Mastering Ergonomics & Navigating Injury

MentesLiterales - Recomendaciones y reseñas de libros

Play Episode Listen Later Nov 17, 2025 29:00

Stop powering through the pain! Surgery is a high-performance sport, yet surgeons often operate with minimal support, leading to chronic pain and potential career-ending injuries. This episode dives into the crucial topic of surgical ergonomics, explaining why your posture, instrument size, and even hydration impact your performance and longevity. Learn essential OR hacks—from adjusting monitor height and using micro-break stretches to strategic pre-case fueling—to mitigate the physical toll. We also share candid stories from surgeons who faced debilitating injuries, providing critical advice on acknowledging pain, seeking help, and treating recovery like a full-time job. It's time to invest in your physical health, because your hands and posture are your most vital instruments. Hosts: Agnes Premkumar, MD (General Surgery Resident at Creighton University) @agnespremkumar Steven Thornton, MD (General Surgery Resident at Duke University) @swthorntonjr Guests: Kathryn Coan, MD (Dignity Health, Phoenix) Anathea Powell, MD (Renown Health, Reno) Danielle Tanner, MD (Creighton University, Phoenix) Dr. Kathryn Coan is an endocrine surgeon, and associate professor at the Creighton University School of Medicine in Phoenix. Outside of the OR, she enjoys being active such as playing golf, hockey, and hiking. Dr. Anathea Powell is a colorectal surgeon working at Renown Health in Reno, Nevada and the University of Nevada, Reno. Outside of the OR, she has certifications in personal training as well as coaching for nutrition, sleep and recovery, mobility, and menopause. She is also a former All American in triathlon and aquabike (swim-bike). Dr. Danielle Tanner is a PGY-5 at Creighton University School of Medicine in Phoenix and aspires to be a rural general surgeon. Publications and Applications Discussed: Black Belt Academic Surgical Skills: https://bbass.org/ Epstein S, Sparer EH, Tran BN, Ruan QZ, Dennerlein JT, Singhal D, Lee BT. Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists: A Systematic Review and Meta-analysis. JAMA Surg. 2018 Feb 21;153(2):e174947. doi: 10.1001/jamasurg.2017.4947. Epub 2018 Feb 21. PMID: 29282463; PMCID: PMC5838584. https://pubmed.ncbi.nlm.nih.gov/29282463/ Sutton E, Irvin M, Zeigler C, Lee G, Park A. The ergonomics of women in surgery. Surg Endosc. 2014 Apr;28(4):1051-5. doi: 10.1007/s00464-013-3281-0. PMID: 24232047. https://pubmed.ncbi.nlm.nih.gov/24232047/ Patel VR, Stearns SA, Liu M, Tsai TC, Jena AB. Mortality Among Surgeons in the United States. JAMA Surg. 2025 Sep 1;160(9):1032-1034. doi: 10.1001/jamasurg.2025.2482. PMID: 40737024; PMCID: PMC12311820. https://pubmed.ncbi.nlm.nih.gov/40737024/ Lee MR, Lee GI. Does a robotic surgery approach offer optimal ergonomics to gynecologic surgeons?: a comprehensive ergonomics survey study in gynecologic robotic surgery. J Gynecol Oncol. 2017 Sep;28(5):e70. doi: 10.3802/jgo.2017.28.e70. Epub 2017 Jun 23. PMID: 28657231; PMCID: PMC5540729. https://pubmed.ncbi.nlm.nih.gov/28657231/ Berguer R. The application of ergonomics in the work environment of general surgeons. Rev Environ Health. 1997 Apr-Jun;12(2):99-106. doi: 10.1515/reveh.1997.12.2.99. PMID: 9273926. https://pubmed.ncbi.nlm.nih.gov/9273926/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

El libro de las cochinadas

Play Episode Listen Later Nov 17, 2025 56:50

En este episodio nos sumergimos en El libro de las cochinadas, una lectura tan irreverente como entretenida que juega con el humor, la curiosidad y el lado más travieso de la vida cotidiana. Mix y Any platican sobre los capítulos más hilarantes, las ocurrencias que te sacan carcajadas inesperadas y las situaciones tan absurdamente reales que hacen que este libro sea perfecto para desconectar y reírte un buen rato.Hablamos de:

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#126 – What's the Microbiome Gut to Do with It

Breakpoints

Play Episode Listen Later Nov 14, 2025 68:15

Dr. Julie Ann Justo is joined by experts Drs. Krista Gens and Javier A. Villafuerte Gálvez as they dive deep into the gut microbiome and explore the latest therapeutic frontier for C. difficile infections. From bacteria battles to breakthrough treatments, this one's a must-listen! You can also review the helpful infographic on our website (https://breakpoints-sidp.org/infographics/). This podcast was supported by an unrestricted grant from Nestlé Health Science. References: Helpful review from one of our guest experts: Gens KD, et al. Fecal microbiota transplantation and emerging treatments for Clostridium difficile infection. J Pharm Pract. 2013 Oct;26(5):498-505. doi: 10.1177/0897190013499527. PMID: 23966282. More modern review: Herbin SR, et al. Breaking the Cycle of Recurrent Clostridioides difficile Infections: A Narrative Review Exploring Current and Novel Therapeutic Strategies. J Pharm Pract. 2024 Dec;37(6):1361-1373. doi: 10.1177/08971900241248883. Epub 2024 May 13. PMID: 38739837. Review on designing microbiota based therapies (pre-print only): Ke S, et al. Rational Design of Live Biotherapeutic Products for the Prevention of Clostridioides difficile Infection. 2024 May 02. doi: 10.1101/2024.04.30.591969. [FDA Guidance regarding IND requirements for fecal microbiota transplant](https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-policy-regarding-investigational-new-drug-requirements-use-fecal-microbiota). 2022 Nov. OpenBiome webpage with resources for hospitals: How to Start an FMT Program. 2025. Peery AF, et al. AGA Clinical Practice Guideline on Fecal Microbiota-Based Therapies for Select Gastrointestinal Diseases. Gastroenterology. 2024 Mar;166(3):409-434. doi: 10.1053/j.gastro.2024.01.008. PMID: 38395525. Johnson S, et al. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clin Infect Dis. 2021 Sep 7;73(5):755-757. doi: 10.1093/cid/ciab718. PMID: 34492699. Henry Ford's experience getting fecal microbiota products for patients: Abene S. Fecal Microbiota Capsules Improve CDI Access Through Specialty Pharmacy Integration. Contagion Live. 2025 Jul 11. An international view on CDI management: Mendo-Lopez R, et al. Best Practices in the Management of Clostridioides difficile Infection in Developing Nations. Trop Med Infect Dis. 2024 Aug 19;9(8):185. doi: 10.3390/tropicalmed9080185. PMID: 39195623. Review on investigational LBP agents: Monday L, et al. Microbiota-Based Live Biotherapeutic Products for Clostridioides Difficile Infection- The Devil is in the Details. Infect Drug Resist. 2024 Feb 15;17:623-639. doi: 10.2147/IDR.S419243. PMID: 38375101. More on quorum sensing: Falà AK, et al. Quorum sensing in human gut and food microbiomes: Significance and potential for therapeutic targeting. Front Microbiol. 2022 Nov 25;13:1002185. doi: 10.3389/fmicb.2022.1002185. PMID: 36504831. Economic impacts of CDI pts: Reilly J, et al. Economic impact of multiple recurrent Clostridioides difficile infection in a community teaching hospital. Infect Control Hosp Epidemiol. 2025 Sep 29:1-3. doi: 10.1017/ice.2025.10295. Epub ahead of print. PMID: 41020576.

November Storytelling

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Play Episode Listen Later Nov 14, 2025 16:22

My books and stories are always written with the intention that you will receive what you most need right now from the magic within the pages. Be it healing, guidance, love, magic, or laughter.Join me this month as we fall into magical portals of adventure with the Mist Vamp. This book is part of my Spirit Guides of Tessa Loch series and the ebook can be read for free at all major ebook providers.THANKS FOR Being here

IMD Research Round-Up: Mitochondrial disease

JIMD Podcasts

Play Episode Listen Later Nov 11, 2025 37:38

The Research Round-Up returns! Hosts Silvia Radenkovic and Rodrigo Starosta are joined by Dr Hilary Vernon and Dr Austin Larson for a deep dive into the latest discoveries in mitochondrial disease. Together they explore how new biomarkers like FGF21 and GDF15 are reshaping diagnosis, how multi-omics approaches are accelerating precision care, and what large-scale data from gnomAD to stem-cell models is revealing about disease mechanisms and therapeutic opportunities. A lively, expert-led discussion connecting science, diagnostics, and patient impact across the mitochondrial field. Laricchia KM, et al Mitochondrial DNA variation across 56,434 individuals in gnomAD. Genome Res. 2022 Mar;32(3):569-582. doi: 10.1101/gr.276013.121. Epub 2022 Jan 24. PMID: 35074858; PMCID: PMC8896463. Liu O, et al FGF21 and GDF15 are elevated in Barth Syndrome and are correlated to important clinical measures. Mol Genet Metab. 2023 Nov;140(3):107676. doi: 10.1016/j.ymgme.2023.107676. Epub 2023 Aug 2. PMID: 37549445. Van Hove JLK, et al Protein biomarkers GDF15 and FGF21 to differentiate mitochondrial hepatopathies from other pediatric liver diseases. Hepatol Commun. 2024 Jan 5;8(1):e0361. doi: 10.1097/HC9.0000000000000361. Erratum in: Hepatol Commun. 2024 Jan 29;8(2):e0390. doi: 10.1097/HC9.0000000000000390. PMID: 38180987; PMCID: PMC10781130. Starosta RT, et al An integrated multi-omics approach allowed ultra-rapid diagnosis of a deep intronic pathogenic variant in PDHX and precision treatment in a neonate critically ill with lactic acidosis. Mitochondrion. 2024 Nov;79:101973. doi: 10.1016/j.mito.2024.101973. Epub 2024 Oct 15. PMID: 39413893; PMCID: PMC11578067. Jain IH, et al Hypoxia as a therapy for mitochondrial disease. Science. 2016 Apr 1;352(6281):54-61. doi: 10.1126/science.aad9642. Epub 2016 Feb 25. PMID: 26917594; PMCID: PMC4860742 Sandlers Y, et al Metabolomics Reveals New Mechanisms for Pathogenesis in Barth Syndrome and Introduces Novel Roles for Cardiolipin in Cellular Function. PLoS One. 2016 Mar 25;11(3):e0151802. doi: 10.1371/journal.pone.0151802. PMID: 27015085; PMCID: PMC4807847. Sniezek Carney O, et al. Stem cell models of TAFAZZIN deficiency reveal novel tissue-specific pathologies in Barth syndrome. Hum Mol Genet. 2025 Jan 23;34(1):101-115. doi: 10.1093/hmg/ddae152. PMID: 39535077; PMCID: PMC11756277.

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Episode 44: Dare to Share

I Hate James Dobson

Play Episode Listen Later Nov 10, 2025 89:32

We've read the book, now it's time to look at the world around Dare 2 Share. In this episode, Brooke and Jake talk about Greg Stier, Dare 2 Share events, Promise Keepers, Skillet, and (as a treat) Propaganda.Trigger Warning for depictions of hell 31:00 - 33:15Check out Propaganda's work: @prophiphop on social media and wherever you get your musicReferences:Anthony, D. & Reynolds, G. (2020, August 4). 441 - Promise Keepers [Audio Podcast]. Onmy Studio.Ashely, F. Interrogating Gender-Exploratory Therapy. Perspect Psychol Sci. 2023 Mar;18(2):472-481. doi: 10.1177/17456916221102325. Epub 2022 Sep 6. 36068009; PMCID: PMC10018052Dare 2 Share Ministries. (2021, April 27). The Greg Stier Ministry Podcast - The Power of the Gospel with Skillet's John Cooper. [Video]. YouTube. https://www.youtube.com/watch?v=o3EUm-F2XcI&t=790sFocus on the Family. (2022, November 16). How a Dysfunctional Street Kid Became a Radical Disciple of Jesus (Part 1) - Greg Stier. [Video]. YouTube. https://www.youtube.com/watch?v=4GFh2h6pgUgGraham, R. (2024, August 11). The All-Male Christian Group Seeking a Resurrection in the Trump Era. New York Times. https://www.nytimes.com/2024/08/11/us/promise-keepers-evangelical-christians.htmlMatt Clayberg Ministries. (2013, August 24th). A Letter from Hell. [Video]. YouTube. https://www.youtube.com/watch?v=8oGXPRjk1HI&t=325sNameless Christian. (2013, October 19). Dare2Share 2013. [Video]. YouTube. https://www.youtube.com/watch?v=B0SavotwEZ0&t=33sn.a. (2023). Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth. Substance Abuse and Mental Health Services Administration (SAMHSA). https://archive.org/details/httpsstore.samhsa.govsitesdefaultfilespep22-03-12-001/page/n21/mode/2upPetty, J. (2021, May 21). ALLOW ME TO REINTRODUCE MYSELF [Audio Podcast]. Cool Zone MediaStier, G. (2016, September 1). 25 milestones during 25 years of Dare 2 Share. GregStier.com. https://gregstier.org/25-milestones-during-25-years-of-dare-2-shareStier, G. (2024, July 23). The Power of the Gospel and the Potential of Teens. Dare2Share.org. https://www.dare2share.org/blog/the-power-of-the-gospel-and-the-potential-of-teensWidaman, D. (2020, August 29). Skillet lead singer John Cooper armed self to protect family against Kenosha rioters. Metro Voice News. https://metrovoicenews.com/skillet-lead-singer-john-cooper-armed-self-to-protect-family-against-kenosha-riotersMusic from #Uppbeat (free for Creators!):https://uppbeat.io/t/mood-maze/trendsetterLicense code: 9OT2MTBHWWSRZP5S Hosted on Acast. See acast.com/privacy for more information.

Una vida tranquila… hasta que tocan a la puerta

MentesLiterales - Recomendaciones y reseñas de libros

Play Episode Listen Later Nov 10, 2025 81:00

En este episodio exploramos un thriller que juega con los clichés de la vejez, la invisibilidad y el crimen: Too Old for This, de Samantha Downing. Prepárense para conocer a una abuelita para nada común, un pasado oscuro que se resiste al olvido… y un nuevo visitante que agita el orden de las cosas.La obra nos presenta a Lottie Jones, una mujer de 75 años que lleva una vida tranquila en un pequeño pueblo: bingo semanal en la iglesia, tertulias con amigas, y la rutina cómoda de su retiro.Pero lo que la mayoría no sabe es que hace décadas ella cambió de identidad para ocultar que era una asesina en serie. - Consigue la novelaSi gustas escucharnos en nuestro contenido de Patreon no dudes en acompañarnos por esos rumbos lectores.Recuerda que si gustas apoyarnos en nuestras lecturas y reseñas, lo puedes realizar mediante: ☕️ Paypal o a través de nuestras redes sociales o correo electrónico.También te agradeceríamos

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November Energy Hangout

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Play Episode Listen Later Nov 9, 2025 30:24

This month's energies include a Mercury Retrograde that is all about hurry up and wait. We also share how to feel the love energy cord between you and your person of interest. As relationship healing came up for our collective as a theme this month as well. And we continue to talk about how to create positive karma in your life as part of our ongoing teachings on the channel. Let's explore these themes together while having some magical fun.THANKS FOR Being here

CCBs and Oxygenation: Why the Sat Falls After the Drip

Saving Lives: Critical Care w/eddyjoemd

Play Episode Listen Later Nov 8, 2025 7:46

Intravenous dihydropyridine calcium channel blockers can quietly worsen oxygenation by blunting hypoxic pulmonary vasoconstriction. In this episode, we break down the bedside mechanism, which agents are implicated, who's at highest risk (post-op atelectasis, obesity, pneumonia, focal ARDS, COPD), how soon it happens, and exactly what to do.The Vasopressor & Inotrope HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citations:Weir EK, López-Barneo J, Buckler KJ, Archer SL. Acute oxygen-sensing mechanisms. N Engl J Med. 2005 Nov 10;353(19):2042-55. doi: 10.1056/NEJMra050002. PMID: 16282179; PMCID: PMC2803102.Weir EK, Olschewski A. Role of ion channels in acute and chronic responses of the pulmonary vasculature to hypoxia. Cardiovasc Res. 2006 Sep 1;71(4):630-41. doi: 10.1016/j.cardiores.2006.04.014. Epub 2006 Apr 27. PMID: 16828723.Lumb AB, Slinger P. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications. Anesthesiology. 2015 Apr;122(4):932-46. doi: 10.1097/ALN.0000000000000569. PMID: 25587641.Timour G, Fréderic V, Olivier S, Shango DN. Nicardipine-induced acute respiratory failure: Case report and literature review. Clin Case Rep. 2023 May 1;11(5):e7186. doi: 10.1002/ccr3.7186. PMID: 37143457; PMCID: PMC10151601.McMurtry IF, Davidson AB, Reeves JT, Grover RF. Inhibition of hypoxic pulmonary vasoconstriction by calcium antagonists in isolated rat lungs. Circ Res. 1976 Feb;38(2):99-104. doi: 10.1161/01.RES.38.2.99. PMID: 1245025.Simonneau G, Escourrou P, Duroux P, Lockhart A. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. N Engl J Med. 1981 Jun 25;304(26):1582-5. doi: 10.1056/NEJM198106253042606. PMID: 7231503.Kennedy T, Summer W. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. Am J Cardiol. 1982 Oct;50(4):864-8. doi: 10.1016/0002-9149(82)91246-2. PMID: 7124646.Chrétien B, Decros JB, Suard F, Dolladille C, Fischer MO, Alexandre J, Descamps R. Hypoxia Associated With Dihydropyridine Calcium Channel Inhibitors: A Pharmacovigilance Study in VigiBase. Clin Pharmacol Ther. 2023 Sep;114(3):686-692. doi: 10.1002/cpt.2970. Epub 2023 Jun 29. PMID: 37309986.Burghuber OC. Nifedipine attenuates acute hypoxic pulmonary vasoconstriction in patients with chronic obstructive pulmonary disease. Respiration. 1987;52(2):86-93. doi: 10.1159/000195309. PMID: 3671896.Suard F, Mombrun M, Fischer MO, Hanouz JL, Decros JB, Derville S, Gakuba C, Al Issa G, Menard C, Chretien B, Descamps R. Oxygenation Effects of Antihypertensive Agents in Intensive Care: A Prospective Comparative Study of Nicardipine and Urapidil. Clin Pharmacol Ther. 2025 Mar;117(3):742-748. doi: 10.1002/cpt.3509. Epub 2024 Nov 27. PMID: 39604146.

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What About Narcissists Who Had a Happy Childhood?

Heal NPD

Play Episode Listen Later Nov 7, 2025 14:55

In this episode, Dr. Mark Ettensohn responds to a common question: How can someone with a perfectly normal and mostly happy childhood develop narcissistic personality disorder? The discussion challenges the widespread misconception that narcissism is simply a personality type, a collection of traits, or the result of genetics alone. Dr. Ettensohn explains that pathological narcissism is a disorder of self-esteem regulation and identity formation, not just a pattern of behavior. Drawing on clinical research and developmental theory, he explores how early experiences that appear loving and stable can still leave important parts of the self unseen, unrecognized, or conditionally valued. These subtle, chronic relational injuries, repeated over years rather than occurring as a single traumatic event, can distort the developing self's capacity to maintain a stable and realistic sense of worth. The episode distinguishes between “popular narcissism,” which focuses on abusive behavior, and clinical narcissism, which reflects an internal system of dysregulated self-esteem. Through metaphor and clinical reflection, Dr. Ettensohn illustrates how a child can grow up in an environment that looks healthy on the surface yet still learn to equate love with performance, value with achievement, and safety with control. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Article Citations: Vater, A., Ritter, K., Schröder-Abé, M., Schütz, A., Lammers, C.-H., & Roepke, S. (2013). When grandiosity and vulnerability collide: Implicit and explicit self-esteem in narcissistic personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 44(1), 37–47. https://doi.org/10.1016/j.jbtep.2012.07.004 Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400.

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Seminar Series 3: Beyond Traits - The Relational roots of NPD

Heal NPD

Play Episode Listen Later Nov 6, 2025 53:25

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Narcissistic Personality Disorder: Progress in Understanding and Treatment by Igor Weinberg, Ph.D., and Elsa Ronningstam, Ph.D. The conversation examines recent advances in how clinicians conceptualize and treat narcissistic personality disorder, moving beyond fixed trait models toward a dynamic, relational understanding of the self and its development. Themes include the interplay between grandiose and vulnerable self-states, the interdependence of self-esteem regulation, affect, cognition, empathy, and interpersonal functioning, and the recognition that narcissistic pathology evolves through cumulative disruptions in early attunement and relational safety. The discussion also explores how developmental misattunements - whether through neglect, overindulgence, or inconsistency - shape defensive adaptations and contribute to the oscillation between self-inflation and shame. Throughout the seminar, the team reflects on the therapeutic process of working with narcissistic patients, emphasizing empathy, reflective capacity, and the slow, relational work of rupture and repair that makes genuine transformation possible. This series is designed for clinicians, students, and anyone interested in a nuanced, compassionate understanding of narcissism, personality, and psychological change. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Citation for the article discussed: Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400. Full text of the article: https://pmc.ncbi.nlm.nih.gov/articles/PMC10187400/

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Forgotten Realms Heroes and Adventures in Faerun Spotlight – Lazy RPG Talk Show

Sly Flourish's Lazy DM Prep

Play Episode Listen Later Nov 3, 2025 63:19

D&D and RPG news and commentary by Mike Shea of https://slyflourish.com Contents 00:00 Show Start 00:38 Sly Flourish News: Improv vs. Prep, Three Initiative Options 02:12 Patreon Spotlight: Dyson Commercial Maps Gallary 05:15 Sly Flourish News: Halloween Shadowdark Ravenloft Game 08:47 Sly Flourish News: Appearance on EN World 09:32 Commentary: Evil Hat Games and EPUB for Accessibility 13:44 Commentary: What Is the Lazy RPG Talk Show? 26:36 Product Spotlight: Forgotten Realms Heroes and Adventures of Faerun 49:29 Patreon Question: Improvising Map Annotations and Details 54:15 Patreon Question: Connecting with Another Player's Character 56:15 Patreon Question: How do you Review the Characters? Links Subscribe to the Sly Flourish Newsletter Support Sly Flourish on Patreon Buy Sly Flourish Books: Morrus's Unofficial Tabletop RPG Talk with Mike

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Folic Acid Update: Women on Epilepsy Meds Do NOT Need More

Play Episode Listen Later Nov 2, 2025 29:02

Taking folic acid prior to conception and during pregnancy can help protect the unborn baby from developing abnormalities. Supplements are particularly important for women who have epilepsy, as anti-seizure medication (previously known as anti-convulsants or anti-epileptic drugs) can lead to a deficiency in folic acid. Until 2023, high doses of 4-5 mg per day were recommended. However, this has changed as the data has changed. Did you know the SMFM no longer recommends “high dose” folic acid preconceptionally for patients on seizure medications? This is also highlighted in a recently released epub from Obstetrics and Gynecology (Green Journal) on October 31, 2025. Listen in for details. 1. Mokashi, Mugdha MD, MPH; Cozzi-Glaser, Gabriella MD; Kominiarek, Michelle A. MD, MS. Dietary Supplements in the Perinatal Period. Obstetrics & Gynecology ():10.1097/AOG.0000000000006098, October 31, 2025. | DOI: 10.1097/AOG.00000000000060982. Asadi-Pooya AA. High dose folic acid supplementation in women with epilepsy: are we sure it is safe? Seizure. 2015 Apr;27:51-3. doi: 10.1016/j.seizure.2015.02.030. Epub 2015 Mar 7. PMID: 25891927.3. https://aesnet.org/about/aes-press-room/press-releases/guideline-issued-for-people-with-epilepsy-who-may-become-pregnant4. Turner C, McIntosh T, Gaffney D, Germaine M, Hogan J, O'Higgins A. A 10-year review of periconceptual folic acid supplementation in women with epilepsy taking antiseizure medications. J Matern Fetal Neonatal Med. 2025 Dec;38(1):2524094. doi: 10.1080/14767058.2025.2524094. Epub 2025 Jun 30. PMID: 40588438.5. https://www.aan.com/PressRoom/Home/PressRelease/5170#:~:text=The%20guideline%20recommends%20that%20people,and%20possibly%20improve%20neurodevelopmental%20outcomes.6. https://aesnet.org/about/aes-press-room/press-releases/guideline-issued-for-people-with-epilepsy-who-may-become-pregnant

women ms supplements mph meds epilepsy obstetrics gynecology doi epub seizure pmid dietary supplements folic acid aog smfm

#125 – The Scariest and Baddest: Burkholderia, Achromobacter, and Elizabethkingia

Breakpoints

Play Episode Listen Later Oct 31, 2025 92:54

Drs. Maria Mojica, Robert Bonomo, and Ryan Shields join Dr. Erin McCreary (@erinmccreary) for a Halloween special reviewing the scariest resistance mechanisms and baddest bugs – Burkholderia spp., Achromobacter spp., and Elizabethkingia spp. Never have beta lactamase enzymes and other complexities been explained so hauntingly well. We don't want to spook you, but these environmental, opportunistic pathogens are found around the globe. While we hope you don't encounter them, take a listen to prepare in case one jumps out in your practice! This episode was sponsored by an unrestricted grant from Shionogi Inc. References: Spencer HK, Spitznogle SL, Borjan J, Aitken SL. An Overview of the Treatment of Less Common Non-Lactose-Fermenting Gram-Negative Bacteria. Pharmacotherapy. 2020 Sep;40(9):936-951. doi: 10.1002/phar.2447. Epub 2020 Aug 14. PMID: 32687670. Defining antimicrobial susceptibility testing methods and breakpoints among Achromobacter species SIDP 2025 Webinar | Mind the Gap: CLSI M100 Updates to Optimize Stewardship and Patient Care Outcomes Yasmin M, Rojas LJ, Marshall SH, Hujer AM, Cmolik A, Marshall E, Boucher HW, Vila AJ, Soldevila M, Diene SM, Rolain JM, Bonomo RA. Characterization of a Novel Pathogen in Immunocompromised Patients: Elizabethkingia anophelis-Exploring the Scope of Resistance to Contemporary Antimicrobial Agents and β-lactamase Inhibitors. Open Forum Infect Dis. 2023 Jan 31;10(2):ofad014. doi: 10.1093/ofid/ofad014. PMID: 36820316; PMCID: PMC9938519. Warner NC, Bartelt LA, Lachiewicz AM, Tompkins KM, Miller MB, Alby K, Jones MB, Carr AL, Alexander J, Gainey AB, Daniels R, Burch AK, Brown DE, Brownstein MJ, Cheema F, Linder KE, Shields RK, Longworth S, van Duin D. Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections. Clin Infect Dis. 2021 Oct 5;73(7):e1754-e1757. doi: 10.1093/cid/ciaa1847. PMID: 33313656; PMCID: PMC8678443. El Chakhtoura NG, Saade E, Wilson BM, Perez F, Papp-Wallace KM, Bonomo RA. A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration. Clin Infect Dis. 2017 Oct 15;65(8):1253-1259. doi: 10.1093/cid/cix559. PMID: 29017247; PMCID: PMC5848224.

halloween resistance defining treatments exploring adult drs infection scope scariest epub pmid baddest inhibitors characterization pharmacotherapy clin infect dis burkholderia robert bonomo ryan shields

Episode 205: Atopic Dermatitis

Rio Bravo qWeek

Play Episode Listen Later Oct 31, 2025 23:45

Episode 205: Atopic Dermatitis Kara Willbanks (medical student) explains the definition, pathophysiology, and treatment of eczema. Dr. Arreaza adds some input about bleach baths and topical steroids. Written by Kara Willbanks, MSIV, American University of the Caribbean. Comments and edits by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.October is the Eczema Awareness Month!What Is Atopic Dermatitis? Atopic dermatitis, a form of eczema, is a chronic, relapsing inflammatory skin disorder that often begins in childhood but can affect people of all ages. Other eczematous dermatoses include seborrheic dermatitis, contact dermatitis, juvenile plantar dermatosis, and stasis dermatitis. Atopic dermatitis is one of the most common skin conditions in the developed world, typically affecting up to 20% of children and 5-10% of adults. Patients usually present with severe pruritus (itchiness) and dry, inflamed patches of skin. Common sites include the face and extensor surfaces in infants, and flexural areas — like the elbows and knees — in older children and adults. Atopic dermatitis is often associated with other allergic conditions like asthma and allergic rhinitis — what we call the “atopic triad.” These conditions should also be considered when diagnosing someone with atopic dermatitis. PathophysiologyAtopic dermatitis is believed to occur due to a combination of genetic, immune, and environmental factors. A major component is a defective skin barrier, often linked to mutations in the filaggrin gene. This allows irritants, allergens, and microbes to penetrate the skin more easily, triggering inflammation.Differential DiagnosisAtopic dermatitis can sometimes mimic other skin conditions, so it's important to keep a differential in mind: -Contact dermatitis – triggered by allergens or irritants; often limited to the area of exposure but also tends to be very itchy. -Seborrheic dermatitis – greasy scales, typically on the scalp, eyebrows, and nasolabial folds -Psoriasis – well-demarcated plaques with silvery scales; sometimes found in similar areas of the body as eczema. -Tinea (fungal infections) – ring-shaped lesions with active, scaly borders -Important to note that treatment of tinea with topical steroids can make the rash much worse. -Scabies – intense itching, especially at night, with burrows between fingers. Ruling out these conditions helps guide the right treatment and prevent chronic mismanagement. As a recap our main differential diagnosis: contact dermatitis, seborrheic dermatitis, psoriasis, tinea, and scabies.The treatment cornerstone: Moisturizers The most important daily treatment for atopic dermatitis is regular moisturizing. Moisturizers repair the skin barrier, reduce water loss, and protect against irritants. They should be applied at least twice daily, ideally right after bathing while the skin is still damp (within 3 minutes is most ideal). Use greasy ointments or thick creams rather than lotions — think products with ceramides or glycerin (hydrates and protects skin). It is best to choose ointments or creams without additives, perfumes or fragrances. Greasier ointments are the preferred vessel; however, patient compliance may be less as they may be unpleasant to some.Bleach Baths For patients with frequent skin infections or severe eczema, dilute bleach baths can be a game-changer. How to do it? Use ¼ to ½ cup of household bleach in a full standard bathtub of water (about 40 gallons) and soak for 10 minutes, twice a week. This helps reduce bacterial colonization — particularly Staphylococcus aureus — which commonly worsens eczema. After the bath, pat the skin dry and immediately apply a moisturizer (within 3 minutes). Bleach baths are endorsed by the American Academy of Pediatrics and the American Academy of Dermatology as an adjunctive treatment for atopic dermatitis, especially in patients with moderate to severe disease and frequent bacterial infections, but the evidence for their efficacy is mixed, and further well-designed studies are needed.Medical Treatments-Topical corticosteroids: When moisturizers alone aren't enough, we move to anti-inflammatory therapy. Topical corticosteroids are the first-line treatment for flares. Some studies suggest that a short burst of a high-potency topical corticosteroid to rapidly control active disease, followed by a quick taper in potency, is most effective, whereas others use the lowest-potency agent thought to be needed and adjust upward only if this fails. Common steroids used are hydrocortisone (low potency), triamcinolone (medium potency), or betamethasone (high potency). -High-potency steroids should never be applied to sensitive skin like the face. With short-term use of lower-potency steroids, there is a low likelihood of skin atrophy but use for more than 6 months is linked with greater levels of skin thinning -Wet wrap therapy: Wet wrap therapy improves absorption of topic steroid. Apply a topical steroid, then layer a wet dressing and then a dry dressing over the top of that. This can be beneficial in providing both relief of symptoms and prevention of itching. In pediatric patients it is called “daddy's socks therapy” because large socks may be used to cover the arms of kids.-Topical calcineurin inhibitors — like tacrolimus — are great alternatives for sensitive areas or for maintenance once inflammation is under control. They may burn upon application which can scare patients away from their use.-PO antihistamines can help with itching, especially at night, but they don't treat inflammation itself.-Systemic therapies, like dupilumab (Dupixent®), an IL-4 receptor antagonist, are reserved for moderate to severe cases unresponsive to topical therapy. This is a great time to refer to your local dermatologist for management! Many of the newer treatments are highly effective but can require more frequent monitoring.Recent Research One recent study is the 2024 Cochrane network meta-analysis comparing effectiveness of topical anti-inflammatory treatments for eczema that was recently published in the AFP Journal in July of 2025.Here are the highlights:-Over 291 RCTs with ~45,846 participants were included. -The analysis ranked potent topical corticosteroids, JAK inhibitors (for example ruxolitinib (Opzelura® 1.5 %), and tacrolimus 0.1 % among the most effective for reducing signs and symptoms of eczema. -In contrast, PDE-4 inhibitors [like crisaborole (Eucrisa®) 2 %] were among the least effective in this comparison. -Regarding side effects: tacrolimus and crisaborole were more likely to cause burning or stinging at the application site; corticosteroids were less likely in the short term to cause local irritation.-Long-term outcomes regarding effectiveness or safety of treatments for eczema were not addressed by the review because they are rarely reported.”-Another insight from this study is considering cost when initiating treatment. Most topical steroids are significantly more cost effective than JAK inhibitors or calcineurin inhibitors so it may be best to start with a cheaper solution in an uninsured patient considering their relative effectiveness. Additional Tips & Lifestyle -Keep baths and showers short and in lukewarm water.-Avoid harsh soaps and detergents — use gentle, fragrance-free cleansers.-Wear soft cotton clothing instead of wool or synthetics.-Identify and avoid triggers — common ones include stress, sweating, allergens, and certain foods (especially in kids).-Ice packs can help reduce itching and relieve any burning sensation.-Keep fingernails short, especially in children, help cause less trauma to the skin from repeated itching. Living with eczema Many celebrities like Kerry Washington, Jessica Simpson, Kelly Rowland, Brad Pitt and Kristen Bell have spoken out about their lives with eczema. They have shared personal stories about how they were diagnosed, what treatment works for them, and the general impact it has had on their lives and mental health. I feel like it can be so important for celebrities to speak out about their lives with certain conditions because it helps to normalize the condition, raise awareness of the struggles, and encourages more open dialogue.It is important to remember that for patients living with eczema, the persistent itch-scratch cycle can be very distressing, causing patients to struggle with their sleep and day-to-day activities. Anxiety and depression are common in patients with eczema so as physicians it is vital to monitor for signs of distress. Support groups can be incredibly helpful for patients [National Eczema Association]If you are interested in providing additional information to your patients or getting this for yourself, you can find more resources on altogethereczema.org or nationaleczema.org. Key Takeaways Atopic dermatitis is chronic but manageable. Moisturizers are the foundation of treatment. Topical steroids and calcineurin inhibitors control inflammation. Bleach baths help reduce bacterial load and flare severity. Always rule out other skin conditions to ensure appropriate management. Atopic dermatitis can be managed by the primary care physician but in certain cases (cases refractory to standard topical treatment, recurrent infections, etc.), a referral to dermatology can be especially helpful.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! References:Coping with eczema. Allergy & Asthma Network. (2025, May 20). https://allergyasthmanetwork.org/what-is-eczema/coping-with-eczema/.Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014 Feb;70(2):338-51. doi: 10.1016/j.jaad.2013.10.010. Epub 2013 Nov 27. PMID: 24290431; PMCID: PMC4410183. https://pubmed.ncbi.nlm.nih.gov/24290431/.Yancey, J. R., & Green, S. (2025, July 15). Effectiveness of topical anti-inflammatory drugs for eczema. American Family Physician. https://www.aafp.org/pubs/afp/issues/2025/0700/cochrane-eczema.html.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

New Med For Hot Flashes

Play Episode Listen Later Oct 29, 2025 21:57

Elinzanetant, sold under the brand name Lynkuet, receivedapproval from the U.S. Food and Drug Administration (FDA) on October 24, 2025, for the treatment of moderate to severe hot flashes due to menopause. How is this different than Fezolinetant, which was approved in 2023? Listen in for details. 1. Menegaz de Almeida, Artur MS; Oliveira, Paloma MS; Lopes, Lucca MD; Leite, Marianna MS; Morbach, Victória MS; Alves Kelly, Francinny MD; Barros, Ítalo MS; Aquino de Moraes, Francisco Cezar MS; Prevedello, Alexandra MD. Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-analysis. Obstetrics & Gynecology 145(3):p 253-261, March 2025. | DOI: 10.1097/AOG.00000000000058122. Pinkerton JV, Simon JA, Joffe H, Maki PM, NappiRE, Panay N, Soares CN, Thurston RC, Caetano C, Haberland C, Haseli Mashhadi N, Krahn U, Mellinger U, Parke S, Seitz C, Zuurman L. Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause: OASIS 1 and 2 Randomized Clinical Trials. JAMA. 2024 Aug 22;332(16):1343–54. doi: 10.1001/jama.2024.14618. Epub ahead of print. PMID: 39172446; PMCID: PMC11342219.3. Cardoso F, Parke S, Brennan DJ, Briggs P,Donders G, Panay N, Haseli-Mashhadi N, Block M, Caetano C, Francuski M, Haberland C, Laapas K, Seitz C, Zuurman L. Elinzanetant for Vasomotor Symptomsfrom Endocrine Therapy for Breast Cancer. N Engl J Med. 2025 Aug 21;393(8):753-763. doi: 10.1056/NEJMoa2415566. Epub 2025 Jun 2. PMID: 40454634.STRONG COFFEE PROMO: 20% Off Strong CoffeeCompany https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Emergency Medical Minute

Play Episode Listen Later Oct 29, 2025 57:21

Contributors: Preeya Prakash MD, Adam Greenhaw PharmD, Travis Barlock MD, and Jeffrey Olson MS4 In this episode, cardiologist Preeya Prakash and medical student Jeffrey Olson listen in as two cases are presented from EMM's recent event, Tox Talk 2025. Talk 1- Digoxin Overdose Dr. Adam Greenhaw presents a case of a Digoxin overdose along with many pearls. During the studio listen in, Dr. Prakash helps to answer the questions of: How does digoxin work? Why might a patient still be on digoxin in 2025? What are the EKG findings of digoxin toxicity? Is there any utility in atropine for bradycardia caused by digoxin? Should you use calcium to treat hyperkalemia in the setting of a digoxin overdose? If/when might a cardiologist get involved in a patient with a digoxin overdose? Talk 2- Propranolol Overdose Dr. Travis Barlock presents a case of a beta blocker overdose as well as many associated pearls. During our studio listen in, Dr. Prakash helps to answer the questions of: What are the different beta blockers and how do they work? If you are worried about a propranolol overdose, what medications do you want on hand? What POCUS cardiac view can give you the most information for different scenarios? Why or why not might transcutaneous or intravenous pacing be a good idea for a beta blocker overdose? If/when might you want a cardiologist to get involved in a patient with a beta blocker overdose? References Alahmed AA, Lauffenburger JC, Vaduganathan M, Aldemerdash A, Ting C, Fatani N, Fanikos J, Buckley LF. Contemporary Trends in the Use of and Expenditures on Digoxin in the United States. Am J Cardiovasc Drugs. 2022 Sep;22(5):567-575. doi: 10.1007/s40256-022-00540-x. Epub 2022 Jun 24. PMID: 35739347; PMCID: PMC10263277. Chan BS, Buckley NA. Digoxin-specific antibody fragments in the treatment of digoxin toxicity. Clin Toxicol (Phila). 2014 Sep-Oct;52(8):824-36. doi: 10.3109/15563650.2014.943907. Epub 2014 Aug 4. PMID: 25089630. Hack JB, Wingate S, Zolty R, Rich MW, Hauptman PJ. Expert Consensus on the Diagnosis and Management of Digoxin Toxicity. Am J Med. 2025 Jan;138(1):25-33.e14. doi: 10.1016/j.amjmed.2024.08.018. Epub 2024 Sep 11. PMID: 39265879. Krenz JR, Kaakeh Y. An Overview of Hyperinsulinemic-Euglycemic Therapy in Calcium Channel Blocker and β-blocker Overdose. Pharmacotherapy. 2018 Nov;38(11):1130-1142. doi: 10.1002/phar.2177. Epub 2018 Oct 4. PMID: 30141827. Patocka J, Nepovimova E, Wu W, Kuca K. Digoxin: Pharmacology and toxicology-A review. Environ Toxicol Pharmacol. 2020 Oct;79:103400. doi: 10.1016/j.etap.2020.103400. Epub 2020 May 7. PMID: 32464466. Rotella JA, Greene SL, Koutsogiannis Z, Graudins A, Hung Leang Y, Kuan K, Baxter H, Bourke E, Wong A. Treatment for beta-blocker poisoning: a systematic review. Clin Toxicol (Phila). 2020 Oct;58(10):943-983. doi: 10.1080/15563650.2020.1752918. Epub 2020 Apr 20. PMID: 32310006. Produced by Jeffrey Olson, MS4 Donate: https://emergencymedicalminute.org/donate/

united states talk management diagnosis overdose epub pmid prakash ekg emm pharmacotherapy beta blockers expenditures digoxin expert consensus am j med clin toxicol phila

Optimizing Surgical Care for Older Adults: An Inside Look at the ACS Geriatric Surgery Verification Program

trauma normal injury surgery guidelines american association minimal scattered brain injuries validating epub emergency departments pmid study group summarized joseph b

Play Episode Listen Later Oct 27, 2025 23:09

In this episode, we explore practical tips for caring for older adults in the clinical setting through a case-based discussion highlighting common perioperative challenges and strategies for success. We also take a deeper dive into the American College of Surgeons Geriatric Surgery Verification Program, including its goals, impact, and how clinicians can get involved in advancing surgical care for the aging patient population. Take Home Points: The older adult population is the fastest growing patient population and it is important we focus on patient-centered care for this population, as this is a population that almost all of us will engage with. If you or your hospital isn't prepared to get verified yet, there are still small processes that can be implemented that can make an impactful difference on your patients. Geriatric Surgery Verification is at the cutting edge of quality improvement. Like other verification programs (trauma, bariatric) patients will soon seek out these centers that can best address their personal needs. Hosts: Agnes Premkumar, MD - General Surgery Resident at Creighton University, @agnespremkumar Nicole L. Petcka, MD – General Surgery Resident at Emory University, @npetcka2022 Guests: Marcia M. Russell, MD - Professor of Surgery and Vice Chair for Quality and Safety at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Healthcare System Caroline Smolkin, MD - General Surgery Resident at Northwell and American College of Surgeons Clinical Scholar Resources: American College of Surgeons Geriatric Surgery Verification Program: https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/ Katlic MR, Wolf J, Demos SJ, Rosenthal RA. Making a Financial Case for the Geriatric Surgery Verification Program. Ann Surg Open. 2024 May 13;5(2):e439. doi: 10.1097/AS9.0000000000000439. PMID: 38911623; PMCID: PMC11191881. https://pubmed.ncbi.nlm.nih.gov/38911623/ Remer SL, Zhou L, Cohen ME, Russell MM, Rosenthal R, Ko CY. Discharge to Post-Acute Care as a Benchmarking Metric for Elderly Surgical Patients. J Am Coll Surg. 2025 Aug 14. doi: 10.1097/XCS.0000000000001495. Epub ahead of print. PMID: 40810404. https://pubmed.ncbi.nlm.nih.gov/40810404/ Jones TS, Jones EL, Richardson V, Finley JB, Franklin JL, Gore DL, Horney CP, Kovar A, Morin TL, Robinson TN. Preliminary data demonstrate the Geriatric Surgery Verification program reduces postoperative length of stay. J Am Geriatr Soc. 2021 Jul;69(7):1993-1999. doi: 10.1111/jgs.17154. Epub 2021 Apr 7. PMID: 33826150. https://pubmed.ncbi.nlm.nih.gov/33826150/ *** UNC Surgery is inviting you to participate in a national survey designed to understand general surgery residents' perspectives on core curriculum content, structure, & delivery. The results of this survey will inform the development of a standardized general surgery education curriculum. SURVEY LINK: https://docs.google.com/forms/d/e/1FAIpQLSeJztQwgB1rJXpCtvboHprGB_gmHGG4UzY1HITAHRmMx9FcRQ/viewform Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Episode 980: Brain Injury Guidelines (BIG)

Emergency Medical Minute

Play Episode Listen Later Oct 27, 2025 3:17

Contributor: Aaron Lessen, MD Educational Pearls: Traumatic Brain Injuries are a frequent complaint in the Emergency Department and have increased in recent years. The American Association for Surgery of Trauma (AAST) has created Brain Injury Guidelines (BIG), in an attempt to categorize brain injuries and the level of treatment they require. They are… BIG 1 Normal neuro exam Not intoxicated Not on anticoagulation or antiplatelet medications Minimal findings on head CT No fracture 8 mm bleed (subdural, epidural, intraparenchymal (or more than 2 locations)) “Scattered” subarachnoid hemorrhage Intraventricular hemorrhage Full treatment, admission to trauma center, neurosurgery evaluation References Joseph B, Friese RS, Sadoun M, Aziz H, Kulvatunyou N, Pandit V, Wynne J, Tang A, O'Keeffe T, Rhee P. The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons. J Trauma Acute Care Surg. 2014 Apr;76(4):965-9. doi: 10.1097/TA.0000000000000161. PMID: 24662858. Joseph B, Obaid O, Dultz L, Black G, Campbell M, Berndtson AE, Costantini T, Kerwin A, Skarupa D, Burruss S, Delgado L, Gomez M, Mederos DR, Winfield R, Cullinane D; AAST BIG Multi-institutional Study Group. Validating the Brain Injury Guidelines: Results of an American Association for the Surgery of Trauma prospective multi-institutional trial. J Trauma Acute Care Surg. 2022 Aug 1;93(2):157-165. doi: 10.1097/TA.0000000000003554. Epub 2022 Mar 28. PMID: 35343931. Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Does Oral PCN Affect OB GBS Culture Result?

Play Episode Listen Later Oct 19, 2025 29:27

Current guidelines recommend universal collection of a vaginal-rectal swab for GBS colonization at 36-37 weeks and 6 days for the identification of patients who require intrapartum IV antibiotic coverage to prevent early onset neonatal GBS infection/sepsis. Recently, we had a patient in clinic whose GBS culture at 36 weeks was negative. Good right? Well, the patient was on amoxicillin at the time for pharyngitis. Did that course of oral PCN based therapy affect the GBS culture result? Should we believe that culture or could it be a false negative, demanding rescreen after therapy completion? There is currently a GAP here in the guidance. In this episode we will cover this controversial scenario, look at the data, and provide a real-world implementable approach to this case.1. Kim DD, Page SM, McKenna DS, Kim CM. Neonatal Group B Streptococcus Sepsis After Negative Screen in a Patient Taking Oral Antibiotics. Obstetrics and Gynecology. 2005;105(5 Pt 2):1259-61. doi:10.1097/01.AOG.0000159040.51773.bf.2. ACOG CO Number 797 (Replaces Committee Opinion No. 782, June 2019.); 20203. Mackay G, House MD, Bloch E, Wolfberg AJ. A GBS culture collected shortly after GBS prophylaxis may be inaccurate. J Matern Fetal Neonatal Med. 2012 Jun;25(6):736-8. doi: 10.3109/14767058.2011.596961. Epub 2011 Aug 1. PMID: 21801141.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

culture current affect iv gap result oral obstetrics gynecology epub pmid gbs pcn aog house md

Journal Review in Bariatric Surgery: Sleeve vs Bypass and Revisional Strategies