Podcasts about Etiology

On Episode 51 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the April 2025 issue of Stroke: “Clinical Severity and Outcomes in Large Infarcts With Endovascular Therapy: A Post Hoc Analysis of the ANGEL-ASPECT Trial” and “Association Between Thrombus Composition and Etiology in Patients With Acute Ischemic Stroke Treated by Thrombectomy.” She also interviews Dr. Roland Veltkamp about the PRESTIGE-AF trial, presented in February at the International Stroke Conference. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20250414.579089

AFib with RVR: Quick AdmitThis Quick Admit episode on AFib with RVR will focus on only the highest yield information you need when admitting a patient to the hospital.To take your understanding of the disease to the next level, check out the full-length episode for more information including a discussion of the most important clinical pearls and literature.Visit https://www.pointofcaremedicine.com/inpatient-admission/atrial-fibrillation to see the admission template discussed in this episode.Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.Timestamps00:00 Introduction to AFib Management00:24 Initial Assessment and Triage01:06 Reviewing Patient History01:59 Admission Orders and Labs02:29 Initial Treatment Considerations03:41 History of Present Illness (HPI)04:30 Physical Examination04:58 Etiology and Causes05:33 If You Remember Nothing Else06:49 Conclusion and Follow-UpDisclaimer: The content of this video and any associated media is meant for educational and information purposes only. RMO Medical Education does not provide medical advice, diagnosis, or treatment.

This episode was originally released on November 14, 2023Sleep is essential to our lives, but our perception of how it functions in our non-waking life is not always well understood. So in the mires of our busy daily lives do we overlook sleep by seeing it as a means of refilling our energy for a productive day? By questioning this assumption, one term rolls from out of the haze: The ‘Circadian Rhythm'.Dr. Kaylee Byers speaks with Dr. Hiroki Ueda from the University of Tokyo in the Faculty of Medicine on demystifying the links between our sleep and genomics. Then neuroscientist Dr. Andrew Coogan shares the connection between sleep and ADHD. Finally, we hear from Dr. Ueda and Dr. Hiroshi Ono, from Hitotsubashi University Business School, on how their homeland of Japan is reckoning with an off-balance relationship with sleep and work.References:Molecular Mechanisms of REM Sleep | NeurosciThe ability to dream may be genetic | Canadian Broadcast Corporation (CBC)Next-Generation Mice Genetics for Circadian Studies | NeuromethodsEvolution of temporal order in living organisms | Journal of Circadian RhythmsLearn about the bunker experiment to understand the human biological clock | BritannicaGenetic sleep deprivation: using sleep mutants to study sleep functions | EMBO reportsCircadian rhythms and attention deficit hyperactivity disorder: The what, the when and the why | Prog Neuropsychopharmacol Biol PsychiatryInsomnia: Definition, Prevalence, Etiology, and Consequences | Journal of Clinical Sleep MedicineNo Sleep for Japan? Survey Reveals Half of Population May Have Insomnia | Nippon.comWhy Sleep Matters: Quantifying the Economic Costs of Insufficient Sleep | Rand CorporationJapan has some of the longest working hours in the world. It's trying to change | CNBCAnnouncement of the establishment of the nonpartisan "Parliamentary League to Promote Initiatives for People's Quality Sleep" | Sleeping Council FederationFounder/Director CTO Yasumi Ueda gave a speech at the inaugural general meeting of the nonpartisan "Parliamentary League to Promote Initiatives for People's Quality Sleep" | ACCELStarsFree-running circadian activity rhythms in free-living beaver (Castor canadensis) | Journal of Comparative PhysiologyCredits:Dr. Rackeb TesdayeCurbing death by overwork | Financial TimesWhy does Japan Work So Hard? | CNBC ExplainsWorked to Death: Japan questions high-pressure corporate culture | France 24 EnglishInside Japan's growing ‘lonely death' clean-up service | CNN InternationalHow can governments help stop overwork? | The Question | CBC News: The National

For his 40th birthday, a man is treating himself to his very first massage. His health history includes a few noteworthy details, one of which is a condition neither his massage therapist nor I had ever encountered before: hereditary spherocytosis. Are there any potential concerns? Possibly. Resources:  Hereditary Spherocytosis - Symptoms, Causes, Treatment | NORD (no date). Available at: https://rarediseases.org/rare-diseases/anemia-hereditary-spherocytic-hemolytic/ (Accessed: 19 February 2025). Hereditary spherocytosis: MedlinePlus Genetics (no date). Available at: https://medlineplus.gov/genetics/condition/hereditary-spherocytosis/ (Accessed: 19 February 2025). ‘Hereditary Spherocytosis: Practice Essentials, Pathophysiology, Etiology' (2023). Available at: https://emedicine.medscape.com/article/206107-overview?_gl=1*1ulm2jw*_gcl_au*NDQwNzg1MDc3LjE3MzkzMDYxNDM. (Accessed: 19 February 2025). Hereditary Spherocytosis: What It Is, Symptoms, Causes & Treatment (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/23058-hereditary-spherocytosis (Accessed: 19 February 2025). Mehta, P. (no date) What Is Hereditary Spherocytosis?, WebMD. Available at: https://www.webmd.com/children/what-is-hereditary-spherocytosis (Accessed: 19 February 2025).   Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                    About our Sponsors:   Anatomy Trains: www.anatomytrains.com    American Massage Conference:  https://www.massagetherapymedia.com/conferences   Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.                      Website: anatomytrains.com                        Email: info@anatomytrains.com             Facebook: facebook.com/AnatomyTrains                       Instagram: www.instagram.com/anatomytrainsofficial   YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA     American Massage Conference   Get ready to immerse yourself in the excitement as the American Massage Conference (AMC) arrives to Disney Springs near Orlando, Florida (May 16th-18th, 2025)! With a legacy of 17 successful years in Ontario, Canada, this premier event, proudly hosted by ONE Concept Conferences and expertly produced by Massage Therapy Media (MTM), boasts a lineup of presenters from across the nation and around the globe. The American Massage Conference began in Atlanta in 2011 and has been hosted through the years in San Diego, Chicago, and Virginia Beach. The conference provides educational opportunities with engaging one-, two-, three- and four-hour class formats, networking opportunities, masterminds, MTM Talks, demonstrations, and an extensive exhibitor tradeshow.   Mark your calendars for an unforgettable experience filled with education, networking, and the celebration of massage therapy excellence! ABMP members receive a special discount to attend this in-person conference—log in to your ABMP account to access the discount code and register today. Website: https://www.massagetherapymedia.com/conferences  

Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic.   Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow.  Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4  Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically.  Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss.  There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5  Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter.  SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal.  Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery.  The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow.  Thrombosis of the conduit would put the fistula at risk, rather than the native artery.  The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest.  Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss.   3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas.   Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of  methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9     4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11  Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection.   Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics.  If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References   1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067

On Episode 46 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the November 2024 issue of Stroke: “Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Replacement: A Review” and “Oxygen Extraction Fraction Mapping on Admission Magnetic Resonance Imaging May Predict Recovery of Hyperacute Ischemic Brain Lesions After Successful Thrombectomy: A Retrospective Observational Study.” She also interviews Drs. Mitch Wilson and Vasileios-Arsenios Lioutas about their article “Association of Anticoagulant Use With Hemorrhage Location and Etiology in Incident Spontaneous Intracerebral Hemorrhage.” For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20241112.907388

Send a text to Melissa and she'll answer it on the next episode. Unlock the secrets of effective homeopathic treatment with our latest episode, where we break down the essential steps of case-taking in homeopathy. Ever wondered how to pinpoint the right remedy for both chronic and acute conditions? We introduce the powerful C-MELTS acronym—Chief Complaint, Modalities, Etiology, Location, Timing, and Sensation—to help you master this vital skill. By understanding these elements, you'll gain the confidence to assess a patient's needs accurately and provide the most effective treatments. Join us as we share practical tips and real-life examples to enhance your homeopathic practice.We also focus on acute case taking, where getting the details right can make all the difference. Learn why identifying the etiology, location, timing, and sensation of symptoms is crucial for accurate case taking. Discover how to use non-leading questions to get to the heart of a person's condition and how homeopathy stands up to other natural health practices with concrete tests like blood work and stool samples. From sore throats to congestion, we provide the insights you need to tackle acute symptoms effectively. This episode is packed with valuable knowledge to help you navigate the nuances of homeopathic treatment confidently.FIND ME!

Editor in Chief Cecelia E. Schmalbach, MD, MSc, is joined by author Rohani Omar MRCP, MD(Res) and Associate Editor John P. Dahl, MD, PhD, MBA, to discuss causes, especially genetic causes, of pediatric hearing loss as outlined in the paper “Etiology of Childhood Profound Sensorineural Hearing Loss: The Role of Hearing Loss Gene Panel Testing” which published in the November 2024 issue of Otolaryngology–Head and Neck Surgery. They discuss the paper's investigation of gene panel testing for hearing loss in children. Click here to read the full article.

Dr. Jessica Salvatore (Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey) joins AJP Audio to discuss peer social genetic effects and their impact on alcohol and substance use, anxiety, and major depressive disorders in adolescents.  Afterwards, AJP Editor-in-Chief Dr. Ned Kalin takes us through the rest of the September issue of the American Journal of Psychiatry. 00:52     Salvatore interview 02:49     Can the genetic makeup of other people impact your risk for psychiatric conditions? 04:12     Impact on genetic predisposition 05:12     Why look at these effects through a genetic lens? 07:17     Limitations 10:05     Clinical implications 12:40     Further research 13:32     Kalin interview 13:47     Salvatore et al. 15:54     Dalhuisen et al. 19:23     Hess et al. 24:14     Larsen et al. 26:43     Schwippel et al.   Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

#462 - Where does typical picky eating stop and problematic restriction start? Internationally renowned pediatric dietitian and professor Rosan Meyer is here to explain what ARFID (avoidant/restrictive food intake disorder) is and why your baby does not have ARFID. Listen to this episode to learn: What “normal neophobic disgust” is so that you know what's typical behavior in toddlerhood Which symptoms need to be present for ARFID diagnosis and why babies don't have ARFID Why feeding therapists recommend against “contaminating” a safe food for a child with ARFID Shownotes for this episode can be found here: https://www.babyledweaning.co/podcast/462 Links from this episode: Visit Rosan's Website - https://www.rosan-paediatricdietitian.com/ Follow Rosan on Instagram - https://www.instagram.com/rosanpaediatricdietitian/ Twin Study Rosan mentioned in the interview: Dinkler, Lisa et al. “Etiology of the Broad Avoidant Restrictive Food Intake Disorder Phenotype in Swedish Twins Aged 6 to 12 Years.” JAMA psychiatry vol. 80,3 (2023): 260-269. https://psycnet.apa.org/record/2023-56913-007 Diagnosing and Managing ARFID - An Online Course (University of Winchester): https://www.winchester.ac.uk/study/Short-courses/Courses/ARFID/  Other Episodes Related to this Topic Episode 266 - Infant Weight Loss: What to Do When the Doctor Says Your Baby Isn't Gaining Weight with Rosan Meyer, PhD, RD Episode 110 - Catch-Up Weight: Why Starting Solids Early Will Not Help Your Baby Gain Weight with Rosan Meyer, PhD, RD Episode 230 - FPIES: How Do I Know if My Baby Has Food-Protein Induced Enterocolitis Syndrome? with Marion Groetch, MS, RDN

#462 - Where does typical picky eating stop and problematic restriction start? Internationally renowned pediatric dietitian and professor Rosan Meyer is here to explain what ARFID (avoidant/restrictive food intake disorder) is and why your baby does not have ARFID. Listen to this episode to learn: What “normal neophobic disgust” is so that you know what's typical behavior in toddlerhood Which symptoms need to be present for ARFID diagnosis and why babies don't have ARFID Why feeding therapists recommend against “contaminating” a safe food for a child with ARFID Shownotes for this episode can be found here: https://www.babyledweaning.co/podcast/462 Links from this episode: Visit Rosan's Website - https://www.rosan-paediatricdietitian.com/ Follow Rosan on Instagram - https://www.instagram.com/rosanpaediatricdietitian/ Twin Study Rosan mentioned in the interview: Dinkler, Lisa et al. “Etiology of the Broad Avoidant Restrictive Food Intake Disorder Phenotype in Swedish Twins Aged 6 to 12 Years.” JAMA psychiatry vol. 80,3 (2023): 260-269. https://psycnet.apa.org/record/2023-56913-007 Diagnosing and Managing ARFID - An Online Course (University of Winchester): https://www.winchester.ac.uk/study/Short-courses/Courses/ARFID/  Other Episodes Related to this Topic Episode 266 - Infant Weight Loss: What to Do When the Doctor Says Your Baby Isn't Gaining Weight with Rosan Meyer, PhD, RD Episode 110 - Catch-Up Weight: Why Starting Solids Early Will Not Help Your Baby Gain Weight with Rosan Meyer, PhD, RD Episode 230 - FPIES: How Do I Know if My Baby Has Food-Protein Induced Enterocolitis Syndrome? with Marion Groetch, MS, RDN

Understanding Narcissistic Personality Disorder (NPD), including the 9 core signs and symptoms as well as the DSM 5 criteria for diagnosis. Also includes treatment / management options. Free Practice Material:https://app.wisdolia.com/deck/k5eIx6VHKWXwmpbUZGSb?r=DnwHGyl95QQgP3ecVSPDHrFGE0E0qB&ref=rhesusmedicineConsider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is a Personality Disorder? 0:22 What is Narcissistic Personality Disorder? 0:39 Narcissistic Personality Disorder Symptoms2:36 Narcissistic Personality Disorder Diagnosis (DSM 5 Criteria)3:29 Narcissistic Personality Disorder Causes & Epidemiology 4:17 Narcissistic Personality Disorder TreatmentReferencesZimmerman, M - MSD Manual Pro (2023) - “Narcissistic Personality Disorder”. Available at https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/narcissistic-personality-disorder-npdRonningstam, E - “Narcissistic Personality Disorder: A Basic Guide for Providers**”.** Available at ****Narcissistic Personality Disorder: Guide for Providers at McLean HospitalPo Wenger, C (2024) - “Narcissistic Personality Disorder**”.** Available at https://www.mentalhealth.com/library/narcissistic-personality-disorderPsychDB (2024) - “Narcissistic Personality Disorder**”.** Available at https://www.psychdb.com/personality/narcissisticYu, L.L.L, Huajian, C - (2018) “The Etiology of Narcissism: A Review of Behavioral Genetic Studies”. Available at https://link.springer.com/epdf/10.1007/978-3-319-92171-6_16?sharing_token=8TalAHCcduvcrHiO1LQzFfe4RwlQNchNByi7wbcMAY7JlesuMlHV_YZiYCFlxHB5LfgxgMqHTxbtyuZ5Jrkn16vlsJ3o4Ybjmi6BrAeCngLOZ2-cRUzkcXhWjh5rg8kyQl63wbG19HsppBGGIdm7QPUNrT94c_9-yf6xTyhYfgs%3DPlease remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. 

A 60-ish year-old client with a history of surgery for aortic aneurysm insists—INSISTS—that his 21-year-old massage therapist work with him, in spite of his new onset severe leg pain. What are the practitioner's options in this literally life-or-death scenario? This story, that looks cut-and-dried on the surface, is more complex than it appears. Plus, we get to talk about bulges in the aorta, bleeding ruptures, migrating devices, new surgical innovations, and much much more. Listen in to find out how it all turns out. Resources: Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app Ameli, F.M. et al. (1987) ‘Etiology and management of aorto-femoral bypass graft failure', The Journal of Cardiovascular Surgery, 28(6), pp. 695–700. Choi, E. et al. (2021) ‘Risk Factors for Early and Late Iliac Limb Occlusions of Stent Grafts Extending to the External Iliac Artery after Endovascular Abdominal Aneurysm Repair', Annals of Vascular Surgery, 70, pp. 401–410. Available at: https://doi.org/10.1016/j.avsg.2020.06.028. Daye, D. and Walker, T.G. (2018) ‘Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management', Cardiovascular Diagnosis and Therapy, 8(Suppl 1), pp. S138–S156. Available at: https://doi.org/10.21037/cdt.2017.09.17. Endovascular repair of complex aortic aneurysms - Mayo Clinic (no date). Available at: https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/endovascular-repair-of-complex-aortic-aneurysms/mac-20429867 (Accessed: 31 July 2024). Ivancev, K. and Vogelzang, R. (2020) ‘A 35 Year History of Stent Grafting, and How EVAR Conquered the World', European Journal of Vascular and Endovascular Surgery, 59(5), pp. 685–694. Available at: https://doi.org/10.1016/j.ejvs.2020.03.017. Modern History of Aortic Surgery, by Hazim J. Safi, MD | McGovern Medical School (no date). Available at: https://med.uth.edu/cvs/2020/08/25/modern-history-of-aortic-surgery-by-hazim-j-safi-md/ (Accessed: 31 July 2024). Park, K.-M. et al. (2017) ‘Long Term Outcomes of Femorofemoral Crossover Bypass Grafts', Vascular Specialist International, 33(2), pp. 55–58. Available at: https://doi.org/10.5758/vsi.2017.33.2.55. Sponsors: Anatomy Trains: www.anatomytrains.com  MassageBook: www.massagebook.com Elements Massage: www.elementsmassage.com/abmp

Mohamed is joined by The Dental Guys, Dr. Jon Rogers and Dr. Wes Mullins to talk about comprehensive dentistry. The Dental Guys are an OG dental podcast who have been talking about high quality dentistry, research and data for years! Wes and Jon even joined Alan in the very first "podcast lounge" at the glorious (and very first) Voices of Dentistry in Nashville, TN! This conversation goes all over the place and is part one of a two part series. Part two will be over on the Dental Guys podcast! What is comprehensive dentistry? Dental school and single tooth dentistry Comprehensive dentistry means different things to different people Comprehensive isn't about procedure competency, it's about understanding the big picture Etiology drives diagnosis Do people deserve the ideal plan? Is it possible for dental school to make you an excellent diagnostician? Understanding the fundamentals Where to start with comprehensive dentistry How will your first job affect your ability to learn and deliver comprehensive dentistry? (where, what kind of practice, demographics) Developing a niche (easier in a less saturated area?) Instagram dentistry: where are the hard cases? Not everyone deserves to be treated the same way (how are new patients brought in to the practice?) Coming soon: what are the strategies and paths to take in order to become a comprehensive dentist?  Some links from the show: The Dental Guys podcast Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy" or "Lipscomb!" The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! -- Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code “VERYDENTAL10” you'll get another 10% off your order! Go save yourself some money and support the show all at the same time! -- The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! -- Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! -- CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!  

We discuss getting and keeping this year's calf crop healthy.  Plus, updates on Beef imports and exports, new possible genetic defects, markets, recaps, sales and more on this all new episode of the Ranch It Up Radio Show. Be sure to subscribe on your favorite podcasting app or on the Ranch It Up Radio Show YouTube Channel. EPISODE 189 DETAILS BOVINE RESPIRATORY DISEASE (BRD), MANAGE IT NOW.  OVERVIEW OF BOVINE RESPIRATORY DISEASE COMPLEX Bovine respiratory disease (BRD), shipping fever pneumonia, or undifferentiated fever is a respiratory disease of cattle of multifactorial etiology with Mannheimia haemolytica and, less commonly, Pasteurella multocida, Histophilus somni ( see Histophilosis), or Mycoplasma bovis being the important bacterial agents involved. Viral pathogens may also be involved, such as bovine herpesvirus 1, parainfluenza-3 virus, and bovine respiratory syncytial virus. BRD has a multifactorial etiology and develops as a result of complex interactions between environmental factors, host factors, and pathogens. Environmental factors (eg, weaning, transport, commingling, crowding, inclement weather, dust, and inadequate ventilation) serve as stressors that adversely affect the immune and nonimmune defense mechanisms of the host animal. In addition, certain environmental factors (eg, crowding and inadequate ventilation) can enhance the transmission of infectious agents among animals. Many infectious agents have been associated with BRD. An initial pathogen (eg, a virus) may alter the animal's defense mechanisms, allowing colonization of the lower respiratory tract by bacteria. BRD is most commonly associated with the transport and assembly of large groups of recently weaned calves into feedlots. Morbidity in these types of feeder calves often peaks within the first 7–10 days after feedlot arrival. Morbidity can approach 35%–50%, and case fatality is 5%–10%; however, the levels of morbidity and mortality strongly depend on the array of risk factors present in the cattle being fed. The use of broad-spectrum antimicrobials labeled for bovine respiratory disease is the primary treatment, with macrolides and fenicols most commonly used as first-line treatment. Prevention and control are achieved via vaccination programs, preconditioning, identification and treatment of subclinically infected animals, and biosecurity. Etiology of Bovine Respiratory Disease The pathogenesis of bovine respiratory disease involves a stress factor, sometimes coupled with viral infection, which results in suppressed immune defenses and the proliferation of bacteria in the upper respiratory tract. Subsequently, these bacteria colonize the lower respiratory tract and cause bronchopneumonia with a cranioventral distribution in the lung. Many of the bacteria and viruses involved are commensal organisms of the upper respiratory tract that can be isolated from a proportion of healthy animals. Multiple stress factors contribute to the suppression of host defense mechanisms in cattle. Weaning is a noteworthy stressor, and the incidence of this disease is highest in recently weaned calves. Transportation over long distances serves as a stressor; it may be associated with exhaustion, starvation, dehydration, chilling, and overheating, depending on weather conditions. Additional important stressors include passage through auction markets; commingling, processing, and surgical procedures on arrival at the feedlot; dusty environmental conditions; and nutritional stress associated with a change to high-energy rations in the feedlot. The individual viral and bacterial etiologies, clinical signs, lesions, and treatment are discussed under Viral Infections Associated with Bovine Respiratory Disease Complex in Cattle and Bacterial Pneumonia in Cattle with Bovine Respiratory Disease Complex. Viruses associated with BRD include: bovine herpesvirus 1 (IBR) bovine respiratory syncytial virus parainfluenza-3 virus bovine viral diarrhea virus bovine adenovirus bovine coronavirus Bacteria associated with BRD include: Mannheimia haemolytica Pasteurella multocida Histophilus somni Mycoplasma bovis Bibersteinia trehalosi Control and Prevention of Bovine Respiratory Disease Prevention of bovine respiratory disease should focus on decreasing the stressors that contribute to development of the disease. Cattle should be assembled rapidly into groups, and new animals should not be introduced to established groups. Mixing of cattle from different sources should be avoided or minimized if possible; however, in the North American beef industry, this risk factor is almost unavoidable for large intensive feedlots. Transport time should be minimized, and rest periods, with access to feed and water, should be provided during prolonged transport. Calves should ideally be weaned 2–3 weeks before shipment, and surgical procedures should be performed in advance of transport; however, the availability of these “preconditioned” calves is quite limited. Cattle should receive arrival processing, which would include vaccinations and possibly metaphylactic antimicrobials within 48 hours after arrival at the feedlot. Adaptation to high-energy rations should be gradual, because acidosis, indigestion, and anorexia may inhibit the immune response. Vitamin and mineral deficiencies should be corrected. Dust control measures should be used. Metaphylaxis with long-acting antimicrobials, such as oxytetracycline, tilmicosin, florfenicol, gamithromycin, tildipirosin, or tulathromycin, has been widely adopted as a control measure given “on arrival” to cattle at high risk of developing shipping fever pneumonia. Metaphylaxis on arrival has been shown to substantially decrease morbidity, improve rate of gain, and, in some cases, decrease mortality. Mass medication in feed or water is of limited value because sick animals do not eat or drink enough to achieve inhibitory blood levels of the antimicrobial, and many of these oral antimicrobials are poorly absorbed in ruminants. On arrival, processing usually involves administration of modified live virus vaccines for viral antigens and for bacterial components of shipping fever pneumonia. Because most cases of pneumonia occur during the first 2 weeks after arrival, these on-arrival vaccines may not have adequate time to stimulate complete immunity in all individuals. When possible, vaccinations for the viral and bacterial components of shipping fever pneumonia should be given 2–3 weeks before transport or earlier and can be repeated on entry to the feedlot. Key Points BRD is the most common and costly disease affecting the North American beef cattle industry. BRD risk factors include weaning, transportation, adverse weather, commingling, and stressful events such as dehorning and castration. BRD is caused by suppressed immune responses and initial viral infection, which allow colonization of the lung by commensal URT bacteria. Preconditioning, minimizing mixing, vaccination for BRD pathogens, and metaphylaxis for high-risk animals are major control methods. Broad-spectrum antimicrobials labeled for bovine respiratory disease are the primary treatment.   For More Information Key elements for implementing antimicrobial stewardship plans in bovine veterinary practices. American Association of Bovine Practitioners. Updated March 2022 Joint AABP-AVC Judicious Therapeutic Use of Antimicrobials in Cattle   Cattle Industry News: Beef From Australia, New Genetic Defects, Alberta Prepares for HPAI, Trips Suspended to Michigan Farms U.S. IMPORTS OF AUSTRALIAN BEEF UP 74% FROM A YEAR AGO  Australian exports of beef to the United States have soared in the last 12 months, hitting over 31,000 tons in May. Compared to the same month a year ago, that sum is 74% higher, according to global supply analyst Tim Jackson of Meat & Livestock Australia, a checkoff group for the country's red meat producers. Australian farmers have also gained beef market share in Japan and South Korea largely at the expense of U.S. exporters, Jackson said. Australia's global beef exports last month were up 9% from April and 25% from May 2023, hitting almost 114,000 tons — the highest level in more than four years. Jackson commented that the U.S. declines in production are now having a noticeable impact on export flows.  NEW GENETIC DEFECT AFFECTING CATTLE MOBIDITY AND MEAT QUALITY Cattle have long been a cornerstone of agriculture, providing us with milk, meat, and various other products that nourish and sustain our communities. Ensuring the cattle's health and optimal muscle development is vital when producing high-quality beef. However, various genetic conditions can disrupt muscle metabolism, affecting animals' well-being and the quality of the meat they produce. Researchers at the University of Nebraska — Lincoln have discovered a new defect in composite cattle (Simmental, Red Angus, Gelbvieh) that often caused physical collapse when they exercised, with some calves unable to recover. This is an autosomal recessive genetic defect, which means both parents of affected calves must carry one copy of the mutation.     TRIPS SUSPENDED TO MICHIGAN FARMS The Michigan Department of Health and Human Services asked the public to postpone visits to farms with dairy herds and poultry flocks amid the HPAI outbreak. Over the past few weeks, Michigan has reported two human cases of the H5 virus. The department asked schools, daycares, camps and other programs to delay any planned field trips to farms.   ALBERTA PREPARES FOR HPAI IN CATTLE According to Chris Scott with Meating Place dot com, Confirmation of H5 virus infections in U.S. dairy cows is prompting animal health officials in Canada to consider their options to prevent the virus from affecting herds north of the U.S. border. Dr. Keith Lehman, Alberta's chief veterinarian, told CBC News that vigilant surveillance is critical to protecting the Canadian dairy herd from a virus that has been confirmed among dairy cows in nine U.S. states so far. Canada imposed new import rules last month that require lactating cows from U.S. dairy farms test negative for H5 within seven days of export to help the nation maintain its HPAI-free status among cattle.   UPCOMING SALES & EVENTS ISA Beefmasters: October 5, 2024, San Angelo, Texas     BULL SALE REPORT & RESULTS Churchill Cattle Company Van Newkirk Herefords Gardiner Angus Ranch Cow Camp Ranch Jungels Shorthorn Farms Ellingson Angus Edgar Brothers Angus Schaff Angus Valley Prairie Hills Gelbvieh Clear Springs Cattle Company CK Cattle Mrnak Hereford Ranch Frey Angus Ranch Hoffmann Angus Farms Topp Herefords River Creek Farms Upstream Ranch Gustin's Diamond D Gelbvieh Schiefelbein Farms Wasem Red Angus Raven Angus Krebs Ranch Yon Family Farms Chestnut Angus Eichacker Simmentals & JK Angus Windy Creek Cattle Company Pedersen Broken Heart Ranch Mar Mac Farms Warner Beef Genetics Arda Farms & Freeway Angus Leland Red Angus & Koester Red Angus Fast - Dohrmann - Strommen RBM Livestock Weber Land & Cattle Sundsbak Farms Hidden Angus Wheatland Cattle Company Miller Angus Farms L 83 Ranch U2 Ranch Vollmer Angus Ranch A & B Cattle Carter Angus Farms Roller Ranch Montgomery Ranch Jorgensen Farms DLCC Ranch Four Hill Farm North Country Angus Alliance Spruce Hill Ranch Wilson Angus   FEATURING Dave Sjeklocha, DVM Merck Animal Health @merckanimalhealth https://www.merckvetmanual.com/ https://www.merck-animal-health-usa.com/ Mark VanZee Livestock Market, Equine Market, Auction Time https://www.auctiontime.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ @LivestockMkt @EquineMkt @AuctionTime Kirk Donsbach: Stone X Financial https://www.stonex.com/   @StoneXGroupInc    Shaye Koester Casual Cattle Conversation https://www.casualcattleconversations.com/ @cattleconvos   Questions & Concerns From The Field? Call or Text your questions, or comments to 707-RANCH20 or 707-726-2420 Or email RanchItUpShow@gmail.com FOLLOW Facebook/Instagram: @RanchItUpShow SUBSCRIBE to the Ranch It Up YouTube Channel: @ranchitup Website: RanchItUpShow.com https://ranchitupshow.com/ The Ranch It Up Podcast available on ALL podcasting apps.   Rural America is center-stage on this outfit. AND how is that? Tigger & BEC Live This Western American Lifestyle. Tigger & BEC represent the Working Ranch world and cattle industry by providing the cowboys, cowgirls, beef cattle producers & successful farmers the knowledge and education needed to bring high-quality beef & meat to your table for dinner. Learn more about Jeff 'Tigger' Erhardt & Rebecca Wanner aka BEC here: TiggerandBEC.com https://tiggerandbec.com/ #RanchItUp #StayRanchy #TiggerApproved #tiggerandbec #rodeo #ranching #farming References https://www.stonex.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ https://www.auctiontime.com/ https://gelbvieh.org/ https://www.imogeneingredients.com/ https://alliedgeneticresources.com/ https://westwayfeed.com/ https://medoraboot.com/ http://www.gostockmens.com/ https://www.imiglobal.com/beef https://www.tsln.com/ https://transova.com/ https://axiota.com/ https://www.merckvetmanual.com/respiratory-system/bovine-respiratory-disease-complex/overview-of-bovine-respiratory-disease-complex#Key-Points_v74932778 https://www.meatingplace.com/Industry/News/Details/114883 https://www.cattlebusinessweekly.com/articles/new-genetic-defect-impacting-cattle-morbidity-and-meat-quality/ https://www.meatingplace.com/Industry/News/Details/114869 https://www.meatingplace.com/Industry/News/Details/114841 https://www.merck-animal-health-usa.com/

In this episode of the American Shoulder and Elbow Surgeons podcast, hosts Dr. Peter Chalmers and Dr. Brian Waterman conduct a roundtable interview on the etiology of glenohumeral osteoarthritis with Drs. Ben Zmistkowski and Jean-David Werthel.

Send us a Text Message.Discover the critical insights from Dr. Janet Grimes and Townes Hillier as they join us to unravel the complexities of splenic masses in dogs. Their extensive knowledge sheds light on the limitations and potential of predictive calculators like the HeLP score and T-STAT, providing a clearer understanding for veterinarians and pet owners making difficult treatment decisions for patients with splenic masses. Join us as we explore the intricacies of splenic mass diagnosis and the importance of clinical judgment as well as the need for more reliable predictive calculators.JAVMA article: https://doi.org/10.2460/javma.24.01.0016INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals

CME credits: 1.00 Valid until: 30-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/understanding-cias-what-does-current-literature-say-about-the-etiology-and-pathophysiology-of-cias/20291/ This series of bite-sized episodes will provide important information on cognitive impairment associated with schizophrenia. Drs. Philip Harvey and Martin Strassnig discuss the pathophysiology, diagnosis, and emerging therapies to treat cognitive impairment associated with schizophrenia.

We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/ARDS.mp3 Download Leave a Comment Tags: Critical Care, Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure. Berlin criteria for diagnosis include acute onset within 7 days, bilateral pulmonary infiltrates on imaging, not fully explained by cardiac failure or fluid overload, and impaired oxygenation with PaO2/FiO2 ratio 5 cm H2O. Severity based on oxygenation (Berlin criteria): Mild: PaO2/FiO2 200-300 mmHg Moderate: PaO2/FiO2 100-200 mmHg Severe: PaO2/FiO2

Authors:  Sebouh Bazikian - MS4 at Keck School of Medicine of University of Southern California Gowri Gowda - PGY1 at the University of California Davis Integrated Vascular Surgery Program Steven Maximus- Vascular surgery attending at the University of California Davis, Director of the Aortic Center   Resources:  Rutherford's 10th Edition Chapters: 88, 89, and 91 The North American Symptomatic Carotid Endarterectomy Asymptomatic Carotid Atherosclerosis Study Audible Bleeding's eBook chapter on cerebrovascular disease Houston Methodist CEA Dissection Video: Part 1: https://www.youtube.com/watch?v=wZ8PzhwmSXQ Part 2: https://www.youtube.com/watch?v=E_wWpRKBy4w   Outline:  1. Etiology of Carotid Artery Stenosis Risk factors: advanced age, tobacco use, hypertension, diabetes. Atherosclerosis as the primary cause. Development of Atherosclerotic Disease and Plaque Formation LDL accumulation in arterial walls initiating plaque formation. Inflammatory response, macrophage transformation, smooth muscle cell proliferation. Role of turbulent blood flow at carotid bifurcation in plaque development. Clinical Features of Carotid Artery Stenosis Asymptomatic nature in many patients. Symptomatic presentation: Transient ischemic attacks, amaurosis fugax, contralateral weakness/sensory deficit. Carotid bruit as a physical finding, limitations in diagnosis. Importance of Evaluating CAS Assessing stenosis severity and stroke risk. Revascularization benefits dependent on stenosis severity. Classification of Stenosis Levels Clinically significant stenosis: ≥ 50% narrowing. Moderate stenosis: 50%–69% narrowing. Severe stenosis: 70%–99% narrowing. Stroke Risk Associated with Carotid Stenosis Annual stroke rate: ~1% for 50-69% stenosis, 2-3% for 70-99% stenosis. Diagnosis and Screening No population-level screening recommendation. Screening for high-risk individuals as per SVS guidelines. Carotid Duplex Ultrasound as primary diagnostic tool. Additional tools: CT angiography, Magnetic Resonance Angiography. Handling of 100 cm/sec, Internal/Common Carotid peak systolic velocity Ratio > 4. Revascularization Criteria Symptomatic Patients: 50-69% or 70-99% stenosis, life expectancy at least three or two years, respectively. Asymptomatic Patients: 70% stenosis, considering life expectancy. Surgical Indications and Contraindications Indications: symptomatic patients, life expectancy considerations. Contraindications: Stenosis

This full-length episode on the inpatient management of acute pancreatitis includes not only the admission framework, but also key clinical pearls on the background, pathophysiology, etiologies, presentation, diagnosis, treatment, and complications associated with the disease to help take your understanding to the next level! Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode. Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia. Timestamps 00:00:00 - Background and Epidemiology 00:01:13 - A Note on Chronic Pancreatitis 00:01:31 - Admission Checklist 00:03:49 - HPI Intake 00:04:33 - Physical Exam 00:05:20 - Etiology and Differential 00:06:20 - Plan - Work Up 00:07:30 - Plan - Treatment 00:09:31 - If You Remember Nothing Else 00:10:04 - Pearls - Pathophysiology 00:11:15 - Pearls - Etiology and Risk Factors 00:12:56 - Pearls - Presentation and Diagnosis 00:15:56 - Pearls - Treatment 00:18:08 - Pearls – Complications Show Notes Reviews Acute Pancreatitis: A Review ⁠(JAMA, 2021)⁠ Acute Pancreatitis ⁠(NEJM, 2016) Trials WATERFALL Trial - Aggressive (20 ml/kg bolus + 3 ml/kg/hr) vs Non-Aggressive (10 ml/kg bolus + 1.5 ml/kg/hr) fluid resuscitation in acute pancreatitis - fluid overload resulted in 20.5% vs 6.3% of patients but no difference in the development of moderately severe or severe pancreatitis ⁠(NEJM, 2022) Other Literature Enteral versus parenteral nutrition for acute pancreatitis ⁠(Cochrane, 2010)⁠ A Critical Evaluation of Laboratory Tests in Acute Pancreatitis ⁠(Am J Gastroenterol, 2002) Blogs and Summaries Clinical Problem Solvers - Acute Pancreatitis Illness Script Internet Book of Critical Care - Pancreatitis Radiopaedia - Imaging Findings in Acute Pancreatitis Pathway Guidelines Summary - Acute Pancreatitis

ADHD Coach Katherine Sanders ADHD Coach Katherine is back for 2024 with a new series that will take you through everything that you need for getting a great life with ADHD. In this episode of ADHD: Powerful Possibilities, host Katherine explores the topic of ADHD and its different presentations. She discusses what ADHD is, how it shows up in everyday life, and debunks common myths surrounding ADHD. Katherine also shares her personal experiences. The episode concludes with a special announcement about a guide for understanding different presentations of ADHD. Tune in for an engaging discussion on ADHD and discover powerful possibilities for managing it.Connect with Katherine here:WebsiteInstagramTiktokFacebookYoutubeLinkedINThreads ADHD presentations & self-assessment - get your copy HEREhttps://www.lightbulbadhd.com/adhd-presentationsUK diagnosis pathway (general)https://adhdaware.org.uk/what-is-adhd/getting-nhs-diagnosis/NHS diagnosis guidelines (NICE)England & Wales https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/diagnosis/Scotlandhttps://www.scottishadhdcoalition.org/wp-content/uploads/2019/07/Guide-to-adult-ADHD-assessment-July-2019.pdfUSA diagnosis guidelineshttps://chadd.org/for-adults/diagnosis-of-adhd-in-adults/#:~:text=For%20adults%2C%20an%20ADHD%20diagnostic,physician)%20or%20clinical%20social%20workers.Self assessment scale for adultshttps://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdfSelf assessment for womenhttps://adhdrollercoaster.org/wp-content/uploads/2019/03/SASI.pdf 1. Anxiety Disorders and ADHD: - Reference: Sciberras, E., Mulraney, M., Silva, D., & Coghill, D. (2017). Prenatal Risk Factors and the Etiology of ADHD—Review of Existing Evidence. Current Psychiatry Reports , 19(1), 1-9. [Link to the...

In this episode, John Vervaeke, Iain McGilchrist, and Daniel Schmachtenberger dive deep into the metacrisis, unraveling its intricate layers. They discuss the role of hemispheric differences in shaping human experiences and worldviews, explore the contemporary meaning crisis, and analyze how human psychology intersects with global crises. Throughout their conversation, they stress the importance of shifting from extrinsic to intrinsic purposes, critique the dominance of the left hemisphere, and advocate for wisdom-based values. The panelists also ponder the potential for a new philosophical awakening, the reinterpretation of existing religions, and the necessity of holistic education. Importantly, they emphasize the significance of nurturing beauty, embracing awe, and recognizing our sacred obligation to protect our ever-evolving reality. The dialogue provides insights into how individuals can navigate this complex landscape and contribute to a wiser, more connected world. Iain McGilchrist: Iain McGilchrist is a renowned psychiatrist and writer known for his exploration of the brain's hemispheres. His seminal work, "The Master and His Emissary," delves into how the brain's structure affects human behavior, culture, and society, offering insightful perspectives on the cognitive underpinnings of modern challenges. Daniel Schmachtenberger: Daniel Schmachtenberger is a multidisciplinary thinker dedicated to addressing global existential risks. His work focuses on the intersection of technology, human psychology, and civilization dynamics. He is recognized for his deep insights into systemic health, generative societal design, and strategies for a sustainable and flourishing future.   Glossary of Terms Metacrisis: A term encompassing various global existential risks and challenges. Meaning Crisis: The widespread feeling of lack of meaning in modern society. Relevance Realization: A cognitive process of determining what information is relevant in a given context. Resources and References: Dr. John Vervaeke: Website | YouTube | Patreon | X | Facebook Iain McGilchrist: Website | YouTube |  X | Facebook  Daniel Schmachtenberger: Website | Facebook | LinkedIn The Vervaeke Foundation John Vervaeke YouTube Awakening from the Meaning Crisis Books The Master and His Emissary: The Divided Brain and the Making of the Western World - Iain McGilchrist  How the West Really Lost God: A New Theory of Secularization - Mary Eberstadt The Psychology of Belonging - Kelly-Ann Allen Zombies in Western Culture: A Twenty-First Century Crisis - John Vervaeke, Christopher Mastropietro, and Filip Miscevic Heidegger, Neoplatonism, and the History of Being: Relation as Ontological Ground - James Filler Nonzero: The Logic of Human Destiny - Robert Wright Quotes   "What in the nature of human mind, in the nature of human conditioning experience, we might even find that the term psychology or cognitive drivers are insufficient, which is fine, has brought us here, and what might a different relationship to human mind, psychology, cognition look like that might allow a more viable, better future. Before World War II, there was no risk that we could very quickly destroy the entire habitability of human civilization. That was brought into being with very powerful technology, nuclear weapons. And for the first time ever, we had the ability to make a series of bad decisions and radically change the possibility space of the world"​ - Daniel Schmachtenberger "Where there has been a significant drop in IQ, the insult is almost always in the right hemisphere. So, it's very important that the right hemisphere should remain the position of the master. And as long as the emissary follows the direction of the master that sees more, it's very helpful and useful. It's a good servant of a very poor master."​​ - Iain McGilchrist "The right hemisphere seems to be more in touch with presence, whereas the left hemisphere is more about re-presentation, representing something that is abstracted out of the living world." - Iain McGilchrist "The prevalence of meaninglessness in modern society can be linked to a lack of purpose and belonging, a critical factor in the development of the metacrisis." - John Vervaeke Chapters with Timestamps [00:00:00] Introduction to the Metacrisis [00:01:04] Defining Metacrisis and Initial Thoughts [00:08:26] The Role of Brain Hemispheres in Human Experience [00:21:29] The Meaning Crisis in Modern Society [00:30:45] Human Mind and Cognition in the Metacrisis [00:39:42] Exploration of Etiology and Psychological-Environmental Interrelations [00:58:26] Redefining Purpose: Intrinsic vs. Extrinsic [01:08:16] Hemispheric Imbalance and Its Impact on Civilization [01:15:25] Rebalancing Power and Wisdom in Influential Figures [01:39:05] Navigating the Dance of Reason, Authority, and Power [01:53:19] Imagination in Rational Thinking [02:02:45] Philosophical Awakening and Global Issues [02:14:55] Human Responsibility in the Evolution of the Divine [02:34:15] Fostering Global Wisdom through Pluralism [02:39:25] The Intersection of Religion and Scale [02:55:29] Revitalizing Religion for Modern Challenges [03:05:56] Reimagining Education and Institutional Structures [03:14:24] Embracing Beauty and Sacred Obligation   Timestamped Highlights [00:01:04] - Daniel Schmachtenberger introduces the metacrisis topic and its significance. [00:08:26] - Iain McGilchrist discusses the role of hemispheric differences in shaping human experience and worldviews. [00:21:29] - John Vervaeke addresses the meaning crisis and its implications in modern society. [00:30:45] - The panel delves into how the nature of human mind and cognition has contributed to the current state of the world. [00:39:42] - Exploring the roots of societal issues, highlighting the interplay between psychology and global crises, and the importance of relational human experiences. [00:58:26] - Discussion on the contrast between intrinsic and extrinsic purposes, emphasizing the need to shift focus from utility to deeper values like relationships, nature, and the sacred. [01:08:16] - The dialogue critiques the left hemisphere's dominance and its role in driving competitive, destructive outcomes, highlighting the need for a wisdom-based value shift. [01:15:25] - Exploring the interplay between power, wisdom, and the need to rediscover the sacredness of existence to foster meaningful connections and inspire change in influential individuals. [01:39:05] - Discussion on the Enlightenment's impact in differentiating reason from pure calculation, stressing the importance of maintaining reason as a balanced, experiential approach to life. [01:53:19] - The panelists discuss the importance of imagination and aspiration in rational thinking. [02:04:45] - Reflections on the potential for a new philosophical awakening in addressing global issues. [02:14:55] - The panelists explore the idea that humans have a role in responding to the divine, facilitating its evolution, and highlight the importance of our responsibility in this process. [02:34:15] - Vervaeke and McGilchrist advocate for fostering global wisdom by embracing pluralistic philosophies and emphasizing the role of individual and community models. [02:39:25] - Integrating differentiation in a potential new religion that aligns with existing faiths and addresses contemporary issues is discussed. [02:55:29] - How existing religions can be reinterpreted to address contemporary issues and foster wisdom development. [03:05:56] - A call for holistic, integrated education, breaking feedback loops hindering progress, and nurturing wisdom and sacredness in governance and society. [03:14:24] - Conclusion: The panelists emphasize the importance of nurturing beauty, embracing awe, and recognizing a sacred obligation to protect reality in our ever-changing world.  

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode. Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia. Timestamps: 00:00:07 - Background and Epidemiology 00:00:42 - Pathophysiology 00:02:29 - Admission Checklist 00:04:29 - HPI Intake 00:05:15 - To Note on Exam 00:05:25 - Etiology and Differential 00:06:10 - Plan - Treatment 00:07:56 - If You Remember Nothing Else 00:08:40 - Pearls - Etiology 00:09:44 - Pearls - Presentation and Diagnosis 00:12:03 - Pearls - Treatment Trials and Literature Clinical Management of Hyperkalemia (Mayo Clin Proc, 2021) An Integrated View of Potassium Homeostasis (NEJM, 2015) Risk of Hospitalization for Serious Adverse Gastrointestinal Events Associated With Sodium Polystyrene Sulfonate Use in Patients of Advanced Age (JAMA, 2019) - Kayexalate is associated with serious GI adverse events over 30 days (0.2% of people who take vs. 0.1% who don't) - NNH is 1000; intestinal ischemia is the most common Sodium zirconium cyclosilicate in hyperkalemia (NEJM 2015) - reduces K over placebo Other Resources: Clinical Problem Solvers - Hyperkalemia Schema Core EM - Hyperkalemia (good EKG change images) Life in the Fastlane - EKG Features of Hyperkalemia

Challenging our assumptions about sleepSleep is essential to our lives, but our perception of how it functions in our non-waking life is not always well understood. So in the mires of our busy daily lives do we overlook sleep by seeing it as a means of refilling our energy for a productive day? By questioning this assumption, one term rolls from out of the haze: The ‘Circadian Rhythm'.Dr. Kaylee Byers speaks with Dr. Hiroki Ueda from the University of Tokyo in the Faculty of Medicine on demystifying the links between our sleep and genomics. Then neuroscientist Dr. Andrew Coogan shares the connection between sleep and ADHD. Finally, we hear from Dr. Ueda and Dr. Hiroshi Ono, from Hitotsubashi University Business School, on how their homeland of Japan is reckoning with an off-balance relationship with sleep and work.—Highlights:(06:37) - Clocks in our bodies, understanding Circadian Rythms(10:17) - Attention Hyperactivity Deficit Disorder and later sleep, a chicken or egg dilemma(15:19) - Challenging overwork in Japan and the importance of sleep—Learn-A-Long: (Coming Soon)—Resources:Molecular Mechanisms of REM Sleep | NeurosciThe ability to dream may be genetic | Canadian Broadcast Corporation (CBC)Next-Generation Mice Genetics for Circadian Studies | NeuromethodsEvolution of temporal order in living organisms | Journal of Circadian RhythmsLearn about the bunker experiment to understand the human biological clock | BritannicaGenetic sleep deprivation: using sleep mutants to study sleep functions | EMBO reportsCircadian rhythms and attention deficit hyperactivity disorder: The what, the when and the why | Prog Neuropsychopharmacol Biol PsychiatryInsomnia: Definition, Prevalence, Etiology, and Consequences | Journal of Clinical Sleep MedicineNo Sleep for Japan? Survey Reveals Half of Population May Have Insomnia | Nippon.comWhy Sleep Matters: Quantifying the Economic Costs of Insufficient Sleep | Rand CorporationJapan has some of the longest working hours in the world. It's trying to change | CNBCAnnouncement of the establishment of the nonpartisan "Parliamentary League to Promote Initiatives for People's Quality Sleep" | Sleeping Council FederationFounder/Director CTO Yasumi Ueda gave a speech at the inaugural general meeting of the nonpartisan "Parliamentary League to Promote Initiatives for People's Quality Sleep" | ACCELStarsFree-running circadian activity rhythms in free-living beaver (Castor canadensis) | Journal of Comparative PhysiologyCredits:Dr. Rackeb TesfayeCurbing death by overwork | Financial TimesWhy does Japan Work So Hard? | CNBC ExplainsWorked to Death: Japan questions high-pressure corporate culture | France 24 EnglishInside Japan's growing ‘lonely death' clean-up service | CNN InternationalHow can governments help stop overwork? | The Question | CBC News: The National

If you care about AF you will love this conversation. Soren has some interesting ideas about what AF is now vs what AF was in the past. Here are some links:The LOOP Study (which was non-significant). Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP StudySeverity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke: A Post Hoc Analysis of the LOOP Randomized Clinical TrialSensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.BTW: This is the kind of content we aim to bring you at Sensible Medicine. Thanks for your support. I have some great ideas for future conversations. Feel free to let me know your interests, too. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Dry socket, also known as alveolar osteitis, is a painful condition that can occur after tooth extraction. It is characterized by the partial or total loss of the blood clot that forms in the socket after tooth extraction, leading to exposure of the underlying bone and nerve endings. This condition can cause severe pain and discomfort. In this episode, we focus on the pathogenesis, etiology, prevention, and treatment of dry socket with Dr. Jake Stucki (brother of Dr. Grant Stucki), an oral maxillofacial surgery resident in Cleveland at The Case School of Dental Medicine. In our conversation, we discuss the causes of dry socket and possible prevention strategies. We delve into the role of bacteria, poor oral hygiene, surgical trauma, and smoking in its development. We also touch on medications and anatomical factors contributing to this condition, alongside valuable approaches for reducing the risk and managing dry socket. We also highlight seminal work on the subject and provide listeners with key insights from the articles to help them stay ahead of the latest research. Join us for an in-depth and engaging discussion on dry socket, and gain a wealth of knowledge with Dr. Jake Stucki!Key Points From This Episode:Introduction and brief background to today's special guest, Dr. Jake Stucki.Dr. Jake Stucki provides an overview of alveolar osteitis and its symptoms.Reasons why dry socket is difficult to diagnose.What symptoms patients can expect when experiencing dry socket.Steps to distinguish dry socket from inflammation in the socket.The main causes of dry socket and how to prevent it from happening.Discover the role of bacteria in the development of alveolar osteitis.Explore the link between poor oral hygiene and the incidence of dry socket.Learn how surgical trauma can induce the development of alveolar osteitis.How the mechanical and chemical aspects of smoking can create dry socket.Medications linked to higher occurrences of alveolar osteitis in patients.Anatomical and age considerations for the onset of dry socket.Approaches for reducing the risk of alveolar osteitis in patients.Valuable insights into managing and treating dry socket.Recommendations for movies, books, and more!Links Mentioned in Today's Episode:Dr. Jake Stucki — https://www.linkedin.com/in/jake-stucki-ab19a593/Dr. Jake Stucki — jakestucki@gmail.comThe Case School of Dental Medicine — https://case.edu/dental/'Alveolar Osteitis: A Review of Current Concepts' — https://pubmed.ncbi.nlm.nih.gov/32348729/KLS Martin — https://www.klsmartin.com/Rick and Morty — https://www.imdb.com/title/tt2861424/Think Again — https://www.amazon.com/Think-Again-Power-Knowing-What/dp/1984878107Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today's episode is on the inpatient workup and management of Community-Acquired Pneumonia featuring an admission checklist, HPI intake, differential, plan, and high-yield clinical pearls. Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode. Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care without getting bogged down by unnecessary details or trivia. Show Notes: 00:00:08 - Background and Definitions 00:01:13 - Etiology and Pathophysiology 00:02:49 - Admission Checklist 00:05:16 - HPI Intake 00:06:38 - Physical Exam Findings 00:07:30 - Differential 00:08:48 - Treatment Plan 00:10:15 - If You Remember Nothing Else 00:11:47 - Clinical Pearls - Etiology 00:13:47 - Clinical Pearls - Presentation and Diagnosis 00:16:53 - Clinical Pearls - Treatment 00:19:52 - Clinical Pearls - Complications

As mentioned in the previous episode, we are continuing to provide some of the basic information that is imparted by the Higher Mind Training, which is a new personal growth program being prepared for release by the Better Angels Publishing Company. Its purpose is to help the normal, everyday person emerge from the prison of self-sabotage into the freedom of self-empowerment. The program probably won't be released until the middle of next year, but we want to give our podcast subscribers the information now, so you can begin using it right away, if you like.           To begin this episode, let's start out by taking a little detour in time and space back to August 13, 1865 to a sanitarium in Vienna, Austria, which is the date upon which one of its inmates named Ignatz Semmelweis died. He had suffered from a nervous breakdown and had been confined to the sanitarium a few months earlier. Outspoken, unruly, and constantly arguing that he was being held against his will, he suffered regular beatings from the guards. The cause of his death had been a gangrenous wound on his right hand, which was a probable result of one of these beatings.           Surprisingly, Semmelweis was a physician and scientist who had fallen into serious disrepute among the medical establishment of the capital city. He had been doing research on the mortality rates among women during childbirth and at one point, he had come up with a radical new idea that became extremely unpopular, primarily because there was absolutely no scientific basis for it. Even so, it seemed to make intuitive sense to him, so he began to institute it at Vienna General Hospital's First Obstetrical Clinic.           He documented the results of his unfounded and unaccepted new procedure and found that over several months, the maternal mortality rate in the obstetrical clinic dropped from 18% to 2%. Even though he still had no scientific theory upon which to base any medical hypothesis whatsoever, he still published a book about his findings in 1861, called “Etiology, Concept and Prophylaxis of Childbed Fever.”           Given the story so far, the next obvious question would be – what was this radical new idea that Dr. Semmelweis had come up with that had seemingly cut the maternity mortality rate by nearly ninety percent? Now remember, he had no scientific explanation for how or why his procedure worked and every medical professional who had heard about it was adamantly opposed to it.           Get ready. You will probably find this quite shocking. He proposed that all the health care workers in the hospital, the doctors, nurses, and midwives, should wash their hands before they performed any procedure on any patient. In fact, he felt they should wash their hands before they even touched anyone at all and he came up with a chlorinated lime solution to do the job.           He had absolutely no scientific reasoning to support his supposition and his outrageous idea was met with ridicule and universally condemned by the entire medical establishment. They were certain of their opinion because, in their highly educated minds, the concept made absolutely no sense. Why would washing your hands have anything to do whatsoever with protecting the health of mothers and babies during childbirth?           And on top of that, the doctors felt personally offended. Why should they have to wash their hands? Afterall, doctors were considered to be refined gentlemen and gentlemen never have to wash their hands. That was for laborers and other members of the lower classes.           Following his clashes with the medical establishment, Semmelweis got involved with some other societal and political battles as well, and was ridiculed, ostracized, and finally ruined. He suffered a nervous breakdown and was committed to an asylum where he eventually died from the beatings he received from the guards.           All of this came from the audacity he had to suggest that medical professionals should wash their hands before treating patients. And don't forget, they weren't treating just anybody. This was the upper crust of Austrian society.  Many of the mothers and babies who died in the contaminated obstetrical hospitals were members of the aristocracy and royalty of Europe, who were being treated by the finest doctors of the day.           Many years after his death, because of his efforts to protect the maternity environment, he became widely known as the “Savior of Mothers.” Of course, he wasn't the first savior to be crucified by his detractors and certainly not the last.           To put the story into historical perspective, Dr. Semmelweis had made his radical handwashing suggestion about twenty years before the general emergence of germ theory into the scientific world, which followed the work of Pasteur and Lister.   Back in 1860, they knew nothing about germs whatsoever. They had never even heard the term. They still believed that disease was caused by liquid “humors” in the body, a two-thousand-year-old concept that was concocted by ancient Greek and Roman doctors. In the middle of the nineteenth century, the standard accepted medical procedure of the day for treating disease was still simple bloodletting. And they felt that the state of their medical understanding was incredibly advanced.           As primitive as they may appear today, this has been the case with most cultures. Every society thinks they are incredibly advanced, and this conceit goes way back. When chariots were invented in about 1600 BC, they were all the rage. The Hittites took them to an unheard-of level of comfort and maneuverability, and eventually refined them for warfare. The most advanced military battle of its time was fought in 1274 BC with over five thousand chariots helping to boost the carnage. I'm sure the warriors were all proud of the level of modernity they had achieved.           Going back to the “Savior of Mothers” 1860 example, let's back up a little to 1830's, 40's and 50's, and consider the tremendously advanced water system that was set up to bring water into the White House. It was complete with steam driven pumps and cast-iron piping and the fact that water was delivered in this way to the White House was a marvel of the times.           Of course, no one knew anything about germ theory and although the piping system was ingenious, the water that it carried was severely contaminated, coming from wells that abutted wastewater dumps that were loaded with pathogens. It is now believed that Presidents Henry Harrison, James Polk and Zachary Taylor all died as a result of exposure to the water brought in by that otherwise innovative system.           And that's not to mention the tragic death of Abraham Lincoln's beloved eleven-year-old son, Willie, who died from typhoid fever which was directly related to the putrid White House water.           So, due to their significant technological advances, they were able to distribute water in a more convenient way, but with their ignorance of germ theory, they just made it more convenient for people to get sick and die.           Of course, we've come a long way and hand sanitization has become almost universal, especially since the pandemic. But back then, they just didn't know what they didn't know. And guess what? Neither do we. No one ever does. I often find myself wondering what the people living a hundred and fifty years from now will think of us. Like all previous cultures, we believe we are incredibly advanced. But what critical factors don't we know now, that will be common knowledge throughout the world in 2175? With my lifelong focus on the evolution of human consciousness, my assumption as well as my hope is that it will have something to do with the way we use our minds. Because to put it simply, the way we use our minds is the basic root of all the major troubles that we face today. Look at it this way. We live in an extremely troubled world, nearly drowning in a sea of immense problems, and from what I've read, if you ask artificial intelligence to come up with a plan that would quickly and efficiently save the planet, it would simply respond, “Get rid of the human beings.” Of course, it's a shocking response, and some AI experts find it deeply disturbing, but you can see the troubling logic behind it. And if we are the primary cause of the problems that are plaguing our world, what's wrong with us?  Again, the answer is dramatically simple. It's our mind. That's right. the most advanced biological evolution since the beginning of life on earth, and indeed the very factor that enabled us to emerge from the brutal tests of survival of the fittest, this miraculous organ is the very cause of all our issues. And it isn't really the mind itself that is the problem. It's the way we use it. Let's refine that statement a little. It's the unconscious way that we've been unconsciously trained to unconsciously use it that's creating the problem. We have a mind with nearly unfathomable intelligence, but we haven't learned how to use it in a human-centric way. We develop incredible technology, but we don't use it in a way that serves humanity or the rest of the planet.   And this lack of evolved consciousness is nothing new. Just look at our track record. It's pretty dismal. And that's not just in caring for the planet, it's also deeply troubling in taking care of ourselves. Here is a particularly disgusting example.  About 160,000 people die each week from starvation on earth. That means that close to 8,500,000 people literally starve to death each year. They die because they simply don't get enough food to eat.           Now, get this – in the United States alone, 119 billion pounds of food is wasted each year. That means that 130 billion meals, $408 billion in food or about 40% of the total food supply is simply thrown out. Discarded. Four hundred and eight billion dollars of food is wasted each year, while 8,500,000 people die of starvation.           We have the money and we have the technology. We just have a serious problem with the way we misuse our intelligence. And personally, I believe that if and when people 150 years from now look back on us, it will be the generally primitive level of our human consciousness that will be so shocking to them. Because when it comes to the overall state of our consciousness, basically, we're still living a glorified law of the jungle. You know the drill – I, me, mine. Dog eat dog, Winner takes all, and the countless variations of the same primitive, fear-based theme, which leads to the sad conclusion that in the entire world, we have no greater enemy than ourselves. No other creature or factor poses a greater threat to our survival than we do. If the human species is ever destroyed, there is a high probability that it will be a case of unconscious suicide.           So, there can be no doubt that the growth of our inner consciousness is critical to our survival as a species, and I'd like to offer two of my favorite quotes on the subject. Albert Einstein said, “No problem can be solved from the same level of consciousness that created it.” And Dr. Carl Jung said, “The greatest and most important problems of life are all fundamentally insoluble. They can never be solved, but only outgrown.”           So again, we must grow. And when it comes to inner growth, I'd like to suggest a “what if.”  What if it's not all that hard? What if like the germs in the nineteenth century, there is something incredibly basic that we just don't know yet? And what if the key to our advancement is as simple as just washing your hands?           Well, this seems like a good place to stop. We'll go a couple of steps deeper in the coming episode, so keep your eyes, mind and heart open, and let's get together in the next one.

Drs Michelle M. Kittleson and Kathryn J. Lindley discuss current approaches to treating patients with peripartum cardiomyopathy as well as patients with heart failure who want to become pregnant. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982165). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Pregnancy as an Early Cardiovascular Moment: Peripartum Cardiovascular Health https://pubmed.ncbi.nlm.nih.gov/37289905/ Considerations for Specific Cardiomyopathies During Pregnancy https://pubmed.ncbi.nlm.nih.gov/37016994/ Intersection of Heart Failure and Pregnancy: Beyond Peripartum Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/33980039/ Peripartum Cardiomyopathy: Progress in Understanding the Etiology, Management, and Prognosis https://pubmed.ncbi.nlm.nih.gov/30449378/ Thyroid Disorders in Pregnancy https://pubmed.ncbi.nlm.nih.gov/23007317/ Management of Clinical Chorioamnionitis: An Evidence-Based Approach https://pubmed.ncbi.nlm.nih.gov/33007269/ Takotsubo Cardiomyopathy: A Brief Review https://pubmed.ncbi.nlm.nih.gov/32341693/ Pheochromocytoma/Paraganglioma-Associated Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/37522121/ B-Type Natriuretic Peptide and Echocardiography Reflect Volume Changes During Pregnancy https://pubmed.ncbi.nlm.nih.gov/28195551/ Peripartum Cardiomyopathy: Challenges in Diagnosis and Management https://pubmed.ncbi.nlm.nih.gov/27276444/ Postpartum Cardiomyopathy https://www.ncbi.nlm.nih.gov/books/NBK534770/ Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/34857089/

Scripture Reading (for the next three weeks): Genesis 1:1-3:24Last week I attempted to make three simple points:(1) Simply assuming that a text should be read literally is not a “safer” approach than being open to figurative understandings—that is, that assumption runs the “risk” of forcing a wrong interpretation of the text.(2) Texts that are meant to be understood non-literally can convey information—they are not so open to interpretation that they can mean anything at all. Even in cases when the message lacks specificity or clarity, the message still has a limited semantic range. Put simply, non-literal text can have meaning, be interpreted correctly, and be interpreted incorrectly.(3) Finally, the early chapters of Genesis have been interpreted non-literally since the dawn of the church (and before). The accusation that only modern Christians, yielding to the pressure of modern science, have conveniently interpreted the text figuratively is simply false. To interpret the text non-literally is not a departure from established church (or Jewish) tradition.All three points can be summarized as follows: genre is key to reading a text. Reading poetry like historiography or historiography as poetry is dangerous. Neither approach is likely to reach truth.I am well aware that, so far, I have not offered a shred of evidence that the early chapters of Genesis should be read literally or otherwise. That has been intentional. All I have attempted to show is that considering a non-literal interpretation is not offensive in itself and foreclosing that interpretation a priori may force a reader to reach the wrong conclusions.So, with all that in mind, the time has come to read the text. 1 In the beginning God created the heavens and the earth.2 Now the earth was without shape and empty, and darkness was over the surface of the watery deep, but the Spirit of God was moving over the surface of the water. 3 God said, “Let there be light.” And there was light! 4 God saw that the light was good, so God separated the light from the darkness. 5 God called the light “day” and the darkness “night.” There was evening, and there was morning, marking the first day.6 God said, “Let there be an expanse in the midst of the waters and let it separate water from water.” 7 So God made the expanse and separated the water under the expanse from the water above it. It was so. 8 God called the expanse “sky.” There was evening, and there was morning, a second day.9 God said, “Let the water under the sky be gathered to one place and let dry ground appear.” It was so. 10 God called the dry ground “land” and the gathered waters he called “seas.” God saw that it was good.11 God said, “Let the land produce vegetation: plants yielding seeds and trees on the land bearing fruit with seed in it, according to their kinds.” It was so. 12 The land produced vegetation—plants yielding seeds according to their kinds, and trees bearing fruit with seed in it according to their kinds. God saw that it was good. 13 There was evening, and there was morning, a third day.14 God said, “Let there be lights in the expanse of the sky to separate the day from the night, and let them be signs to indicate seasons and days and years, 15 and let them serve as lights in the expanse of the sky to give light on the earth.” It was so. 16 God made two great lights—the greater light to rule over the day and the lesser light to rule over the night. He made the stars also. 17 God placed the lights in the expanse of the sky to shine on the earth, 18 to preside over the day and the night, and to separate the light from the darkness. God saw that it was good. 19 There was evening, and there was morning, a fourth day.20 God said, “Let the water swarm with swarms of living creatures and let birds fly above the earth across the expanse of the sky.” 21 God created the great sea creatures and every living and moving thing with which the water swarmed, according to their kinds, and every winged bird according to its kind. God saw that it was good. 22 God blessed them and said, “Be fruitful and multiply and fill the water in the seas, and let the birds multiply on the earth.” 23 There was evening, and there was morning, a fifth day.24 God said, “Let the land produce living creatures according to their kinds: cattle, creeping things, and wild animals, each according to its kind.” It was so. 25 God made the wild animals according to their kinds, the cattle according to their kinds, and all the creatures that creep along the ground according to their kinds. God saw that it was good.26 Then God said, “Let us make humankind in our image, after our likeness, so they may rule over the fish of the sea and the birds of the air, over the cattle, and over all the earth, and over all the creatures that move on the earth.”27 God created humankind in his own image,in the image of God he created them,male and female he created them.28 God blessed them and said to them, “Be fruitful and multiply! Fill the earth and subdue it! Rule over the fish of the sea and the birds of the air and every creature that moves on the ground.” 29 Then God said, “I now give you every seed-bearing plant on the face of the entire earth and every tree that has fruit with seed in it. They will be yours for food. 30 And to all the animals of the earth, and to every bird of the air, and to all the creatures that move on the ground—everything that has living breath in it—I give every green plant for food.” It was so.31 God saw all that he had made—and it was very good! There was evening, and there was morning, the sixth day.1 The heavens and the earth were completed with everything that was in them. 2 By the seventh day God finished the work that he had been doing, and he ceased on the seventh day all the work that he had been doing. 3 God blessed the seventh day and made it holy because on it he ceased all the work that he had been doing in creation.4 This is the account of the heavens and the earth when they were created—when the Lord God made the earth and heavens.5 Now no shrub of the field had yet grown on the earth, and no plant of the field had yet sprouted, for the Lord God had not caused it to rain on the earth, and there was no man to cultivate the ground. 6 Springs would well up from the earth and water the whole surface of the ground. 7 The Lord God formed the man from the soil of the ground and breathed into his nostrils the breath of life, and the man became a living being.8 The Lord God planted an orchard in the east, in Eden; and there he placed the man he had formed. 9 The Lord God made all kinds of trees grow from the soil, every tree that was pleasing to look at and good for food. (Now the tree of life and the tree of the knowledge of good and evil were in the middle of the orchard.)10 Now a river flows from Eden to water the orchard, and from there it divides into four headstreams. 11 The name of the first is Pishon; it runs through the entire land of Havilah, where there is gold. 12 (The gold of that land is pure; pearls and lapis lazuli are also there.) 13 The name of the second river is Gihon; it runs through the entire land of Cush. 14 The name of the third river is Tigris; it runs along the east side of Assyria. The fourth river is the Euphrates.15 The Lord God took the man and placed him in the orchard in Eden to care for it and to maintain it. 16 Then the Lord God commanded the man, “You may freely eat fruit from every tree of the orchard, 17 but you must not eat from the tree of the knowledge of good and evil, for when you eat from it you will surely die.”18 The Lord God said, “It is not good for the man to be alone. I will make a companion for him who corresponds to him.” 19 The Lord God formed out of the ground every living animal of the field and every bird of the air. He brought them to the man to see what he would name them, and whatever the man called each living creature, that was its name. 20 So the man named all the animals, the birds of the air, and the living creatures of the field, but for Adam no companion who corresponded to him was found. 21 So the Lord God caused the man to fall into a deep sleep, and while he was asleep, he took part of the man's side and closed up the place with flesh. 22 Then the Lord God made a woman from the part he had taken out of the man, and he brought her to the man. 23 Then the man said,“This one at last is bone of my bonesand flesh of my flesh;this one will be called ‘woman,'for she was taken out of man.”24 That is why a man leaves his father and mother and unites with his wife, and they become one family. 25 The man and his wife were both naked, but they were not ashamed.1 Now the serpent was shrewder than any of the wild animals that the Lord God had made. He said to the woman, “Is it really true that God said, ‘You must not eat from any tree of the orchard'?” 2 The woman said to the serpent, “We may eat of the fruit from the trees of the orchard; 3 but concerning the fruit of the tree that is in the middle of the orchard God said, ‘You must not eat from it, and you must not touch it, or else you will die.'” 4 The serpent said to the woman, “Surely you will not die, 5 for God knows that when you eat from it your eyes will open and you will be like God, knowing good and evil.”6 When the woman saw that the tree produced fruit that was good for food, was attractive to the eye, and was desirable for making one wise, she took some of its fruit and ate it. She also gave some of it to her husband who was with her, and he ate it. 7 Then the eyes of both of them opened, and they knew they were naked; so they sewed fig leaves together and made coverings for themselves.8 Then the man and his wife heard the sound of the Lord God moving about in the orchard at the breezy time of the day, and they hid from the Lord God among the trees of the orchard. 9 But the Lord God called to the man and said to him, “Where are you?” 10 The man replied, “I heard you moving about in the orchard, and I was afraid because I was naked, so I hid.” 11 And the Lord God said, “Who told you that you were naked? Did you eat from the tree that I commanded you not to eat from?” 12 The man said, “The woman whom you gave me, she gave me some fruit from the tree and I ate it.” 13 So the Lord God said to the woman, “What is this you have done?” And the woman replied, “The serpent tricked me, and I ate.”14 The Lord God said to the serpent,“Because you have done this,cursed are you above all the cattleand all the living creatures of the field!On your belly you will crawland dust you will eat all the days of your life.15 And I will put hostility between you and the womanand between your offspring and her offspring;he will strike your head,and you will strike his heel.”16 To the woman he said,“I will greatly increase your labor pains;with pain you will give birth to children.You will want to control your husband,but he will dominate you.”17 But to Adam he said,“Because you obeyed your wifeand ate from the tree about which I commanded you,‘You must not eat from it,'the ground is cursed because of you;in painful toil you will eat of it all the days of your life.18 It will produce thorns and thistles for you,but you will eat the grain of the field.19 By the sweat of your brow you will eat fooduntil you return to the ground,for out of it you were taken;for you are dust, and to dust you will return.”20 The man named his wife Eve, because she was the mother of all the living. 21 The Lord God made garments from skin for Adam and his wife, and clothed them. 22 And the Lord God said, “Now that the man has become like one of us, knowing good and evil, he must not be allowed to stretch out his hand and take also from the tree of life and eat, and live forever.” 23 So the Lord God expelled him from the orchard in Eden to cultivate the ground from which he had been taken. 24 When he drove the man out, he placed on the eastern side of the orchard in Eden angelic sentries who used the flame of a whirling sword to guard the way to the tree of life.Does Genesis Belong to the Literary Genre of Myth?We must face the million-dollar question: are there clues in the text of Genesis that would lead the reader to believe that it is not to be taken literally? Notice that the question focuses and begins with the text itself. The endeavor is to read the text the way it “wants” to be read. This interpretive exercise is not starting out with modern beliefs and reading the text the way a modern reader may want to read it.However, before we start this conversation, I want to address why we are having this conversation at all. Spoiler alert—the ending of the story is this: when we focus on the potential concordance between science and Genesis we are asking the wrong questions. Not only will this result in wrong answers, it will keep us from asking the right questions! Ultimately, that is what I want. I want to take Genesis seriously—dead seriously. I believe in Genesis. I believe it is scripture. I believe it is true. My view of everything is shaped by it. So I am eager to discuss the truths that Genesis truly means to convey. An yes, I believe Genesis is historical just not historiography. It conveys real world truths in figurative language.Ok, back to the myth discussion. (Most of the discussion in this week's blog comes from William Lane Craig's In Quest of the Historical Adam: A Biblical and Scientific Exploration. Sometimes the discussion is a summary of his work, sometimes it is a straight copy. I would certainly fail for plagiarism if this blog were a paper.)Before You Stone Me—A Definition of MythThe word myth is nowadays used to refer to a false fact, statement, or story. If I told you that chewing bread while chopping an onion will prevent teary eyes, you might respond, “That's just a myth.” If I were calling Genesis a myth in that sense—well, go ahead and stone me. It would be well deserved.When I use the term myth in this discussion, I mean something else entirely. I am using the term as another element in the set containing poetry, epic, biography, and historiography. I am not using myth as a synonym for lie, fiction, wives' tale, or falsity. Explained differently, I am using myth the way a folklorist would.In the field of folklore, a myth is a sacred narrative explaining how the world and man came to be in their present form. Let's break down this brief definition. First, a myth is a linguistic composition, either oral or literary. Second, it is a narrative; that is to say, it is a story, which involves characters and a plotline. Third, it is a sacred narrative—it has religious significance in the culture in which it is embraced. This implies that it will have something to do with a deity as one of its principal figures. Fourth, (and this is implied) it is a traditional narrative, one that is handed down over the generations, not a recent, free composition.Myths are narratives that, in the society in which they are told, are considered to be truthful accounts of what happened in the remote past. They are to be believed and may be cited as authoritative. They are the embodiment of dogma and are often associated with theology and ritual. Their main characters are not usually human beings but deities, heroes, or animals, whose activities are set in an earlier age, when the earth was different than it is today, or in another realm such as the sky or underworld. Compare this to, for example, legends. Legends are similar to myths, but they take place in the current era, not in the remote past, and are not considered sacred. Compare myths also to folktales. Folktales are narratives that, in the society in which they are told, are regarded as fiction. The events they relate may or may not have happened. They are not to be taken seriously as dogma or history.Finally, myths are often highly metaphorical rather than literal. Let's focus on Ancient Near Eastern myths to provide evidence of this point. The first example we can examine is the Mesopotamian myth Enuma elish. As a scholar put it, “[n]o one but a lunatic . . . could ever arrive at the theory that [the earth and sky] were originally formed by splitting the body of a dragon in half.” We can be confident that no ancient Babylonian looking to the sky expected to see the desiccated flesh and bones of Tiamat overhead, nor did he expect to find the Tigris and Euphrates flowing out of Tiamat's eye sockets. These are figurative images. The same could be said for Egyptians and their myths. In Egyptian mythology, for example, the sky could be depicted as the goddess Nut arched over the earth with hands and feet touching the ground. No Egyptian looking at the sky expected to see the body of a naked woman arched above him. Sadly, when we refer to ancient peoples as believing these things literally, it is us who do not understand and impose an overly literalistic interpretation of their myths. So, are the early chapters of Genesis a myth? To determine what is a myth, one can look for certain elements that are shared by most myths (i.e., “family resemblances”). We can summarize these family resemblances as follows:(1) Myths are narratives, whether oral or literary.(2) Myths are traditional stories handed down from generation to generation.(3) Myths are sacred for the society that embraces them.(4) Myths are objects of belief by members of the society that embraces them.(5) Myths are set in a primaeval age or another realm.(6) Myths are stories in which deities are important characters.(7) Myths seek to anchor present realities such as the world, mankind, natural phenomena, cultural practices, and the prevailing cult in a primordial time.(8) Myths are associated with rituals.(9) Myths express correspondences between the deities and nature.(10) Myths exhibit fantastic elements and are not troubled by logical contradiction or incoherence.By the way, these characteristics of myth come from folklorist, scholars who study myths of many different cultures and religions—not from biblical scholars. In other words, this is not an attempt to draft a definition of myth that will conveniently fit the Genesis account.Application to Genesis 1-11Let us apply the list of elements above to the early chapters of Genesis and see if Genesis might belong to the genre of myth.(1) Myths are narratives, whether oral or literary.Not only the individual units of Genesis 1-11 work as narratives, but the first 11 chapters as a whole constitute a narrative as well. These chapters tell the story of primaeval events in roughly chronological succession. For example, the fall of mankind occurred after the creation of mankind, the flood occurred after the fall, and the confusion of languages at the Tower of Babel occurred after the flood.(2) Myths are traditional stories handed down from generation to generation.Genesis 1-11 is universally recognized as comprising traditional stories. That is to say, the author of Genesis (traditionally held to be Moses), wrote down the traditions passed down to him. Most scholars adopt what is termed the “documentary hypothesis,” which explores the potential sources upon which the Genesis author relied.(3) Myths are sacred for the society that embraces them.Again, there is universal agreement that the narratives of Genesis 1-11 are sacred for Israelite society. Not only do these stories tell the acts of the God of creation, but more particularly they tell the acts of Israel's covenantal God, Yahweh. Sabbath observance and animal sacrifice, so central to Israel's cult, are already grounded in the early chapters of Genesis. Moreover, Genesis 1-11 provides the prehistory and foundation for Yahweh's call of Abraham to establish the nation of Israel in order to achieve the blessing of all mankind that was forfeited by Adam and Eve.(4) Myths are objects of belief by members of the society that embraces them.We see this fact clearly when later passages in the Pentateuch (the first five books of the Bible) reaffirm statements in the primaeval narrative. For example, in Exodus 20:8-11 we have a recapitulation of the creation week: “Remember the Sabbath day to set it apart as holy. For six days you may labor and do all your work, but the seventh day is a Sabbath to the Lord your God; on it you shall not do any work, . . . . For in six days the Lord made the heavens and the earth and the sea and all that is in them, and he rested on the seventh day; therefore the Lord blessed the Sabbath day and set it apart as holy.”(5) Myths are set in a primaeval age or another realm.The stories of Gen 1-11 are set in a primaeval age. The primaeval age in Genesis runs right back to God's creation of the world “in the beginning” (Gen 1:1). Moreover, the Genesis account narrates the creation of humankind as well as of plant and animal life. The origin of civilization and several of its inventions, such as metallurgy and music, are related. The origin of the world's languages is described. The period described is thus truly the primal age of mankind and the world.(6) Myths are stories in which deities are important characters.This element is controversial, but not for the reason you might think. Many folklorist do not consider the Genesis account to be myth because it does not involve many gods. In their view, monotheism is antithetical to myth. This seems to be a mistake, however. There is no reason that a monotheistic society could not use the genre of myth.(7) Myths seek to anchor present realities such as the world, mankind, natural phenomena, cultural practices, and the prevailing cult in a primordial time.This is the very heart of myth. In grounding present realities in the primordial past, the narrative functions to establish Israel's worldview. Notice, it does not ground the founding of Israel as a nation, at least not merely that. More fundamentally, the Genesis myth is universal in that it explains the origin of the world, the origin of humanity, and natural phenomena. All three of these ideas will be explored later.(8) Myths are associated with rituals.The narratives of Gen 1-11 do not seem to be associated with rituals, despite the motif of animal sacrifice. But inclusion of this eighth family resemblance probably reflects the influence of the so-called myth and ritual school, which is now widely rejected. While some myths have ritual associations, such a connection is missing from many myths.(9) Myths express correspondences between the deities and nature.The primaeval narratives of Genesis likewise do not express correspondences between deities and nature. But the absence of such correspondences from Genesis 1-11 is due to Israel's monotheism, in contrast to the polytheism of its neighbors.(10) Myths exhibit fantastic elements and are not troubled by logical contradiction or incoherence.Does the Genesis narrative exhibit fantastic elements? Is it untroubled by logical contradiction or incoherence? It seems that on both counts the primaeval narrative shares this family resemblance of myths, even if to several orders of magnitude less in comparison to Ancient Near Eastern polytheistic myths.(a) Anthropomorphisms. Despite God's transcendence so dramatically declared in Genesis 1, God is portrayed in the story of man's creation in Genesis 2 as a humanoid deity worthy of polytheistic myths, as he forms man from the dirt and breathes the breath of life into his nostrils. The same is true of the story of the fall in Genesis 3, where God strolls in the cool of the day and searches for the man and woman hiding among the trees. One must wonder whether the author meant these anthropomorphic descriptions of God to be just part of the storyteller's art or serious theology.(b) Narrative Inconsistencies. The author of Genesis seems untroubled by the apparent inconsistencies that occur in his narratives. It would have been easy for him to bring the account of the creation of man in Genesis 2 into accord with Genesis 1, rather than leave the apparent inconsistencies concerning the order of creation of man, the vegetation, and the animals. In Genesis 1, vegetation is created in the third day (Genesis 1:11-13):God said, “Let the land produce vegetation: plants yielding seeds and trees on the land bearing fruit with seed in it, according to their kinds.” It was so. 12 The land produced vegetation—plants yielding seeds according to their kinds, and trees bearing fruit with seed in it according to their kinds. God saw that it was good. There was evening, and there was morning, a third day.Also, in Genesis 1 man is created after vegetation.Man is not made until the sixth day (see Genesis 1:28-30). However, in Genesis 2 we read the following (Genesis 2:5-7):Now no shrub of the field had yet grown on the earth, and no plant of the field had yet sprouted, for the Lord God had not caused it to rain on the earth, and there was no man to cultivate the ground. Springs would well up from the earth and water the whole surface of the ground. The Lord God formed the man from the soil of the ground and breathed into his nostrils the breath of life, and the man became a living being.(c) Fantastic Elements. Before we can determine whether Genesis contains fantastic elements, we must explain that term. Miracles and fantastic elements are not the same. I believe in miracles! Fantastic means events that are so extraordinary or odd that, on their face, seem palpably false to the audience. I am not saying these events seem palpably false to us in light of increased knowledge of the world. Fantastic means palpably false to the original audience. Put another way, these are elements that both the original author and original audience understand to be figurative. Allow me to provide modern examples. If I told you I was diagnosed with cancer but after my church prayed for me I received a healthy diagnosis, I have not narrated a “fantastic element.” I have narrated a miracle which, even if you disbelieve it, you and I both understand that I mean for you to believe it. On the other hand, imagine that before you announce your wife's pregnancy I somehow find out, and when you ask me how I learned of it, I respond, “A little birdy told me.” That is much closer to a fantastic element. Both you and I, the speaker and the audience, understand that the statement is too odd to be taken as anything other than a literary device.So, are there fantastic elements in Genesis? I think so. The best example is the snake. The snake may very well represent Satan, but notice the actual description in the text, “Now the serpent was shrewder than any of the wild animals that the Lord God had made.” In the story, the snake is a snake—just a snake. And no one is surprised by the talking snake! And the implication that the snake is shrewder than other animal is that other animals are like the snake (presumably they can also speak), just a little less clever. In fact, an ancient Jewish interpretation explains the reference to the serpent precisely in this literal manner, attributing the capacity to speak to all the animals in the orchard (Jubilee 3:28).Other great examples of fantastical elements are the trees of life and of knowledge of good and evil. Notice that in regard to the effect of eating the fruits of these trees there is no hint of miraculous action on God's part. The trees seem to be “magical.” God does not bestow eternal life if one eats from the tree of life. The tree does it. Man could event subvert God's punishment if he could simply get his hands on that fruit. “And the Lord God said, ‘Now that the man has become like one of us, knowing good and evil, he must not be allowed to stretch out his hand and take also from the tree of life and eat, and live forever'” (Genesis 3:22).Conclusion and CliffhangerOk, there's my abbreviated argument that the early chapters of Genesis are myth. Now, allow me to return to the definition of myth and the entire reason I am spending time on this topic: Myths are narratives that, in the society in which they are told, are considered to be truthful accounts of what happened in the remote past. They are to be believed and may be cited as authoritative. Sure, the fact that they are truthful does not mean that they are literal—but they are truthful! So, what are these truths that story conveys? We won't have time to explore this until next week, but let me give you a brief taste of what is to come:Themes and Etiology(1) Origin of the World. Genesis 1 is obviously an etiological account of the origin of the world through God's creative activity. As such it is spectacularly different from the cosmic etiologies of Israel's neighbors. In contrast to Babylonian and Egyptian myths, there is neither theogony nor theomachy in Genesis; rather, “In the beginning God created the heavens and the earth” (Gen 1:1). All of physical reality is brought into being by an unoriginate and transcendent Deity.(2) Origin of Humanity. In Genesis 2 we have an etiological account of the origin of humanity that supplements the brief notice of mankind's creation in 1:26–27. In other myths in the Ancient Near East, humans are often treated as later creations of the gods for the purpose of relieving the minor deities of backbreaking labor. For example, in the Atrahasis Epic the minor deities are said to have labored for thousands of years before finally rebelling against their overseers, necessitating the creation of man to take over their labors.Scholars have often asked why the Pentateuch does not begin with the call of Abraham and the founding of Israel in Genesis 12. Commentators seem widely agreed that the reason the author prefixes the prehistory to the patriarchal narratives is his universalizing interest. He wants to show that God's original plan was to bless all mankind and that this aim still remains ultimately in mind through the election of Israel, which is now God's means of fulfilling his original intent. Moreover, Ancient Near East myths share an etiological interest in telling how mankind in general came to exist. For example, as cited above, in the Atrahasis Epic, in response to protests and rebellion of the lesser gods over their burdensome labors, the mother goddess decides to create man to take over the labor for them. Humans were created basically as slave labor for the gods. Such stories seek to answer the question of human origins in general. When read against this backdrop, Genesis 2 is seen to share a similar etiological interest—but with a very different answer!Finally, etiology comes explicitly to the fore in the closing comment on the story, “Therefore a man leaves his father and his mother and cleaves to his wife, and they become one flesh. And the man and his wife were both naked, and were not ashamed” (Gen 2:24–25). The man and the woman are now man and wife. Marriage is thus God's plan for man and woman and is grounded in the primordial creation of man and of woman as his helper. The marriage relationship is taken to be the proper sphere for human sexual activity. This etiological note confirms that the author takes his story to be universal in scope, for marriage is not plausibly taken to be merely God's special provision for this specially created couple but his intention for all humanity.(3) Natural Phenomena. Etiological motifs concerning natural phenomena are also evident in Genesis 1-11. Such motifs are especially obvious in the account in Genesis 3 of the primordial couple's disobedience to God as a result of their seduction by the serpent. In the punishments pronounced by God on the serpent, the man, and the woman, etiological motifs abound. For example, the toil of farming is attributed to the fact that the land is cursed because of the man's disobedience. Thus, natural phenomena with which later Israelites would have been all too familiar are explained in terms of our primordial parents' fall into sin.Next week I want to explain these ideas further. I hope you give me the chance.

On this episode we interview… co-host Kevin King! What?!? Again with the bro talk? Apologies to everyone in our audience but look on the bright side, you can use this time again to catch up on old Webster episodes. If you do listen, we'll talk about the etiology of substance use and substance use disorders, examining training and education of research methods through an implementation science lens, and quiz Kevin on his knowledge of Star Wars. Dora, J., Piccirillo, M., Foster, K. T., Arbeau, K., Armeli, S., Auriacombe, M., ... & King, K. M. (2023). The daily association between affect and alcohol use: A meta-analysis of individual participant data. Psychological Bulletin, 149(1-2), 1. Dora, J., Schultz, M. E., Shoda, Y., Lee, C. M., & King, K. M. (2022). No evidence for trait-and state-level urgency moderating the daily association between negative affect and subsequent alcohol use in two college samples. Brain and Neuroscience Advances, 6, 23982128221079556. Feil, M., Halvorson, M., Lengua, L., & King, K. M. (2020). A state model of negative urgency: Do momentary reports of emotional impulsivity reflect global self-report?. Journal of Research in Personality, 86, 103942. Halvorson, M. A., Pedersen, S. L., Feil, M. C., Lengua, L. J., Molina, B. S., & King, K. M. (2021). Impulsive states and impulsive traits: A study of the multilevel structure and validity of a multifaceted measure of impulsive states. Assessment, 28(3), 796-812. King, K. M., Feil, M. C., Halvorson, M. A., Kosterman, R., Bailey, J. A., & Hawkins, J. D. (2020). A trait-like propensity to experience internalizing symptoms is associated with problem alcohol involvement across adulthood, but not adolescence. Psychology of Addictive Behaviors, 34(7), 756. King, K. M., Pullmann, M. D., Lyon, A. R., Dorsey, S., & Lewis, C. C. (2019). Using implementation science to close the gap between the optimal and typical practice of quantitative methods in clinical science. Journal of abnormal psychology, 128(6), 547–562. https://doi.org/10.1037/abn0000417 Kummerfeld, E., & Jones, G. L. (2023). One data set, many analysts: Implications for practicing scientists. Frontiers in psychology, 14, 1094150. https://doi.org/10.3389/fpsyg.2023.1094150

Have you ever had this overwhelming desire or strong urge to eat a particular food?   On today's episode we tackle the meaning or etiology of these cravings and urges that you may experience, and you may be surprised to find out they are caused by many factors such as:   Physiological  Psychological  Environmental  Evolutionary  Genetic  Oftentimes, what is causing your craving may be oversimplified, but it may be more complex in nature than you realize. When it comes to our health, everyone is different! What causes a symptom for you may not cause a symptom for someone else.   What is happening in your body and your health is individualized to you and only you. It's a discovery process that will bring you many clues unique to you. Once you can understand the etiology of why these cravings and urges are happening to you, then you can start looking for a solution if you feel like it is negatively impacting your life.  Grab your FREEBIE BELOW!  Five simple things you can do today to keep yourself healthy for tomorrow. As we age, our health and well-being become a bigger focus in our life. You may be worried that it's too late. But there is still hope!!! Discover the health changes you can make today to preserve your health for tomorrow.    https://upbeat-hustler-2294.ck.page/06d0e2ccf9    Where can you find us?      https://triciard.com/      https://www.instagram.com/wholehealthempower/      https://www.facebook.com/groups/wholehealthempower      Keywords:  motivate, self-care, tips, taking care of yourself    

Did you know that consuming ultra-processed foods harms both our physical and mental health? Join Food Sleuth Radio host and Registered Dietitian, Melinda Hemmelgarn, for her interview with Eric Hecht, MD, MPH, PhD, Founder and Executive Director of the Institute of Etiological Research, and author of the paper, “Cross-sectional examination of ultra-processed food consumption and adverse mental health symptoms,” published in the Journal of Public Health Nutrition. Hecht explains epidemiology, defines “ultra-processed foods,” and discusses the challenges of behavior change, as well as the multiple negative health effects of consuming ultra-processed foods.Related website:  Institute of Etiological Research: https://www.etioinstitute.org; NOVA Classification of Ultra-Processed Foods: https://www.cambridge.org/core/journals/public-health-nutrition/article/un-decade-of-nutrition-the-nova-food-classification-and-the-trouble-with-ultraprocessing/2A9776922A28F8F757BDA32C3266AC2A 

Words have meaning; sometimes we misuse them to our detriment (like trauma and acne) while sometimes we use them as tools to get what we want. Sometimes jargon is not a sign of intellect but a mask trying to hide something else...and maybe from yourself. Topics covered in today's episode: Why is trauma gaining popularity? I share a personal experience with someone with a deterministic view of stuff... On body positivity…is it actually positive? The red flag of too much jargon and regurgitation. Specialness as a tool to manipulate and control. Does the past determine the present? Book: The Courage To Be Disliked Buy on amazon.ca, amazon.com Book: The Courage To Be Happy How we experience the past, and what affects that experience. Etiology vs teleology. Vulnerability moments on The Bachelor and Bachelorette. The thing about love and acceptance. Trauma and acne comparison. Specialness without effort. About a “crystal child”. How can we have value? Avoid books from HayHouse. Seriously. Who do I create content for? Subscribe to this podcast on your favorite podcast platform so you don't miss an episode! If you enjoy listening, make sure to leave a nice review! Your words mean a lot to me! Say hello and don't miss the latest skin transformations on Instagram https://www.instagram.com/olenabeley/Sign up for 28 Days of Clear Skin here https://olenabeley.com/28 (free email series).For more information on how you can get clear skin visit my website olenabeley.com

Jody reviews hyperparathyroidism including the underlying pathophysiology, diagnosis, and treatment.Sources:Sternlicht H, Glezerman IG. Hypercalcemia of malignancy and new treatment options. Ther Clin Risk Manag. 2015 Dec 4;11:1779-88. doi: 10.2147/TCRM.S83681. PMID: 26675713; PMCID: PMC4675637Overbaugh, J.L.H.K.H.C. K. (2021). Lippincott CoursePoint Enhanced for Brunner & Suddarth's Textbook of Medical-Surgical Nursing (15th ed.). Wolters Kluwer Health. https://coursepoint.vitalsource.com/books/9781975186722Nussey S, Whitehead S. Endocrinology: An Integrated Approach. Oxford: BIOS Scientific Publishers; 2001. Chapter 5, The parathyroid glands and vitamin D. Available from: https://www.ncbi.nlm.nih.gov/books/NBK24/Lippincott Advisor for EducationUpToDate Articles (multiple authors):1) Etiology of Hypercalcemia2) Kidney Transplantation in Adults - Persistent Hyperparathyroidism After Kidney Transplantation3) Management of Secondary Hyperparathyroidism in Adult Dialysis Patients4) Management of Secondary Hyperparathyroidism in Adult Non-Dialysis Patients with CKD5) Overview of Chronic Kidney Disease - Mineral & Bone Disorder6) Preoperative Localization for Parathyroid Surgery in Patients with Hyperparathyroidism7) Primary Hyperparathyroidism - Diagnosis, Differential Diagnosis, & Evaluation8) Primary Hyperparathyroidism - Management9) Primary Hyperparathyroidism - Pathogenesis & Etiology10)  Primary Hyperparathyroidism - Clinical Manifestations11) Refractory Hyperparathyroidism and Indications for Parathyroidectomy in Adult Dialysis Patients Support the showWant to get in touch? Email any time at thekppod@gmail.com.

Joan Hunter - Miracles - Kenya - Procrastination on Steroids (Joan Hunter Ministries) Radio / The Etiology of Demons in People (OmegaManRadio with Shannon Davis 06/30/23) 2023/07/14 (Shortwave Air Date) World Ministries International Eagles Saving Nations Dr. Jonathan Hansen - Founder & President Rev. Adalia Hansen worldministries.org (360) 629-5248 WMI P.O. Box 277 Stanwood, WA 98292 warning@worldministries.org Visit our website http://www.worldministries.org/ and subscribe to Eagle Saving Nations https://www.worldministries.org/eagles-saving-nations-membership.aspx Sign up for Dr. Hansen's FREE newsletters http://www.worldministries.org/newsletter-signup.html Support Dr. Hansen through your financial gift https://www.worldministries.org/donate.aspx Order Dr. Hansen's book “The Science of Judgment” https://www.store-worldministries.org/the-science-of-judgment.html

Compression fractures are commonly associated with osteoporosis in older adults.  However, what happens when these fractures occur in young males? In this episode, Erica and Susan discuss a patient who sustained a T6 compression fracture.  It is intriguing to note that it is a young male in his 20's not an older woman in her 70s. Do they require different treatments? Detecting a compression fracture is not difficult thanks to musculoskeletal imaging. However, considering the radiological changes that occur at the vertebral level with compression fractures can sometimes make exercise progression difficult.  They discuss an initial treatment plan for him and what needs to happen to help him tolerate sustained sitting and standing.   A glance at this episode: [2:06] Introduction to patient & history  [4:09] Suffering a compression fracture  [7:19] Trunk rotation and alignment  [9:06] Foam roller exercises  [12:03] Thoracic posterior vs anterior translation  [13:58] How to get traction on a foam roller  [17:27] Etiology of compression fractures  [19:00] Sustained positioning and compression   Related links: Tough To Treat Website Erica's Course: Decoding the Complex Patient Susan's Pelvic Health Education Subscription Access the Transcript

Eugene Trufkin (@eugene_trufkin is returning guest and certified personal trainer, as well as the author of Laws of Aesthetics and the Anti-Factory Farm Shopping Guide. In the last episode we covered everything with grocery labels, myths and lies around that, and how to actually buy high quality food. Check that episode out if you missed it: https://www.scottmys.com/podcast/eugene.  Eugene is also the owner of Trufkin Athletics, a business dedicated to helping people interested in attaining six-pack abs, traveling, eating a well-balanced diet, and pursuing an anti-sedentary lifestyle. Finally, he has his own podcast - Eugene Trufkin Radio - which I was recently on and where we had a very interesting conversation so be sure to check that out. https://www.instagram.com/eugene_trufkin/ Eugene Trufkin Radio: https://www.youtube.com/channel/UC-ZS-3YJxVRCunXnsSLyqjQ Laws of Aesthetics: https://a.co/d/aMP1Q12 1https://www.amazon.com/Laws-Aesthetics-Definitive-Blueprint-Health-Centered-ebook/dp/   This episode is brought to you by Optimal Carnivore. Do you struggle to eat organ meat? Optimal Carnivore was created by Carnivores for Carnivores. They created a unique organ complex from grass-fed animals in New Zealand. It includes 9 different organs -  Liver, Brain, Heart, Thymus, Kidney, Spleen, Pancreas, Lung etc.  Taking 6 capsules is the same as eating an ounce of raw organ meat from the butcher. Get 10% off your order by going to https://optimalcarnivore.com/scott  (currently only shipping within the US)   LMNT is offering a free sample pack along with any regular purchase when you use my custom link drinklmnt.com/carnivorecast . The LMNT Sample Pack includes 1 packet of every flavor. This is the perfect offer for 1) anyone who is interested in trying all of our flavors or 2) wants to introduce a friend to LMNT. Go to drinklmnt.com/carnivorecast to claim this awesome deal!   What questions would you like answered or who would you like to hear from in the carnivore or research community?   Let me know on Twitter, Instagram, and Facebook.  

Back again to the podcast, but this time to talk about nerve injury etiology, diagnosis, treatment, and postoperative management, is Dr. David Salomon, an Oral and Maxillofacial Surgeon practicing in Connecticut. This is a topic that we are constantly dealing with and each time we dive into a discussion on it there is always something new that pops up. In this conversation, we tackle many different aspects surrounding surgery and nerve injuries, including the products and practices surgeons need to be cautious of that can lead to endodontic injuries and why it's essential to educate referrals on the possible causes of chemical injuries. He talks about different nuances of techniques that can lead to nerve injury and includes some tips regarding sectioning techniques. We touch on radiographic predictors of nerve injury, why it's vital to understand and master a full sensory examination, and the different components of treatment planning. If you want to hear more about what a nerve injury repair surgery looks like, tips on flap closures, other techniques, and more, then be sure to tune in and start listening now. Key Points From This Episode:Dr. Salomon introduces the topic of today's episode: nerve injuries.Basics of the etiology of nerve injuries.Products and practices surgeons need to be aware of that can cause chemical injuries. The importance of educating your referrals on possible causes of chemical injury. Dr. Salomon shares the nuances of techniques to avoid nerve injury. Theory of mind regarding unattached tissue and the possibility of the presence of a nerve.We provide some tips regarding sectioning techniques and the principle of surgery. Dr. Salomon stresses the point around the different complexities of taking out a third molar. We dive into the different components of nerve injury treatment planning.What defines a good nerve recovery. His thoughts, and further tips, on flap closures and other techniques.His post-op protocols and what he tells his patients to expect.Dr. Salomon talks about neuropathic pain best practices. More on the demographic of his surgical patients. The effects of dysaesthesia, anesthesia, and paraesthesia. The importance of thinking about the medical/legal ramifications relating to this topic. Rapid fire answers and enlightenments from Dr. Salomon. Links Mentioned in Today's Episode:Dr. David Salomon on LinkedIn — https://www.linkedin.com/in/david-salomon-b8ab1431/ Dr. David Salomon Email - DPSalomo@gmail.com35% off Instruments PROMO CODE — EOSSummer2023Severance — https://tv.apple.com/us/show/severance/umc.cmc.1srk2goyh2q2zdxcx605w8vtx Top Gun: Maverick — https://tv.apple.com/us/movie/top-gun-maverick/umc.cmc.670544bajp6s4pysx4rvctczz Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

We speak to Simblified fan (!) and microbiologist Avraneel Paul on a whole bunch of things related to what happens inside our body! Viruses and bacteria, how vaccines work, how those WBC badasses keep us safe, and so on. Along the way, we also speak about exciting advancements like CRISPR, and explore philosophical questions like whether Covid has changed the field... And what a day in the life of a scientist looks like. There's loads of trivia, loads of simblification and a few bad jokes as well in this two-part episode. We hope you like it and have renewed appreciation for scientists (and your body!) after it! Add one part news, one part bad jokes, one part Wikipedia research, one part cult references from spending too much time on the internet, one part Wodehouse quotes, and one part quality puns, and you get Simblified. A weekly podcast to help you appear smarter, to an audience that knows no less! Your four hosts - Chuck, Naren, Srikeit, and Tony attempt to deconstruct topics with humor (conditions apply). Fans of the show have described it as "fun conversations with relatable folks", "irreverent humor", "the funniest thing to come out of Malad West" and "if I give you a good review will you please let me go". Started in 2016 as a creative outlet, Simblified now has over 300 episodes, including some live ones, and some with guests who are much smarter than the hosts. Welcome to the world of Simblified! You can contact the hosts on: Chuck: http://twitter.com/chuck_gopal  / http://instagram.com/chuckofalltrades Naren: http://twitter.com/shenoyn  / http://instagram.com/shenoynv Tony: http://twitter.com/notytony  / http://instagram.com/notytony Srikeit: http://twitter.com/srikeit  / http://instagram.com/srikeitSee omnystudio.com/listener for privacy information.

The myth of Cygnus and Achilles is a story of war, violence, and revenge. It is also a story of love, loss, and redemption. The moral and ethical implications of the story are complex and can be interpreted in many ways. In the story, Cygnus is a Trojan prince who is invulnerable to harm. He is the son of Poseidon, the god of the sea. Achilles is a Greek warrior who is also invulnerable to harm. He is the son of Peleus, the king of the Myrmidons, and Thetis, a sea nymph. The two men meet in battle and fight to the death. Achilles is unable to kill Cygnus with his weapons, so he strangles him with his helmet strap. Poseidon, who is watching the battle, is furious. He transforms Cygnus into a swan and carries him away to the sea. The myth of Cygnus and Achilles can be interpreted in many ways. Some see it as a story of the futility of war. Others see it as a story of the power of love and the importance of forgiveness. Still others see it as a story about the dangers of revenge. The myth of Cygnus and Achilles can be applied to both classical antiquity and our modern world. In classical antiquity, the story was used to teach lessons about the dangers of war and the importance of forgiveness. In our modern world, the story can be used to teach lessons about the importance of peace and non-violence. The myth of Cygnus and Achilles is a powerful story that has been told and retold for centuries. It is a story that can teach us about the human condition and the importance of love, forgiveness, and peace. --- Support this podcast: https://podcasters.spotify.com/pod/show/liam-connerly/support

In this episode, Martin Krsak, MD, MSc, FASAM, provides background and context on skin and soft tissue infections. Listen as he gives perspectives on:Epidemiology and clinical outcomesEconomic impactBacterial etiologyImportance of appropriate antimicrobial prescribingClinical presentationSeverity classification and distinction between purulent and nonpurulent infectionsRole of incision and debridement vs antimicrobial managementComplications to be ruled out prior to treatmentFaculty:Martin Krsak, MD, MSc, FASAMAssociate Professor of MedicineDivision of Infectious Diseases University of Colorado School of MedicineDenver, ColoradoLink to full program: CCO: https://bit.ly/3J4mg8hProCE: https://bit.ly/3P0vB4E

Most epidemiological studies of heart failure have been conducted in high-income countries. JAMA Senior Editor Kristin L. Walter, MD, MS, interviews Philip George Joseph, MD, from the Population Health Research Institute, Ontario, Canada, about a study of more than 23 000 patients with heart failure in 40 countries. Related Content: Global Variations in Heart Failure Etiology, Management, and Outcomes

Editor's Summary by Kristin Walter, MD, MS, Senior Editor of JAMA, the Journal of the American Medical Association, for the May 16, 2023, issue.

Commentary by Dr. Valentin Fuster

Reporting on potential fraud in medicine, AF, stroke, a possible new cholesterol-lowering drug, and the tone of debate in medical science are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Potential Fraud in Medicine Inside the Big Business of Clogged Arteries https://www.medscape.com/viewarticle/988448 II. AF Screening and Stroke STROKE AF at 3 Years: High AF Rate After Atherosclerotic Stroke https://www.medscape.com/viewarticle/988076 Severity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke https://jamanetwork.com/journals/jamaneurology/fullarticle/2795865 III. Bempedoic Acid New Studies Give Bempedoic Acid a Bump as Lipid-Lowering Agent https://www.medscape.com/viewarticle/911100 - Rationale and design of the CLEAR-outcomes trial: Evaluating the effect of bempedoic acid on cardiovascular events in patients with statin intolerance https://doi.org/10.1016/j.ahj.2020.10.060 - Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol https://www.nejm.org/doi/full/10.1056/NEJMoa1803917 - Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease https://jamanetwork.com/journals/jama/fullarticle/2754792 - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 - Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022 IV. The Technique of Critical Appraisal Why Evidence-Based Medicine Enthusiasts Could Use a Lesson in Persuasion https://www.medscape.com/viewarticle/988227 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Scarlet fever is treatable with antibiotics, but in the middle of the 19th century, it was the leading cause of death in children in some parts of the world. Today, there are several ongoing mysteries about the disease. Research: Branswell, Helen. “Scarlet fever, a disease of yore, is making a comeback in parts of the world.” 11/27/2017. https://www.statnews.com/2017/11/27/scarlet-fever-cases/ Lamagni, Theresa et al. “Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study.” The Lancet Infectious Diseases. Vol. 18, Issue 2. February 2018. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30693-X/fulltext?elsca1=tlpr Ferretti, Joseph and Werner Köhler. “History of Streptococcal Research.” From “Streptococcus pyogenes : Basic Biology to Clinical Manifestations.” Ferretti JJ, Stevens DL, Fischetti VA, editors. Oklahoma City (OK): University of Oklahoma Health Sciences Center; 2016. https://www.ncbi.nlm.nih.gov/books/NBK333430/ Doherty Institute. “Scarlet fever is on the rise, after being almost eradicated by the 1940s.” 10/6/2020. https://www.doherty.edu.au/news-events/news/scarlet-fever-is-on-the-rise-after-being-almost-eradicated-by-the-1940s Potter, Christina. “Scarlet Fever Makes a Comeback.” Outbreak Observatory. Johns Hopkins. 12/12/2019. https://www.outbreakobservatory.org/outbreakthursday-1/12/12/2019/scarlet-fever-makes-a-comeback Lynskey, Nicola N. et al. “Emergence of dominant toxigenic M1T1 Streptococcus pyogenes clone during increased scarlet fever activity in England: a population-based molecular epidemiological study.” The Lancet Infectious Diseases. Vol. 19, Issue 11. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30446-3/fulltext Tatiana Ninkov and Mike Cadogan, "Second disease," In: LITFL - Life in the FastLane, Accessed on January 25, 2023, https://litfl.com/second-disease/. Bright, Richard. "Dr. Bright on Renal Disease.” From Guy's Hospital reports. ser.1 v.1 1836. https://babel.hathitrust.org/cgi/pt?id=iau.31858046169490&view=1up&seq=392&skin=2021 Ledford, Heidi. “Why is strep A surging — and how worried are scientists?” 12/9/2022. https://www.nature.com/articles/d41586-022-04403-y Thomas Sydenham, ""On Scarlet Fever" [Excerpt]," in Children and Youth in History, Item #156, https://cyh.rrchnm.org/items/show/156 (accessed August 10, 2021). Annotated by Lynda Payne Klein, E. “The Etiology of Scarlet Fever.” Proceedings of the Royal Society of LondonVolume 42, Issue 251-257. https://royalsocietypublishing.org/doi/epdf/10.1098/rspl.1887.0030 Duncan CJ, Duncan SR, Scott S. The dynamics of scarlet fever epidemics in England and Wales in the 19th century. Epidemiol Infect. 1996 Dec;117(3):493-9. doi: 10.1017/s0950268800059161. PMID: 8972674; PMCID: PMC2271647. Klass, Perri. “Fever Dreams.” Harvard Medicine. Autumn 2022. https://hms.harvard.edu/magazine/handed-down/fever-dreams Davenport, Romola J. “Urbanization and mortality in Britain, c. 1800–50.” Economic History Review. 2/21/2020. https://onlinelibrary.wiley.com/doi/10.1111/ehr.12964 Thomson, Arthur S. et al. “History of the First Epidemic of Scarlet Fever which Prevailed in Auckland, New Zealand, During the Year 1848.” The Lancet. Vol. 55, Issue 1376. January 12, 1850. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)88319-2/fulltext Kaiser, Albert D. “Scarlet Fever.” The American Journal of Nursing , Jun., 1915, Vol. 15, No. 9 (Jun., 1915). Via JSTOR. https://www.jstor.org/stable/3404148 Eyler, John M. “The Epidemiology of Milk-borne Scarlet Fever: The Case of Edwardian Brighton.” American Journal of Public Health. May 1986, Vol. 76, No. 5. Wilson, Leonard G. “The Historical Riddle of Milk-borne Scarlet Fever.” Bulletin of the History of Medicine. Fall 1986. Vol. 60, No. 3. Via JSTOR. https://www.jstor.org/stable/44442285 Scamman, Clarence L. “Milk-Borne Septic Sore Throat and Scarlet Fever.” American Journal of Public Health. December 1929. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1581415/ Lee, Charles A. “Notes on the History and Pathology of Scarlatina.” Boston Medical Journal. 7/22/1835. Dick, George F. and Gladys R. Dick. “Immune Reactions in Scarlet Fever.” The Journal of Infectious Diseases, Vol. 19, No. 2 (Aug., 1916).” Via JSTOR. https://www.jstor.org/stable/30080317 Radikas, Regina and Cindy Connolly. “Young Patients in a Young Nation; Scarlet Fever in Early Nineteenth Century Rural New England.” Pediatric Nursing. January-February 2007. Rolleston, J.D. “The History of Scarlet Fever.” The British Medical Journal. 11/24/1928. See omnystudio.com/listener for privacy information.

In 1753 a Scottish doctor named James Lind published Treatise of the Scurvy where he named oranges and lemons as cures for the disease. However, it wasn't until 1912 when researcher Casimir Funk published The Etiology of Deficiency Diseases, introducing the concept of illness as a result of something lacking in the body, a concept unknown during Lind's initial study of scurvy.  Since then, major vitamins and their health effects were discovered and recommendations for vitamin intake were made. But as we learn more about how certain foods and nutrients interact with the body and even with the specific bacteria in our gut, we gain a greater understanding of nutrition and what it takes to be well. Gain insight into what's on your plate and in your body on this episode of Trailblazers.  Featuring Dariush Mozaffarian, Marion Nestle, T. Colin Campbell, Lee Chae and Tim Spector. For more on the podcast go to delltechnologies.com/trailblazers