POPULARITY
12 episodes with Etoh
4 episodes with Etoh
2 episodes with Etoh
2 episodes with Etoh
2 episodes with Etoh
2 episodes with Etoh
2 episodes with Etoh
2 episodes with Etoh
2 episodes with Etoh
Join us on our latest episode where we talk about beavers and whiskey, and even better...a whiskey made from a beaver?Featured spirit: Eau de Musc from Tamworth Distilling. Description per their website: Eau de Musc proudly features an old-world flavoring technique that uses the oil extract from the castor gland of the North American beaver, which exudes a leathery, raspberry taste, and acts to fortify the whiskey flavors. The full-bodied, two-year aged bourbon whiskey has a bolstered mouthfeel with a vanillin nose and notes of spice. The addition of birch oil, raspberry and Canadian snakeroot, a woody spice akin to ginger, comingle with the natural fruitiness of the castorerum, making the finish warm, crisp, and incredibly palatable. New Hampshire life is ruled by the wilderness, and beavers are widely prevalent, extremely territorial, and prone to overpopulation. Therefore, rural communities like Tamworth work with licensed and responsible trappers to manage the population in order to sustain the local ecosystem. To source the castoreum for the limited-edition release, the Tamworth Distilling team works with Anton Kaska, a professional trapper and outdoor skill instructor who is known for his commitment to sustainable practices. Anton provides the distillery with the castoreum sacs, which would otherwise be discarded, to produce the infused bourbon whiskey.Why in the world would anyone use beaver castor glands to make a beverage? What other items is this used for? Does the whiskey taste like beaver? Only one way to find out...Special guest on this episode, our good friend Drew. https://www.delawareonline.com/story/news/2018/06/16/beaver-butt-whiskey-review-eau-de-musc/707831002/https://shop.tamworthdistilling.com/product/eau-de-musc-200ml/210#newrelease #tamworth #distillery #beaver #whiskey #brandmysticism #drinkreview #podcast #isitworthit #arsenicculture This Whiskey Is Made With Beaver Musk-E105https://www.youtube.com/@arsenicculturehttps://instagram.com/arsenicculturehttps://tiktok.com/@arsenicculturehttps://www.facebook.com/arsenicculture/https://x.com/arsenicculture
Join us on our latest episode where we try Japanese Whiskey created in America? Thanks to the patented Takamine Process, which uses Japanese Koji mold to help ferment the barley, this 8-year whiskey "perfectly blends rich umami character with an underlying sweetness" per their website. What do medical adrenaline, cherry blossom trees in Washington, D.C. and Koji Whiskey have in common? Is Koji Whiskey any good? Is it worth it? Only one way to find out...Special guests on this episode are our friends Brandon and Justin from Ethereal Brewing and The Void Sake Company in Lexington, KY.https://takaminewhiskey.com/?srsltid=AfmBOooQIxy_xT_ZqsGoiiB9z7CGq0lJWe5k-CM6XgnVBpGfZ0nLKQvChttps://www.winebow.com/knowledge/takamine-whiskey-story#whiskey #koji #japanese #koji #spiritreviews #drinkreview #podcast #isitworthit #arsenicculture The Harrowing Escape Of Takamine And His Coveted Koji Whiskey-E99https://www.youtube.com/@arsenicculturehttps://instagram.com/arsenicculturehttps://tiktok.com/@arsenicculturehttps://www.facebook.com/arsenicculture/https://x.com/arsenicculture
Join us on our latest episode where we try the most consumed spirit in Japan, Shochu. This Japanese distilled beverage is typically distilled from rice, barley, sweet potatoes, buckwheat, or brown sugar, though it is sometimes produced from other ingredients such as chestnut, sesame seeds, potatoes, or even carrots. The main crucial ingredient in shochu is Koji and is a cooked grain (rice, soybeans or barley, etc) that has been inoculated with a fermentation culture called Aspergillus oryzae, koji mold. Koji is prepared by adding koji mold to steamed grains, then carefully kept in warm, humid conditions that promote growth. Rice is the most frequently used grain for making koji.Is Shochu good? Does it really deserve to be the most consumed spirit in Japan? Is it worth it? Only one way to find out...Special guest on this episode is our friend Brandon from Ethereal Brewing and The Void Sake Company in Lexington, KY.https://www.satsuma.co.jp/english/con-shiru-shochu.htmlhttps://honkakushochu-awamori.jp/english/professional/shochu-production-method/koji/#newrelease #shochu #koji #spiritreviews #drinkreview #podcast #isitworthit #arsenicculture https://www.youtube.com/@arsenicculturehttps://instagram.com/arsenicculturehttps://tiktok.com/@arsenicculturehttps://www.facebook.com/arsenicculture/https://x.com/arseniccultureShochu And The Mold That Makes IT Great-E98https://www.youtube.com/@arsenicculturehttps://instagram.com/arsenicculturehttps://tiktok.com/@arsenicculturehttps://www.facebook.com/arsenicculture/https://x.com/arsenicculture
References Guerra, Daniel J. 2024 Biochemistry lecture archives Cells.2019 Nov 12;8(11):1424 Front Cell Neurosci 2017 Feb1;11:14. Neuropharmacology 2014.79, April : 1-9 Front Mol Neurosci. 2024 May 22;17:1389100. Byrds. 1971. Byrdmaniax lp https://youtu.be/SEBecV36esY?si=wtSnoWe-fAHZzbNv Porter and Fletcher.1934 "Don't Fence Me In" Bing Crosby and Andrew Sisters (1945) https://youtu.be/ILyuEtGrMwI?si=WpBi9KG9m7dzufW4 --- Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
References Neuropharmacology. 2014. 79, April : 1-9 Alcoholism: Clinical and Experimental Research 2007. 31.12. Cancer Epidemiol Biomarkers Prev. 2014 Oct 3;23(12):2943–2953. Alcohol Research. Current Reviews. 2017.38.2: 55-76. Alcohol Clin Exp Res. 2011 Feb;35(2):235-9. Neuropsychopharmacol Rep. 2021 Sep;41(3):352-361. Bracken, J. 1972. "Steppin Out". Live Cream Vol II. https://youtu.be/XAB6K-5XWU4?si=wURdUuCQpssf8tUA Betts, D. 1972 "Blue Sky" Allman Brothers on Eat a Peach lp. https://youtu.be/JSMubgZoL58?si=QGYWPPywXkV8Qk0D Tchaikovsky,P.I. 1878. Violin Concerto D. Major. Op. 35 https://youtu.be/2Q_DzWUvcL8?si=iSqyBV2Fpy2BWOfW Beethoven. LV. 1824.Ninth Symphony. D Minor Op. 125. Chicago Philharmonic .Muti. https://youtu.be/rOjHhS5MtvA?si=r-zvj5jYQ6uQVLs5 --- Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
References Guerra, DJ.2024. Biochemistry Lectures. Cell Metab. 2019 Apr 2;29(4):856-870. Alcohol, 2017-12-01, Volume 65:51-62 Hunter-Garcia 1970. "Ripple" https://youtu.be/xofhZx9eWUQ?si=TvFBFagovrpvKdGj Lennon-McCartney. 1966. "For No One" https://youtu.be/sep5E3ssXLQ?si=ANvuJgO2wmg2IXFt Kantner/Slick/Crosby 1970. "A Child is Coming" https://youtu.be/1D0Qr7VxaMs?si=XPNnjdqN7O7Scm0j Croce, J.1973. "It Doesn't Have to Be That Way" https://youtu.be/Sxvd8NEd_C8?si=RtZ80hQvVPynfzhZ Lamb, R. 1969. "Beginnings" CTA. https://youtu.be/lI-BMDnti4c?si=tO4b_-xsksk8pM67 Chopin, F. 1844.Nocturne in F Minor, Op 55, No 1. https://youtu.be/E3qHO9aOQYM?si=RZzRaZxvLGS73Zzy --- Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
References Toxics.2024 Feb 29;12(3):190 Int J Environ Res Public Health. 2010 Apr 4;7(4):1540–1557. Davies, R.1971. "Alcohol" . Kinks. Muswell Hillbillies lp. https://youtu.be/LJ4KMBA_ewU?si=ySyDMVtGvMsHB63B Tchaikovsky, P.I. 1893. "Pathetique" Symphony 6. in B Minor. Opus 74. https://youtu.be/qVA1ieo9Js4?si=-SvYucqWMDVCpFk2 --- Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
Join us on this episode where we try Korea's most iconic spirit, and one of the most popular types of booze in the world, Soju. This national spirit of South Korea is known for being affordable and approachable with a full flavor profile. If this drink is so readily available, how have we never tried it? Watch (or listen) and find out all the details for yourself.Special guest on this episode, our friend Brandon from Ethereal Brewing and The Void Sake Company in Lexington, KY.https://www.bonappetit.com/story/what-is-soju?srsltid=AfmBOopJq-qIf2wTSGdyWhXjETcbtZ5C_ehA39Ahw-VBZM0nyNyh-uzq#soju #bestbooze #soju #podcast #drinkreview #newrelease #arsenicculture The Best Booze You've Never Had-E92https://www.youtube.com/@arsenicculturehttps://instagram.com/arsenicculturehttps://tiktok.com/@arsenicculturehttps://www.facebook.com/arsenicculture/https://x.com/arsenicculture
Caring for patients withdrawing from alcohol can be challenging to say the least. In this episode, host Sarah Lorenzini shares a case of a patient recovering from emergency surgery, and highlights the subtle but critical signs of alcohol withdrawal—like anxiety, tremors, confusion, tachycardia, and hypertension—that often go unrecognized until symptoms escalate.Key topics covered in this episode include:The pathophysiology of alcohol withdrawal, focusing on how chronic alcohol use disrupts the balance between the brain's inhibitory GABA and excitatory glutamate neurotransmitter systems.A detailed timeline of alcohol withdrawal symptoms, from early signs (6-12 hours) to severe complications like delirium tremens (48-72 hours).The importance of compassionate, non-judgmental care for patients with alcohol use disorder (AUD) during withdrawal, and why judgment rarely leads to positive change.The role of CIWA-Ar scoring to assess withdrawal severity and guide treatment, including common medications like benzodiazepines and the emerging use of phenobarbital for symptom management.Critical reminders to carefully evaluate all symptoms and avoid misattributing every instance of confusion or agitation to alcohol withdrawal, ensuring comprehensive care.Tune in to learn how to recognize and manage alcohol withdrawal, keep patients safe, and provide the compassionate care they need during this vulnerable time.Mentioned in this episode:Rapid Response Academy LinkWanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/communityRapid Response and Rescue Intro CourseCONNECT
Join us as we track down and try the national spirit of Columbia, Aguardiente. The beverage (also knows as guaro) is a clear, anise-flavored liquor made from distilled sugar cane. Is it worth it? Does it taste like fire water? Only one way to find out...New episode. New name and logo. Same awesome (debatable) co-hosts Matt and Jason!https://en.wikipedia.org/wiki/Aguardientehttps://www.theunconventionalroute.com/colombian-aguardiente-facts/#newrelease #aguardiente #guaro #columbia #drinkreview #podcast #isitworthit #arsenicculture The Fire Water of Columbia-E73https://www.youtube.com/@arsenicculturehttps://instagram.com/arsenicculturehttps://tiktok.com/@arsenicculturehttps://www.facebook.com/arsenicculture/https://x.com/arsenicculture
Sobriety in general is a topic rarely discussed in general, let alone in the aesthetic space. In this episode, we are joined by Brandon Mullen (@the_aestheticconsultant) and Shelbi Sloan FNP-C (@shelbi.sloan), injector and founder of @SnatchedbySloan, as they share their experience with sobriety, what life was like without it, and how they navigate life ETOH-free :-). Need more podcasts? Tune into Shelbi's super fun @getsnatchedpod Find us: Apple
On this hilarious episode of As the Rotor Turns hosts Carlos and Trish welcome back Los' brother from another mother, Josh Granada and they don't waste a second kick'n off the episode with which actor would play them in a movie and then remanence on The Rescue Company1's rookie years, lot lizards, gas station cheese steaks, Shamon's, Josh meeting Hilary Clinton, their up coming presidential election prediction, Love is Blind, and why Chuey got the taste slapped out of his mouth. Get ready to literally LOL again! AsTheRotorTurns.comThe opinions and views shared here on As The Rotor Turns are strictly those of the hosts and do not reflect the professional capabilities of The Rescue Company 1 or the amazing Dr. Benjamin Abo. Any medical information shared is not instruction and should not be used in place of your local protocols. ALWAYS FOLLOW YOUR PROTOCOLS AND POLICIES!#ceu #ceus #criticalcare #Firefighter #paramedic #fpc #ccpc #trc1 #thatothersmaylive #ctrn #cfrn #rn #cen #tncc #flightnurse #flightmedic #hems #swet #huet #aha #ETOH #wildernesssurvival #podcast #watersurvival #tpc #airmedicine #emt #emtp #sar #florida #martincounty #CarlosTavarez #JoshuaGranada #AllAccess #PabstBlueRibbon #EMSPodcast #comedypodcast #DisasterTriage #Nursing #EmergencyNursing #FirstResponders #PulseNightClub #MattDamon #JaredLeto #MovieReviews #LoveIsBlind #HilaryClinton #DonaldTrump #JoeBiden #VivekRamaswamy #BraxtonCollege #Joshua
Hosts' Carlos and Trish are back for an ALL NEW As the Rotor Turns with special guests Ben, Cory, and Amy who review a variety of EMS history and T.V. shows like Emergency 51!, then dabble in some vodka and PBR induced movie reviews of The Italian Job starring Mark Wahlberg, the new Netflix series Griselda starring Sophia Vergara, and Road House starring Jake Gyllenhaal. Then wrap up with some life lessons in kindness which were also likely induced by the vodka and PBR. Insert innocent shrug here. The opinions and views shared here on As The Rotor Turns are strictly those of the hosts and do not reflect the professional capabilities of The Rescue Company 1 or the amazing Dr. Benjamin Abo. Any medical information shared is not instruction and should not be used in place of your local protocols. ALWAYS FOLLOW YOUR PROTOCOLS AND POLICIES!#ceu #ceus #criticalcare #Firefighter #paramedic #fpc #ccpc #trc1 #thatothersmaylive #ctrn #cfrn #rn #cen #tncc #flightnurse #flightmedic #hems #swet #huet #aha #ETOH #wildernesssurvival #podcast #watersurvival #tpc #airmedicine #emt #emtp #sar #florida #martincounty #Carlos Tavarez #AllAccess #PabstBlueRibbon #DisasterTriage #Nursing #EmergencyNursing #FirstResponders #ConorMcGregor #RoadHouse #JakeGyllenhaal #MovieReviews
We are back, today we are chatting with Tobias with etOH spirits. This is some cool stuff, we are talking reactor whiskey. You can find them here. etoh.dk badmotivatorbarrels.com/shop/?aff=3 whiskeyshamanpodcast@gmail.com
Vincent travels to McGill University in Montreal, Canada to join Angela for a discussion of the careers and the research of two faculty members, Corinne Maurice and Jesse Shapiro, and their PhD trainees Anshul Sinha and Sana Naderi. Hosts: Vincent Racaniello and Angela Mingarelli Guests: Corinne Maurice, Jesse Shapiro, Anshul Sinha and Sana Naderi Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server MicrobeTV store at Cafepress Become a member of ASV (asv.org) Research assistant position in Rosenfeld Lab CBER/FDA (pdf) The New City by Dickson Despommier Phage and colitis (Microbiome) Origins and evolution of Lassa virus (Cell) Phage replication in human gut microbiota (iScience) Phages in infant gut (ISME J) Early SARS-CoV-2 transmissions in Quebec (Genome Med) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv
References Brain Imaging Behav. 2011 Sep; 5(3): 189–202 PLoS One. 2019; 14(1): e0210888. Alcohol, 2017-12-01, Volume 65, Pages 51-62 Clapton, E. and Martin Sharp .1967 "Tales of Brave Ulysses" https://youtu.be/I32Wwfv8v1U?si=TfUX6Xldenp_f5M5 --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
References PLoS One. 2019; 14(1): e0210888 Trends Neurosci. 2015 Jun; 38(6): 364–374 Addict Biol. 2006 Sep; 11(3-4): 339–355 Sci Rep. 2022; 12: 19463. Beethoven, L. 1809. Piano Concerto #5 in E-flat major, Op. 73, "Emperor Concerto " https://youtu.be/kiW-QnQzN9Y?si=qT6PgbhB9L5jpzcZ --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
References Sci Adv. 2020 Jun; 6(26): eaba0154 Brahms , J. 1869 Schicksalslied ∙ hr-Sinfonieorchester. https://youtu.be/yC8CNpFu_7Q?si=ZqE0nuvXjaRJVcMh --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support
Show notes available at podcast.RnRRounds.ca Produced by Heather Lean ACP, BSc
It's time for a double episode. Max talk's to Tobias and Aleksander from EtOH spirits. Tobias and Aleksander age their spirits different than you might expect. Let's dive in the science of aging spirits and how to do it in 12 days... https://etoh.dk/whisky-compounds-of-interest/ OUR AD BARREL-TEA Meer info over het Podcast Abbonement! Volg Max op Instagram Volg Lucia op Instagram Volg ons op Facebook
Can you believe that in 1977, the public health guidelines issued by the National Institutes of Health suggested a two-drink-per-day limit for pregnant women? It's TRUE. Ethanol had even been investigated, and promoted, and an "effective tocolytic agent". We now, of course, understand that there is no safe amount of ethanol use during pregnancy. Our understanding of FASD has evolved over the years, so much so that we now understand that FASD is possible by PATERNAL use of alcohol in the prericonception period. This is due to epigenetic changes in the sperm. In this episode we will review some historical facts regarding the use of alcohol in pregnancy and summarize new data demonstrating the MALE partner's contribution to FASD.
Alcohol withdrawal can send our patients into a spiral of delirium and downstream complications in the ICU. What are the risks of benzodiazepines for our patients even during alcohol withdrawal? How can we give our patients the best chance to walk away from ETOH withdrawal and critical illness? Dr. Obiajulu Anozie, MD joins us in this episode to explore the benefits of phenobarbital for alcohol withdrawal. www.daytonicuconsulting.com --- Support this podcast: https://podcasters.spotify.com/pod/show/restoringlife/support
The JournalFeed podcast for the week of Jan 30 – Feb 3, 2023.These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.WEST Aorta Guidelines Spoon FeedThe Western Trauma Association Algorithms Committee has released new evaluation and management guidelines and a step-by-step algorithm (see below) surrounding blunt thoracic aortic injury.Guess The EtOH Spoon FeedED clinicians are often inaccurate in their estimations of patients' blood alcohol content (BAC). Overestimation is common, especially in patients arriving by ambulance compared to walk-ins.
References Neural Plasticity. 2019; 2019: 1648736. Molecular Pharmacology May 2017, 91 (5) 451-463. --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References PLoS One. 2011;6(5):e17711 J Neuroinflammation. 2020; 17: 207 Front Neurosci. 2019 Nov 26;13:1280 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References Dr Guerra EtOH lectures Dr Guerra Reward Pathway lectures Biol Psychiatry. 2020 Jan 1; 87(1): 64–73 Biochemistry and Cell Biology. 2019. Volume 97, Number 4.August. --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References Dr Guerra EtOH lectures Physiol Rev 2016. 96: 1261–1296. Clinical and Molecular Teratology. 2016. Volume 106, Issue 9 Pages 749–760 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References Dr Guerra's EtOH lectures Cells. 2020 Sep; 9(9): 2125. --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References Dr. Guerra's EtOH lectures Clinical and Molecular Teratology 2016. Volume 106:749–760 Stat Pearls. Embryology and Gastrulation. NIH 2022. https://www.ncbi.nlm.nih.gov/books/NBK554394/ --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References Clinical and Molecular Teratology Volume 106, Issue 9 September 2016 Pages 749–760 Alcohol, 2017-12-01, Volume 65, Pages 51-62 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
References Dr Guerra EtOH lectures PNAS November 5, 2013 vol. 110 no. 45 Alcohol, 2017-12-01, Volume 65, Pages 51-62 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
Go to Kumba and raise funds for the Health Centre. Send your money.
Reference Alcohol Clin Exp Res. 2011 Aug; 35(8): 1435–1444 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.14.516444v1?rss=1 Authors: Quadir, S. G., Arleth, G. M., Cone, M. G., High, M. W., Ramage, M. C., Effinger, D. P., Echeveste Sanchez, M., Herman, M. A. Abstract: Alcohol use disorders are complex conditions characterized in part by excessive ethanol (EtOH) drinking and withdrawal-induced malaise. The corticotropin releasing factor-1 receptor (CRF1) has been implicated in EtOH drinking, affective states, and pain sensitivity; often in a sex-dependent manner. The studies presented here investigate the associations between baseline behavior, chronic intermittent EtOH intake, and withdrawal-induced affective behavior in male and female CRF1:cre: tdTomato rats. There were no sex differences in basal affective state or thermal sensitivity, as measured by the splash test, novelty suppressed feeding test, and Hargreaves, respectively. However, female rats displayed increased mechanical sensitivity, measured by the Von Frey test. Following baseline testing, rats underwent voluntary EtOH or water drinking under intermittent access conditions. Female rats consumed significantly more EtOH, but only during the first week. There were no group effects of EtOH on behavioral tests, but all of the rats demonstrated increased malaise upon repeated testing. There were significant individual differences where affective behavior positively correlated with negative affect in both sexes. There were also significant correlations between EtOH intake and CRF1-cFos co-expression in the infralimbic cortex and basolateral amygdala. EtOH decreased CRF1+ expression in the lateral amygdala, but there were no significant group effects of EtOH on cFos or CRF1-cFos co-expression in the medial prefrontal cortex or amygdala. Together, these results illustrate the complex interplay between affect, pain sensitivity, EtOH drinking, and the role of CRF1 containing neurons in mediating these behaviors. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.06.511140v1?rss=1 Authors: Mukherjee, A., Paladino, M. S., McSain, S. L., Gilles-Thomas, E. A., Lichte, D. D., Camadine, R. D., Willock, S., Sontate, K., Honeycutt, S. C., Loney, G. C. Abstract: Background: Intermittent access to ethanol (EtOH) drives persistent escalation of intake and rapid transition from moderate to compulsive-like drinking. Intermittent EtOH drinking may facilitate escalation in part by altering aversion-sensitive neural substrates, such as the insular cortex (IC), thus driving greater approach toward stimuli previously treated as aversive. Methods: We conducted a series of experiments in rats to examine behavioral and neural responses associated with escalation of EtOH intake. First, taste reactivity analyses quantified the degree that intermittent brief-access ethanol exposure (BAEE) alters sensitivity to the aversive properties of EtOH. Next, we determined whether pharmacological IC inhibition facilitated EtOH escalation. Finally, given that IC is primary gustatory cortex, we employed psychophysical paradigms to assess whether escalation of EtOH intake induced changes in EtOH taste. These paradigms measured changes in sensitivity to the intensity of EtOH taste and whether escalation shifts the salient taste quality of EtOH by measuring the degree that the taste of EtOH generalized to a sucrose-like (sweet) or quinine-like (bitter) percept. Results: We found a near complete loss of aversive oromotor responses in EtOH-exposed relative to -naive rats. Additionally, we observed significantly reduced expression of EtOH-induced c-Fos expression in the posterior IC in exposed rats relative to naive rats. Inhibition of the IC resulted in a modest, but statistically reliable increase in acceptance of higher EtOH concentrations in naive rats. Finally, we found no evidence of changes in the psychophysical assessment of the taste of EtOH in exposed, relative to naive, rats. Conclusions: Our results demonstrate that neural activity within the IC adapts following escalation of EtOH intake in a manner that correlates with reduced sensitivity to the aversive hedonic properties of EtOH. These data further establish that IC may be driving exposure-induced escalations in EtOH intake and directly contributing to development of compulsive-like EtOH drinking. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer
EN ÅSNERYGGSBÅGE ATT LITA PÅ. Mathias har varit i Danmark och bär i triumf med sig 12 dagar gammal whiskydryck. Svensk whisky för Ukraina – en given beställning på ett snyggt samarbete. Men etiketten … Självklart pratar vi Åsneryggsbåge eller Ogee i veckans ord, för att runda av med en rykande färsk flukt på Mossburn distillers nya bygge Reivers. Och vem är åsnan nu? Vad var det i glaset? Mathias smuttade tolvdagarssprit med namnet Livet från de här nissarna, EtOH: https://etoh.dk/ Och dansk whisky från Ærø: https://aeroewhisky.com/ Mer exakt pimplade han deras Standard Issue: https://www.whiskybase.com/whiskies/whisky/133528/r-whisky-standard-issue David fortsätter gilla Hvenus från Spirit of Hven som i detta nu faktiskt inte finns på Systembolaget, what the hey? Jeroen körde Särimner från Bergslagens destilleri (lagret från Gryhyttan) som han gillade massor: https://www.systembolaget.se/produkt/sprit/sarimner-3728102/ Davids smaknoter här: https://tjederswhisky.se/sarimner-fran-bergslagens-grythyttan/ Svensk whisky för Ukraina! Här är den (var den?) på Systemet: https://www.systembolaget.se/produkt/sprit/svensk-whisky-for-ukraina-5752101/ Här pressreleasen: https://www.hven.com/spirits/blended/svensk-whisky-for-ukraina/ Facebookgruppen Svenska whiskydestillerier: https://www.facebook.com/groups/2332967570128273 Blended malten Bländande (Spirit of Hven och Smögen): https://www.systembolaget.se/produkt/sprit/blandande-svensk-blended-malt-whisky-4086002/ https://tjederswhisky.se/blandande-blended-malt/ Veckans ord: ogee Forsyths om former av pannor: https://forsyths.com/distillation/pot-stills/ Själva formen som alltså tydligen heter kölbåge eller åsneryggsbåge på svenska: https://en.wikipedia.org/wiki/Ogee Dr. Dres The Chronic: https://en.wikipedia.org/wiki/TheChronic Anfang: https://sv.wikipedia.org/wiki/Anfang(typografi) Veckans destilleri: Reivers Hemsidan har knappt något innehåll alls än: https://reiverspirit.com/ Mossburn Distillers: https://mossburndistillers.com/ Torabhaig: https://www.torabhaig.com/ Svensken bakom Mossburn Distillers vars namn David inte kom på heter förresten Frederik Paulsen. Han hade 2021 en personlig förmögenhet på runt 70 miljarder minsann. En låååång bokrecension av Ian Buxtons bok Whiskies galore: https://tjederswhisky.se/bokrecension-ian-buxton-whiskies-galore/ Här når du oss: En trea whisky på Facebook (https://www.facebook.com/entreawhisky) Maila till oss på hej@entreawhisky.se Davids blogg tjederswhisky.se (https://www.tjederswhisky.se) Följ oss på Instagram: https://www.instagram.com/entreawhisky Bli medlem! https://entreawhisky.memberful.com/checkout?plan=74960
Take Home Message Do not ignore abnormal vital signs – they can be the harbinger of badness Watch out for developing withdrawal, treat early and aggressively These patients are a major fall risk – keep rails up, place on safety observation Obtain a CT Head for anyone with external signs of trauma EtOH level not ... Read more The post REBEL Core Cast – Basics of EM – Intoxication appeared first on REBEL EM - Emergency Medicine Blog.
Alcohol Withdrawal, Part 2SummaryDrinking alcohol (specifically ethanol) on a regular basis leads to alcohol dependence. When alcohol dependent persons stop drinking, they experience withdrawal. Withdrawal from alcohol is very dangerous and should be managed aggressively in order to prevent long term complications and death. This podcast will teach you the ins and outs of recognizing and managing alcohol withdrawal both in the inpatient and outpatient setting.Morbidity and MortalityAlmost 100,000 people die every year from ETOH abuse in the United States alone. It is not known how many people die a year from alcohol withdrawal. If delirium tremons develops, it is estimated that about 25% of people will die without treatment.StoryEver drink too much at night and then wake up suddenly at 5am feeling wide awake? Ever feel inner tension, agitation, or heart palpitations after a long party weekend with friends? If so, you have experienced symptoms of alcohol withdrawal.Key Points1. Tachycardia, tachypnea, hypertension, hyperthermia, tremors, anxiety, and GI upset are the hallmarks of alcohol withdrawal.2. Severe symptoms may include hallucinations, delirium, seizures, and death3. Vitamin and electrolyte repletion are critical for sick alcohol dependent patients.4. Aggressively treating withdrawal by slowly coming off alcohol or using medications like barbiturates, benzodiazepines, and other CNS depressants can be lifesaving. Use medication liberally in this setting!References-Saitz M, Mayo-Smith MF, Redmond HA, Bernard DR, Calkins DR. Individualized treatment for alcohol withdrawal. A randomized double-blind controlled trial. JAMA 1994- Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015- https://www.who.int/news-room/fact-sheets/detail/alcohol- Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. - In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/- Nisavic M, Nejad SH, Isenberg BM, Bajwa EK, Currier P, Wallace PM, Velmahos G, Wilens T. Use of Phenobarbital in Alcohol Withdrawal Management - A Retrospective Comparison Study of Phenobarbital and Benzodiazepines for Acute Alcohol Withdrawal Management in General Medical Patients. Psychosomatics. 2019 - Wikipedia, alcohol withdrawal syndrome- Personal experience treating ETOH withdrawal in the inpatient and outpatient setting
SummaryDrinking alcohol (specifically ethanol) on a regular basis leads to alcohol dependence. When alcohol dependent persons stop drinking, they experience withdrawal. Withdrawal from alcohol is very dangerous and should be managed aggressively in order to prevent long term complications and death. This podcast will teach you the ins and outs of recognizing and managing alcohol withdrawal both in the inpatient and outpatient setting. Morbidity and MortalityAlmost 100,000 people die every year from ETOH abuse in the United States alone. It is not known how many people die a year from alcohol withdrawal. If delirium tremons develops, it is estimated that about 25% of people will die without treatment. StoryEver drink too much at night and then wake up suddenly at 5am feeling wide awake? Ever feel inner tension, agitation, or heart palpitations after a long party weekend with friends? If so, you have experienced symptoms of alcohol withdrawal. Key Points1. Tachycardia, tachypnea, hypertension, hyperthermia, tremors, anxiety, and GI upset are the hallmarks of alcohol withdrawal.2. Severe symptoms may include hallucinations, delirium, seizures, and death3. Vitamin and electrolyte repletion are critical for sick alcohol dependent patients.4. Aggressively treating withdrawal by slowly coming off alcohol or using medications like barbiturates, benzodiazepines, and other CNS depressants can be lifesaving. Use medication liberally in this setting! References-Saitz M, Mayo-Smith MF, Redmond HA, Bernard DR, Calkins DR. Individualized treatment for alcohol withdrawal. A randomized double-blind controlled trial. JAMA 1994- Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015- https://www.who.int/news-room/fact-sheets/detail/alcohol- Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. - In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/- Nisavic M, Nejad SH, Isenberg BM, Bajwa EK, Currier P, Wallace PM, Velmahos G, Wilens T. Use of Phenobarbital in Alcohol Withdrawal Management - A Retrospective Comparison Study of Phenobarbital and Benzodiazepines for Acute Alcohol Withdrawal Management in General Medical Patients. Psychosomatics. 2019 - Wikipedia, alcohol withdrawal syndrome- Personal experience treating ETOH withdrawal in the inpatient and outpatient setting
Serving great beers and food to the neighborhood/village of Villeray in Montreal since 2013, EtOH Brasserie might not be as well-known to people living outside of the island. The ABI crew definitely wanted to shine a spotlight on Mireille and her crew for the amazing work they've been doing for the craft beer scene and their local community for almost 10 years now. All Beer Inside is a podcast by and for craft beer lovers. We travel near and far to sample the best brews and meet fellow aficionados. Drink craft, not crap! Please like, share, comment, subscribe and hit that notification bell! Beers tasted:- Pilsner- NEIPA- Double Blanche du Brochet- Best Bitter EtOH Brasserie8100 Rue Saint-Denis, Montreal, QuebecWebsite, Instagram, Facebook, Twitter All Beer Inside:Website, Instagram, Twitter, Facebook, Untappd: @allbeerinside The video portion of this interview can be found here Search for All Beer inside in all your favorite apps. #CraftBeer #DrinkCraftNotCrap #EtOHBrasserie
Serving great beers and food to the neighborhood/village of Villeray in Montreal since 2013, EtOH Brasserie might not be as well-known to people living outside of the island. The ABI crew definitely wanted to shine a spotlight on Mireille and her crew for the amazing work they've been doing for the craft beer scene and their local community for almost 10 years now. All Beer Inside is a podcast by and for craft beer lovers. We travel near and far to sample the best brews and meet fellow aficionados. Drink craft, not crap! Please like, share, comment, subscribe and hit that notification bell! Beers tasted: - Pilsner - NEIPA - Double Blanche du Brochet - Best Bitter EtOH Brasserie 8100 Rue Saint-Denis, Montreal, Quebec Website, Instagram, Facebook, Twitter All Beer Inside: Website, Instagram, Twitter, Facebook, Untappd: @allbeerinside The video portion of this interview can be found here Search for All Beer inside in all your favorite apps. #CraftBeer #DrinkCraftNotCrap #EtOHBrasserie
Initial Assessment: Obtain Vitals and blood glucose level Time of onset (important for tPA/TNK vs thrombectomy) Neurologic and Cardiac Examination / NIHSS do not delay head CT to complete NIHSS, can always finish after CT Assess contraindications for tPA Workup: Labs: CBC, CMP, Troponin, Coags, EtOH, bedside accucheck CXR and UA (infections can cause recrudescence […]
Trying to keep up with the medical literature but...You've just watched Squid Games, you're feeling a bit stressed, and you thought some light-hearted medical education was just the ticket?Your ears are in the right place.Tonight your ears are joined by Barney, Cami and Alvin as we wade through an amazing collection of medical literature to bring you the best, most interesting and practice-changing information out there...In order:Respiratory RS - what O2 to use in COVID?AF - to screen or not?Metabolism over life - is this why we get fat later in life?Statins in elderly - to stop or not?Exercise in polluted areas - do the risks outweigh benefits?Cycling for diabetes - GET ON YOUR BIKES!Alcohol preventing diabetes - no, really?Sleep duration and delirium riskCan watching TV cause DVTs?Physician attire - what not to wearENJOY. And if you do enjoy, why not rate us on apple? And follow us on Twitter (please). And send wedding congratulations to Jon and Katia. I think that's it.
Can low temperature-aged garlic enhance exercise performance? Korea Univesity & National Institute of Agricultural Sciences (South Korea), October 8, 2021 Scientists from South Korea's National Institute of Agricultural Sciences and Korea University looked at aged garlic to see whether it could help reduce fatigue. To do this, they conducted a study on mice fed with a special low-temperature-aged garlic (LTAG). Their findings were published in the Journal of Medicinal Food. Testing the fatigue-fighting effects of low temperature-aged garlic The researchers chose to use LTAG because it lacked the pungent odor and spicy flavor of regular garlic, making it easier to use for animal testing. To create the LTAG, the researchers stored garlic in a sealed container, aging at 60 C for 60 days. The resulting LTAG was then peeled and pulverized, before being added to 200 milliliters of 70 percent ethanol (EtOH), which was then subjected to ultrasonic extraction three times. This 70 percent EtOH and LTAG extract was then concentrated under a vacuum at 45 C and then lyophilized to create a dry LTAG residue. After the creation of the LTAG, the researchers then separated mice into six groups. The first group was given a low dose of LTAG extract; the second was fed a high dose of LTAG extract; the third was given a low dose of garlic extract; and the fourth was given a high dose of garlic extract. The fifth and sixth groups consisted of normal mice that were given phosphate-buffered saline (PBS) instead of garlic. One of these control groups was made to exercise while the other group was not. The mice in the five groups were forced to run on a treadmill for four weeks. With each passing week, the amount of exercise the mice would have to do on the treadmills would increase. This was done by increasing both the speed that the mice had to run, and the amount of time they had to spend running. (Related: How to alleviate fatigue with herbal medicine.) After 28 days of treatment, five mice from each group were subjected to a final, exhaustive treadmill test. This test increased the treadmill speed from 15 meters per minute (m/min) to 40 m/min every 3 minutes. During this test, the running time was monitored until each mouse failed to follow the increase in speed on three consecutive occasions and lag occurred. At this point, the mouse's total running time was recorded. The effect of the LTAG on the levels of glucose, lactate dehydrogenase (LDH), free fatty acid (FFA) and lactate in the mice's blood. Following the final exercise, the mice were killed and blood samples were collected from them. In addition, the mice's gastrocnemius muscles were also isolated and frozen in liquid nitrogen for testing. LTAG treated mice demonstrated less fatigue Following the exhaustive running tests, the researchers found that the mice treated with LTAG extract were able to run for much longer than the control mice. Meanwhile, looking at the blood tests, they noted that the mice treated with LTAG extract exhibited lower levels of glucose, LDH, FFA and lactate. More importantly, the LTAG treated mice had increased amounts of glycogen and creatine kinase (CK) in their muscles. Glycogen storage is an important source of energy during exercise. It serves a central role in maintaining the body's glucose homeostasis by supplementing blood glucose. Because of this, glycogen is seen as an accurate marker for fatigue, with increased glycogel levels closely associated with improved endurance and anti-fatigue effects. CK, on the other hand, is known to be an accurate indicator of muscle damage. During muscle degeneration, muscle cells are dissolved and their contents enter the bloodstream. As a result, when muscle damage occurs, muscle CK comes out into the blood. As such, fatigue tends to lead to lower muscle CK levels and higher blood CK levels. Higher levels of glycogen and muscle CK in the LTAG treated mice indicated that they experienced less fatigue than the other groups. Based on these findings, the researchers believe that LTAG has potential for use as an anti-fatigue agent. Mindfulness meditation helps preterm-born adolescents University of Geneva (Switzerland), October 7, 2021 Adolescents born prematurely present a high risk of developing executive, behavioral and socio-emotional difficulties. Now, researchers from Geneva University Hospitals (HUG) and the University of Geneva (UNIGE) have revealed that practicing mindfulness may help improve these various skills. The study, published in the journal Scientific Reports, suggests using mindfulness as a means of clinical intervention with adolescents, whether prematurely born or not. Several studies have already shown that very preterm (VPT) children and adolescents are at higher risk of exhibiting cognitive and socio-emotional problems that may persist into adulthood. To help them overcome the difficulties they face, researchers from the HUG and UNIGE have set up an intervention based on mindfulness, a technique known to have beneficial effects in these areas. Mindfulness consists in training the mind to focus on the present moment, concentrating on physical sensations, on breathing, on the weight of one's body, and even on one's feelings and thoughts, completely judgment-free. The mindfulness-based interventions generally take place in a group with an instructor along with invitations to practice individually at home. To accurately assess the effects of mindfulness, a randomized controlled trial was performed with young adolescents aged 10 to 14, born before 32 weeks gestational weeks. Scientists quickly found that mindfulness improves the regulation of cognitive, social and emotional functions, in other worlds, our brain's ability to interact with our environment. Indeed, it increases the ability to focus on the present—on thoughts, emotions and physical sensations, with curiosity and non-judgment. Thanks to this practice, adolescents improve their executive functions, i.e. the mental processes that enable us to control our behavior to successfully achieve a goal. As a result, young people find it easier to focus, manage and regulate their behavior and emotions in everyday life. For eight weeks, the young teens spent an hour and a half each week with two mindfulness instructors. They were further encouraged to practice mindfulness daily at home. Parents were also involved in this study. They were asked to observe their child's executive functions, for example the ability to regulate their emotions and attentional control, their relationships with others and their behavior. The adolescents also underwent a series of computerized tasks to assess their reactions to events. A comparison of their test results with a control group that did not practice mindfulness shows a positive impact of the intervention on the adolescents' everyday life and on their ability to react to new events. "Each teenager is unique, with their own strenghts and difficulties. Through their involvement in this study, our volunteers have contributed to show that mindfulness can help many young people to feel better, to refocus and to face the world, whether they were born preterm born or not," agree Dr. Russia Hà-Vinh Leuchter, a consultant in the Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics at Geneva University Hospitals, and Dr. Vanessa Siffredi, a researcher at the Child Development Laboratory at the Department of Paediatrics, Gynaecology and Obstetrics at the UNIGE Faculty of Medicine, two of the authors of this work. "However, while the practice of meditation can be a useful resource, it is important to be accompanied by well-trained instructors", they specify. The adolescents who took part in the program are now between 14 and 18 years. Scientists are currently evaluating the long-term effects of mindfulness-based intervention on their daily attention and stress. Furthermore, to validate their clinical data with neurobiological measurements, researchers are currently studying the effects of mindfulness on the brain using magnetic resonance imaging (MRI). Iron deficiency in middle age is linked with higher risk of developing heart disease University Heart and Vasculature Centre Hamburg (Germany) 6 October 2021 Approximately 10% of new coronary heart disease cases occurring within a decade of middle age could be avoided by preventing iron deficiency, suggests a study published today in ESC Heart Failure, a journal of the European Society of Cardiology (ESC).1 “This was an observational study and we cannot conclude that iron deficiency causes heart disease,” said study author Dr. Benedikt Schrage of the University Heart and Vasculature Centre Hamburg, Germany. “However, evidence is growing that there is a link and these findings provide the basis for further research to confirm the results.” Previous studies have shown that in patients with cardiovascular diseases such as heart failure, iron deficiency was linked to worse outcomes including hospitalisations and death. Treatment with intravenous iron improved symptoms, functional capacity, and quality of life in patients with heart failure and iron deficiency enrolled in the FAIR-HF trial.2 Based on these results, the FAIR-HF 2 trial is investigating the impact of intravenous iron supplementation on the risk of death in patients with heart failure. The current study aimed to examine whether the association between iron deficiency and outcomes was also observed in the general population. The study included 12,164 individuals from three European population-based cohorts. The median age was 59 years and 55% were women. During the baseline study visit, cardiovascular risk factors and comorbidities such as smoking, obesity, diabetes and cholesterol were assessed via a thorough clinical assessment including blood samples. Participants were classified as iron deficient or not according to two definitions: 1) absolute iron deficiency, which only includes stored iron (ferritin); and 2) functional iron deficiency, which includes iron in storage (ferritin) and iron in circulation for use by the body (transferrin). Dr. Schrage explained: “Absolute iron deficiency is the traditional way of assessing iron status but it misses circulating iron. The functional definition is more accurate as it includes both measures and picks up those with sufficient stores but not enough in circulation for the body to work properly.” Participants were followed up for incident coronary heart disease and stroke, death due to cardiovascular disease, and all-cause death. The researchers analysed the association between iron deficiency and incident coronary heart disease, stroke, cardiovascular mortality, and all-cause mortality after adjustments for age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation. Participants with a history of coronary heart disease or stroke at baseline were excluded from the incident disease analyses. At baseline, 60% of participants had absolute iron deficiency and 64% had functional iron deficiency. During a median follow-up of 13.3 years there were 2,212 (18.2%) deaths. Of these, a total of 573 individuals (4.7%) died from a cardiovascular cause. Incidence coronary heart disease and stroke were diagnosed in 1,033 (8.5%) and 766 (6.3%) participants, respectively. Functional iron deficiency was associated with a 24% higher risk of coronary heart disease, 26% raised risk of cardiovascular mortality, and 12% increased risk of all-cause mortality compared with no functional iron deficiency. Absolute iron deficiency was associated with a 20% raised risk of coronary heart disease compared with no absolute iron deficiency, but was not linked with mortality. There were no associations between iron status and incident stroke. The researchers calculated the population attributable fraction, which estimates the proportion of events in 10 years that would have been avoided if all individuals had the risk of those without iron deficiency at baseline. The models were adjusted for age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation. Within a 10-year period, 5.4% of all deaths, 11.7% of cardiovascular deaths, and 10.7% of new coronary heart disease diagnoses were attributable to functional iron deficiency. “This analysis suggests that if iron deficiency had been absent at baseline, about 5% of deaths, 12% of cardiovascular deaths, and 11% of new coronary heart disease diagnoses would not have occurred in the following decade,” said Dr. Schrage. “The study showed that iron deficiency was highly prevalent in this middle-aged population, with nearly two-thirds having functional iron deficiency,” said Dr. Schrage. “These individuals were more likely to develop heart disease and were also more likely to die during the next 13 years.” Dr. Schrage noted that future studies should examine these associations in younger and non-European cohorts. He said: “If the relationships are confirmed, the next step would be a randomised trial investigating the effect of treating iron deficiency in the general population.” Consumption of a bioactive compound from Neem plant could significantly suppress development of prostate cancer National University of Singapore, September 29, 2021 Oral administration of nimbolide, over 12 weeks shows reduction of prostate tumor size by up to 70 per cent and decrease in tumor metastasis by up to 50 per cent A team of international researchers led by Associate Professor Gautam Sethi from the Department of Pharmacology at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that nimbolide, a bioactive terpenoid compound derived from Azadirachta indica or more commonly known as the neem plant, could reduce the size of prostate tumor by up to 70 per cent and suppress its spread or metastasis by half. Prostate cancer is one of the most commonly diagnosed cancers worldwide. However, currently available therapies for metastatic prostate cancer are only marginally effective. Hence, there is a need for more novel treatment alternatives and options. "Although the diverse anti-cancer effects of nimbolide have been reported in different cancer types, its potential effects on prostate cancer initiation and progression have not been demonstrated in scientific studies. In this research, we have demonstrated that nimbolide can inhibit tumor cell viability -- a cellular process that directly affects the ability of a cell to proliferate, grow, divide, or repair damaged cell components -- and induce programmed cell death in prostate cancer cells," said Assoc Prof Sethi. Nimbolide: promising effects on prostate cancer Cell invasion and migration are key steps during tumor metastasis. The NUS-led study revealed that nimbolide can significantly suppress cell invasion and migration of prostate cancer cells, suggesting its ability to reduce tumor metastasis. The researchers observed that upon the 12 weeks of administering nimbolide, the size of prostate cancer tumor was reduced by as much as 70 per cent and its metastasis decreased by about 50 per cent, without exhibiting any significant adverse effects. "This is possible because a direct target of nimbolide in prostate cancer is glutathione reductase, an enzyme which is responsible for maintaining the antioxidant system that regulates the STAT3 gene in the body. The activation of the STAT3 gene has been reported to contribute to prostate tumor growth and metastasis," explained Assoc Prof Sethi. "We have found that nimbolide can substantially inhibit STAT3 activation and thereby abrogating the growth and metastasis of prostate tumor," he added. The findings of the study were published in the April 2016 issue of the scientific journal Antioxidants & Redox Signaling. This work was carried out in collaboration with Professor Goh Boon Cher of Cancer Science Institute of Singapore at NUS, Professor Hui Kam Man of National Cancer Centre Singapore and Professor Ahn Kwang Seok of Kyung Hee University. The neem plant belongs to the mahogany tree family that is originally native to India and the Indian sub-continent. It has been part of traditional Asian medicine for centuries and is typically used in Indian Ayurvedic medicine. Today, neem leaves and bark have been incorporated into many personal care products such as soaps, toothpaste, skincare and even dietary supplements. Review looks at the efficacy of acupuncture in treating insulin resistance Guangzhou University of Chinese Medicine (China), October 8, 2021 In their report, researcherss from Guangzhou University of Chinese Medicine in China explored the role of acupuncture in treating insulin resistance. The study was published in the journal Complementary Therapies in Clinical Practice. Earlier studies have reported the effectiveness of acupuncture in treating insulin resistance and related conditions. The review looked at acupuncture and its effects on clinical outcomes. The researchers searched the following databases for randomized controlled trials involving insulin resistance patients treated with acupuncture: Cochrane Central Register of Controlled Trials Embase Medline (via OVID) China National Knowledge Infrastructure (CNKI) Wan Fang and China Science and Technology Journal Database (VIP) The studies show that homeostasis model assessment of insulin resistance significantly decreased with acupuncture treatment. Other significant decreases include fasting blood glucose, postprandial blood glucose and fasting insulin. Acupuncture increased insulin sensitivity with very few adverse effects. In sum, acupuncture is a safe and effective alternative treatment for insulin resistance. Blueberries may improve attention in children following double-blind trial University of Reading (UK), October 10, 2021 Primary school children could show better attention by consuming flavonoid-rich blueberries, following a study conducted by the University of Reading. In a paper published in Food & Function, a group of 7-10 year olds who consumed a drink containing wild blueberries or a matched placebo and were tested on their speed and accuracy in completing an executive task function on a computer. The double blind trial found that the children who consumed the flavonoid-rich blueberry drink had 9% quicker reaction times on the test without any sacrifice of accuracy. In particular, the effect was more noticeable as the tests got harder. Professor Claire Williams, a neuroscience professor at the University of Reading said: "This is the first time that we have seen the positive impact that flavonoids can have on the executive function of children. We designed this double blind trial especially to test how flavonoids would impact on attention in young people as it's an area of cognitive performance that hasn't been measured before. "We used wild blueberries as they are rich in flavonoids, which are compounds found naturally in foods such as fruits and their juices, vegetables and tea. They have been associated with a range of health benefits including antioxidant and anti-inflammatory effects, and our latest findings continue to show that there is a beneficial cognitive effect of consuming fruit and vegetables, tea, coffee and even dark chocolate which all contain flavonoids." The children were then asked to pay attention to an array of arrows shown on a PC screen and press a key corresponding to the direction that the central arrow was facing. The task was repeated over a number of trials, where cognitive demand was manipulated by varying how quickly the arrows appeared, whether there were additional arrows appearing either side of the central arrow, and whether the flanking arrows were pointing in the same/different direction as the central arrow. Previous Reading research has shown that consuming wild blueberries can improve mood in children and young people, simple memory recall in primary school children, and that other flavonoid rich drinks such as orange juice, can also improve memory and concentration. The Wild Blueberry Association of North America provided a freeze-dried powder made from wild blueberries which was used in the study but did not provide any additional financial support and did not play a role in the design of the study. Wild blueberries are grown and harvested in North America, and are smaller than regular blueberries, and are higher in flavonoids compared to regular varieties. The double-blind trial used a flavonoid-rich wild blueberry drink, with a matched placebo contained 8.9g of fructose, 7.99g of glucose and 4 mg of vitamin C matching the levels of nutrients found in the blueberry drink. The amount of fructose is akin to levels found in a standard pear. This was an executive function task- requiring participants to pay attention to stimuli appearing on screen and responding correctly. The task was a simple one- responding to the direction of an arrow in the middle of a screen (by pressing left/right arrow key) but we then varied how quickly the stimuli appeared, whether there was additional arrows appearing either side of the stimuli and whether those flanking arrows were pointing in the same/different direction as they direction you had to respond. There are 6 main classes of flavonoids: Anthocyanins – found in berry fruits such as the blueberries used in this study and also in red wine. Flavonols - found in onions, leeks, and broccoli Flavones - found in parsley and celery, Isoflavones - found in soy and soy products, Flavanones - found in citrus fruit and tomatoes Flavanols—found in green tea, red wine, and chocolate Nocebo effect: Does a drug's high price tag cause its own side effects? University Medical Center Hamburg (Germany), October 5, 2021 Pricey drugs may make people more vulnerable to perceiving side effects, a new study suggests—and the phenomenon is not just "in their heads." The study delved into the so-called "nocebo effect." It's the negative version of the well-known placebo effect, where people feel better after receiving a therapy because they expected good things. With the nocebo effect, patients' worries over treatment side effects make them feel sick. In this study, researchers found that people were more likely to report painful side effects from a fake drug when told it was expensive. But it wasn't just something people were "making up." Using brain imaging, the researchers traced the phenomenon to specific activity patterns in the brain and spine. "These findings are a strong argument against the perception of placebo and nocebo effects as being only 'fake' effects—created purely by imagination or delusions of the patient," said lead researcher Alexandra Tinnermann. She is with the University Medical Center Hamburg-Eppendorf, in Germany. Dr. Luana Colloca, a researcher at the University of Maryland in Baltimore, agreed. "This is not merely a reflection of people's biases," said Colloca, who wrote an editorial published with the study. "Expectations do modulate symptoms and patients' responses to treatment," she said. For the study, Tinnermann's team recruited 49 healthy volunteers and randomly assigned them to test one of two itch-relieving "medical creams." In reality, both creams were identical and contained no active ingredients. However, people in both groups were told that the products could have the side effect of making the skin more sensitive to pain. There was only one apparent difference between the two phony creams: One came in fancy packing with a high price tag; the other was cheap. After participants applied the creams to their forearms, the researchers had them undergo a standard test that measured their tolerance for heat-induced pain. It turned out that people who'd used the expensive cream were more sensitive to pain during the tests. On average, their pain rating hovered around a 15—within the "mild" pain range—whereas people using the cheap cream barely registered any discomfort. It's likely, Tinnermann said, that people expect a pricey medication to be potent—which could also make them expect more side effects. Colloca agreed. We are all "vulnerable" to such outside influences, she said, be it a drug's price or how it's given (by IV versus mouth, for instance). However, we are not just imagining those placebo or nocebo effects, both researchers noted. Using functional MRI brain scans, Tinnermann's team found specific patterns of nervous system activity in people who had a nocebo response to the pricey cream. That included a change in "communication" between certain brain structures and the spinal cord, Tinnermann said. According to Colloca, research like this can have practical uses. Doctors could, for instance, inform patients that drug prices or other factors can sway their expectations about a treatment's benefits and risks—and that, in turn, can influence whether they feel better or develop side effects. There is, however, no research into whether that kind of knowledge helps prevent patients from the nocebo effect, Tinnermann said. But, she added, health professionals can be aware that patients' expectations "play a huge role in medicine"—and be mindful of how they talk about a medication and its possible side effects. It's an important matter, Colloca said, because the nocebo effect can cause people to stop taking needed medications. Colloca pointed to the example of cholesterol-lowering statins. The potential for those medications to cause muscle pain has been widely reported. And one recent study found evidence that this knowledge can make statin users more likely to report muscle pain side effects. Other research, Colloca said, has shown that when people stop taking their statins, their risk of heart attack and stroke rises.
Tobias and Johan from ETOH in Denmark explain the technical process of using their Whiskey Reactor to accelerate the ageing process of whisky and rum. They also share the ehtos, convictions and creative flair behind the technique. Find ETOH here: https://etoh.dk Get your own kick ass shirt from into the am: https://www.intotheam.com/chase
Writer and mental health advocate, Olachi Tiffany Etoh, shares her experience living with bipolar and how an episode of psychosis landed her in jail. She talks about archaic mental health laws and her struggle with release from a state institution. More About Olachi Website: olachitiffany.com Twitter: @OlachiTiffany You can also find more resources at your local NAMI chapter. But Olachi is most affiliated with NAMIChicago, a wonderful organization creating real change. Support Our Sponsors! This episode is sponsored by BetterHelp online counseling. To get 10% off your first month go to www.BetterHelp.com/mental Must be 18. For those under 18 you will be redirected to or can go directly to TeenCounseling at www.teencounseling.com WAYS TO HELP THE PODCAST ______________________ Subscribe via iTunes and leave a review. It costs nothing. https://itunes.apple.com/us/podcast/mental-illness-happy-hour/id427377900?mt=2 ————————————————————————— Spread the word via social media. It costs nothing. Our website is www.mentalpod.com our FB is www.Facebook.com/mentalpod and our Twitter and Instagram are both @Mentalpod -------------------------------------------------------- Become a much-needed Patreon monthly-donor (with occasional rewards) for as little as $1/month at www.Patreon.com/mentalpod Become a one-time or monthly donor via Paypal or Zelle (make payment to mentalpod@gmail.com) ------------------------------------------------------------------------------ Try Our Sponsor's Products/Services --------------------------------------------------- See omnystudio.com/listener for privacy information.
Hold on tightly, this one might make your butt hole pucker ladies and gents! This week we travel down a rabbit hole of two very hard-to-kill men! ETOH levels higher than a freshman frat boy at his first tailgate! And the world's first miniature rocket, launching itself through someone's noggin! Have your cocktails ready, and your kids asleep!
IL ROTI is Minnesota as a Gnostic witch; the land. Of course Lutheran synod trannies cannot be on the witch since they are working for the season of the witch (episcopal work of sacrificing their lives for the Goddess who carries God in teste. I suppose you know I support retardation of nature just not prohibition of hezbullha or ETOH aka EBOM aka RIKA, you are on KGB. You are KMS KLM icarus the aborted from hiv. Fun Vatican women are (fe) male penis carrying mammals the four legged kind in bipedal robes aka Narnians HTTPS NIN.
In this episode we discuss acute alcohol intoxication and withdrawal. We go into the pathophysiology of EtOH intoxication, a common approach to patients with intoxication and withdrawal, and an approach to management plans. Finally, we finish off by discussing the JAMA rational clinical exam article "Will this Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?”. Written by Dr. Nikita-Kiran Singh (internal medicine resident) and edited by Dr. Peter Wu, Internal Medicine and Clinical Pharmacology/Toxicology specialist, and Dr. Gillian Spiegle, General Internal Medicine specialist. Infographic by Dr. Caitlyn Vlasschaert.
Do you hear that coming? It's the unmistakable sounds of The Avalanches. A single Avalanches song may include 10 different samples across 4 different genres across 3 different continents. Their projects are at once nonsensical and thematic. For their upcoming 3rd album, "We Will Always Love You", The Avalanches are going from thematic to cinematic. To understand The Avalanches and their unique sound, Dan calls on his friend Oliver the indie music oracle to help paint a picture of one of music's most unique modern acts. The 3rd Avalanches LP will be reviewed on Audioface #169.Check out Oliver's band "Sun Bear Hum"! Subscribe to Audioface wherever you're listening so you always get new episodes. For politics, Subscribe to Power Report if you haven't already. Send us music recommendations @audiofacepod on Twitter, Instagram, or YouTube. We appreciate it, and you!
Ataxia, GI bleeds, ascites, jaundice... patient's with long term, heavy alcohol consumption can have head-to-toe problems. Dr. Natalie Htet, emergency physician and intensivist, and I go over the expected assessment findings of the ETOH patient, what to look out for, and long-term management of alcoholic cirrhosis.
In this episode Robin Stebbins interviews Mike Shaldone, owner of Phoenix Wellness. Mike has over 5,000 hours in addiction counseling and is a Certified AOD counselor. Using mindfulness, nature, nutrition, yoga and cognitive behavioral therapy as healing modalities, he teaches these in recovery from personal experience: “We can all be addicted in some way to something. Perhaps it’s chemicals. Perhaps it’s behaviors. Perhaps it’s judgements, resentments and lack of tolerance. Diving deep into self-love and acceptance provides freedom from this bondage. In the past, I considered myself a victim, which denied me the ability to see the blessings of my circumstances. Fully surrendering, healing myself through these modalities and ascending into new understanding has allowed me to pursue my purpose, my dharma.” In this episode we discuss alcohol and wellness. If you believe yourself to be an awakened spiritual being this is a conversation around the vibrational energy of alcohol and the spirit. To find Mike: https://www.phoenixwellnesssacramento.com/about-us https://www.facebook.com/PHOENIXWELLNESSSACRAMENTO/ https://www.instagram.com/phoenixwellnesssacramento/ To find Robin: https://www.robinstebbins.com/
My Take is this if we want to see change and instead of using the People of America as a leverage tool with money and AGENDAS Bipartisan, Ware is Republarats or Demacans. What seems to me to be going on is Laws are made but our own Government is choosing to break those very laws. I am for most laws but without integrity they mean nothing. I am for Legal Immigration but if you are for Whatever, and say yes on Sanctuary and mean truly mean it, then I'm for you as well with one thing in mind, You will open your house up for me and anyone who should want to stop by, Let me utilize your house and all that is there, to include your car, food, and gas all while you pay for it. This is just a few, I view myself as pretty open-minded but Practical as well. Nobody wants gun laws but Background checks are good and only apply to reasonable Law Abiding citizens. Ware guns are illegal crime with guns are at there highest.I want to give my take on the Impeachment of Press Trump, If I saw direct definitive proof of wrongdoing or directly indication Solely benefits his 2020 Campaign than I could say Impeach, However I look at it like Wow The Bidens had this going on. Sounds like Money Laundering. Did Biden have the power to say I will have America Make a deal but in return, My Son sits a table drawing $50,000 a month? I don't have all the answers but a sweet deal like that should require some investigation Politically we can not ask. On a Job Interview, there are rules and a script is fallowed. but in the end, they ask is there anything else you might what us to know about you...... Do you ever disclose the bad stuff..... it is there but hidden. As long as it doesn't affect the Job all is good, PTSD, ETOH, Drugs, Problems, I won't always ask what's wrong but I will ask what you are doing about it. General T.S. Jones Outdoor Odyssey For Wounded Warrior Bn West (Job Interview training) good stuff... Ootdoorodyssey.orgCombat Vet VisionWeb – https://sitchradio.com/our-shows/combat-vet-vision/Facebook – https://www.facebook.com/CombatVetVision/If you have a question or comment, please leave me a message.Aaron Seibert at Sitch Radio (714) 643-2500 x 425
Story 1: China suspends its plans to implement a 10% EtOH blend in Gasoline. Story 2: Impossible Foods no longer trying to partner with McDonald's. Story 3: New Holland to partner with the National Hemp Association.
In this second part of the Abnormal Liver Function Test podcast series, Dr. Tara McMichael continues her discussion and case presentation around abnormal liver function tests. Enjoy the second part of the "Abnormal Liver Function Test" podcast! Objectives: Upon completion of this podcast, participants should be able to: Identify the appropriate next steps when discovering abnormal liver function tests. Identify how to diagnose cirrhosis, autoimmune hepatitis, and cholecystitis. Address appropriate 2nd and 3rd line testing for abnormal LFTs. CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within 2 weeks. You may contact the accredited provider with questions regarding this program at rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit: CME Evaluation: "Abnormal Liver Function Tests (LFTs) - Part 2" (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.” FACULTY DISCLOSURE ANNOUNCEMENT It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. SHOW NOTES: PART-2: CASE 2: 69 yo female with 2 days of low back pain. Also some dark urine for about a week. She has some fatigue as well. No jaundice or bowel changes. She's not much of a drinker, minimal wine. PMH incudes obesity, hyperlipidemia and a prediabetic state. She take vitamins, calcium and glucosamine. No drugs and no significant family history. She's had about a 10 lb unintential weight loss. Also some early satiety. Her BMI is 32, but otherwise her VS and entire exam is normal. Additionally, she's been taking aspirin for her back pain. Laboratory eval reveals AST of 767, ALT 818, and ALP 173. These are all modestly to significantly elevated. The AST and ALT are over 4 times upper limit of normal. Basically she's not really ill appearing at this point. Differential diagnosis at this point includes acute viral hepatitis. We must consider testing for A, B, C as well as EBV and CMV. These are IgM and IgG studies typically. Billiary obstruction and cirrhosis seems less likely in this case. Also not likely ETOH related. NASH is a possibility. We should also review her meds as a potential cause. Was she actually taking aspirin, or is she just calling it aspirin. Let's not forget some of the less common diseases like autoimmune hepatitis, Wilson's hemochromatosis and other rare infections. Right-sided heart failure may be an option. Hepatitis serologies, EBV, CMV, Tylenol level, iron and copper levels, ESR as well as PT/INR would be appropriate. CRP was a bit elevated at 11. Gamma globulins are obtained and noted to be elevated. The rest of the labs were all normal as well. A liver ultrasound reveals no abnormalities. A GI consult was obtained and it was felt this is a case of autoimmune hepatitis. Typically this is a dx of exclusion, and now that we've excluded a lot, we will shift to various autoimmune tests. ANA. This may be positive, however there are more specific tests for this condition, such as anti-smooth muscle, antimitochondrial, and anti liver-kidney microsomal antibodies, and various other antibody tests. Gamma globulins are also often elevated in AIH What is this condition? We don't fully know. There are several types of autoimmune hepatitis, however type-1 is the most common. It is actually not an entirely uncommon disease with a prevalence in Europe of 11 to 25 per 100,000. In the U.S., there is no exact data. One could infer that it would be similar. Ultimately, the body is attacking the liver for unclear reasons. Concurrent autoimmune thyroiditis can accompany this. A known hx of inflammatory bowel dz can predispose to this condition. Typically AST and ALT are 10-20 times upper limits of normal, usually therefore much higher than cirrhosis. Imaging is usually normal, unless the disease has advanced by the time diagnosis is made. Remission is not uncommon, upwards of 50 to 60%. Corticosteroids and azathioprine are common medications given for this. These can be tapered, and LFTs are rechecked on a regular basis throughout the taper and discontinuation of the medications. Sometimes, stronger immunosuppressants are needed. GI at minimum but sometimes hepatology referral is warranted for this diagnosis. Liver biopsy is often done for this condition. And indeed was on this patient which showed findings consistent with autoimmune hepatitis. Often, a degree of fibrosis is seen in AH. Well people, that's a wrap. for autoimmune hepatitis. Stay tuned for the final case presentation in the next segment, coming up shortly with Dr. McMichael here on Ridgeview Podcast CME series. CASE 3: So, the final caser is an 80 yo male with fever and confusion. He's high functioning at baseline, lives alone at home. He called his daughter and she noted he wasn't "acting himself". Altered mental status can be caused by many things, as we know. The differential diagnosis includes infection, hypoxia, metabolic derangement, toxin related, dementia, CNS lesions and so many more! This guy has a hx of CLL and type 2 DM, as well as HTN and BPH. Not a big drinker, about 1 to 2 beverages per day. He has a fever of 100.8. VS are normal otherwise. He's uncomfortable and restless appearing. Alert and oriented to person. Sepsis now is a big concern. What's causing it? He still has a gallbladder, but we need to know some more about his exam reveals not much more, other than tenderness in the epigastric and LUQ areas of the abdomen. Preliminary labs include normal UA, EBC 35.8, but remember the cLL hx. BMP unremarkable but a little dry with BUN 32. ALP is 256. AST and ALT are just bumped over normal. Lipase and trop are normal. Total bili is normal. So probable not ascending cholangitis. CXR was normal. So prompted a CT abdomen to rule out abdominal pathology. This revealed cholelithiasis. Compared to ultrasound, CT is not as helpful in terms of ruling out biliary obstruction, although often we will see pericholecystic inflammation. For cases of acute cholecystitis (AC), CT scan findings include the following: gallstones within the gallbladder (GB), the cystic duct, or both; more than 3mm of focal or diffuse thickening of the GB wall in a non-contracted GB; indistinct liver-GB interface; fluid in the GB fossa in the absence of ascites, enlargement of the GB, with the transverse diameter measuring more than 5 cm; infiltration of the surrounding fat; increased bile attenuation, caused by biliary sludge; and GB mucosal sloughing. At the same time, ultrasound is the gold standard. So this was done, and antibiotics were ordered. There is a non-mobile gallstone in the gallbladder neck. The CBD also has a small distal stone. He was admitted, taken to surgery for lap cholecystectomy and cholangiogram which confirmed the distal CBD stone. He was taken for ERCP and stenting the next day. In cholestatic presentations, the ALP is usually higher than AST and ALT. Serum bilirubin is not as helpful in delineating hepatocellular vs cholestatic picture. The Tokyo guidelines? Not widely used at this point. They're used to grade who needs to go to surgery first. In general, it's recommended to follow the American Anesthesiology guidelines for physical status. There are several grading systems, but there is little banter about this when it comes down to the decision to go to surgery or not. According to a paper in 2017 in the American Journal of Surgery by Madni et al, "Most grading scales which have been developed are used to predict the risk of conversion to an open cholecystectomy. There is a paucity in the literature of scoring systems to predict other metrics such as hospital length of stay, iatrogenic injury, and total operative time." HIDA scan can be done if there is no obvious stone, and whether you think this is truly gallbladder dysfunction and the patient should go to surgery, according to the World Society of Emergency Surgery Guidelines. Now, if this were a woman child-bearing age, while there could be a gallbladder etiology, always be sure to check a pregnancy test. HELLP syndrome must be considered. Fitz Hugh Curtis syndrome should also be considered in sexually active women with abdominal pain and elevated LFTs. Remember, especially in patients with altered mental status to keep your net cast wide. Our elderly patients are notorious for unusual presentations of common disease. Just a fair warning. A special thanks to Dr. McMichael for joining us and sharing these cases today. Have a great month everyone and we'll see you soon. REFERENCES:1. D'Amico et al. J Hepatology, 2006, Natural History and Prognostic Indicators in Cirrhosis: A systematic review 2. Salpeter et al. Am J Med. 2012. Systematic Review of Noncancer Presentations with a median survival of months or less. 3. Wond et al, Gastroenterology, 2015. Nonalcoholic Steatohepatitis is the second leading cause of liver disease in adults awaiting liver transplantation in the United States.
Story 1: Moody's says RenovaBio will boost EtOH demand in Brazil. Story 2: White House economic advisor tapped to find Renewable Fuels Standard solution. Story 3: Yale researchers convert carbon dioxide and water into methanol with electricity. Story 4: Senators express concerns to EPA administrator about 2020 RFS proposal
In this podcast, Dr. Joshua Buckler, a cardiologist with Minneapolis Heart Institute at Ridgeview Heart Center, provides an overview of growing issue of atrial fibrillation, and the increased need for its awareness and the modalities to evaluate and treat it. Objectives: Upon completion of this podcast, participants should be able to: Identify risk factors for atrial fibrillation. Express the importance of screening for atrial fibrillation. Recognize when a patient needs to be referred for atrial fibrillation. CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion honoring you 1.25 CME/CEU credits within 2 weeks. You may contact the accredited provider with questions regarding this program at rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit: CME Evaluation: "Atrial Fibrillation (Podcast)" (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.” FACULTY DISCLOSURE ANNOUNCEMENT It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed no conflict of interest exists with the presentation/educational event. SHOW NOTES: CHAPTER 1: We understand around 10% about an Atrial Fibrillation (A-Fib or AF), which makes understanding it a challenge. The majority of AF starts in the left atrium likely due to left atrial stretch secondary to mitral regurgitation or hypertension. This then leads to loss of connectivity and communication of the atrial cells, leading to micro reentry circuits. A lot of the AF comes from the pulmonary vessels where they connect to the LA. Why does this happen? Currently, we are unsure. AF comes down to the irregularity of atrial contraction fighting to get through AV node, resulting in irregularities of the ventricular action. AF runs about 300-500 bpm. Those high irregular rates through the AV node can result in symptomatic patients trying to maintain cardiac function over prolonged periods of time. Second, is the loss of AV synchronization - which is how the atrium and ventricle work in concert together. Lastly, is stroke risk. AF is so important, because it is grossly under-recognized and the implications of stroke and heart failure (HF), which can be catastrophic. The literature seems to support that individuals with AF seem to have a lower quality of life. The statistics are staggering, that a patient with AF has a 5x risk of stroke, 3x risk of heart failure, 3x risk of myocardial infarction or dementia. There has been a 5-6 fold increase in rates of AF since 1999. AF is commonly found with patients who are obese, diabetics, those who use alcohol and untreated obstructive sleep apnea. Dr. Buckler believes that entry point into the healthcare system is crucial for the success of AF patients. Establishing a one call system with curbside to the cardiologist for patients experiencing new onset AF. Obesity is a direct risk factor for AF. The "Legacy trial" was performed in Adelaide, Australia. It looked at losing 10% of body weight dramatically reduces AF following cardiac ablation. Patients with smaller weight fluctuations, around 2% of body weight, did better post-ablation, than those with higher weight fluctuations of around 5% increase in body weight. CHAPTER 2: AF is similar to diabetes. It affects everything. It's affected by everything and no one wants to deal with it. There is a large multidisciplinary approach to the treatment of AF due to the complex nature of the disease process. There is a large push to get the AF patient into the sleep clinic, as OSA and AD are closely intertwined. Furthermore, there is independent data that if OSA is treated, so is the patient's AF. Dr. Buckler believes in a team approach to the successful management of AF. He notes that is the PMD can start the workup by getting thyroid testing, sleep study, setting up the echo and placing the patient on anticoagulation as well as a rate limiting medication is a good start. Most cardiologists believe a rhythm control strategy is the way to go for treating most AF patients. The utilization patterns of AF patients is problematic. Most AF patients are costing the healthcare system around $8,700 per year/per patient. Dr. Buckler mentions a study that if some AF are ablated early in their disease state, the short-term cost far outweigh the costs downstream if they have recurrent AF. Addressing risk factor modifications, including OSA, obesity, ETOH, DM, smoking, are instrumental in the care of the AF patient. Believe it or not, endurance athletes have higher rates of AF. Whereas, high endurance women athletes actually have lower rates of AF. Something to chew on. Ablation has a high likelihood of success with initial treatment successful upwards of 90% of the time. The network of AF patient and how they enter the system is highly complex and intertwined coming down to primary care, emergency medicine, hospital medicine and cardiology. Building in pathways to the neurologist is critical for those individuals who may have experienced a cryptogenic stroke from undiagnosed AF. CHAPTER 3: How do we screen for AF? Holter monitors are still being used which seem to be of low yield. The ZIO patches are also used as well, but for around 14 days - but what if the patient does not have an episode of AF? Even 30-day monitors are good, but not great, as the average time period a patient will have an episode is around 42-43 days. So maybe we should consider an implantable cardiac monitor or better yet, what about consumer wearable's. What are consumer wearable you may ask well they are the: apple watch which have been FDA cleared not approved for AF detection or another device called Kardia single lead EKG machine that can tell you if you are in AF or other dysrhythmias. Some non-western medicine approaches to the treatment of AF are yoga, acupuncture and biofeedback. Ultimately, Dr. Buckler believes that across the country no one has a truly good data set that documents the burden of AF patients. Furthermore, AF patient's generally have longer lengths of stay when hospitalized. Some interesting modalities not quite ready for prime-time at the ED entry point may be, TEE, cardio version, or CTA, evaluating for left atrial appendage clot then cardio version which might be promising. Dr. Buckler believes that every AF patient should be seen by cardiology, at least once. Cardiology should be the repository for AF. Optimally, the idea would be to offer that service within 48-hours. Also, would like the patient to get through risk factor management more efficiently. The check list once again -- everyone needs a sleep study, echo, thyroid testing, etc.
In this episode, we cover the last half of phenobarbital week! This is a long one, but we cover the Farkas manifesto on by phenobarb is superior to standard approaches to alcohol withdrawal management. -Dosing -Indications/Contraindication -Adjuvant therapies & more
Get our free clinical lab guide: https://www.medgeeks.co/labguide - You have a 54 year old male patient with a past medical history of schizophrenia, ETOH abuse, drug abuse (crack cocaine), hypertension, hyperlipidemia, and diabetes. He was brought in by police for aggressive behavior in public. The patient was roaming the street, yelling and banging on restaurant windows. Upon police arrival, the patient was awake and alert. However, he wasn't calm or cooperative; ultimately he required restraints by EMS. You're unable to get his vital signs due to his agitation. So, what would you do? Today, I want to discuss the agitated patient and how we should approach this scenario. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
Get our free clinical lab guide: https://www.medgeeks.co/labguide - We have a 32 year old male with a past medical history of ETOH abuse (1 pint of vodka daily), ETOH related seizures, and hypertension. He presents with a complaint of severe epigastric pain and tenderness which started about a day ago and has progressively worsened over the day. The patient said he attempted to eat and drink this morning, but became nauseous and had one episode of non-bloody vomiting. The patient's last alcoholic drink was the night prior. He has no new medications. Vitals: 101.1F, HR 110, BP 89/68, 98% O2 sat RA. On exam, there is significant epigastric tenderness. But, no rebound or gaurding or peritoneal signs. Labs: WBC 15.4, H/H 15.7/43.5, platelets 188, BUN:Cr 10:1, Lipase is 2,806, and lactate of 10.3 Electrolytes, bilirubin, LFT, triglycerides normal. Today, we'll be breaking down acute pancreatitis. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
How the body works when caffeine, theanine, opiates, or EtOH are consumed. It really is fascinating how our bodies cope with stressors. Learn how caffeine and theanine may help work performance, why withdrawal symptoms mirror opiate relief mechanisms, and how we develop tolerances to alcohol and other mild food drugs. --- Support this podcast: https://anchor.fm/s3/support
Today, we're going to talk about the patient, who makes you want to go home and have your own drink. You get a page from the ER about a new admission. It's a 35 year old male patient with a past medical history of heavy alcohol abuse - he presents to the hospital asking for detox. For every ETOH patient that walks through the door, Zach normally has a set of questions he likes to ask, depending on the patient's cooperation... 1. How long have you been drinking for? 2. How much do you drink on a daily basis? Is it daily or do you take breaks? 3. What is your drink of choice? 4. When was your last drink? 5. Have you ever been hospitalized for drinking? 6. Have you ever had ETOH withdrawal, seizures, or delirium tremens? 7. Have you ever been intubated in the ER due to alcohol abuse? 8. Is there any other drug use? 9. Why did you decide to come in today? These questions will help you triage the patient to see what level of care they will require. Today, you'll learn all about alcohol withdrawal syndrome. - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
You're on the rapid response team and are called over to a patient presenting with hypotension. Per nursing, the patient is a 58 year old male with a PMH of: ETOH abuse (1 pint of vodka daily) Cirrhosis While in the room, the patient vomits a large amount of bright red blood, followed by a drop in the systolic blood pressure to the 70s. The patient looks lethargic, unresponsive to verbal stimuli or a sternal rub. You see fresh blood in the oropharynx. What should you do next? We'll walk you through and answer that for you in today's podcast. p.s. this is part 3 of 3 for the GI bleed lecture series. Next week, we'll tackle a brand new topic. - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
How do you calculate macros from alcohol? What is the real deal?! We break it down in simple terms! We are bringing you #simplifiedscience on everything #alcohol - effects on your body, your nutrition, and how you can still be #onaquest with sound nutrition making sense of how alcohol and calories mix! - FAST FACTS: 1. “A drink” is defined as: • 12 oz beer • 8oz malt liquor • 5oz wine • 1.5oz 80-proof spirits or liquor 2. “Binge drinking” is defined as: • Men: 5 or more drinks in a single session • Women: 4 or more drinks in a single session 3. “Heavy drinking” is defined as: • Men: 15 or more drinks per week • Women: 8 or more drinks per week The key is responsible drinking in moderation! Now, let's dive into nutrition and how alcohol fits: - ALCOHOL AND NUTRITION: How to track o 7kCal/gram for alcohol (EtOH), but some drinks do contain carbs o Technically broken down like fat, but metabolized more as a carb o It's conceptually similar by saying track fiber, starch, and sugar separately. We don't differentiate each one separately, though we could, because ultimately, we categorize it all as a carb due to how the body is using it. - HOW TO ACCURATELY TRACK: o Example: Michelob Ultra has 95kcal and “2.6g of carbs;” that's 10.4kcal, so where's the remaining 84.6kcal coming from? Nutrition label doesn't list EtOH, so gets away with this o Calorieking.com has EtOH listed, so for this beer it has 11.9g of EtOH 11.9g x 7 = 83.3kcal, which makes up the remaining difference There's a trace amount of protein to completely count everything o You could take calories and divide into fat (9) or carb grams (4) or both o ***SIMPLE SOLUTION: I would just take kcals and divide by 4 (carbs) to yield 23.75g; logging only fat would yield 10.5g; and a combo of each would yield 11.9g of carbs and 5.25g of fat o Example: vodka with 146kcal = 36.5g of carbs OR 146kcal = 16.2g of fat OR combo of each (18.25g of carbs and 8.1g of fat) - SUGAR ALCOHOLS RECAP: o Sugar alcohols can raise an individual's blood sugar albeit much lower, so they still need to be counted as carbs (~2kcal/g) o Just because something doesn't exert an insulin response doesn't mean it's free of calories (mention stress, sleep, thoughts) Side note: too much of these can have a laxative effect or other GI disturbances! Thank you for watching! Please “LIKE” and “SUBSCRIBE” to the channel for more great content to come! Social Media: -Kevin IG: @brunofnp -Adam IG: @thefitpharmacist -Kevin Website: http://www.thedietdoc-independence.com -Adam Website: http://thefitpharmacist.com
Author: Erik Verzemnieks, M.D. Educational Pearls: ● Common causes of nystagmus: Congenital disorders, CNS diseases (MS, CVA), Intoxication ● Drugs associated (ETOH, Ketamine, PCP, SSRI, MDMA, Lithium, Phenytoin, Barbiturates) ● If a patient has nystagmus and is intoxicated, consider other drugs and etiologies as potential sources References: Alpert JN. (1978). Downbeat nystagmus due to anticonvulsant toxicity. Annals of Neurology. 4(5):471-3. Rosenberg, ML. (1987) Reversible downbeat nystagmus secondary to excessive alcohol intake. Journal of Clinical Neuroophthalmology. 7(1):23-5. Weiner AL, Vieira L, McKay CA, Bayer MJ. (2000). Ketamine abusers presenting to the emergency department: a case series. Journal of Emergency Medicine. 18(4):447-51.
Cette semaine on se rend à la microbrasserie EtOH pour parler des 3 bières du band Jardin Mécanique avec 2 membres du band ainsi que Marie-Laurence Jacob et un copropriétaire de la brasserie, Guillaume Boucher. On parle également de la sortie imminente de leur BD et de musique de films. On s'égare du sujet à quelques reprise ce qui nous mènes à parler de Bruce Lee habillé en romain qui stab Hans Zimmer sur la croix pendant que Marie-Mai pleure devant un mosh pit d'enfants... ================================================ Suivez nousFacebook:https://www.facebook.com/AGOPODCAST/ iTunes:https://itunes.apple.com/ca/podcast/ago-lartiste-le-geek-et-lotaku/id1160600289?mt=2 Google Play:https://play.google.com/music/listen?u=0#/ps/I5ums36up7yzq57w3wqsjrb6aaa Twitter:https://twitter.com/AGO_Podcast Podbean:http://agopodcast.podbean.com
L’EtOH Brasserie: un incontournable du quartier Villeray Depuis 2013, le quartier Villeray, à Montréal, a sa propre microbrasserie artisanale grâce à l’initiative et aux efforts soutenus de quatre partenaires d’affaires et entrepreneurs visionnaires, désireux de s’impliquer socialement et culturellement dans leur communauté. L’EtOH brasserie a pignon sur rue au 8100 St-Denis, à l’angle de la rue Jarry, un emplacement fort bien choisi, en plein coeur de la vie culturelle foisonnante de Villeray. Les Podcastors ont rencontré François Bélanger, l’un des quatre cofondateurs et propriétaires de l’EtOH, afin qu’ils nous raconte son étonnant parcours, depuis les tout débuts du projet jusqu’à la création, dernièrement, d’une gamme de bières artisanales à l’effigie des personnages du groupe de musique québécois Jardin Mécanique. Cette association entre l’EtOH et Jardin Mécanique a piqué notre curiosité et nous a incités à interviewer également deux des membres du groupe, dans le cadre d’une seconde entrevue complémentaire à celle-ci, que nous vous invitons évidemment à écouter! Écoutez la suite à l’épisode 4:La fabuleuse histoire de Jardin Mécanique Le site officiel:http://etohbrasserie.com Sur Facebook:https://facebook.com/EtOH_brasserie Twitter:https://twitter.com/EtOH_Brasserie
This episode covers Chapter 80 of Rosen's Emergency Medicine 9th edition. (Yes the new edition). Building on previous episodes (see fever, Jaundice and abdo pain), today we take a look at all things right upper quadrant badness. 1) List 8 ddx for hepatitis 2) Complete the following table for Hepatitis A, B & C: Transmission, Risk Factors, Carrier State, Acute Infection, Previous Infection, Chronic Infection, Prev Vaccine, Transmission Risk, Vaccine. (show notes: What is hepatitis E? Where is it commonly found (geographically)? What is the significance of hepatitis D?) 3) Describe the post-exposure prophylaxis for exposure to HepA, HepB, HepC 4) Compare the expected lab work in acute viral hepatitis vs EtOH hepatitis 5) What liver diseases are associated with alcohol abuse? What non-hepatic conditions are associated with alcohol abuse? Describe the management of EtOH hepatitis 6) List 6 stigmata of chronic liver dz and list 3 complications 7) How is are chronic cirrhosis and ascites managed in the ER? 8) Describe a grading scale for hepatic encephalopathy and list 5 management considerations 9) Describe the ER diagnosis and management of SBP. 10) List 3 types of drug-induced liver disease. 11) What are two types of hepatic abscesses? How are they diagnosed and treated? 12) What is budd-chiari syndrome? How is it managed? 13) What is primary sclerosing cholangitis (PSC)? What is primary biliary cirrhosis? What is PSC associated with? 14) List 6 RFs for Cholelithiasis 15) Describe the clinical presentation of cholecystitis. List Lab, Xray (3) and US (4) findings 16) List 4 patients that get acalculous cholecystitis 17) List 4 considerations in the management of acute cholecystitis. When is surgery performed early? 18) What is the classic presentation of ascending cholangitis? What two clinical eponyms are described? How is ascending cholangitis managed? Wisecracks: 1.. Which conditions are associated with transaminases in the 10000s? How do you approach a patient with a needlestick injury? What is the risk of transmission following a needlestick? What are underlying causes of hepatic encephalopathy in patients with known liver disease? What are the typical investigations performed on ascites fluid? What is the SAAG and how is it interpreted? What is the significance of a calcified gallbladder?
This episode covers Chapter 80 of Rosen's Emergency Medicine 9th edition. (Yes the new edition). Building on previous episodes (see fever, Jaundice and abdo pain), today we take a look at all things right upper quadrant badness. 1) List 8 ddx for hepatitis 2) Complete the following table for Hepatitis A, B & C: Transmission, Risk Factors, Carrier State, Acute Infection, Previous Infection, Chronic Infection, Prev Vaccine, Transmission Risk, Vaccine. (show notes: What is hepatitis E? Where is it commonly found (geographically)? What is the significance of hepatitis D?) 3) Describe the post-exposure prophylaxis for exposure to HepA, HepB, HepC 4) Compare the expected lab work in acute viral hepatitis vs EtOH hepatitis 5) What liver diseases are associated with alcohol abuse? What non-hepatic conditions are associated with alcohol abuse? Describe the management of EtOH hepatitis 6) List 6 stigmata of chronic liver dz and list 3 complications 7) How is are chronic cirrhosis and ascites managed in the ER? 8) Describe a grading scale for hepatic encephalopathy and list 5 management considerations 9) Describe the ER diagnosis and management of SBP. 10) List 3 types of drug-induced liver disease. 11) What are two types of hepatic abscesses? How are they diagnosed and treated? 12) What is budd-chiari syndrome? How is it managed? 13) What is primary sclerosing cholangitis (PSC)? What is primary biliary cirrhosis? What is PSC associated with? 14) List 6 RFs for Cholelithiasis 15) Describe the clinical presentation of cholecystitis. List Lab, Xray (3) and US (4) findings 16) List 4 patients that get acalculous cholecystitis 17) List 4 considerations in the management of acute cholecystitis. When is surgery performed early? 18) What is the classic presentation of ascending cholangitis? What two clinical eponyms are described? How is ascending cholangitis managed? Wisecracks: 1.. Which conditions are associated with transaminases in the 10000s? How do you approach a patient with a needlestick injury? What is the risk of transmission following a needlestick? What are underlying causes of hepatic encephalopathy in patients with known liver disease? What are the typical investigations performed on ascites fluid? What is the SAAG and how is it interpreted? What is the significance of a calcified gallbladder?
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Join Brian, Jordan, and special guest AmErika for an exquisite meal and a few adult beverages. Happy Easter, everybody!
On today’s show, we’re talking about Alcohol and working out: how last night’s cocktail can affect today’s workout, how a post-workout drink can impact how you benefit from your gym efforts, drinks that are easier on the body, and best practices if you ARE going to balance alcohol consumption with your fitness plan. We're back with our 72nd episode of the Fed+Fit Podcast! Remember to check back every Monday for a new episode and be sure to subscribe on iTunes! Find us HERE on iTunes and be sure to "subscribe." Episode 72 Transcription On today’s show, we’re talking about alcohol and working out. How last night’s cocktail can affect today’s workout; how a post workout drink can have an impact on how you may benefit or not benefit from your gym efforts; drinks that are a little bit easier on the body, and best practices if you are going to balance alcohol consumption with your fitness plan. Cassy Joy: Welcome back to the Fed and Fit podcast! I’m excited about today’s episode. This is an episode topic I’ve actually had jotted down in my scrolling iPhone notepad for months and months now, and I’m glad we’re getting to it. We’re going to talk today about alcohol and working out. Really, how does alcohol affect the body; how does last night’s drink have an effect on today’s workout, and then if you are going to, if you do choose to have some adult beverages in and around your workout, what are maybe some best practices that maybe will keep your cocktails from sabotaging some of your efforts in the gym. So I’m excited about today’s episode; I hope you find it interesting. When I asked you guys; I asked on Snapchat, I think I had four podcast topics in my queue that I was getting ready to research, and this was an overwhelming number of you voted for this episode. So I’m excited about it, and I hope you really enjoy today’s show. I’m going to try and keep it pretty short and sweet, and I’m going to try not to get too sciencey, because I don’t want to lose anybody. We’re just going to talk about really general, I’ve done a bunch of research and I’ve tried to pull out, skim off, you know, the cream off the top and really give you some best practices and some very basic science. So, let’s jump into it! First, let’s talk about alcohol. If you just topped off of a, I don’t know, maybe you’re a caveman. What movie was that? I wish there was someone here that I could ask, where the guy was buried in the ice. The caveman; I used to love that movie! {Encino Man} And he came into the modern world, and all of it was new. So let’s say if you’re that guy; what the heck is alcohol? Alcohol, or ETOH is a substance usually found in various volumes in adult beverages. So when you look on a bottle of wine or on a bottle of beer, it will say alcohol by volume. So that’s what we’re talking about. Most of it, when consumed, is absorbed by the stomach and the rest is absorbed through the small intestine. And then it makes its way around the body, causing all of those funny, loose feelings, while the liver works furiously to metabolize, or deconstruct the alcohol brought to it by the blood stream. Ok, so that’s kind of the basic overview of how alcohol works in the body. If you want more information on alcohol, and you know, how it’s made; we get into a little bit more of the science weeds, you should definitely look up alcohol 101 episode, on this podcast, it was episode number 21 if you want to scroll back through the archives. Ok, let’s start with the first, most pertinent question that we’re all wondering. How does last night’s drink affect today’s workout? So this is a great question, and in all of this I want you guys to understand that I’m not trying to be preachy, by any means. I definitely enjoy a couple of cocktails a week, so you choose what’s best for you. I’m just going to kind of try to give you a broad overview. And sometimes I abide by these things and sometimes I don’t, so you do you.
Episode 1 – Dilated, Restrictive, and Hypertrophic Obstructive Cardiomyopathy. Hot Points: Dilated: systolic failure, thinning and weakening of the ventricles, low EF most common form by far defined as EF
The Fed+Fit Podcast | Nurturing a Healthy Mindset for a Healthy Lifestyle We're back with our 21st episode of the Fed+Fit Podcast! Remember to check back every Monday for a new episode and be sure to subscribe on iTunes! Find us HERE on iTunes and be sure to "subscribe." Episode 21 Topics: Last week to sign up for the June Fed+Fit Project! Learn more HERE. Last day for the Autoimmune Bundle! Learn more HERE. What is alcohol? How is drinking alcohol (EtOH) made? Four sources of drinking alcohol. How the body processes alcohol. How-to prepare for a night of drinking. How Charissa and Cassy personally choose to indulge. We would LOVE some feedback, so feel free to leave a review in iTunes, comment below, or even give us a shout on social media! Ep. 21: Alcohol 101 This is the Fed and Fit podcast starting your week off with motivational thoughts on real food and fun fitness activities with Cassy Joy Garcia and co-host, Charissa Talbot. Remember our disclaimer; the information and opinions shared in this podcast are solely those of any given individual, and not a substitute for medical advice. Here are the ladies. Today we’re going to talk about where alcohol comes from, how it’s processed in our bodies, how you can prepare for a night out of drinking, and how we personally choose to indulge. Topics 1. Updates from Cassy [1:31] 2. Updates from Charissa [6:30] 3. What is alcohol? [10:01] 4. How is drinking alcohol (EtOH) made? [15:02] 5. How the body processes alcohol. [22:30] 6. Red wine and clear liquors; healthier? [30:12] 7. How-to prepare for a night of drinking. [33:21] 8. Health benefits of alcohol [38:55] 9. How Charissa and Cassy personally choose to indulge. [45:43] Cassy Joy: Hey Charissa! Charissa Talbot: Hey Cassy! Cassy Joy: {laughs} If you’re listening on Monday the 25th, then Charissa and I wish you a very happy memorial day. Charissa Talbot: That’s right! I’ve been so busy working I didn’t even remember it’s a holiday weekend. Cassy Joy: Today’s a holiday! As an entrepreneur and as someone who works from home, you kind of lose track. Charissa Talbot: You do. Cassy Joy: What the holidays are. Charissa Talbot: In that case, this episode is perfect! I hope everyone listens to it this morning so they thoroughly enjoy their holiday evening, or day! 1. Updates from Cassy [1:31] Cassy Joy: Yes. Today we are so excited about our topic. Before we get to it, Charissa, I’ve got to really important update for you. Charissa Talbot: Oh, I’m ready. Cassy Joy: {laughs} Charissa Talbot: I’m so ready. Wait, wait. Ok, now I’m ready. {laughs} Cassy Joy: Now you’re ready? {laughs} It’s about my garden. Charissa Talbot: Oooh! Cassy Joy: It’s really important. I never realized how much of my littler heart that garden would consume. Charissa Talbot: Mmm. Cassy Joy: I love it so much. It is exploding. I started everything from seeds, and if you’re a first time listener, this past spring I decided, I live in suburbia of San Antonio, and Austin, my fiancé, built me 3 raised beds that are, what are they, 4 x 8 each. So they’re pretty good sized, and we filled them with organic soil and I sprouted seeds, I was so excited, and things are doing really well. My spaghetti squash is enormous. I have a cabbage patch full of kale and collards, and I have a nightshade patch, which is something that probably only a nutritionist would think about. {laughs} Charissa Talbot: {laughs} Right. Cassy Joy: They’re foods, but I’m growing jalapenos and tomatillos, eggplants, and then some tomatoes, of course. Anyway, everything is doing really well. But something that I did not expect is the little friendly family of 6 and 8 legged little critters that have decided to move in because of the garden. And that has been interesting to watch. We’ve got an orb weaver, which is a spider, and a bunch of caterpillars munching on my baby cabbage patch...
Fakultät für Chemie und Pharmazie - Digitale Hochschulschriften der LMU - Teil 01/06
In dieser Arbeit werden die ersten röntgenographisch charakterisierten Kristallstrukturen von Mangan(IV)-Polyolato-Komplexen vorgestellt (1–11, 13). Ausgehend von Mangan(II) wird mittels zwei Äquivalenten Kaliumhexacyanoferrat(III) die Oxidationsstufe +IV erreicht. Alle Komplexe entstehen aus wäßriger, stark alkalischer Lösung. Die Kristallisation erfolgt in der Kälte, da Mangan(IV)-Komplexe bei Raumtemperatur innerhalb eines Tages zu Mangan(III) reduziert werden. Mangan(IV) zeigt eine starke Präferenz für Koordinationsoktaeder, welches ein stabiles Struk- turelement darstellt. Das Metallion wird von mindestens zwei 1,2-Diolato- oder 1,3-Diolato- Gruppen chelatartig koordiniert. Mangan(IV) bildet mit D-Glucon- und Lactobionsäure jeweils einen mononuklearen Komplex, KNa3[Mn(D-Glc1AH–4)2] · 7 H2O (1) und KNa2,5[Mn(Lac1AH–3,75)2] · 19,23 H2O (2). D-Glu- conato(4–)-Liganden koordinieren über die Sauerstoff-Donoren der Alkohol-Gruppen an C3, C4 und C6, während Lactobionato(3,5–)-Liganden über die Sauerstoff-Donoren der Alkohol- Gruppen an C2, C3 und C5 an Mangan(IV) binden. Dieses Koordinationsmuster entspricht einer threo-Sequenz, von der die dritte Koordinationsstelle um ein C-Atom weiter entfernt liegt. Lactobionsäure besitzt D-Gluconsäure-Teilstruktur, was sich auch im Bauprinzip wie- derfindet. In 1 liegen die Kalium- und Natrium-Ionen mit den Mangan-Atomen auf unendlich langen Strängen entlang [001]. In 2 entsteht ein dreidimensionales Netzwerk mit dimeren Un- tereinheiten aus kantenverknüpften Oktaedern. Auch mit Dulcitol gelingt es, zwei Komplexe zu kristallisieren, die das Bindungsstellenmus- ter der Lactobionato(3,5–)-Liganden aufweisen: K6[Mn(Dulc2,3,5H–3)2]2 [DulcH–2] · 12 H2O (3) und Ba4[Mn(Dulc2,3,5H–3)2]2 [Fe(CN)6] · 8 H2O (4). Die beiden Dulcitolato-Komplexe unterscheiden sich nicht vom Bindungsmodus her, sondern nur in der Art der eingelagerten Gegenionen. In 3 verknüpfen die Kaliumkationen zwei Komplexanionen aus benachbarten Strängen miteinander, des weiteren koordinieren diese an die bindenden Alkohol-Gruppen der Dulcitolato-Liganden, als auch an die Sauerstoff-Atome des zweifach deprotonierten, nicht- koordinierenden Dulcitol. In 4 beteiligen sich die Bariumkationen sowohl an der Reduktion der effektiven Ladung an Mangan als auch am Aufbau eines dreidimensionalen Netzwerks über die Anbindung an Stickstoffatome des Hexacyanoferrat(II)-Ions. Mangan(IV) und Methyl-β-D-ribopyranosid-2,3,4-ato(3–)-Liganden bilden ebenfalls ein Ko- ordinationsoktaeder, Na4[Mn(Me-β-D-Ribp2,3,4H–3)2]2 · 4 H2O (5). Methyl-β-D-ribopyranosid koordiniert in 1C4-Konformation, in welcher die drei cis-ständigen Hydroxyl-Gruppen als Tri- olatoeinheit auf einer Seite zu liegen kommen. Die Natriumkationen binden an Ligand-O- Atome und ein Wassermolekül. Es entsteht ein dreidimensionales Netzwerk mit dimeren Un- tereinheiten von flächenverknüpften Oktaedern, jedoch fehlt eine Verknüpfung der Stränge entlang [001] wie in 4. Es ist kein Wasserstoffbrückenbindungssystem vorhanden. Pentaerythritol-Liganden bilden mit Mangan(IV) zwei Komplexe, die sich nicht in ihren Bin- dungsmodi, sondern in der Art der eingebauten Gegenionen als auch in der Ladung ihrer Komplexanionen unterscheiden, KLi4[Mn(C5H9O4)(C5H8O4)][Mn(C5H9O4)2] · 21 H2O (6) und Na6[Mn(C5H8O4)2][Mn(C5H9O4)2] · 20 H2O (7). Sowohl in 6 als auch in 7 entstehen mehrere kantenverknüpfte Polyeder, die wiederum einen unendlich langen Strang bilden. Mit α- und β-Cyclodextrin sind bei Verwendung von Lithiumhydroxid als Base zwei Kom- plexe durch Kristallisation zugänglich, Li2[∆-Mn(α-CDH–2)3] · 3 EtOH · 38 H2O (8) und K3Li4[Λ-Mn(β-CDH–3,67)3] · 33 H2O (9). Die Ausbildung von intramolekularen Wasserstoff- brückenbindungen wird durch die eingebauten Gegenkationen erleichtert, wodurch es zu einer Reduktion negativer Ladung um das Zentralmetall kommt. Die Koordinationsstelle wird durch die sperrigen Liganden nach außen abgeschirmt. Eine Anbindung von Lithium- bzw. Kalium-Ionen an die koordinierenden Alkohol-Gruppen ist deshalb nicht möglich. Die La- dungskompensation um das Zentralion geschieht allein durch intramolekulare Wasserstoff- brückenbindungen. Allerdings sind die höhere Ladungsdichte des Lithium-Ions bzw. des Ka- lium-Ions und die passende Größe für die Stabilität des Komplexes entscheidend. Xylitol und D-Threitol koordinieren mit jeweils zwei Liganden an Mangan(IV), die Koordina- tionssphäre wird durch eine di-µ-Oxo-Brücke vervollständigt. Xylitol besitzt D-Threitol- Teilstruktur. Es entstehen die Komplexe Ca8[Mn2(Xylt2,4H–2)4 (µ-O)2]2 [Fe(CN)6]2 · 24 H2O (10) und Ca4[Mn2(rac-Thre2,4H–2)4 (µ-O)2] [Fe(CN)6] · 22 H2O (11). Beiden Komplexen ist die zentrale, dimere Einheit [Mn2O2]4+ gemeinsam, die in Inversionssymmetrie vorliegt. Die Koordinationspolyeder sind untereinander kantenverknüpft. Die Annäherung der Mangan(IV)- Zentren liegt in derselben Größenordnung (in 10 287,4(2) pm, in 11 284,4(6) pm). Sowohl in 10 als auch in 11 finden sich Calcium- und Hexacyanoferrat(II)-Ionen, welche für die Stabili- sierung des Komplexes erforderlich sind. In beiden Fällen entsteht ein dreidimensionales Netzwerk mit dimeren Untereinheiten von kantenverknüpften Polyedern. Die Manganzentren sind jeweils antiferromagnetisch gekoppelt (für 10: J/k = –12,2 K und für 11: J/k = –15,2 K). Cytidin bildet mit Mangan(IV) ein Koordinationsoktaeder, K2[Mn(CytH–2)3]·17H2O (13), in welchem drei Cytidin-Liganden als 1,2-Diolat wirken. Mit meso-D-Glycero-D-gulo-heptitol gelingt lediglich die Kristallisation eines Mangan(III)- Komplexes, K2Ba11[Mn2(HeptH–7)2]2 [Fe(CN)6]4 · 49,8 H2O (12). Der Heptitol-Ligand weist sieben Hydroxyl-Gruppen auf, von denen fünf für die Komplexierung des Mangan(III) betätigt werden, wobei eine Hydroxyl-Gruppe µ2-verbrückend wirkt. Die Annäherung der Man- gan(III)-Zentren beträgt 326,3(2) pm bzw. 328,7(3) pm. Der Komplex zeigt die für Man- gan(III) typische Jahn-Teller-Verzerrung, die in den µ2-Oxo-Brücken zum Ausdruck kommt. Die Manganzentren sind ferromagnetisch gekoppelt (J/k = +1,1 K). Die UV/VIS-Spektren der intensiv roten Mangan(IV)-Polyol-Lösungen zeigen nur wenig cha- rakteristische Absorptionsbanden (Schulter bei ca. 520 nm bzw. 19230 cm–1). 4.2 Untersuchungen zur Sauerstoffabsorption wäßriger Mangan(II)- Polyol-Systeme Für die Untersuchung der Sauerstoffabsorption wäßriger Mangan(II)-Polyol-Systeme entfiel die Wahl auf vier Polyole, D-Gluconsäure, Dulcitol, Xylitol und α-Cyclodextrin. Das Ver- hältnis von Base : Mangan(II) : Ligand betrug 10:1:3,5, im Fall des α-Cyclodextrins 10:1:3. Es wurden zwei Meßreihen bei verschiedenen Temperaturen, 20 °C und 5 °C, durchgeführt. Die Messungen bei 20 °C wurden zudem UV/VIS-spektroskopisch verfolgt. Als relevante Parameter sind die Konzentration der Reaktionsteilnehmer, das gewählte Ver- hältnis von Base : Mangan(II) : Ligand, der pH-Wert, die gewählte Base und die Temperatur anzusehen. Auch dem eingesetzten Liganden muß ein Einfluß zugebilligt werden. Die Untersuchungen zeigen, daß eine sukzessive Erhöhung der Mangan(II)-Konzentration bei konstantem Verhältnis von Base : Mangan(II) : Ligand und bei konstanter Temperatur sowohl das Anwachsen der Basenkonzentration sowie des pH-Wertes als auch einen steigenden Sau- erstoffverbrauch bewirken. Starke Abweichungen vom theoretisch zu erwartenden Sauer- stoffbedarf zeigen sich bei hohen Konzentrationen (0,06 M Mn(II)) der Reaktionsteilnehmer. Dies konnte in beiden Meßreihen festgestellt werden. Die bessere Löslichkeit des Sauerstoffs bei abnehmender Temperatur läßt sich bestätigen, da der Gesamtsauerstoffbedarf bei hohen Konzentrationen der Reaktionsteilnehmer niedriger lag als bei den Messungen bei 20 °C. Die spektroskopischen Daten zeigen, daß die Oxidation zunächst sehr schnell voranschreitet und schließlich immer langsamer wird. Da die Reaktionsgeschwindigkeit von der Oxidationszahl des Zentralatoms abhängt und um so schneller ist, je niedriger die Oxidationszahl des Zentral- atoms und je größer das Zentralatom ist, erfolgt die Bildung von Mangan(IV) demnach (klei- nes Metallion, hohe Oxidationszahl) langsam. Bei einer sequentiellen Oxidation von Man- gan(II) über Mangan(III) zu Mangan(IV) wird ein isosbestischer Punkt bei Verwendung von D- Gluconsäure, Dulcitol und Xylitol durchlaufen. Dieser zeigt an, daß zwei Spezies den glei- chen Extinktionskoeffizienten haben. Bei Messungen mit α-Cyclodextrin ist kein isosbesti- scher Punkt vorhanden. Daher sind wohl thermodynamische Aspekte zu berücksichtigen, die einerseits die Stabilisierung von Mangan(III) begünstigen und andererseits die Stabilisierung von Mangan(IV). Die Auswertung des Sauerstoffverbrauchs im Zusammenhang mit der Rot- verschiebung der Absorptionsbanden deckt eine Diskrepanz auf: Es ist ein Überschuß an Sau- erstoff vorhanden, welcher nicht für die Oxidation von Mangan(II) zu Mangan(IV) genutzt wird. Der Gesamtsauerstoffbedarf setzt sich folglich aus zwei Komponenten zusammen. Ab- hängig von der Einwaage an Mangan(II) dient ein Teil dazu, Mangan(II) zu Mangan(IV) zu oxidieren, der Rest des Sauerstoffverbrauchs läßt auf Ligandoxidationsprozesse schließen. Analyseverfahren wie die HPLC oder/und die Cyclovoltammetrie könnten dieses Ergebnis untermauern. Eine Ausnahme bilden Mangan(II)-α-Cyclodextrin-Systeme: Diese erreichen den theoretisch zu erwartenden Verbrauch nicht. Ob Diskrepanzen in den ermittelten Ergeb- nissen apparativ bedingt sein können, muß geprüft werden. Untersuchungen mit Wasserstoffperoxid und natronalkalischen Gluconat-Lösungen sprechen für den gleichen Sachverhalt. Der theoretisch zu erwartende Verbrauch bei hohen Konzentra- tionen der Reaktionsteilnehmer und bei gleicher Meßtemperatur wird ebenfalls überschritten. Die spektroskopischen Daten zeigen die gleiche Rotverschiebung der Absorptionsbanden. Die Annahme, daß es sich bei der reaktiven Spezies in Lösung um die gleiche handeln könnte, scheint nicht abwegig.
Die metallorganischen Lewissäuren (OC)5Re+ und Cp(OC)(Ph3P)Ru+ bilden Addukte mit den O- bzw. N-Donoren H2O, EtOH, THF, Aceton, CH3CN, Carbonsäureester, NCCH2CO2Me, BrCH2CO2Me, γ-Valerolacton, δ-Valerolactam, ε-Caprolactam, Benzophenonimin. Der chirale Ethanolkomplex [Cp(OC)(Ph3P)Ru(HOEt)]+BF4− kristallisiert als Enantiomerenpaar SRuSO und RRuRO und die Röntgenstrukturanalyse zeigt eine Wasserstoffbrücke zwischen dem Sauerstoffatom des koordinierten Ethanol und dem Tetrafluoroborat-Anion.
Die schwach koordinierten Anionen X− in Cp(CO)2LM-X (M = Mo, W; L = CO, PPh3, P(OPh)3; X = FBF3, FPF5, FAsF5, FSbF5) lassen sich leicht durch Wasser, Alkohol, Aceton und Ether unter Bildung der ionogenen Verbindungen [Cp(CO)2LML′]+ X− substituieren (L′ = H2O, Me2CO, EtOH, Me2CHOH, Et2O). Diese Komplexe sind gegen Hydrolyse labil und zersetzen sich in Lösung. Am stabilsten sind die Wolfram-Verbindungen mit SbF6−.
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